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Forrest, D.V. (2017). Is it all in Your Head? True Stories of Imaginary Illness, by Suzanne O'Sullivan, M.D., Other Press, New York, 2015, 293 pp.. Psychodyn. Psych., 45(4):598-601.

(2017). Psychodynamic Psychiatry, 45(4):598-601

Book Reviews

Is it all in Your Head? True Stories of Imaginary Illness, by Suzanne O'Sullivan, M.D., Other Press, New York, 2015, 293 pp.

Review by:
David V. Forrest, M.D.

Suzanne O'Sullivan, M.D. is the kind of neurologist with whom you would want to collaborate. Reading her book on psychogenic illnesses, appropriate for general or professional audiences, we learn more and more about her professional personality in the stories of her patients, as her logical (neuro-logical?) positivism melts with the truth of her empathy for them.

Ironies abound in psychogenic illness. As psychiatry becomes increasingly Apollonian in preoccupation with ratiocination and uninterested in the Dionysian passions of unconscious drives and conflict, today's neurologists remain devotedly Freudian. Not only do they cherish Freud as one of their own greatest, they grapple daily with the unseen forces causing the nonorganic symptoms, while psychiatrists skate on the surface of cognitive restructuring. Neurologists “believe” in the unconscious.

Make no mistake: no self-respecting psychogenic patient reports first to a psychiatrist, and if referred to us, come very reluctantly.

The next irony is that, unlike us psychoanalysts and dynamic psychiatrists, who are devalued now by some in academic psychiatry (Lieberman, 2015), but remain as skilled as ever, neurologists, by natural inclination or professional nurture, are unwilling or unable to deal with the mental phenomenology or the murky conflicted emotions against which the symptoms defend.

O'Sullivan's experience is that of a British epileptologist who “has developed an expertise in working with patients with psychogenic disorders, alongside her work with those suffering from physical diseases, such as epilepsy” (author's bio, p. 293).

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