If You’re Sick And Nobody Knows Why, Here’s What You Need To Know

It’s not all in your head.

Why 'Psychosomatic' Does NOT Mean Your Illness Is Fake Getty Images 

There are few things scarier than getting sick.

It makes us feel so vulnerable. We’re at the mercy of our bodies and, often, the only respite we receive is whatever treatment or advice we can get from our doctor.

But imagine how terrifying it must be, while you’re violently ill or suffering from a chronic debilitating condition, if your doctor looked you straight in the face and said, “We can’t find anything wrong with you.”


How do you react? You’re still feeling what you’re feeling, even if the causes aren’t showing up on an X-ray or blood test, so what do you do when you hear “Nothing’s wrong?” How do you move forward?

The sad fact is that I know at least some of the people reading this know EXACTLY what I’m talking about.

MILLIONS of people around the globe seek treatment for “medically unexplained” symptoms every single year, a sobering fact that I learned in Dr. Suzanne O’Sullivan’s fascinating new book, Is It All In Your Head?: True Stories of Imaginary Illness.

(It’s now on sale now from Other Press and I can’t recommend it enough.)


This book opened my eyes in a huge way because I’ve known people throughout my life with these kinds of chronic conditions — family friends who would always cancel plans at the last minute due to their fibromyalgia or co-workers who would constantly complain due to their inexplicable recurring joint pain.

And, I’ll be honest, I didn’t always have sympathy for them. I thought I knew the word that explained their conditions — “psychosomatic” — which was just a fancy way of saying “it’s all in your head.”



But Is It All In Your Head? completely changed how I think about those kinds of conditions. Not only can they be just as serious as “regular” disorders, but they are also INCREDIBLY common.

Dr. O’Sullivan is a noted neurologist, who is now a consultant in clinical neurophysiology and neurology at London’s National Hospital for Neurology and Neurosurgery, so she knows what she’s talking about.

According to her research, as many as ONE-THIRD of people who go to see their doctor every day have symptoms that can’t easily be explained by medical science.

The World Health Organization conducted a study in 1997, in fifteen different cities around the world, to try to quantify how often primary care doctors were encountering “psychosomatic” symptoms in their patients.


The final results showed that as many as 20 percent of the patients exhibited at least SIX medically unexplainable symptoms, or, to quote Dr. O’Sullivan, “a sufficient number to significantly impair their quality of life.”

A 2005 study estimated that the cost of treating psychosomatic disorders in the United States was $256 billion a year.

Those are big numbers, right? That alone should convince you that these conditions are prevalent enough to be taken seriously. These are not a few fringe crackpots convincing themselves that they’re sick because they want the attention.

This is a global health crisis. This is something REAL.


The Mix

Those numbers sound like something you might read on a particularly distressing health pamphlet. Something to be consumed, worried about briefly and then forgotten. But, thankfully, Is It All In Your Head? isn’t just about trying to scare you with statistics.

Dr. O’Sullivan uses her book to make a reasoned, yet impassioned case for why the world needs to change how it thinks about the relationship between our physical and psychological health. (And that’s coming from a neurologist.)

The actual meaning of the word psychosomatic has to do with “physical symptoms that occur for psychological reasons.”This doesn’t mean that those symptoms aren’t real. Anyone who has experienced them can tell you — the pain is real, the fatigue is real, the discomfort is real.


But it does mean that those symptoms can’t always be easily explained away by tests or examinations, and there’s a stigma attached to that.

The patient hears that their tests came back fine, but they KNOW they’re still feeling ill. A doctor can’t find the root cause of a patient’s pain, so they start to doubt that it exists. Or they label it as “psychosomatic,” which, unfortunately, has a certain connotation.

It has that prefix “psycho” on there. It makes the patient feel like they’re being accused of something. That they could snap themselves out of it if they stopped willing themselves to be sick. But that’s not how these conditions work.

It doesn’t mean that the symptoms aren’t real. It just means that the symptoms might need to be treated on a psychological level more than a physical level.


That is REAL. It’s just a different way of thinking.

Spoon University

Throughout Is It All In Your Head?, Dr. O’Sullivan collects a series of case studies discussing real patients who have been slapped with that psychosomatic label.

There was Pauline, a promising young woman who spent her youth consumed by pain and unrelenting seizures, who slowly started to see her symptoms lessen after she began counseling with a psychiatrist.


And there was Matthew who was convinced that he had multiple sclerosis until Dr. O’Sullivan convinced him that suppressed stress might be interrupting the messages that his brain was sending to his legs. (Psychological treatment significantly improved his condition.)

There are thousands of cases like these. They’re confounding and unique and hard to diagnose — and they’re REAL.

To quote Dr. O’Sullivan, “There is no point resisting: disability for psychological reasons is all around us, it can exist and does. It is a common problem that could affect anybody — ourselves as well as the people we know and love.”


More than anything, doctors, patients, and the people who know them — heck, we ALL need to exhibit more empathy in the face of these medically unexplainable disorders and not stigmatize the suggestion that physical symptoms can have psychological origins.

We experience those kinds of symptoms all the time — when we laugh, when we blush, when we cry — so why can’t we also accept that same explanation when someone experiences a physical ailment that can’t easily be explained away by a disease?

If you know anyone in your life who has struggled with a seemingly unexplainable medical condition (or if you’ve experienced one yourself), I strongly suggest you pick up a copy of Is It All In Your Head?: True Stories of Imaginary Illness.

Dr. O’Sullivan’s message is a powerful one — YOU ARE NOT ALONE.


Her case studies and hard-won empathy will convince you of the inextricable ties between our physical and psychological selves and remind you that just because an illness doesn’t have any easy explanation, it doesn’t make it any less severe.

Created in partnership with Other Press.

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