"That the body is the mouth-piece of the mind seems self-evident to me, but I have the sense that not everybody feels the connection...as vividly as I do." After an encounter with the sleeping refugee children of Sweden, Wellcome Prize-winning neurologist O'Sullivan travels from a post-Soviet mining town in Kazakhstan, to Colombia, to visit communities where there have been outbreaks of mysterious, psychosomatic illness. At the heart of her investigation is a key question: who gets to define what is, and what isn't an illness?
O’Sullivan argues, convincingly, that psychosomatic illnesses are every bit as real to the sufferer as more easily identifiable diseases. No one is forcing those children to stay in bed for several years. They haven’t ‘decided’ to be ill. In Sweden, the authorities thought their parents had put them up to it, but you would only need to spend five minutes with the parents to know that wasn’t true.
O’Sullivan’s thesis is that resignation syndrome is influenced as much by the idiosyncratic aspects of individual cultures as they are by human biology.
In this illuminating and often challenging book, she travels the world, bringing her expertise and curiosity to some astonishing cases of MPIs. In Sweden, she hears that children begin to fall asleep when their families’ asylum applications are rejected: “The children are the ones who open the letters.” Her whistle-stop tour of ex-Soviet Kazakhstan helps to explain why older people are falling ill in two cold, run-down towns that they still remember as “paradise”; with a genuine, physical illness associated with the location they can finally give themselves permission to leave. In Colombia she finds an epidemic of self-appointed experts who are blaming the HPV vaccine for girls’ symptoms.
The Swedes call it uppgivenhetssyndrom, or “giving-up-ness syndrome”, and it is just one example of what used to be called “mass hysteria”, but is now known as mass psychogenic illness — which is the fabulous subject of this book, although you wouldn’t know it from the title. Suzanne O’Sullivan is a neurologist specialising in psychosomatic conditions, and a writer who has been compared to Oliver Sacks, the master of compelling tales of outlandish neurology. The quintessential example of mass psychogenic illness, she observes, is an outbreak of fainting or convulsions among schoolgirls.
O’Sullivan’s beautifully written book interweaves the stories of those afflicted in this way around the world, in a travelogue of illness that is ultimately a travelogue of our own irrational, suggestible minds. She does not spare those of us in the West who might claim to have transcended such suggestibility. “Psychosomatic symptoms have a social life that moves with the times,” she says. “The recent exponential rise in the reporting of food intolerances comes in large part from modern folklore.” The French, meanwhile, have a disease unique to their medical literature, called “heavy legs”.
O’Sullivan travels the world collecting fascinating stories of culture-bound syndromes, which she relays with nuance and sensitivity. Among the Miskito of Nicaragua, young people, mainly girls, suffering from “grisi siknis” experience dizziness, convulsions and terrifying visions of the devil. Unless they are restrained, and the evil spirits ritually exorcised, they may succumb to violent behaviour and self-harm. In a tropical town in Guyana, teenage girls began collapsing en masse, recovering only when they left their boarding school and returned to their families. An epidemic of convulsions gripped a school in upstate New York, which was resolved only after the camera crews and newscasters – some of whom insisted that the children had been poisoned by the residue of a long-ago chemical spill – finally left.