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Suzanne O'Sullivan, the Irish neurologist whose 2016 Is It All in Your Head?: True Stories of Imaginary Illness won the 2016 Wellcome prize and is the best book about functional neurological disorders, has returned with a new book about group outbreaks of functional disorders. She has ventured out from her London practice as an epileptologist to investigate these emotionally contagious afflictions worldwide, from upstate New York to a derelict Russian mining town, Nicaragua's Mosquito Coast, the mountains of Colombia, and the sites of the Havana Syndrome. Her slogan might be, “Have biopsychosocial model will travel.” Neurologists, not psychiatrists, must diagnose functional disorders by their complex clinical maneuvers and experience with neurological patterns, so she is secure in her ability to able to rule out neurological etiologies and move on to sensitive readings of the individuals' psychodynamic motivations and social constraints.
She has some neuro-‘splaining for nonmedical readers, but what sets this book apart is its analysis of the social contributions to the disorders. O'Sullivan relies upon the theories of British anthropologist Ian Hacking (1986, 1995), who described making up people as the construction of identities under the influence of society, and what he called looping, which is the circular reinforcing between an individual's symptoms and societal input. I might interject from my years of psychoanalytic anthropological studies, that anthropologists construe individuals as playing roles always. This is an opposite of essentialism. Hacking's far-ranging proposal in O'Sullivan‘s hands is that patients construct an illness identity from what is supplied to them, just as they construct a gender or ethnic identity or a sexual orientation, and how encompassing an identity it becomes is influenced by what one's culture will label or even license or defend legally. O'Sullivan analogizes that, just as a gay identity is a more recent construction, whereas h