The Times: "The Sleeping Beauties by Suzanne O’Sullivan review — how the human mind can make us sick" by Tom Whipple, 2021

[Jonathan Edwards]

https://www.thetimes.co.uk/article/the-sleeping-beauties-by-suzanne-o-sullivan-review-29kq7wdtb

Interesting article by Whipple on a book by Suzanne Sullivan.

Essentially Whipple accepts Sullivan's claim that there are illnesses due to the idea of having the illness. The clearest example is asylum seeking girls in Sweden who develop 'sleeping beauty' illness specific to asylum seekers in Sweden. I think this is fair. There must be illnesses like this based on suggestion.

However, Whipple has a sting in his tail. He wonders if these disease are spread by giving diagnoses then maybe they will be spread further by the book. He concludes that if anything in the book makes sense in terms of treatment it is seeing a shaman in the Caribbean.

I am not sure that most readers will quite get what Whipple is saying. I also think that Whipple does not make it clear enough that the problem with Sullivan is that she wants to extend her analysis of these illnesses of suggestion widely to all sorts of other illnesses. Nor that the pseudo-epileptic illness in the Caribbean probably has a very different basis from the asylum seeker illness and that there is no one explanation that can be used as a general theory.

But maybe Whipple has picked out the things that matter. And particularly the irony that it may be people like Sullivan and Stone and co who are actually driving these illnesses as much as anyone.

 

[Jonathan Edwards]

It is one of those things you can access if yo are lucky by a free trial. Not sure if there is a way round that.

The first bit:

It seems fair to say that grisi siknis was named before doctors worried too much about the niceties of political correctness. This disease mainly afflicts teenage girls on Nicaragua’s Mosquito Coast. Symptoms vary, but it often begins with a hallucination, a visitation from a terrifying man in a hat — sometimes described as the Devil. Next come the convulsions, the tremors, the superhuman strength that means many from the village have to hold the girl down.

The symptoms are real. The cause, the Miskito people believe, are demons. It is, writes Suzanne O’Sullivan, a “biological disorder induced by something spiritual”.

 

[Hoopoe]

The clearest example is asylum seeking girls in Sweden who develop 'sleeping beauty' illness specific to asylum seekers in Sweden. I think this is fair. There must be illnesses like this based on suggestion.

I was very skeptical about such claims but since these cases apparently exist only in Sweden and are not isolated events local factors must play a part in the development of this illness.

 

[Adam pwme]

Doctor Sullivan other book It's All In Your Head about medically unexplained symptoms and psychosomatic illness includes a chapter on ME/CFS.

https://me-pedia.org/wiki/Suzanne_O'Sullivan

 

[Trish]

I can't access the whole article, as it's paywalled. The title is:

"BOOK OF THE WEEK
The Sleeping Beauties by Suzanne O’Sullivan review — how the human mind can make us sick
This is a superb study of the many strange ways that psychosomatic illnesses manifest themselves, says Tom Whipple"

Seeing this article just as I'm taking a break from watching Michael Sharpe's talk to Swiss Re about long covid in which he does all his usual psychosomatic illness stuff about media articles and support groups generating and perpetuating illness, symptom focusing, etc. I worry about O'Sullivan's work and Whipple giving it such high praise.

Don't forget O'Sullivan wrote the awful book 'It's all in your head' that won prizes and got lots of media attention that had a chapter on ME/CFS being an imaginary illness based on one patient.
https://www.s4me.info/threads/suzanne-osullivan-the-reality-of-imaginary-illness-video-2016.6891/
https://www.s4me.info/threads/suzanne-o’sullivan-on-bbc-the-life-scientific.6289/

I don't think we have strong evidence that psychosomatic illnesses are a common phenomenon. The fact that O'Sullivan has to dig up extreme instances like those mentioned in the first part of the article that I have seen suggests to me that they are anything but common. The problem is that these extreme cases titillate the public unhelpfully and people start believing people like Sharpe and O'Sullivan that ME/CFS and long Covid are psychosomatic too, and we need to be sent to CBT or LP to disabuse us of our false beliefs.

 

[Jonathan Edwards]

I was very skeptical about such claims but since these cases apparently exist only in Sweden and are not isolated events local factors must play a part in the development of this illness.

Unlike the psychiatrists I try not to pretend that I actually know what is going on.But my guess would be that there are two factors. The first is the response of a girl's brain to being in an extremely confusing and threatening environment. The culture dislocation in Sweden may even be more severe than in most places for asylum seekers.

But the second is what Whipple hints at but perhaps does not spell out clearly enough. The peculiar 'sleeping beauty' pattern may relate to a suggestion by others of the existence of such a pattern and the people who are central to doing the suggesting are doctors. The 'something spiritual' that turns this into a special illness is the doctors' label 'sleeping beauty illness'. Some psychiatrist has come back to the department saying 'oh, I had another of those sleeping beauty cases today in an asylum seeker' and an illness is born.

Or in simple terms these are illnesses created by shamans in order to be cured by shamans.

 

[Hoopoe]

In Nicaragua, it is apparently normal to believe in demons as cause of illness.

In other places it's normal to believe in psychosomatic causes of illlness, but just because something is a commonly accepted belief doesn't mean it's any more valid scientifically.

 

[Jonathan Edwards]

I worry about O'Sullivan's work and Whipple giving it such high praise.

I do too. In a sense the last paragraph changes that. Whipple is really saying: This is a superb study of the many strange ways that psychosomatic illnesses manifest themselves, and it's probably all your bloody fault, Sullivan" but I don't think he says it in a way that most readers will twig to.

I also agree that these illnesses of suggestibility are relative rarities. Moreover, Whipple does not tease out the distinction between psychosomatic and suggestibility related. The real issue that maybe Whipple should have focused on is the extrapolation from these cases to all sorts of illnesses that clearly have nothing to do with suggestibility at all.

 

[mango]

For those of you wanting to have a closer look at the evidence for the diagnosis and treatments of resignation syndrome ('sleeping beauty' illness, apathetic asylum-seeking children), you might want to start with the 2020 SBU report:

https://www.sbu.se/en/publications/responses-from-the-sbu-enquiry-service/resignation-syndrome/

Some Swedish BPS proponents/ME deniers have made comparisons between ME and resignation syndrome over the years.

The Swedish ME researcher Jonas Bergquist has done some research into resignation syndrome, for example:

Patterns of endogenous steroids in apathetic refugee children are compatible with long-term stress
https://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-186

Bevis på att apatiska barn inte simulerar
https://unt.se/uppsala/bevis-pa-att-apatiska-barn-inte-simulerar-1733200.aspx

...which some BPS proponents/ME deniers have used against Bergquist in the ME debate on social media; used criticism of his RS study to undermine his credibility in the ME field.

 

[Jonathan Edwards]

I looked up the etymology of 'spiritual'. This is something I deal with in my philosophy writing and I wanted to check here the word arises.

It turns out that this is one of those words which has three forms and the meaning can change dramatically between the first and third form leaving the middle one ambiguous. In this case we have

spirit spiritual spirituality

Spirit comes from the Latin via early French into Middle English. It basically relates to movement, action, force, purpose, doing, breathing (it comes from spirare to breathe), life, and therefore maybe biology. In its more recent history it also implies subjective experience or 'mentality', as in Descartes.

Spirituality develops a meaning in the Middle Ages that it still has: to do with religion, priests, relation to a God, thoughts dissociated from the material world, imaginativeness.

The problem is that spiritual is mostly used to imply spirituality but in the context of this article it does not mean that at all so must be about spirit. What does not help is that readers will not have noticed the difference and will happily continue thinking that this is something to do with spirituality, which they probably see as a the touchy-feely sort of 'creative imaginative thought'.

So what is the history of 'spirit' in science, as opposed to lay chat?

Descartes distinguishes spirit from matter in 1641. For him spirit means action or force and also subjective experience. (He also links it to a capacity for logic and language but note that for him spirit is what moves billiard balls as well as people. For billiard balls it is God that is moving things logically.)

In 1693 Leibniz points out that in fact everything is spirit. A lot of people thought he was being imaginative and 'idealist' but he was simply making use of the work of Robert Hooke, of Hooke's law that we learnt in school - the length of a spring is proportional to the weight you put on it. What Hooke showed, and understood, even if he didn't say it like Leibniz, was that matter is just forces in various directions. Modern physics totally incorporated that once Rutherford's 'solar system' model of the atom was destroyed by quantum theory.

So it is in several ways scientifically illiterate to contrast spiritual with biological. Spirit was always linked to biology and it is now the basis of everything else as well.

What Sullivan is talking about is suggestibility - things happening to people as a result of hearing words. It is about time people stuck to plain English.

 

[Kalliope]

I was very skeptical about such claims but since these cases apparently exist only in Sweden and are not isolated events local factors must play a part in the development of this illness.

I remember there were some critical articles in Sweden on this phenomenon a while back. They're referenced in this paragraph on Wikipedia:

- More recently, this phenomenon has been called into question, with two children witnessing that they were forced by their parents to act apathetic in order to increase chances of being granted residence permits.[3][4] As evidenced by medical records, healthcare professionals were aware of this scam, and witnessed parents who actively refused aid for their children, but remained silent at the time. Later, Sveriges Television, Sweden's national public television broadcaster, were severely critiqued by investigative journalist Janne Josefsson for failing to uncover the truth.[5] In March 2020, an article states that a report from the Swedish Agency for Medical and Social Evaluation, SBU, says "There are no scientific studies that answer how to diagnose abandonment syndrome, nor what treatment works."[6]

Wikipedia: Resignation syndrome

The phenomenon was also discussed on the following thread (members only):
https://www.s4me.info/threads/the-new-yorker-the-trauma-of-facing-deportation.3603/

 

[InitialConditions]

If you ask Suzanne and her peers about all the so-called psychosomatic illnesses through history that have eventually been shown to be disease rather than 'just illness', what is their response?

 

[Forbin]

Curiously there's also a story about a woman who was supposedly in a state of hibernation for 32 years between 1876 and 1908, and this also took place in Sweden.

The woman suffered some kind of head injury 4 days before apparently falling into more than three decades of sleep, but there's some doubt about how uninterrupted her sleep was. For one thing, her fingernails, toenails and hair did not seem to grow while she slept. It was later revealed that she did wake up on occasion.

I wonder if this story is well known enough in Sweden for the more recent "sleeping beauty" stories there to have been influenced by it.

She submitted to psychiatric testing in Stockholm and was found to be in full possession of the faculties that she had possessed before she fell asleep.
https://en.wikipedia.org/wiki/Karolina_Olsson

 

[Sean]

But the second is what Whipple hints at but perhaps does not spell out clearly enough. The peculiar 'sleeping beauty' pattern may relate to a suggestion by others of the existence of such a pattern and the people who are central to doing the suggesting are doctors. The 'something spiritual' that turns this into a special illness is the doctors' label 'sleeping beauty illness'. Some psychiatrist has come back to the department saying 'oh, I had another of those sleeping beauty cases today in an asylum seeker' and an illness is born.

Or in simple terms these are illnesses created by shamans in order to be cured by shamans.

There it is.

I completely agree with the psychs that false beliefs are creating non-existent illness categories. Their false beliefs.

It's projection all the way down with these guys.

All I can say is they best not look too closely into any nearby mirrors.

 

[Jonathan Edwards]

I remember there were some critical articles in Sweden on this phenomenon a while back. They're referenced in this paragraph on Wikipedia:

That little Wikipedia entry shows just what a can of worms this is.
So maybe the word did indeed get about that doctors were diagnosing this illness so others developed the same.

I think Whipple tries to make a good point in this respect - that it seems that all this theorising is helping nobody and maybe should be left alone until something new and intelligent can be said.

 

[Nellie]

May be of interest

this morning at 9 on radio 4
Defining mental illness
Start the Week
Suzanne O’Sullivan, Lucy Foulkes and Sally Holland explore where to draw the line between suffering and illness, with Andrew Marr

 

[Jonathan Edwards]

Interesting to listen to Suzanne O'Sullivan. My overall impression is that intuitively she has a reasonable grasp of the complexity of the problem but that rather than saying anything new or useful she is getting herself tied in the same pseudoscientific knots as Stone and Mark Edwards. The giveaway was when she talked of emotional responses playing out 'predictive coding'. This is just straight bullshit. It doesn't even mean anything in predictive coding theory and predictive coding theory is speculative and probably says nothing very new anyway.

The other thing she suffers from is pigeonholing - the assumption that the processes in everyone with a particular syndrome are the same and identifiable as the same. Who knows? And in Sweden it looks as if it may be much more complicated that she presents. The one thing I suspect she gets right is Havana Syndrome, which I take to be pure suggestibility based on politics and maybe an original case of someone with an ear problem.

 

[Snow Leopard]

The other thing she suffers from is pigeonholing - the assumption that the processes in everyone with a particular syndrome are the same and identifiable as the same. Who knows? And in Sweden it looks as if it may be much more complicated that she presents. The one thing I suspect she gets right is Havana Syndrome, which I take to be pure suggestibility based on politics and maybe an original case of someone with an ear problem.

The big mistake she is making is confusing the message with the messenger.

The presentation of illness to medical practitioners (or shamans or whatever) is very much socially influenced and can explain these strange observations, without requiring any notion of social factors causing those illnesses.

But this is a major problem in evidence based medicine where symptom reports are treated as synonymous with the experience of symptoms, without any consideration of how symptom reporting can be biased by a variety of psychological and social factors.

 

[Hutan]

The clearest example is asylum seeking girls in Sweden who develop 'sleeping beauty' illness specific to asylum seekers in Sweden. I think this is fair. There must be illnesses like this based on suggestion.

The first is the response of a girl's brain to being in an extremely confusing and threatening environment.

There were boys as well as girls supposedly affected by the Swedish 'Sleeping Beauty Syndrome'.

As discussed on our thread on this subject https://www.s4me.info/threads/the-new-yorker-the-trauma-of-facing-deportation.3603/, this particular psychosomatic syndrome always looked unlikely to be true. That this 'false illness belief' was accepted and promulgated so uncritically, (scientific papers were even written on the mechanism causing the syndrome) is a topic that is worthy of investigation.

 

[ME/CFS Skeptic]

The one thing I suspect she gets right is Havana Syndrome, which I take to be pure suggestibility based on politics and maybe an original case of someone with an ear problem

Really? I thought that case wasn't as clear either. From Wikipedia:

U.S. National Academies of Sciences, Engineering, and Medicine expert committee concluded in December 2019 that microwave energy (specifically, directed pulsed RF energy) "appears to be the most plausible mechanism in explaining these cases among those that the committee considered" but that "each possible cause remains speculative.