What is psychosomatic illness? (with Suzanne O'Sullivan)

Nov 12, 2025 1h 49m 8 insights Episode Page ↗
Dr. Suzanne O'Sullivan, a neurologist and clinical neurophysiologist, discusses long COVID, arguing that a significant portion of cases are psychosomatic. She explains how psychological mechanisms, attention, and expectation can manifest as real, disabling physical symptoms, and how to approach such conditions.
Actionable Insights

1. Limit Excessive Medical Testing

If experiencing mysterious symptoms, find a trusted doctor to help determine when enough tests are enough. Excessive testing can lead to false positives, incidental findings, and increased anxiety, which can exacerbate symptoms.

2. Shift Focus from Bodily Symptoms

Actively find a purpose or focus outside of your bodily symptoms and concerns. A great deal of what perpetuates symptoms is the anxious attention paid to them, so redirecting focus can be helpful for recovery.

3. Challenge Symptom Expectations

Learn and apply distraction techniques to break the brain’s predictive patterns for symptoms. If you expect symptoms to progress in a certain way, your brain can make it happen, so force symptoms in a different direction.

4. Engage with a Good Therapist

Seek psychological rehabilitation with a psychologist, psychotherapist, or psychoanalyst. A good therapist can help manage anxiety, understand emotions, and develop coping strategies, even if the disorder isn’t purely psychological.

5. Practice Non-Reactive Symptom Awareness

Develop a different relationship with your symptoms by noticing them without interpreting them as inherently wrong or bad. This mindfulness approach can reduce stress and frustration, potentially improving your ability to function.

6. Address Fear-Avoidance Patterns

Identify and challenge situations or activities you are avoiding due to fear of symptoms. Breaking these fear-avoidance cycles, often with the help of a psychologist, is crucial for recovery and regaining function.

7. Seek Physical Rehabilitation

If physical symptoms are present, engage in physical rehabilitation with physiotherapists and occupational therapists. This can help re-learn physical functions that may have been ‘unlearned’ due to psychological mechanisms.

8. Support Others without Confrontation

When supporting friends or family with these disorders, avoid confronting their personal theories about their illness or immediately suggesting psychological mechanisms. Instead, encourage a return to normality in a non-confrontational way to avoid alienating them.