United Kingdom: Dr Suzanne O’Sullivan (BPS neurologist)

Sean said:
WTF? o_O

Feeling dizzy and lightheaded after a physical blow to the head is psychosomatic?
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Of course it does! Getting hit in the head is scary and you might become afraid of using your head again. Skilled practitioners like O’Sullivan are able to instantly recognise the telltale signs of any psychosomatic conditions.

In other news, the new state of the art treatment for post-bonk-head-light sensitivity just released: Solar Process. Choose life every day by staring directly at the source of all life - the sun - whenever you feel that you do light sensitivity. 100 % of the participants report zero light sensitivity after only three days!

/s
 
Deanne NZ said:
Link to RNZ interview.
https://www.rnz.co.nz/national/prog...e-o-sullivan-on-the-dangers-of-over-diagnosis
Kathryn Ryan the interviewer has a reputation of being sympathetic to MECFS & LC.
She challenged O’Sullivan towards the end. Kathryn ended the interview with a long “Hmmmm!” Which i translated as “I am not buying what you are selling Dr O’Sullivan”
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I have never listened to the dude, but what I heard about Joe Rogan is that his thing is mostly that he is a very gullible person who simply agrees with everything his guests say. Anything they say and he'll respond things like "really?", "oh wow!", "I didn't know that", and so on. He doesn't have the wit to know any better, and he doesn't challenge anyone. He has some assistant who sometimes does a quick Google to look for confirmation, which is frankly about on par with the process that psychosomatic ideology uses. This is one reason why guests love to go on his show, they can say whatever they want.

And when it comes to psychosomatic beliefs, one thing I notice is that when it's discussed, almost everyone turns into Joe Rogan. They accept all the claims without any challenge, without even thinking that it could possibly be incorrect. The claims are their own evidence, they need no substance and have to be taken as fact. Separate from all real forms of expertise, just them saying it is the whole evidence.

So it's very rare to have someone go off script. It's so bizarre to see. People just want this stuff to be true so bad, and medicine has built up so much hype about this for so long that they can't even face the possibility that it's wrong. It would be like finding out that every single day you have been pushing buttons that send people to their death or a life of misery. And you pushed it vigorously. With zeal. For years. Thinking it was buttons that helped people.

Most humans can't face being responsible for something like this. So they just rationalize it. And keep doing it. Which is how evil, indifference to suffering, becomes institutionalized. It has, in fact, become a tradition, a common good.

Damn humans are weird.
O'Sullivan said:
concussion, by the way, produces some of the commonest psychosomatic symptoms there are such as feeling dizzy or lightheaded and things like that.
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The entire argument for psychosomatic is: it could be, it's possible that it could be, therefore it is, unless you have a better answer (guilty until proven innocent). That's it. That's the whole thing. Tens of millions of lives have been sacrificed to this simple bit of nonsense, short enough to fit as a t-shirt slogan. Humans are absurdly weird.
 
O'Sullivan said:
concussion, by the way, produces some of the commonest psychosomatic symptoms there are such as feeling dizzy or lightheaded and things like that.
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Meanwhile in Neurology (impact factor 11.8, "The most widely read and highly cited peer-reviewed neurology journal")

Post-Concussion Brain Changes Relative to Pre-Injury White Matter and Cerebral Blood Flow (2025)
Nathan W. Churchill, Michael G. Hutchison, Simon J. Graham, Tom A. Schweizer

BACKGROUND AND OBJECTIVES
Medical clearance for return to play (RTP) after sports-related concussion is based on clinical assessment. It is unknown whether brain physiology has entirely returned to preinjury baseline at the time of clearance. In this longitudinal study, we assessed whether concussed individuals show functional and structural MRI brain changes relative to preinjury levels that persist beyond medical clearance. Secondary objectives were to test whether postconcussion changes exceed uninjured brain variability and to correlate MRI findings with clinical recovery time.

METHODS
For this prospective observational study, healthy athletes without a history of psychiatric, neurologic, or sensory-motor conditions were recruited from a single university sport medicine clinic. Clinical and MRI data were collected at preseason baseline, and those who were later concussed were reassessed at 1–7 days after injury, RTP, 1–3 months after RTP, and 1 year after RTP. A demographically matched control cohort of uninjured athletes was also reassessed at their subsequent preseason baseline. Primary outcomes were postconcussion changes in MRI measures of cerebral blood flow (CBF), white matter mean diffusivity (MD), and fractional anisotropy (FA), evaluated using mixed models. Secondary outcomes were group differences in MRI change scores and correlations of change scores with days to RTP.

RESULTS
Of the 187 athletes enrolled in the study, 25 had concussion with follow-up imaging (20.3 ± 1.5 years, 56% male, 44% female) and were compared with 27 controls (19.7 ± 1.8 years, 44% male, 56% female). Concussed athletes showed statistically significant changes from baseline, including decreased frontoinsular CBF (mean and 95% CI −8.97 [−12.80, −5.01] mL/100 g/minute, z = −4.53), along with increased MD (1.94 × 10−5 [1.26, 2.69] × 10−5, z = 5.48) and reduced FA (−7.30 × 10−3 [-9.80, −5.05] × 10−3, z = −6.07) in the corona radiata and internal capsule. Effects persisted beyond RTP, although only CBF changes exceeded longitudinal variability in controls. For participants with longer recovery periods, significantly greater changes in medial temporal CBF were also seen (ρ = 0.64 [0.44, 0.81], z = 6.80).

DISCUSSION
This study provides direct evidence of persistent postconcussion changes in CBF and white matter at RTP and up to 1 year later. These results support incomplete recovery of brain physiology at medical clearance, with secondary analyses emphasizing the sensitivity of CBF to clinical recovery.

Link | PDF (Neurology)
 
SNT Gatchaman said:
Meanwhile in Neurology (impact factor 11.8, "The most widely read and highly cited peer-reviewed neurology journal")

Post-Concussion Brain Changes Relative to Pre-Injury White Matter and Cerebral Blood Flow (2025)
Nathan W. Churchill, Michael G. Hutchison, Simon J. Graham, Tom A. Schweizer

BACKGROUND AND OBJECTIVES
Medical clearance for return to play (RTP) after sports-related concussion is based on clinical assessment. It is unknown whether brain physiology has entirely returned to preinjury baseline at the time of clearance. In this longitudinal study, we assessed whether concussed individuals show functional and structural MRI brain changes relative to preinjury levels that persist beyond medical clearance. Secondary objectives were to test whether postconcussion changes exceed uninjured brain variability and to correlate MRI findings with clinical recovery time.

METHODS
For this prospective observational study, healthy athletes without a history of psychiatric, neurologic, or sensory-motor conditions were recruited from a single university sport medicine clinic. Clinical and MRI data were collected at preseason baseline, and those who were later concussed were reassessed at 1–7 days after injury, RTP, 1–3 months after RTP, and 1 year after RTP. A demographically matched control cohort of uninjured athletes was also reassessed at their subsequent preseason baseline. Primary outcomes were postconcussion changes in MRI measures of cerebral blood flow (CBF), white matter mean diffusivity (MD), and fractional anisotropy (FA), evaluated using mixed models. Secondary outcomes were group differences in MRI change scores and correlations of change scores with days to RTP.

RESULTS
Of the 187 athletes enrolled in the study, 25 had concussion with follow-up imaging (20.3 ± 1.5 years, 56% male, 44% female) and were compared with 27 controls (19.7 ± 1.8 years, 44% male, 56% female). Concussed athletes showed statistically significant changes from baseline, including decreased frontoinsular CBF (mean and 95% CI −8.97 [−12.80, −5.01] mL/100 g/minute, z = −4.53), along with increased MD (1.94 × 10−5 [1.26, 2.69] × 10−5, z = 5.48) and reduced FA (−7.30 × 10−3 [-9.80, −5.05] × 10−3, z = −6.07) in the corona radiata and internal capsule. Effects persisted beyond RTP, although only CBF changes exceeded longitudinal variability in controls. For participants with longer recovery periods, significantly greater changes in medial temporal CBF were also seen (ρ = 0.64 [0.44, 0.81], z = 6.80).

DISCUSSION
This study provides direct evidence of persistent postconcussion changes in CBF and white matter at RTP and up to 1 year later. These results support incomplete recovery of brain physiology at medical clearance, with secondary analyses emphasizing the sensitivity of CBF to clinical recovery.

Link | PDF (Neurology)
Click to expand...

I did wonder .. just from other current neurologists having been trying to get the message out there for the last five years about the dangers of concussion

including its importance for things like (future potential) MND and dementia

but also don’t most of us know about CTE in American football players and how on autopsy it is so obvious how ‘organic/structural’ it is (I don’t know how not picked up it looks if you just use standard tests assuming all is fine? - I’d be very intrigued here because if not then it would be the textbook area where this ‘common tests look normal so ignore your symptoms’ and ‘it’s psychosomatic because I can’t see it’s organic on these’ habit is shown up as ‘flawed’?)

and isn’t neurology supposed to be her actual subject? When she’s got no qualifications in psychology, not that you’d call her musing on her attitudes to groups of people that anyway (maybe her own personal psychology being shown more) , certainly not autism?

and not an expert in any of the specialisms that could declare long covid non existent etc?

it’s all a bit confusing to me
 
Utsikt said:
Ryan starts this bit by giving an example of a case she knows where a patient presented with symptoms that looked very much like a brain injury, and was successfully treated by doing what you would do with someone that had had a serious concussion.

O’Sullivan (my bolding):
I perhaps don’t think you understand what psychosomatic symptoms are. I see people that have any type of symptoms. I have convulsive seizures and paralysis and blindness and every type of symptoms can be psychosomatic. A concussion, by the way, produces some of the commonest psychosomatic symptoms there are such as feeling dizzy or lightheaded and things like that. So I don’t really see that your argument in any way… That entirely… Everything you’ve described is still consistent with psychosomatic.
Ryan:
Hmmm…
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Thanks to @Deanne NZ for posting a link to the interview. I skipped to the end and listened to just a few mins before this section and this bit. I thought O' Sullivan sounded rude here, it was a thinly veiled 'You're an idiot' and Ryan's high brief "Hm" was a 'Yeah, I'm done with you' and she wrapped up the interview there. [Real quotes in double quote marks, my paraphrasing in single quote marks.]

I thought it was odd for a clinician to lose their patience in this way, as the question posed by Ryan is one that she would meet every day with patients. After presenting the case of someone who was given a test by an optometrist and subsequently had symptoms like those of a brain injury, and responded to treatment that would be used for severe concussion, the question was "Who can be psychosomatically inferring [symptoms of a brain injury] as a symptom?" Why would you expect a broadcaster to know what symptoms can or can't be psychosomatic? Wouldn't you be in full explanatory mode in an interview because you're trying to reach the listeners, not the person interviewing you?

I get that everyone's human and at the end of an interview with someone who you feel disagrees with you, you might be losing patience, but clinicians are so practised at not losing patience in even the most exasperating of interactions. So I listened back to more of the interview, and I don't think Ryan was an exasperating interlocutor at all. They had disagreed a bit about long COVID just before this, but not in a combative way.

I guess perhaps someone who's happy to say, as she does starting at 25:20 "I think there's some very biased researchers, and I would consider Ron Davis to be one of them, I wouldn't necessarily consider him an expert in long COVID" is just someone who's happy to say things that others with a bit more emotional intelligence wouldn't say on the radio. They'd make their point without the ad hominem attack.
 
SNT Gatchaman said:
Meanwhile in Neurology (impact factor 11.8, "The most widely read and highly cited peer-reviewed neurology journal")

Post-Concussion Brain Changes Relative to Pre-Injury White Matter and Cerebral Blood Flow (2025)
Nathan W. Churchill, Michael G. Hutchison, Simon J. Graham, Tom A. Schweizer

BACKGROUND AND OBJECTIVES
Medical clearance for return to play (RTP) after sports-related concussion is based on clinical assessment. It is unknown whether brain physiology has entirely returned to preinjury baseline at the time of clearance. In this longitudinal study, we assessed whether concussed individuals show functional and structural MRI brain changes relative to preinjury levels that persist beyond medical clearance. Secondary objectives were to test whether postconcussion changes exceed uninjured brain variability and to correlate MRI findings with clinical recovery time.

METHODS
For this prospective observational study, healthy athletes without a history of psychiatric, neurologic, or sensory-motor conditions were recruited from a single university sport medicine clinic. Clinical and MRI data were collected at preseason baseline, and those who were later concussed were reassessed at 1–7 days after injury, RTP, 1–3 months after RTP, and 1 year after RTP. A demographically matched control cohort of uninjured athletes was also reassessed at their subsequent preseason baseline. Primary outcomes were postconcussion changes in MRI measures of cerebral blood flow (CBF), white matter mean diffusivity (MD), and fractional anisotropy (FA), evaluated using mixed models. Secondary outcomes were group differences in MRI change scores and correlations of change scores with days to RTP.

RESULTS
Of the 187 athletes enrolled in the study, 25 had concussion with follow-up imaging (20.3 ± 1.5 years, 56% male, 44% female) and were compared with 27 controls (19.7 ± 1.8 years, 44% male, 56% female). Concussed athletes showed statistically significant changes from baseline, including decreased frontoinsular CBF (mean and 95% CI −8.97 [−12.80, −5.01] mL/100 g/minute, z = −4.53), along with increased MD (1.94 × 10−5 [1.26, 2.69] × 10−5, z = 5.48) and reduced FA (−7.30 × 10−3 [-9.80, −5.05] × 10−3, z = −6.07) in the corona radiata and internal capsule. Effects persisted beyond RTP, although only CBF changes exceeded longitudinal variability in controls. For participants with longer recovery periods, significantly greater changes in medial temporal CBF were also seen (ρ = 0.64 [0.44, 0.81], z = 6.80).

DISCUSSION
This study provides direct evidence of persistent postconcussion changes in CBF and white matter at RTP and up to 1 year later. These results support incomplete recovery of brain physiology at medical clearance, with secondary analyses emphasizing the sensitivity of CBF to clinical recovery.

Link | PDF (Neurology)
Click to expand...

Brain remains biophysically compromised, physiosomatically functionally compromised and then finds it harder to deal with things so circumstance, emotions, stimuli mayl put more of a strain on it leading to psychosomatic phenomena, but its still a compromised brain. First comes wound, then comes salt.

Here's my rewrite
concussion, by the way, produces symptoms which are among the most common in psychosomatic cases, though recent research shows ongoing effects on brain tissue so we cannot just assume psychosomatic aetiology in post concussion dizziness. It is unlikely that a brain with ongoing post concussion changes will serve the patient optimally so alleviation of stressors lifestyle adjustment, gentle rehab may be beneficial to avoid further, psychosomatic symptoms. Ignoring the organic may be perilous of course.

Seems to cover it imo as long as the comma appears between further and psychosomatic.

You have to ask whether she covers the organic elsewhere, to be fair to her, and whether it is poor neurology or poor expression or both.

She could develop that thought........
 
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Sean said:
WTF? o_O

Feeling dizzy and lightheaded after a physical blow to the head is psychosomatic?
Click to expand...
The case she had been presented with by the interviewer was that of someone who had a test at the optometrist and subsequently presented with the symptoms of a brain injury. This was in the context of a discussion on long COVID, so my understanding is that the person contracted COVID during the optometrist visit, rather than that the optometrist dealt them a blow to the head!
 
O' Sullivan recounts the case of a mother and daughter, Stephanie and Abigail, apparently the opening anecdote of the book. O' Sullivan was, by her own admission, pretty unsuccessfully treating Stephanie for epilepsy for years, and then Stephanie started having some trouble walking. Stephanie mentioned that her daughter, a teenager, had similar trouble walking. O' Sullivan realised there could be something genetic going on, referred them on, and sure enough, they had a genetic condition. O' Sullivan then describes how rather than feeling great about having discovered this, she felt guilty for years for having given a diagnosis to a teenager who was not bothered by her difficulties at the time. This is despite the fact that the teenager was not bothered by the diagnosis, and it did not distress her or hold her back in any way. And the diagnosis helped the mother, who had been searching for answers for years.

The anecdote suggests to me that O' Sullivan is inordinately distressed by the act of medical diagnosis, because of fears that a medical label will create harm. But somehow, she thinks that a label of psychosomatic illness does no harm.
 
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Adam pwme said:
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I hope to hear her declare that the diagnosis of walkies for fear of walkies to be treated by CBT/GET was an overdiagnosis since so many have not improved.
Diagnoses alone do not necessarily benefit. Treatment may be needed. Her contention is anyway more that certain diagnoses harm, but this may be due to diagnosis + wrong/absent treatment not to the diagnosis itself and where would medicine be if all diagnosis had stopped due to no current treatment and the risk of patient despair etc.
 
Evergreen said:
O' Sullivan recounts the case of a mother and daughter, Stephanie and Abigail, apparently the opening anecdote of the book. O' Sullivan was, by her own admission, pretty unsuccessfully treating Stephanie for epilepsy for years, and then Stephanie started having some trouble walking. Stephanie mentioned that her daughter, a teenager, had similar trouble walking. O' Sullivan realised there could be something genetic going on, referred them on, and sure enough, they had a genetic condition. O' Sullivan then describes how rather than feeling great about having discovered this, she felt guilty for years for having given an diagnosis to a teenager who was not bothered by her difficulties at the time. This is despite the fact that the teenager was not bothered by the diagnosis, and it did not distress her or hold her back in any way. And the diagnosis helped the mother, who had been searching for answers for years.

The anecdote suggests to me that O' Sullivan is inordinately distressed by the act of medical diagnosis, because of fears that a medical label will create harm. But somehow, she thinks that a label of psychosomatic illness does no harm.
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PS diagnoses create labels equally, of course, and the record of PS in achieving improvement is very patchy. Hence for many such diagnoses are by her own definition overdiagnosis.
 
Evergreen said:
O' Sullivan then describes how rather than feeling great about having discovered this, she felt guilty for years for having given an diagnosis to a teenager who was not bothered by her difficulties at the time. This is despite the fact that the teenager was not bothered by the diagnosis, and it did not distress her or hold her back in any way. And the diagnosis helped the mother, who had been searching for answers for years.
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The logical response would have been to feel guilty about misdiagnosing someone, not to feel guilty about having used a medical diagnosis per se.

And the logical response to this guilt would have been to be more diligent next time, not to start throwing around bullshit bps-diagnoses.

Ironically, it seems like she might have become afraid of being wrong again, so she was drawn towards an approach that can’t be wrong (in their opinion at least).
 
How does aphysician decide whether an L-C sufferer is PS or in need of muscle testing as in the Dutch study? Is it not entirely possible that PS phenomena would arise in the context of physiomatic symptoms worthy of investigation.

Strong suspicion that for all the explanations re. All in the head does not mean unreal and is not the patient's fault, the old illness identity trope is a major player and "if you tell them they are physically ill, they' ll love it. so don't investigate just incase they are". + we don't know what to do so the diagnosis will not lead to cure so is an overdiagnosis + assumption that we never will know so end of medicine for those peskies.

So compassionate.....Many on here ahve lived all that.
 
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