Dr. Suzanne O'Sullivan
speaker
271 appearances
2 recordings
2 series
first heard Mar 2025
last heard Apr 2025
Dr. Suzanne O'Sullivan’s voice in public audio — every appearance, attributed to the second.
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That's an extreme example. But for a neurologist dealing with these kind of issues, it's also a common example.
If you talk about dissociative seizures, people think, oh, that's less serious than epilepsy. 70% of people with epilepsy will become completely free on medication, but only 30% of people with dissociative seizures will get better. It is phenomenally hard to make people with these problems completely better. And I think a little bit of that is because it's been such a neglected area of medicine.
There are great scientists working on it now, but during my training period, there was nobody.
Exactly. As a neurologist, so I've told you how often I see these kind of seizures, but I'm in no way trained to treat them. If it's such a big part of my day job, I should be better trained to treat them. But there would be a real expectation for many neurologists that if you see someone and you rule out a brain disease, then it's sort of like, that's fine. Then you can discharge that person.
And that's a big part of the reason why I became interested in it, because I was a young woman and a lot of the patients were young women my age. I was finding myself in a position of potentially sending people home, having lots of seizures.
It is more common in women. So about two thirds of the patients who develop psychosomatic conditions, seizures in particular, are women.
I don't think we really understand it. We can liken it to things in daily life. But do we really know how that is possible? Well, I don't know is the answer to that question. I mean, with regards to some of these things, we talk about how predictive coding. So predictive coding is how we process information. So if I show you this object, you've never seen it before and I tell you what it is.
then you recognize it. But the next time you see this, you will be able to manipulate it in your brain. So the next time you see it from this angle, you don't have to have learned what this looks like from this angle in order to recognize it. So our brains aren't just... They're modeling machines. Exactly. And they're manipulating everything that comes in to try and make sense of it.
We're making sense of the world according to our experience. So this kind of prediction machine that is the brain is making a best guess at what the body should do in this situation and how the world should look in this situation. And you know what? It makes mistakes. That's the bottom line. And these are some sort of mistakes that come out of these faulty predictions or prediction errors.
I mean, is anti-anxiety pharmaceuticals ever tried for this? Other than in a placebo way, medication doesn't really work for this. What can often work is much simpler than that. This probably will shock you a little bit, but I have seen patients who are having 100 seizures a day and one conversation in which you explain what is happening will stop the seizures there dead on the spot. Oh, wow.
Because what you've done then is you've broken the pattern of the expectation. Actually, the one thing that can make these better very quickly for some people, as long as they haven't been there for that long, is just for them to understand what's happening, to be less frightened of it and then distract themselves. Because often it's a kind of a snowball. So you feel the dizziness.
And then you think, oh, what comes after the dizziness? I don't mean this in a conscious way, unconsciously. So I just say to patients, you feel the dizziness. So next time you feel the dizziness, look for everything in the room that is green or list all your favorite football teams. Just do something that breaks the pattern.
Yeah. This is a story that could have begun anywhere in the world, actually, but it happens to be set in Colombia. So I visited this little town in Colombia, beautiful town near Cartagena, right, 2012. In a school in Colombia, it was a very hot classroom. The windows were closed. It was overcrowded. A girl collapsed. We presume she fainted.
And following that, multiple people in the class collapsed. All over the school, they heard the commotion coming from this classroom. So suddenly, you know, everyone's rushing out into the corridors. You can imagine what a heightened situation this was. In that single day, in that one classroom, there were multiple people collapsing.
fainting, collapsing, having convulsions, rushed to the hospital. Those stories are a dime a dozen. You will find similar examples to that exact story happening in the US, happening in England on a semi-regular basis throughout the world. Usually that stops very quickly. So it's a very frightening situation.
What's likely happened is that one person has fainted and then other people have sort of collapses in sympathy really with that person, sudden emotional overwrought situation.
Other people may simply have fainted also. Young people who have low blood pressure, especially girls, because they have lower blood pressure, sudden fright, your blood pressure drops, you faint. So probably the first person fainted, maybe the second person fainted. Eventually, it was more of an emotional contagion, more likely. We call that poisons.
And then that rumor then spread around the town. I spoke to some of them who had even recovered completely. You know how you make these things better is you're positive. So I'm saying to these young women, you look great. You're better. Isn't that wonderful? And they would say, but I know the poison is still inside me. This sort of attitude. And there was a real malign influence move to the town.
There were anti-vax people. And if they get a whiff of somewhere where they can recruit new members to the anti-vax movement, people from all over the world heard of these seizures and went to the town and stoked the fear. So something which should have been gone in 24 hours, it was still ongoing years later.
Wow. And these poor girls, they were so terrified. Let's say you got some doctor from Germany, America, wherever, coming into your town and saying you've been poisoned and you come from this kind of deprived area in Colombia. Who are you to believe? Also, you're in a country where perhaps you trust this outsider more than you trust your local government.
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