Migraine

Awesome book!!! As a long time chronic or common migraine sufferer (as defined by Sacks) and an often frustrated one at that - this book gave me much appreciated information about my condition and it's evolution. I have little doubt every migraine sufferer will find their story in his book regardless of one's specific symptoms and experience as a migraineur. There simply is no other book or part of a book which comes close to this read at virtually every level of understanding or appreciation of migraine.The medically-based discussion can be more than challenging to read and comprehend. However, with some persistence, a dictionary and thinking about context I could understand what was necessary to appreciate the physiological and biological basis for migraine. It is a complex condition which has defied understanding and treatment for centuries so it defies the simpler explanations I'd hoped for! However, I do not believe this is the most helpful or important part of the book for the migraineur.The book gave me relief, hope and empathy - for myself and for anyone dealing with a chronic pain syndrome of any kind. Most importantly and so often overlooked are the deep psycho-physiological issues associated with most long-term migraineurs which Mr. Sacks explains repeatedly and with many case studies. Over his career he REGULARLY cared for over a thousand migraineurs, saw their protracted battle, how the condition can change and morph inexplicably. A person cannot live with migraine for protracted periods of time without changing who they are, physiologically and psychologically, and how they approach life. I found myself in this book (or a composite of myself) and that is healing in and of itself.Importantly, I learned migraine experience IS NOT a one-size fits all condition. It defies simplicity or neat categorization. For this reason, one really needs to read the entire book and re-read, if not study, those parts which resonate with the reader. It took me a couple months (and I am retired) to work through the book. To have not done so would have been to short-change myself. It worth the effort - if only for peace of mind - finally knowing what I needed to know with a high level of confidence from an actual medical professional with unequalled credibility.Yes, there are plenty of treatment and coping suggestions in the book. This includes Mr.Sacks recommended approach for physicians treating migraine. Unfortunately his approach is not what is followed in our traditional, mainstream healthcare system today. The book reinforced my own long term approach to my migraines - in effect being my own GP and advocate for coping with migraine. "Migraine" will be a long term, critical tool in my migraine toolbox.

(Dr.) Oliver Sacks (he didn't seem to insist on his title) was a name I'd come across quite a long time before I finally picked up his very well-known THE MAN WHO MISTOOK HIS WIFE FOR A HAT AND OTHER CLINICAL TALES. I got it from the library, read it, and promptly purchased my own copy. From there I bought several more of his works, beginning with MIGRAINE. Experiencing migraines myself, I wanted to know what this exceptionally intelligent, educated, and insightful man had to say about them. Couched in his sensitive and highly readable style, Sacks communicates to the lay person how many distinct types of migraines there are (including one with no headache but that results in temporary blindness). Besides analyzing the triggers for migraines, Sacks also presents various types of illustrations exemplifying what can happen to the brain -- and its perception of reality -- when a migraine takes over. It is, in short, a highly worthwhile read for anyone, including those who might scoff at those who claim to get migraines, thinking such claims are imaginary or examples of self-indulgence. It may well be impossible to stay that course after reading this book.

In all editions of his book on migraine, Sacks talks about a type of this disorder which is caused by certain easily observed situations and calls it "situational migraine." I sent to him my book on migraine in which I showed that all cases of migraine are situational, except that when the situation that causes it is continuous or is very frequently repeated, symptoms are produced with regular intervals, and that this obscures the situation that causes it. I also showed that migraine is a psychosomatic disorder, of which the symptoms have precise and realistic self-protective functions. Sacks wrote to me in 2002 that he did not believe that all cases of migraine are situational. In the 1999 edition of his book, he says that situational migraine is a psychosomatic disorder, but unlike me, he does not day that its symptoms have precise self-protective functions and says instead that it can be considered "an expression of emotional stress and distress of many different types" (P. 172). Below is a summary of my theory of migraine formulated in a simple way so that it can be presented to the patient to secure his or her conscious contribution to the therapeutic process.Migraine is not an illness caused by any organic or mental defect or dysfunction. It is a condition created by evolution for making the person take better care of himself or herself under unusually difficult and harmful environmental conditions that are accidentally realized. Such conditions and the resulting failures and harms can cause severe psychological disturbances if they are not controlled. Despite this fact, much harm and loss can be tolerated consciously for attaining a worthy goal and thereby preventing other harms and losses. This behaviour is consciously considered a virtue by everyone. The state called migraine is created by the attempts of the unconscious to terminate some types of harm and loss for preventing severe psychological disturbances, as explained below.The seat of consciousness is the left cerebral hemisphere (LH). The right hemisphere (RH) operates automatically outside of consciousness, and its cognition constitutes what is called the Unconscious. The automatic RH matures earlier in childhood than the LH and has therefore functions and abilities that serve principally to realize self-protection which is the main need of the child. The development of the LH picks up speed after puberty when the need for protection has lessened. Consequently, the conscious LH finds time and energy to seek to realize successes and gains of many kinds--as known from daily experience--and is equipped to do that. This means that there is a difference between the goal hierarchies of consciousness and the unconscious. When consciousness tolerates severe harms for attaining a worthy goal, the unconscious can see this behaviour as an intolerably self-harming mistake and can produce automatic self-protection responses known as migraine symptoms. These symptoms seek to terminate the various components or aspects of the self-harming mistake, or behaviour, of consciousness.The mode of cognition and language of the unconscious, i.e., the RH, and of its products is concrete analogic. In this language, migraine headache means, "Stop making that mistake! Terminate your self-harming behaviour!" Eye pain means, "Don't try to ignore the harms and losses that you are suffering!" Visual and auditory disturbances mean, "Don't distort and misinterpret the events!" Nausea and vomiting mean, "Don't tolerate ugly, disgusting events." Face pain means, "Don't tolerate shameful events!" Symptoms also punish the patient for sustaining the self-harming behaviour.Tension headache is caused by having enjoyed a privileged status in the family in childhood for any reason and being harmed by expecting to receive the same treatment from the society also in adulthood. It means, especially when it is accompanied by neck pain, "Stop expecting to be supported and made happy by others; stand on your own feet and behave like a responsible adult so that you can hold your head up proudly!" The so-called "triggers" which are supposed to start migraine attacks are in reality symptoms of migraine that carry self-protective messages like all other symptoms of it. The distinctive feature of migraine is that the self-harming behaviour is sustained, being tolerated consciously. Genetic predisposition may also be involved.When the patient understands the precise meanings and functions of the symptoms with or without the help of a psychotherapist and consciously starts dealing adequately with the harms and losses that cause the symptoms, these vanish by becoming unneeded. This happens in many cases before the harms and losses are actually terminated. Tension headache and psychogenic face pain can be treated like the known symptoms of migraine are, being interpreted as done above. Dreams are interpreted together with symptoms because they have the same basic self-protective function as symptoms but carry more diagnostic information and therapeutic ideas than symptoms do.Thus, migraine symptoms, tension headache, and psychogenic face pain are automatic mechanisms of self-protection, with which every human being is equipped by evolution. Those who become migraineurs are those who accidentally find themselves in very difficult situations and behave in a way that is evaluated as an intolerably hamful mistake by their RH which therefore produces self-protective responses known as symptoms. This can happen to anyone under the same long-lasting conditions, and in fact, the behaviour of a migraineur cannot be evaluated as a mistake at conscious level by anyone and is even considered virtuous, as mentioned above.This theory is supported by research results and is definitely proved by its usefulness in treating migraine, tension head ache, and psychogenic face pain. I cured in very short times about 120 patients suffering from these disorders. I believe that the reader can gain much by evaluating Sacks views on the basis of the this theory.