Posts tagged “not tonight”


For headache specialists, reducing the disorder to a specific mechanism in the brain doesn’t just relieve the symptoms of migraine [referring to development of Imitrex]; it also targets the stigma associated with it by shifting responsibility for the pain away from a weak or neurotic personality toward a body over which the patient has no […]

Headache medicine’s problems with legitimacy persist despite the “discovery” of a neurobiological mechanism underlying migraine. For while the emphasis on the brain does somewhat mitigate migraine’s association with psychosomatic, feminized personalities, locating migraine in the brain also managed to inscribe gendered cultural assumptions about the personalities of headache patients into the physical structure of their […]


Psychological explanations of migraine remain an extraordinarily popular trope in self-help books for migraine care. Take, for example, the most popular self-help book on this topic, Heal Your Headache: The 1.2.3 Program, by David Buchholz, a neurologist from Johns Hopkins School of Medicine. Buchholz recommends a strict treatment protocol for migraine prevention, which includes the […]

[I]n 1973, Seymour Diamond and Donald Dalessio, then codirectors of the famous Diamond Headache Clinic in Chicago, wrote that the inability of people with migraine to adapt represents the repressed hostility of the migraine patient. Joanna Kempner in Not Tonight I am actually pretty angry about having a painful and debilitating disease that most people […]

The internal milieu of the un-curable patient

The embrace of biochemical approaches meant the corresponding rejection of psychogenic theories. … That the efficacy of a medication should erode a psychosomatic theory is not surprising. This is a fairly common phenomenon. Several disorders understood to be psychosomatic (depression or stomach ulcers, for example) were reframed as somatic with the discovery of effective medication. […]

The migraine interactive kind

How did psychological theories come this far in migraine medicine? Judy Segal has argued that the explanatory power and popularity of the migraine personality could be attributed to its expansiveness — the migraine personality could describe almost anyone. The migraine personality became what Ian Hacking refers to as an “interactive kind.” Interactive kinds are categories […]

Just get me a fainting couch

He worried that so many migrainous women sought diagnostic tests and spent so much money on doctors when doctors had so few effective migraine treatments. The more appropriate role for the physician, he argued, would be to spend time with the patient, “in talking over her life problems and in showing her how to live […]