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Health

How I cured my hypochondria

Will Rees' first book is a meandering, contemplative history of hypochondria in literature and medicine with asides on contemporary culture

For about a decade I was convinced I was mortally ill. The identity of my illness changed several times, but the fear was always the same: in short, that I was dying; that I had some dreadful and no doubt painful disease that, for all my worrying, I had carelessly allowed to reach the point at which it had become incurable.

My researches required me to seek the help of doctors. Above all, I wanted a scan that would reveal what was the matter with me. But my doctors tended to take a different view – and the greater my fear at their inaction, the more I convinced them that my symptoms were the result of anxiety. 

The history of hypochondria is probably as old as humanity itself, but – like so much else – the word itself emerged in Ancient Greece. It comes from hypo, meaning below, and chondrium, referring to the cartilage of the ribs. For around two millennia hypochondria was considered to be a physical disease, seated in the abdomen. It was caused by an excess of black bile and was therefore categorised as a form of melancholy, that ambiguous sickness of body and soul.

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In his vast tract The Anatomy of Melancholy (1621), Robert Burton wrote that, in addition to gastrointestinal symptoms, hypochondria could cause “fear and sorrow”.  In the 18th century – after the anatomists who were now dissecting corpses found no trace of this black bile – hypochondria was redescribed as a nervous illness. It was often considered to be a peculiarly male disease: a counterpart to the hysteria that was said to affect women

By the Victorian era, long before my friends started calling me a hypochondriac, the concept had settled into its current meaning: a fear of illness so extreme that it becomes a form of illness. That “strangest spectre”, Charlotte Brontë once called it, speaking to a condition that is both airy and incessant.

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The cure for hypochondria, writes the psychiatrist Arthur Kleinman, consists of “persuading patients that instead of having the disease they fear they have, they are suffering from a psychiatric disorder”. Needless to say, this is easier said than done – not least because, as in my own case, many patients fear that to accept a psychological diagnosis would mean forfeiting a physical examination. 

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By the time I’d reached my 30s, my fears about my health had been put to rest. One thing I think helped was writing about the condition. Reading about the phantom fears of the hypochondriacs who had gone before me – writers such as Alice James, with her mysterious and fluctuating symptoms, and Marcel Proust, with his extreme sensitivity – was strangely consoling and helped keep my own fears under control. 

Hypochondriacs have a reputation for adopting a tragic view of life. But when writing my book, there was something I kept coming upon: how funny hypochondria can be. It is difficult to read the urbane, witty laments of Franz Kafka and Samuel Beckett without laughing. “Hypochondria is the only illness I don’t have,” the comedian Tony Hancock used to quip. Then there is the famous epitaph of Hancock’s friend Spike Milligan, as hilarious as it is haunting: “I told you I was ill.”

In fact I have come to view a certain irony as integral to the very experience of hypochondria. As every psychiatry manual underlines, most hypochondriacs know they are hypochondriacs. Of course for the hypochondriac, the knowledge that the disease may be all in the head fails to fully reassure: what if, this time, one really is unwell? As the critic Brian Dillon writes, hypochondria “makes dupes of us all, because life, or rather death, will have the last laugh”.

Many hypochondriacs never seek treatment. There are several reasons for this, but of course a major reason is the difficulty of convincing patients that hypochondria is the illness that needs treating. In the UK, those who do seek help are generally prescribed a course of cognitive behavioural therapy and occasionally antidepressants. Old medical textbooks offer alternative suggestions, some of them far more harmful than the condition itself: electroshocks, douches, milk diets, thermal springs, rest cures, and bleedings. 

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My favourite cure for hypochondria is the one depicted in Molière’s 1673 comedy Le Malade Imaginaire. Argan – a hypochondriac – is cured when his loved ones convince him to become a doctor, and the play ends with a rowdy graduation ceremony. 

Thus we have comic theatre’s obligatory happy ending – but there is a twist. When it opened in Paris, Argan was played by Molière himself, and on a Friday performance, one week in, he started to cough uncontrollably. Seeing the spluttering actor must have been alarming, a visceral reminder of the body beneath the performance, the tragic that always threatens to intrude upon the comic. Later that evening, Molière returned home, where he died of a pulmonary haemorrhage.

Hypochondria by Will Rees is out now (Coach House Books, £12.99). You can buy it from the Big Issue shop on bookshop.org, which helps to support Big Issue and independent bookshops.

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