By Anna Swann-Pye
Photo by ernestl.
Researchers suggest that about four to nine percent of visits to physicians involve hypochondriacs – people who believe that they feel sick, have symptoms and explanations, but show no physical manifestations.
And what accounts for this nagging non-disorder? According to the University of Maryland’s Medical Center, hypochondria has a few plausible causes, although they make it clear that no one is sure why hypochondriasis happens when it does. They suggest that it could be a result of a “belief that an illness may be deserved due to some past real or imaginary wrongdoing” – in other words, guilt pangs.
It could also be related to the feeling that illness results in reward. People, who were sick a lot as children and were given ice cream or special attention from their parents because of that, are perhaps more likely to invent symptoms later on. Most often, though, it seems, hypochondriasis develops from other psychiatric disorders, such as anxiety or OCD.
But even in the realm of the most dedicated and well-educated modern psychologists, there has been a struggle to understand hypochondria. “The position of hypochondria is still suspended in darkness,” complained Freud in 1909. The psychoanalytic theory was that hypochondria had something to do with a stuck ego – expending useless energy. But what exactly does this mean? Where does this stuck ego come from?
Alexander Nazaryan harps on this notion of darkness. “Hypochondria,” he suggests in his New Yorker article, “is an obsession with what lurks below.” And, later in the piece, he elaborates on this notion of the unseen and unknown:
“As children, we know nothing of what is inside, and so we often posit the body’s inaccessibility as a darkness, albeit one that routinely emits farts, tears, and blood. Later, that darkness is filled with guts, and, later yet, the guts become differentiated into organs with the simplistic functions we learn about in seventh-grade biology class… healthy adults trust that organs will continue doing what the should like diligent workers in need of minimal supervision… the hypochondriac never develops that trust in the body’s efficient functioning. For him, it remains what it was from the start, an unknowable, opaque mess to which he is hopelessly bound.”
Nazaryan believes that hypochondria comes from an inability to trust our body – a fear of the unseeable. While this is, in all likelihood, true, terror in the face of the unknown isn’t quite enough of an explanation. Hypochondria is severe and intense; one can only assume that its roots come from a place far deeper. Why is the unknown so scary, after all? What can the unknown do to a vulnerable and blinded body?
“What’s the obsession with personal vulnerability? When I panic over symptoms that require no more than an aspirin or a little calamine lotion, what is it I’m really frightened of? My best guess is dying…my wife tries to be consoling about mortality and assures me that death is a natural part of life, and that we all die sooner or later,” writes Woody Allen of hypochondria in a New York Times opinion piece.
So, hypochondria emerges from a dark and scary place. But how is it solved? How can you cure a non-illness? I would suggest that every hypochondria sufferer go straight to the internet for treatment suggestions (this is what I – a hypochondriac myself – would do), but the internet is, apparently, a perpetuator and not a solution.
“Hypochondria also has the Internet to thank,” writes Nazaryan in the New Yorker, “as does its sibling paranoia. Some four-fifths of Americans now routinely research their own symptoms online, most of them without bothering to check the credibility of their sources.”
So, although I can tell you that phobias.about.com suggests cognitive-behavioral therapy and the uses of drugs such as Zoloft, Paxil and Prozac to help with severe cases of hypochondria, I think that any suffering hypochondriac’s best bet is to stay away from phobias.com.
Hypochondriacs can get their symptoms under control, it seems, but they ought to do so by seeing a doctor and asking how to do it. And believe me, doctors will be thankful. One appointment to help with a real disorder might well prevent a thousand other appointments to help cure absolutely nothing.