The Complex Nature of Hypochondria: A Closer Look
In the late 14th century, a spate of patients scattered across Europe developed an unusual delusion: They came to believe that their bodies were made of glass. Those suffering from this bizarre affliction were terrified of shattering — at least one of them insisted on sleeping in heaps of straw so as to prevent any mishaps. But to modern-day hypochondriacs, this archaic phobia might represent both a fear and a perverse fantasy. A glass person would be perilously breakable, but her condition would also be blissfully transparent.
The journalist Caroline Crampton often wishes that she could see her own insides. She is as desperate for knowledge of the darkest corners of her anatomy as she is terrified of her fragility. She has suffered from this secondary malady since she was diagnosed with the primary malady of Hodgkin’s lymphoma as a teenager. After months of treatment, her doctors assured her that she was in remission — but a year later, the disease returned. Crampton beat it again, but her anxiety lingers to this day. Is her apprehension irrational?
The Coexistence of Diagnosable Illness and Hypochondria
“A Body Made of Glass” proposes that it is and it isn’t. On the one hand, Crampton often experiences symptoms that she later recognizes to be psychosomatic; on the other, her hyper-vigilance after her supposedly successful first cancer treatment enabled her to spot a suspicious lump the second time. She concludes that “diagnosable illness and hypochondria can coexist.” Although “we tend to think of hypochondria as shorthand for an illness that’s all in your head,” the people most worried about their health are very often the people who have the most reason to be.
Unfortunately, many of us have cause to brood on the indignities of embodiment. Crampton writes that “a serious illness is much easier to cope with if it can be slotted into a familiar structure with a beginning, middle, and end,” but she knows that the comforts of recovery and resolution are denied to the ever-increasing number of patients with chronic or autoimmune conditions. Like those conditions, hypochondria is “a plotless story.”
Indeed, there is no absolute agreement about what qualifies as a diagnosis and what qualifies as a delusion. A host of studies have demonstrated that doctors are less likely to listen to women and non-White people, and Crampton knows that she is “taken more seriously in medical examinations” because she is White and upper middle class. The prejudice cuts both ways: Patients, too, rely on “irrelevant details like confidence, carriage, and body language” to determine whether a physician is trustworthy.
And of course, sickness itself — and therefore hypochondria — is a culturally specific construct that is always subject to revision. The catalogue of medically reputable diseases expands and contracts as research advances and outdated theories are debunked. “It is now possible to test for conditions that were previously undetectable,” Crampton writes.
In 1733, the physician George Cheyne described hypochondria as a “disease of civilization.” According to Crampton, he meant that it was “a consequence of the excesses of an imperial and consumerist society that had abandoned the simplicity of earlier human existence in favor of an indulgent diet and inactive lifestyle.” However, hypochondria is also a disease of civilization because it increases as our knowledge does. The more we understand about the myriad ways our bodies can fail, the more we have to fear.
The Elusive Definition of Hypochondria
Because the boundaries delineating hypochondria from verifiable sickness are not fixed, it is difficult to pin down either notion with precision. Crampton acknowledges that her topic of choice “resists definition, like oil sliding over the surface of water.” She is right that hypochondria is a shifting target, but her refusal to venture even a provisional characterization can make for frustrating reading.
“A Body Made of Glass” is a product of impressively thorough research, but it is sometimes circuitous and digressive to the point of frenzy. It blends memoir and literary criticism with micro-histories of subjects of varying relevance. Still, it is full of fascinating forays. If it is hard to read for its claims or conclusions, it can still be read for its many sobering observations about sickness — a misfortune that will eventually befall even the heartiest among us. After all, as Crampton darkly notes, “hypochondria is merely the human condition with the comforting fictions stripped away. Whether we choose to think about it all the time or not, we are all just one freak accident away from the end.”
