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Self-Knowledge • Growth & Maturity

What Hypochondriacs Aren’t Able to Tell You

By common understanding, the hypochondriac is someone repeatedly and deludedly convinced that they are ill – and who, after a medical examination, is recategorised as in fact being quite ‘well.’ 

But the word ‘well’ is worthy of a closer look. Of course, the person doesn’t have the disease they think they do: there truly is nothing wrong with their sinuses, their kidneys are in great shape, their mole is not cancerous.

Yet it’s rather unimaginative and even distinctly cruel to suppose – on this basis alone – that the person in question is actually in good shape. We might more fairly say that something is wrong with the hypochondriac, just not what they are able to tell us is wrong. 

When a hypochondriac winds up at the doctor’s surgery complaining of a peculiar pain in their elbow or sensation near their rib, they are in an inarticulate, diversionary way attempting to complain about some deep kind of unwellness which eludes their conscious grasp. It is as if an overwhelming psychic wound had jumped location and come to communicate with the world only via the body; as if terror, abandonment, isolation and shame were speaking to us through heart palpitations, insomnia or stomach cramps. If we had the patience and imagination to peer into their souls, we might hear hypochondriacs struggling to let out a more complex message than their symptoms directly suggest: ‘Help me with the loneliness and fear that began when my father died when I was eleven,’ or ‘I don’t feel any confidence that I deserve to exist after what happened with my brother…’ It’s shortsighted indeed to insist that such a person truly has no difficulties. 

Communicating our psychological pains via our bodies can be the most logical strategy when we have been brought up in an environment where parents or caregivers, out of misjudged stoicism or haste, could only be kind and sympathetic when we were ill. What more powerful incentive to manifest as physically unwell than to be deprived of care and interest until we feel we are so.

Hypochondriacs are typically in danger of being labelled attention seekers – which describes well enough what they are up to but in a way that utterly ignores the legitimacy of their aspiration. We all seek – and deserve – plenty of attention. What singles out the hypochondriac is not that they want to be noticed, but their traumatised assumption that they won’t be so until they can be found to have cancer or a heart condition. The solution should not therefore be to cast aspersions on their longing for care; it’s to make care more directly emotionally available to them outside of medical emergencies. Rather than lambasting them for making everything up, we should mourn how very sad it is that they somehow learnt they had to hallucinate an ailment before anyone took notice of them.

We don’t call small children who are afraid there might be a tiger under the bed ‘attention seekers.’ Nor should we use the term with adults who think it might be appendicitis, swine flu or yellow fever (again). We should gently direct our focus onto the true cause of their distemper – and start to give them some of the ample sympathy they have previously been denied and forgotten how to ask for in straighter ways. What the hypochondriac ultimately needs is reassurance: that they have been seen, that their concerns matter, that someone is keeping them in mind, that they are worthy of gentleness and sympathy. 

We will have far fewer emergencies in our bodies once we have learnt to be clearer about, and better able to vocalise, the forgotten pains and panics of our minds. 

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