Caroline Crampton (Granta)
Picture someone with hypochondria. It may be a friend who keeps an inventory of symptoms and ailments, is never without a doctor鈥檚 appointment and turns up armed with the latest from Google. label such people disparagingly as the 鈥渨orried well鈥�, those whose demand on medical services is seen to outweigh their need.
But a new book challenges that derogatory and outdated view of hypochondria 鈥� now more commonly known as health anxiety in response to the stigma 鈥� in favour of one that is more compassionate and better reflects the slippery boundary between body and mind.
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A Body Made of Glass: A history of hypochondria by journalist and podcaster Caroline Crampton is billed as the first social history of this form of anxiety, tracing the condition back to Hippocrates in the 5th century BC. The popular, long-standing comedic treatment of hypochondria, such as in the work of French playwright Moli猫re and films directed by Woody Allen, has contributed to the shame and stigma dogging the condition and those who experience it.
Crampton鈥檚 title refers to a peculiar phenomenon in late 14th- century Europe when people began visiting doctors in the belief that they were made of glass, 鈥渁 fitting touchstone鈥�, she says, 鈥渇or the complex knot of emotions and sensations鈥� that make up our experience of good and poor health.
These days, we increasingly understand that mental health affects physical health and vice versa, such as via the gut microbiome and the impact of emotional trauma on the body 鈥� often making it difficult or even futile to distinguish between 鈥渞eal鈥� and imagined illness.
While health anxiety may well be defined and sometimes dismissed as involving imaginary ailments, the associated distress is undeniable 鈥� and can even be deadly. A by a team at the Karolinska Institute in Sweden found that people with health anxiety had a higher risk of death, dying five years younger on average than those without the condition 鈥� mainly from potentially preventable causes.
Alongside her exhaustively researched cultural history of health anxiety, Crampton鈥檚 own experience illustrates the personal anguish involved. At the age of 17, she was diagnosed with Hodgkin lymphoma. After chemotherapy, she remained attuned to changes in her body, as she was advised to do by her doctors. Her vigilance was warranted: she eventually found a lump in her neck, necessitating more chemotherapy.
At 22, Crampton was declared cured 鈥� but her anxiety persisted. For over a decade, she lived in a 鈥渢wilight zone between illness and health鈥�, compulsively checking for tumours and leaping to worst-case scenarios. Naturally, this anxiety negatively affected her well-being beyond verifiable issues with her physical health.
Crampton鈥檚 moving description of the toll should check those inclined to dismiss her as neurotic. She is terrified of wasting doctors鈥� time. Her history of cancer means even the slightest reports are investigated. Crampton was once referred to a neurologist after mentioning a feeling of pins and needles. With wry humour, she recognises the frequent absurdity of her situation: 鈥淚 sometimes wish I was taken less seriously.鈥�
She is an evocative writer, capable of elegant description and astute analysis, and she captures the ambiguities and contradictions of health anxiety. As in Crampton鈥檚 case, it is often triggered by verifiable physical conditions and exists alongside them, complicating the popular perception of health anxiety being about strictly imaginary ailments.
The authors of the Swedish study likewise concluded that a possible explanation for the increased mortality of people with health anxiety could be the impact of living with the chronic stress of the condition.
In A Body Made of Glass, Crampton sets out to chase this condition through history. She not only succeeds, but ends up posing intriguing and potentially important questions. If a cure leads to complications, or to a new and different illness, can it still be considered a cure? If a treatment alleviates our distress (as the still-controversial eye movement desensitisation and reprocessing trauma therapy treatment did for her), does it matter if it doesn鈥檛 pass muster scientifically? And if we are convinced that we are sick, what difference does it make if no condition can be found?
Elle Hunt is a writer based in Norfolk, UK
