The Empathy Exams of health a personal, literary, and cultural examination of hypochondria from Kafka to Seinfeld.
A free-wheeling philosophical essay, Hypochondria combines incisive contemporary cultural critique, colourful literary history, and the author’s own experience of chronic health anxiety to ask what we might learn from the hypochondriac’s discomforting experience of their body.
Hypochondria is unashamedly capacious in its range of references, from the writings of hypochondriacs such as Franz Kafka and Charlotte Brontë to novel yet accessible readings of theorists such as Lauren Berlant and Maurice Blanchot. Whether he is discussing Seinfeld, John Donne, Robert Burton, Susan Sontag, FitBits, sleep 'hygiene,' or the so-called narcissism epidemic, Rees treats his topic with a mixture of humour and seriousness while revealing himself to be an astute reader of all sorts of texts – not sparing even himself with his own astute and irreverent takes on this popular ailment.
An exercise in what Freud calls 'evenly suspended attention,' Hypochondria demonstrates the rewards – and perils – of reading (too) closely the common but typically overlooked aspects of our lives.
As someone whose parents had to ban her from reading WebMD as a teenager, I deeply related to this book. The author uses his own experience of hypochondria as a jumping off point for diving into a much deeper examination of the oft-misunderstood condition. His research spans the fields of history, philosophy and psychology, and references texts ranging from Shakespeare to Seinfeld. I found this book so fascinating and I feel like I came away from it much more informed. I definitely recommend this one to non-fiction fans!
Thank you to the publisher for gifting me a copy of this book!
This is a very unique book. Instead of focusing on one aspect of hypochondria, Rees combines memoir, philosophy, history, medicine, sociology, and psychology to create a monograph that is extensive yet in depth enough to come out of it feeling like I’ve learned a lot. My one complaint comes from the book feeling like it lacks direction, especially in the middle chapters where the author’s personal story takes more of a backseat role. Regardless, this is a wonderful book and its greatest achievement is relaying the feeling of hypochondria to those who don’t suffer from it. I recommend this book to those who are interested in the intersection of medicine and social science and especially to those who worry about their health. 4/5
took me far too long to read this because I’ve been in the throes of my own hypochondria! extremely interesting and unlike anything i’ve ever read before. was difficult to read at times because of its deep dives into academia (this is not a complaint, just simply addressing that I’m not as scholarly as I’d like to be). I’m definitely going to be on the lookout for more from Will Rees
This was a fascinating deep dive into health, hypochondria, literature, and the medical institution. The beginning lagged a bit because it was very history-heavy, but I loved how the author used his own experiences to explore anthropology, medicine, literature, and philosophy. This was the epitome of many of the nonfiction I love.
* writing about hypochondria, my own and others’, means writing about what didn’t happen, or doesn’t seem to have happened; it means recording what is nearly nothing… For years I trained my eyes on it. Gradually, it revealed itself to be wavering and various; it flickered and shifted, it wouldn’t stay still…what is nothing, or nearly nothing, exerts a pressure on even the most grounded existence: it could be a lie you live, a fear, a dream, a plan that doesn’t come to fruition and that perhaps was not ever intended to. What doesn’t exist, or barely exists, might have an overbearing presence in your daily life, or it might occupy it more minimally, like a name you can’t remember, like a tune that haunts your inner ear. * with his famous practice of ‘evenly suspended attention,’ Freud advised psychoanalysts to bracket the usual hierarchies of significance when interpreting the patient’s experience. Whenever one ‘select[s] from the material before him,’ he warned, ‘he is in danger of never finding anything but what he already knows.’ What Freud advocates for here is a method of reading in which analysts refuse to discriminate in advance between truth and fiction, reality and delusion, the important and the trivial, thereby opening themselves to the possibility of being surprised out of their habitual ways of thinking, finding what they did not already know. * uncertainty is not always a problem to be solved. * It is a condition of knowledge that exceeds medicine’s classification of health and disease because the content of hypochondria concerns the very capacity to make that classification in the first place.’ * David Harvey: sickness under capitalism is defined as the inability to work. * The question of who the hypochondriac is, what’s the matter with them, always speaks to the current position of medical knowledge… Some of those people who currently fall outside of medical categories will eventually come to experience the ambiguous benefits of inclusion; others won’t. Hypochondria, therefore, can function like a sort of waiting room, albeit one in which not everyone’s name will finally be called. * diagnosis starts with conversation… they attempt to convey this experience. This involves an act of translation. * There is a circular logic at work: research into diseases that disproportionately affect more marginalized groups tends to be underfunded, and this in turn increases the likelihood that the narratives of people suffering from these conditions will fall outside the current paradigms of medical knowledge, meaning they are more likely to present in clinical settings as ‘difficult’ patients. * the problem with basing a diagnosis of hypochondria on the foundation of medically unexplained symptoms was that, as the researchers argued, ‘unexplained’ could simply mean ‘unexamined’ – as in the case of Lisa Steen, the doctor who was found to have metastatic cancer having spent years wandering in ‘the wilderness of the medically unexplained.’ * a moral question regarding how much fear or anxiety should be deemed ‘excessive.’ However, now this question could be applied also, and especially, to the diagnosed sufferers of physical illnesses (thus: the DSM as a sort of conduct manual for appropriate suffering * Gilbert Ryle famously summed up Descartes’s mind-body dualism with the phrase ‘the ghost in the machine.’ But in the anxious metaphysics that Descartes left us, and under whose shadow we still live, it is the ghost that is haunted by the machine * where in the twentieth century health organizations used the tools of the advertising industry to publicize health risks, today private companies publicize health risks to sell consumer products. * the WHO’s phantasmatic definition of health as ‘state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.’ Under contemporary conditions the ideal of perfect health becomes something of a self-contradicting enterprise, since the only way it can be ensured is through a practice of conscious scrutiny that is incompatible with any holistic ideal. * Suffering, one can’t help but wonder why. Happy, most people tend to just go with it, to see where it takes them, which means that happiness, like health, is difficult to catch in flight. However, this entails a degree of abandonment that hypochondriacs can’t endure. * Sedgwick reveals the contradiction at the heart of paranoia, the way it claims to doubt everything it sees while placing a huge degree of trust in the efficacy of doubt itself, its ability to see through illusion. * Madness is the doubt of reason. Perhaps it is reason. Who can prove it one way or the other?’ Who can prove it either way? The hypochondriac question par excellence, addressed to the empty space where proofs falter. * Doesn’t all reading involve these sorts of spectres, this following after what might not be there at all? * Where those who never reread are destined to ‘to read the same story everywhere’ – to repeatedly find sameness in difference – rereading affirms the difference in sameness, the non-identity of every text with itself. * The aim of psychoanalysis perhaps consists in only this: accommodating the patient to the inconvertible fact of their opacity to themselves. [comfort w not being able to know everything] * Kierkegaard warns… clownishness can be as much of a rhetorical straitjacket as humourlessness: ‘A fire broke out backstage in a theatre. The clown came out to warn the public; they thought it was a joke and applauded. He repeated it; the acclaim was even greater. I think that’s just how the world will come to an end: to the general applause from wits who believe it’s a joke.’ * A certain type of psychological therapy seeks to placate those who fret about their health by apprising them of, and thus adapting them to, ‘the facts.’ Another approach might be to meet the knowledge-seeking hypochondriac where they find themselves, and to help them make a home in the hazier regions of enchantment, and nescience, and uncertainty. Not in the name of willful ignorance, but simply of a more various orientation toward life where the compulsion to know no longer rules supreme. [2 therapy methods for hypochondria] * To be sick is ruled out by definition, as though hypochondria conferred its victims with a kind of logical immunity. * since the second half of the twentieth century, latency has come to define the collective atmosphere. Gumbrecht describes latency as a mood, a state of anxiety in which some hidden danger constantly threatens to reveal itself – but not yet. * Gawande’s point is that, by extending the interval between diagnosis and death, advances in screening and detection have transformed the way that we die. However, they have also transformed the way that we live. What better illustration of this could there be than the category of the ‘previvor,’ the person who is discovered to be genetically predisposed to a disease that they do not (yet) have. Such people are not sick, they don’t have any disease, yet from the moment they become conscious of their condition it would not be exactly right to call them ‘well’. * biomedical testing has led to a ‘radical expansion of the notion of illness’ and the creation of a new category of subject, ‘the future ill. * Hypochondria is the dream of perfect knowledge. What haunts the hypochondriac is everything that remains out of sight, which refuses to remain out of mind. * far from steadily eroding the regions of latency, replacing hazy ignorance with solid facts, explication in fact serves to generate new latencies. As previously unexpected areas of complexity are revealed, thoughts and suspicions loom about what else remains to be brought to light. * In a rendering by Jan Brueghel the Younger, Adam stands in a forest clearing while a pair of lions lie supplicant at his feet. In such depictions the connection between naming, knowledge, and domination is made clear: nature bows and cowers before an intelligence that names it and, in doing so, masters it. * the parameters of any medical investigation are determined by the story that one tells about oneself. When one leaves a doctor’s office having been told, after a brief examination, not to worry…the feeling tends to be reassuring only in the short term. Before long, doubts set in. What if one has failed to give the really essential piece of information? * In King Lear Cordelia laments, ‘I cannot heave my heart into my mouth.’ She is referring to her inability to give voice to interiority, to perform a private feeling. A patient must heave their entire body into their mouth. They must rally the forces of intellect in order to give an account of a body whose nature is independent of their ability to account for it in language but whose fate now depends on that ability…yet giving a good account of oneself, an account which will convince a doctor that one is worthy of their time, a reliable witness to one’s own body, is also about knowing what not to say. More really isn’t always more. It is a writer’s problem: what to put in, leave out. * The pleasures of not knowing are necessarily belated. One can always choose not to know. But ignorance, consciously chosen, is nothing at all like innocence. * That the fever had gone by this time was not considered a reason to desist; now, and for the very first time, medicine had taken an interest in my body that had nothing to do with my experience of it. * The problem of occasionality points to something that tends to be occluded when people make and publish stories out of their experiences: the unbridgeable gap between writing and reading, the fact that the self that gets written, and therefore read, necessarily lags behind the self that writes, so that endings, however indefinite, however hedged or reflexive, are always openings onto stories that never get told. * There is no health,’ Donne once wrote. ‘Physicians say that we, / At best, enjoy but a neutrality.’ Meanwhile the dictionary says that health is ‘the state of being free from illness or injury.’ This makes it a negative phenomenon – not a presence but an absence. Maybe this is why the search for health so often leads one toward dark places. * The sick person believes that in the recovery of the neutral state lies the greatest pleasure. But for the person already in the throes of pleasure, the same state spells its end and thus the start of their suffering. [sick to neutral vs good to neutral] What, then, we just now described as the intermediate state between the two – this quietude – will sometimes be both pain and pleasure … Is it really possible for that which is neither to become both?’ * in Poe’s ‘The Man of the Crowd,’ the narrator, newly recovered from an unnamed illness, sitting at the bow window of a coffeehouse and watching the scene outside with a sort of free-floating attention: ‘I felt a calm but inquisitive interest in every thing’ (I love that division of the final word, lost in some editions but so essential to Poe’s meaning: the convalescent imagination as a sensitivity to the particular, a refusal to subsume it under the general).
Incredibly interesting subject matter, supplemented with personal accounts and an academic study. A little too seeped in academia, but I’ll let it slide. Definitely a book I will return to in the future.
Rees succeeds at using Hypochondria as a case study to look at the act of diagnosing, flaws and all. He writes, “… however well- founded, every diagnosis is an act of interpretation.” He explains that the idea of “health” is best defined to many as the lack of disease or illness. Hypochondria fights with this definition— where someone is convinced they are not well, but lack the proof of illness to show it. When adding in the historical context of Hypochondria as a physical diagnosis, often juxtaposed to Hysteria, the fluidity of the term ripens. Rees compares Hypochondria to a waiting room, where not everyone’s name will be called. New diagnoses such as fibromyalgia subtract from the pool of hypochondriacs. What’s to say that Hypochondria won’t become a physical diagnosis again?
Having a name— or diagnosis— for pain solidifies the individual experience of suffering. Rees uses the likes of Rumpelstiltskin and Adam in the Garden of Eden to illustrate the idea that “naming = having dominion over.” However, the label of Hypochondria is contradictory itself. Rees asks, “Could it be that hypochondria names a solution disguised as a problem?” To accept oneself as a hypochondriac is deny the reality of self-diagnosed illnesses. What a label of Hypochondria does do, however, is take the patients perspective out of the question.
I found the subject to be a brilliant window into medical sociology. The writing itself could use more cohesion, and I just didn’t relate to the author’s experiences as much as I was expecting. Even so, I’ll be thinking of this book a lot in the future.
Terrific investigation into a thorny, impossible subject matter. Rees's interlocutors in this book include Blanchot, Cioran, Kafka, Berlant, Scarry, and so many others, whose words he synthesizes beautifully and interprets intelligently. I felt so relieved for Rees at the end of this book — not that he's been cured forever of this tendency toward hypochondria, but that he managed to wrangle his thinking around it so expertly into the object that is this book. It must have felt impossible until the day he was finished.
A very thought-provoking and richly referenced essay that makes you question the meaning of illness and the existence (or lack thereof) of health. Learned a lot about the history of medicine and really enjoyed the part about Cartesian mind-body duality and how it relates to hypochondria. Though my favorite thing I learned from this book was the Kafka quote where he says that he doesn’t want to find a cure for his anxiety because he thinks being anxious is what makes him a good writer