48 | NewScientist | 3 October 2009

BOOKS & ARTS

Tormented Hope by Brian Dillon ,

Penguin, £18.99 (published in US

by Faber in February)

Reviewed by Amanda Gefter

FOR me it all began with headaches. Brief, sharp pangs seemed to emanate from deep within the folds of grey matter and every so often I could

swear I heard something snap. I was overwhelmed by a vague but inexorable dread that some unseen, malevolent thing – tumour? aneurysm? – lurked inside my skull. Eventually, I volunteered for a research study in which I was given a brain MRI. A kind neuroradiologist looked over the images and assured me that my brain was perfectly healthy.

I was relieved – and therefore I don’t fit the strictest definition of a hypochondriac. According to the Diagnostic and Statistical

Manual of Mental Disorder (DSM) , hypochondria is an excessive fear of disease for which a doctor’s reassurances are ineffective. But I do fit somewhere along the spectrum of hypochondria specific to our modern times, egged on by the abundance of medical information online, by pharmaceutical adverts targeted at consumers, by doctors’ fear of litigation and resultant over-testing, and by advances in diagnostic technologies that seem to urge the study of one’s own body down to the grittiest details.

Yet hypochondria is far from a modern disorder, as Brian Dillon shows in the beautifully

written Tormented Hope, a collection of biographical sketches of some of history’s most notable hypochondriacs, from Florence Nightingale to Andy Warhol.

Dillon’s thesis is that hypochondria served an artistic or professional purpose for these people, usually by providing them with an excuse to retreat from the world, though he warns against reducing art to mental illness. Charles Darwin’s symptoms – fear, indigestion, shivering and sinking sensations – excused him from social obligations but “do not seem to have seriously affected his work schedule”. Marcel Proust, who suffered from asthma but also exaggerated his symptoms and invented new ones, spent all his time in bed, where he could write. Of Charlotte

Brontë, Dillon writes, “It is only by falling ill that she can find for herself the right kind of solitude, in which to invent her future self.”

Retroactively diagnosing historic figures is always a thorny task, but Dillon uses each subject’s own diary entries and letters to construct compelling cases.

Particularly interesting is that of judge Daniel Paul Schreber, who believed that his organs were being stolen and that, for the purpose of immaculate conception, his male body was being turned into a female’s.

Schreber’s case was extreme –

and later studied by Freud – but all of these cases stem from a fundamental misunderstanding of the body. “The hypochondriac’s historical mistake,” Dillon writes, “is to imagine a condition of bodily being that is physically and psychically null or neutral…According to this fantasy, nothing happens inside the body and yet it continues to function…It does not occur to the hypochondriac that the state he or she describes is a kind of living death.”

But hypochondria is also rooted in the desire for certainty and control in a world where both are impossible. It is no wonder, then, that hypochondria is believed to be related to obsessive-compulsive disorder . Darwin and Proust kept to highly rigid daily schedules, while pianist Glenn Gould diligently logged his vital signs and symptoms.

Ironically, for a hypochondriac the ultimate sense of control can come in the form of an actual diagnosis. Thus Alice James, sister of Henry, was overjoyed when she learned she was dying of breast cancer. “To him who waits, all things come!” she wrote.

As for me, the headaches have subsided, but I’ll find something new to worry about. And is it really so irrational? A broken clock is right twice a day, and a hypochondriac is bound to get sick sometime. What sage advice can dissuade me from the fear of death and the perplexity of feeling like an infinite mind trapped in a finite body ?

“Hypochondria makes dupes of us all,” Dillon writes, “because life, or rather death, will have the last laugh.” ■

Amanda Gefter is an Opinion editor

at New Scientist

“For a hypochondriac the ultimate sense of control can come in the form of an actual diagnosis”

A kind of living deathA look at the history of hypochondria shows it stems from a basic misunderstanding of the body

Excessive fear of disease can be an

ideal excuse to retreat from the world

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