Our September 2024 LMCC meeting took place on Wednesday, September 25 at 5:30pm in UNC’s HHIVE Lab (Greenlaw 524) and
via Zoom. We discussed A Condition of Doubt: The Meanings of Hypochondria by Catherine Belling (Oxford UP, 2012).
Dr. Belling was kind enough to join us for our meeting to provide us with further insights on her work! (We’re very grateful to Dr. Belling and to LMCC member Camille Kroll for making this possible!)
Specifically, we focused on the following aspects of Dr. Belling’s monograph:
- “Introduction: A Dubious Condition” (pp. 1-26)
- Ch. 01: “That Within: Biologies of Hypochondria” (pp. 29-40)
- Ch. 04: “Contested Authority: An Expert Patient Lectures the Physicians” (pp. 77-91)
- Suggested reading: Any additional chapter of your choice, ideally from Part III: “A Cultural Condition” or from Part IV: “A Narrative Condition”
If you missed the meeting, you can still access the text on the Readings page of this site!
You can also access the recording of our meeting here.
All of our meetings this semester will take place at 5:30pm eastern time on the last Wednesday of each month in the HHIVE Lab (Greenlaw 524) with options for people to join via Zoom as well.
We’ll be posting information about our October meeting soon!
A few reminders and announcements:
- Be sure to follow LMCC on Twitter and Instagram to show your support and receive regular updates!
- If you want to get more involved with LMCC, please send us other resources we should post to the site or suggestions for improvements, additions, future readings, etc. We’d love to hear your ideas and input! (See our email addresses on the Home page of this site.)
- Also, please feel free to spread the word about LMCC to other interested graduate or professional students at UNC.
Belling, Catherine. A Condition of Doubt: The Meanings of Hypochondria. Oxford UP, 2012. Oxford Academic, https://doi-org.libproxy.lib.unc.edu/10.1093/acprof:oso/9780199892365.001.0001.
Meeting Notes (courtesy of LMCC Co-Director Mindy Buchanan-King):
- Introduction of Dr. Belling
- The book began originally as a paper proposed for a narrative conference as a grad student, thinking of pathographies/illness narratives and their structure, hypochondria a narrative without a diagnosis, level of thinking of the weird narrative structure of hypochondria; Jaws poster, where a woman thinks that everything is fine, but we as viewer know that it’s not fine; began working at a medical school and realized how the question of uncertainty is a point of anxiety for doctors and patients, how to manage the question of doubt in an environment where medical students are taught by multiple choice; question of hypochondria and contestation; current work on horror is emerging from A Condition of Doubt
- Catherine: A person diagnosed with hypochondria has a better understanding of risk; our world values a denial of reality as “healthy”
- Paul: The push against a need to quantify; pointing out what we lose when we lose sight of one; hypochondria seems such an individual type of experience; we taught to teach that natural sciences is quantitative
- Catherine: Any effort to quantify would immediately destroy the context; struggled with how to do this work, as a literature person trying to write in a medical context; method was trying to figure out what to do, and how to justify it
- Camille: Contrasting hypochondria and hypochondriasis, Elaine Scarry, to hear about someone else’s pain is to doubt; both hypochondria and chronic pain do not have a referent; the junction between them
- Catherine: Just published on pain using Scarry; the crucial difference is the symptom; if you can make the pain go away, you can make the condition go away; in hypochondria, the pain is a useful clue to what’s going on inside, if you take the pain away from a hypochondria, they will be distressed because the referent has gone away because they don’t assume that because the pain has gone away, the hidden thing has gone away
- Camille: Chronic pain and trying to figure out what it is, exactly
- Paul: The paradox of absence of evidence, lingering doubt, vindication in diagnosis; so many tensions here, so how do you turn this into a narrative
- Bri: What is generative/inspirational: Hypochondriacs may continue to seek another diagnosis, the atrophobic actually treats the doctor like they create the disease and the different kinds of reactions to the concept of fear; the way we conceive of hypochondria today is connect to modernism and the role of science and who gets the power to say what is
- Catherine: Modernism in her work is the modern world, versus a literary modernism; the atrophobia question and hypochondria both involve a fear of disease, but for the latter, there is a belief and faith in medicine that, if it were just practiced appropriately, this hidden thing would be found, the assumption is that the hidden thing is already there, and medicine’s aim is to remove it; atrophobia perspective is that I’ll be fine if the doctor doesn’t see inside of me and plant a disease there; both come from a real anxiety about disease; there is a sense of the power of medicine; anxieties of self-fulfilling prophecy, so there’s another piece playing there in the atrophobia; hypochondriacs are a bit wary of individual physicians
- Camille: When did disease begin? Is it when the doctor looks at you? It’s complicated, too, by the idea of disease as not only a lesion, but a metric. When do we determine when you’re diseased?
- Catherine: As a good public health citizen, you’re supposed to pay attention to disease awareness, you’re supposed to pay attention to the possibility that a disease may be there, and you need to find it; it’s at odds with the idea that you’re told that if something isn’t found, you can just say “okay, fine”
- Catherine: The idea of cyberchondria and explosion of amateur expertise, with different levels of scientificity is both scary and you have communities of people who are reading themselves as medical subjects and objects and are sharing the information, their stories and diagnoses/symptoms in an infinitely more extensive way; examples of increasing numbers of functional neurology, and it’s not mimicry or hysteria, it’s a sense in which a syndrome can appear plausibly; the question has expanded hugely, we wouldn’t call it hypochondria, because there are functional symptoms; patients being confident in what they know and pushing against doctors and requesting tests that the doctors don’t think are necessary; scientific expertise has gone through the ringer after COVID-19
- Surasya: Reflecting on the line between hypochondria versus the way we culturally view functional disorders (POTS, etc.); curious about intersectional perspective between gender and psychosomaticization of fear
- Catherine: Intersectionally, there are a range of patients who are taken seriously and those who are not for all sorts of discriminatory reasons, and part of that underlies some part of hypochondria; hysteria used to be the gendered term; reliability is diminished with some types of patients; if women were called hysterical, men with hypochondria were seen as either a fool or, in the Romantic period, someone who was intellectual; believe that hypochondria, though it isn’t in the DSM, is fairly evenly distributed by gender, but it’s managed differently; a recent study has found that someone diagnosed with an illness anxiety was found to die sooner if also diagnosed as hypochondriac, though that may be because more medical tests are done
- Surasya: Patients who feel they are unheard by allopathic modern medicine and turn to alternative methods
- Catherine: That’s the other paradox, is that we can’t know; like the John Diamond story (Ch. 1); in terms of hypochondria, those are the patients who don’t go to non-allopathic practitioners because their real belief that if only doctors practiced correctly, the hidden thing would be found; it’s like a protective effect
- Camille: Interesting interpretations of gendered space, is that the truth doesn’t matter, they’re all real, there’s real pain; pain is generally considered an aversive emotion; there are medical reasons for wanting to know if there’s an organic cause, but we get ourselves into a real quandary of truth/not truth; it’s embodiment versus medical epistemology; embodiment is also considered more female, where positivism is related to masculinity
- Catherine: Interesting to think of those assumptions, and where they originate. Is it the experience of male versus female, or the bodies of those who identify as masculine or feminine, the question of knowing viscerally versus cognitively
- Surasya: Thinking of hypochondria from a non-Western context; what sense do we have about how people in other parts of the world experience hypochondria
- Catherine: Early on decided not to go outside of a specific model; sure there is a related form in any culture where there is someone responsible for identifying and diagnosing illness of any form and treating it; those pieces are present in most cultures. Who gets to resist the expertise?
- Camille: Genealogy of literature, early medical anthropologists in 1980s wrote about somatization from a Western perspective to prove that somatization was quite common among white people, to push back on the middle-class Western perceived rationality and control over the mind
- Catherine: Reflects back on atrophobia: You feel so superstitious that you think going to the doctor will make you sick, whereas the hypochondriac is not somatization because they believe in the biological grounding of it; it’s a different belief in medicine; it’s still about belief
- Bri: Rationalizing fears of death
- Catherine: Favorite discovery of the project, the argument that it is “healthier” to be what’s considered “irrational” and a hypochondriac; the narrative pieces and fiction pieces to some extent consider what stories we tell ourselves; if you buy into medicine, it’s the thing that will make sense of your own interpretation of your experience, which comes at a cost; the great question that gets asked is “How many of your patients will die?” It’s 100% and it’s known, but it’s still somehow a shock
- Sterling: Adding another layer, a use of the term “irrational”; the knowledge that science is irreducible would maybe help others
- Catherine: Working in a medical school, you realize how fragile medicine is; it’s not a bulwark of society; talk about imagination and speculation with medical students, and move to what it means to hypothesize and considering that you can only talk about the future by speculating, and how you extrapolate into the future, which is how science works; reproducibility doesn’t always happen; if you’re doing clinical work, it’s a very different thing than trying to reproduce results; not quite sure where rationality fits into this, as well as objectivity
—
Note: The Featured Image for this post is a poster for the film Jaws (1975), which Belling refers to as a kind of metaphor for hypochondria.