A Body Made of Glass: How health anxiety, hypochondria evolved over time

Caroline Crampton's A Body Made of Glass delves into hypochondria's history, revealing its shifting perceptions from ancient to modern times

A Body Made of Glass: A Cultural History of Hypochondria

Author: Caroline Crampton

Publisher: Granta Books

Pages:  336

Price: Rs 1,784

Today, as we become our own diagnosticians, a quick Google search is handy but not always warranted. Inevitably, one question leads to an obsessive two hour-long spiral down the rabbit hole that is the internet, whether or not the issue deserves such immediacy. This behaviour is not new, as Caroline Crampton points out in her second book, A Body Made of Glass, although it has been on the rise.

On World Mental Health Day today, the book serves as a reminder that there is a distinction, albeit a thin one, between “normal” worry about one’s health and a full-blown anxiety-driven “hypervigilance”. Hypochondria exists on this slippery terrain: “A perceived disease of the body that exists only in the mind”. It manifests itself as a constant fear that one is sick, a constant panic and a constant checking-for-signs for problems that have no visible evidence; “[a]nxiety as a symptom of anxiety”. Ms Crampton makes a case for the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) interpretation of the disorder as seen in light of anxiety and somatic disorders but makes no mention of the International Classification of Diseases (ICD-10) guidelines that offer an independent stand on hypochondria — although a more acceptable term used these days is “health-anxiety”.

This technicality aside, the writer-journalist, who is also a mystery-novels podcaster, maintains a free-flowing account of how hypochondria seems to have a long past. Once believed to function from the liver (in men) and the womb (in women), it has travelled the world in different forms — from something caused by “evil-spirits” to Hippocrates’ humour-based understanding of hypochondria as an anatomical location in the abdomen to recent cognitive perceptions of the condition being a mind-body problem. As she travels through this “convoluted maze of medical jargon and historical etymology,” Ms Crampton remembers her own journey of surviving cancer as a teen, and in return, developing a constant fear that never leaves her side.

Apart from the physiological and psychological aspects of hypochondria, the disorder has always had a social aspect to it. There has always been a discrepancy on whose complaints are listened to and whose are dismissed. This inequality is not only a matter of affordability of medical resources but also has to do with the (un)acceptance of those who belong to the social margins — a privilege that Ms Crampton is well aware of in her case. Hypochondria, she notes, has certainly “democratised” in recent times, not least with the rise of quack practitioners in the business who provide a reassurance to hypochondriacs that medical practitioners often cannot.

There is no dearth of literary as well as cinematic portrayals of the illness: Marcel Proust excessively worried about his breathing; Charles Darwin observed a “Diary of Health” and strictly followed a routine by controlling his walks and baths; John Donne believed that “the knowledge illness can strike at any time is as disabling as the illness itself”; Robert Burton’s The Anatomy of Melancholy (1621) marked a notable shift in his and the world’s understanding of health anxiety; the French playwright and actor Molière played “a very sick man [who] was pretending to be a healthy man who imagined that he was mortally ill” before he succumbed to this irony.

Ms Crampton quotes heavily not only from real life but also from the light-hearted fictional characterisation of hypochondria — from Jane Austen characters (Emma’s Mr Woodhouse and Mrs Churchill, Persuasion’s Mary Musgrove, Mansfield Park’s Lady Bertram, and so on); to Watson’s “psychosomatic limp” in the BBC series, Sherlock (2010); to Woody Allen’s character in Hannah and Her Sisters  (1986); and George Costanza who “manages to hit all of the major hypochondriac tropes” in the  Seinfeld episode titled “The Heart Attack”. As for India, Bhashkor Banerjee (played by Amitabh Bachchan) in the Shoojit Sircar film Piku  (2015) and the 1979 Amol Palekar starrer, Meri Biwi Ki Shaadi,  come to mind.

We see such portraits often passed off as nothing more than funny aberrations. “[H]ypochondria is funny in the way that any kind of delusion can be funny… As with all the best types of humour, there is an edge of cruelty to this too. For centuries, people have been laughing at those who see things that aren’t there,” Ms Crampton points out.

From the “glass people” of the past — people who felt that they were either “fragile, brittle and extremely smashable” as glass or trapped in a glass-vessel, exposed and naked to public scrutiny at all times; to the tech-driven people of today, bent on wearing gadgets that measure their every move and whose obsession with information often turns into “cyberchondria”, the manifestations of hypochondria keep evolving.  The pandemic has fanned this fire.

A Body Made of Glass is not an exhaustive guide on hypochondria. As the author clarifies — it is “a  history of hypochondria, not the history”. Nonetheless, it is a decent place to start understanding the condition both for chronic hypochondriacs as well as those who seldom worry about their health.

The reviewer is a books and culture writer. Instagram @read.dream.repeat