CULTURAL THEORY: Tormented Hope: Nine Hypochondriac LivesBy Brian Dillon Penguin Ireland, 277pp. £18.99
WHEN BRIAN DILLON was a child, his mother’s skin began to harden. Scleroderma or systemic sclerosis was diagnosed. Her oesophagus became like a solid glass tube; her intestines stopped working; her saliva glands packed up: Mrs Dillon’s specialist described her scleroderma as the worst he’d ever seen.
The author's mother died in 1985; his father five years later. For Brian Dillon the cost was huge. As a child he suffered psoriasis-like symptoms, and for much of his early adult life he had a morbid fear of illness and death, or hypochondria. He was also stricken with depression; one episode lasted two years. Eventually, maturation plus analysis freed him. His memoir (which I previously reviewed in these pages), In the Dark Room: A Journey in Memory, is a memorable account of these events.
Brian Dillon's new book, Tormented Hope: Nine Hypochondriac Lives, carries on from where the first left off. However, "This is not a history of hypochondria," as he explains, "but a history of hypochondriacs. Each of the chapters attempts to write the biography of a body".
First up is James Boswell. In 1763, aged 23, the future biographer of Samuel Johnson went to Holland to study law and fell ill. Or did he? Classical physicians conceived of hypochondria as an organic disease that originated in the hypochondrium (the region of the abdomen directly under the ribcage). However, when Robert Burton published his Anatomy of Melancholy in 1621, the idea of hypochondria as a psychological condition began to circulate.
In Holland, Boswell alternated frantically between these two models of illness, sometimes believing he was genuinely ill, seeing doctors and following their advice, and other times thinking he was deluded and needed simply to stop drinking and start taking exercise. To this end Boswell obsessively compiled “To do” lists, which he then ignored. This left him feeling even worse.
Despite his travails, Boswell struggled on; after 11 months his problem, whatever it was, went away and he felt normal again. He didn't forget what had happened though and 25 years later he wrote his first essay for the London Magazinein the persona of "The Hypochondriack"; he produced 70 of these in all. His Dutch ordeal hadn't simply shaped him: it was an inspiration for the art he made, and he wasn't the exception: all the hypochondriacs here took more out of their suffering than their suffering took out of them.
With his next four subjects, Charlotte Brontë, Charles Darwin, Florence Nightingale and Alice James, Dillon gives us biographies of exceptional individuals who were made ill by the constraints and protocols of their culture and who used their illnesses to pursue their vocations and forge independent lives. Their hypochondria nurtured as much as it hobbled. In the histories of hypochondriacs (especially those living in oppressive societies) there’s always this ambiguity; the illness is always both liberating and annihilating.
Daniel Paul Schreber (1842-1911), Dillon's sixth subject, was a paranoid German judge who spent years in asylums believing sinister forces were turning him into a woman. He then wrote an account of his experiences, Memoirs of my Nervous Illness(1903), an extraordinary description of what it feels like to have a mental illness.
Schreber's story is fascinating both because of what happened to him and because of the impact his story had in the culture beyond. Sigmund Freud had thought about hypochondria for years but hadn't pronounced. Then he read Schreber's Memoirs and was moved to write The Schreber Case(1911), which enunciated the psychological model. This was neatly defined by Freud during a meeting in the same year of the Vienna Psychoanalytic Society as "the state of being in love with one's own illness", an ingenious definition that neatly sidestepped the problem of fact and whether a patient was actually ill or not, and emphasised instead that it was the patient's attitude that was all-important.
Finally, with his last three subjects, Marcel Proust, Glenn Gould and Andy Warhol, Dillon shows how despite Freud’s cunning insight, hypochondriac illness continued to be both a brilliant bulwark that protected the sensitive against a predatory world, and at the same time a disabling and isolating condition.
On one level you could say Tormented Hopeis a collection of beautifully crafted medical case histories. However, this book is greater than the sum of its parts; for as well as individual narratives, what Dillon provides here is nothing less than a history of "health anxiety" in our culture from the 18th century to the present.
He also has another ambition. He wants to show that the stereotype of the hypochondriac deriving "from Molière's Le Malade imaginaireand the public persona of Woody Allen . . . as the comic dupe of medical quackery", though it contains a grain of truth, is inadequate.
He concedes hypochondriacs may be funny and illustrates this with anecdotes like the one about Glenn Gould slamming the telephone handset down when polio was mentioned lest he caught it on the line. But, Dillon contends, there's more to it than comedy. It has also produced all sorts of things of value such as works of literature including Remembrance of Things Past, as well as Darwin's On the Origin of Species by Means of Natural Selection, Florence Nightingale's medical reforms, and Glenn Gould's celebrated recording of Bach's Goldberg Variations. Besides its polemical achievements (which are considerable) this is also a beautifully wrought text.
The language is fluent and cogent, the story telling economical and deft. And the whole is a feat of compression. It contains nine biographies, all succinct yet ample and as a reader I never felt either short changed or hurried. Tormented Hopealso gives pleasure. Cultural theorists usually pack any narrative they have inside their argument. Dillon does the opposite, he stitches the argument within the stories.
This is a superb book about a fascinating subject and one I’d recommend to anyone wanting to understand the function of hypochondria in society past and present. And since so many are sufferers, we all need to read this.
Carlo Gébler is an author and writer-in-residence at HMP Maghaberry. My Father's Watch, co-written with Patrick Maguire, youngest of the "Maguire Seven", is currently available in paperback