Tangled up in Blue
Will Rees, Hypochondria
Coach House Books, 232pp, $24.95, ISBN 9781552454848
reviewed by Rosa Appignanesi
I confess my interests here are not dispassionate. The covid pandemic stands out to me, but not because of the virus. Instead, I inspected the whites of my eyes, believing them to have turned blue. Visits to the Mayo Clinic, Web MD and NHS websites confirmed my fears: ‘Blue sclera’ is a symptom of a degenerative neurological condition. Within hours, my vision blurred and an ocular migraine came on. Images of the future moved over me, as if I hadn’t been the one to direct them. Blindness, dependency, death. Looking back, the (relatively small) distress of a young adult forced back into familial dependency by the pandemic seems an obvious contribution. Even at the time I could recognise this as a somewhat reasonable context for anxiety. But it was never enough. I became disturbed by the nebulous quality of this feeling, that didn’t respond to any attempts at rational self-enquiry. ‘The only way to accept you might be healthy is to start believing you are crazy’, I wrote in my Notes app. But being ‘crazy’ surely would make me ‘unhealthy,’ at least psychologically. On the other hand, ‘crazy’ people don’t tend to think of themselves as crazy. As I returned to this sentence again and again, I found it impossible to move beyond paradox. Instead, it just became another form of obsession.
But what if there is no ‘moving beyond’ the questions of bodily narration? In Will Rees’s Hypochondria, the paradoxes prompted by the figure of the hypochondriac are suggestive of a wider instability within philosophical enquiry. For Rees, hypochondria — a fruitfully contentious term in of itself — is a way into reading diagnosis and, more broadly, the very practice of reading. Rees moves through an acrobatic range of disciplines, from historical accounts, literature, philosophy, to what might fashionably be called autotheory, using his own experience to give the variety a steady narrative anchor. Diagnosis, he argues, promises a powerfully final type of knowledge about our bodies; an epistemological structure which claims surety over our most immediate and intimate selves. Only it doesn’t. To make his case, Rees follows his patient zero, hypochondria, from its ancient origins in humoral medicine into the early modern period, which linked it to digestive problems. From the 18th century onwards, psychological explanation and an association with intellect increasingly detached hypochondria from physiology, but Rees describes how the ‘link between hypochondria and flatulence . . . would prove surprisingly tenacious’ and was ‘still a fixture of clinical descriptions well into the Victorian era.’
By the time we get to Freud, a perhaps unsurprisingly prominent voice in Hypochondria, the condition is totally purged of its physical aetiology. Yet it is still, by Freud’s own admittance, ‘suspended in darkness.’ Rees notes that today who is called a ‘hypochondriac’ often falls into patterns of recognisable prejudice, according to ‘who is and isn’t deemed a reliable narrator of their own body.’ Women, for example, are far more likely to be misdiagnosed and sent home during a heart attack, and ‘Black patients are systematically undertreated for pain.’ There is also the plasticity of perception itself, summed up in my own experience with such an obvious symbolism as to be almost trite: I stopped ‘seeing’ the whites of my eyes as white and started seeing them as blue. Rees quotes Kant: ‘A person can ‘feel well . . . but he can never know that he is healthy,’’. The hypochondriac pokes holes in the general acceptance of this not-knowing. But who is to say, really, whether an eye’s blueish tinge is acute enough to start calling it blue instead of white? Or in Rees’s case, if you notice a low-lying headache, amongst other small oddities, whether it is your attention ‘producing these things’ or ‘revealing them’?
The hypochondriac’s relentless checking, and the fact that there is rarely a definitive answer, can make them an object of contempt both medically and socially. Rees draws a powerful thesis from the idiosyncratic history of its diagnosis, and hypochondria’s more metaphysical position:
Hypochondria is as much a book about reading as it is about the experience of having a body. Indeed, psychoanalysis makes clear that the body and the text are not so far apart. Freud’s diagnosis of hysteria patients, who exhibited dramatic symptoms but with no clear physical cause, was that their symptoms were a form of somatic language. The task of psychoanalysis was to trace this somatic language back, via ‘the talking cure,’ to the root of trauma. But through reading the body in this way, psychoanalysis also helped to crystallise a mode of critique which treats the text as having an unconscious life, with a repressed meaning.
The task of the critic, as with the psychoanalyst, becomes overly reified in this understanding.
In both cases, ‘the subject supposed to know’ wields exceptional authority over their interpretative object. The hypochondriac, as an overly attentive, overly prescriptive reader of their own body, lays this shared terminology bare. Even the characterisation of ‘paranoia’ in contemporary academia, which ‘claims to doubt everything it sees while placing a huge degree of trust in the efficacy of doubt itself,’ gets tangled up in the hypochondriac’s ability to doubt even doubt. As such, Rees is refreshing a long argument in literary criticism; the fear that whilst taking apart your object of knowledge, you are simultaneously destroying it: ‘Our meddling intellect / Mis-shapes the beauteous forms of things,’ wrote Wordsworth in 1798, ‘We murder to dissect.’
If there are moments when the argument of Hypochondria can feel tautological, it’s because it is. We don’t know about hypochondria, because hypochondria makes us question what we know. Indeed, Rees’s style often mimics his own argument: ‘understanding a text may require us to give up our fantasies of understanding it completely’ or ‘at once a straight man and clown, a hypochondriac must take themselves seriously while suspecting themself to be a joke.’ Tautology is not a dead-end here but a mode of serious thought. Would it be possible to write about hypochondria without repeating the same, relentlessly cyclical patterns Rees perceives in the hypochondriac? Perhaps not. Perhaps this type of fixation is exactly what the doctor ordered. In his ability to live out the point, Rees is wholly convincing of our need, as ‘critics’ of our own bodies, to both pay attention and let go.
I do wonder, though, why this illness instead of that? Why do neurological conditions keep some people up at night, and for others, it’s unprotected sex? I have friends who have fantasised, fixatedly, about contracting HIV from one careless encounter. Surely, this is also a fantasy of punishment, speaking just as much to societal shame as to the unsolvable reality of never knowing exactly what (or who) is inside your body. Does the more distinct relationship between societal shame and ‘sexual hypochondria’ preclude it from the category? I don’t think it does, but it would be interesting to think further about how specific forms of bodily alienation manifest. This is hardly incompatible with Rees’s thought: Hypochondria is practically a mode of interpretation, and as such has a great degree of flexibility.
For my part, as a non-dispassionate reader, I might have been secretly a little disappointed I am not cured after reading a book which set into words so many of the things I recognise. But Hypochondria gifts its readers a peaceful kind of recognition, which I think will make life a little more comfortable when, inevitably, I next get tangled up in blue.
But what if there is no ‘moving beyond’ the questions of bodily narration? In Will Rees’s Hypochondria, the paradoxes prompted by the figure of the hypochondriac are suggestive of a wider instability within philosophical enquiry. For Rees, hypochondria — a fruitfully contentious term in of itself — is a way into reading diagnosis and, more broadly, the very practice of reading. Rees moves through an acrobatic range of disciplines, from historical accounts, literature, philosophy, to what might fashionably be called autotheory, using his own experience to give the variety a steady narrative anchor. Diagnosis, he argues, promises a powerfully final type of knowledge about our bodies; an epistemological structure which claims surety over our most immediate and intimate selves. Only it doesn’t. To make his case, Rees follows his patient zero, hypochondria, from its ancient origins in humoral medicine into the early modern period, which linked it to digestive problems. From the 18th century onwards, psychological explanation and an association with intellect increasingly detached hypochondria from physiology, but Rees describes how the ‘link between hypochondria and flatulence . . . would prove surprisingly tenacious’ and was ‘still a fixture of clinical descriptions well into the Victorian era.’
By the time we get to Freud, a perhaps unsurprisingly prominent voice in Hypochondria, the condition is totally purged of its physical aetiology. Yet it is still, by Freud’s own admittance, ‘suspended in darkness.’ Rees notes that today who is called a ‘hypochondriac’ often falls into patterns of recognisable prejudice, according to ‘who is and isn’t deemed a reliable narrator of their own body.’ Women, for example, are far more likely to be misdiagnosed and sent home during a heart attack, and ‘Black patients are systematically undertreated for pain.’ There is also the plasticity of perception itself, summed up in my own experience with such an obvious symbolism as to be almost trite: I stopped ‘seeing’ the whites of my eyes as white and started seeing them as blue. Rees quotes Kant: ‘A person can ‘feel well . . . but he can never know that he is healthy,’’. The hypochondriac pokes holes in the general acceptance of this not-knowing. But who is to say, really, whether an eye’s blueish tinge is acute enough to start calling it blue instead of white? Or in Rees’s case, if you notice a low-lying headache, amongst other small oddities, whether it is your attention ‘producing these things’ or ‘revealing them’?
The hypochondriac’s relentless checking, and the fact that there is rarely a definitive answer, can make them an object of contempt both medically and socially. Rees draws a powerful thesis from the idiosyncratic history of its diagnosis, and hypochondria’s more metaphysical position:
Hypochondria gnaws at the edges of the disciplines through which the body becomes an object of knowledge; it thrives in the gaps between the certainty that medicine appears to promise and the uncertainty to which we are always actually confined. In this way it addresses itself to the broader and more uncomfortable truth that, however well-founded, every diagnosis is an act of interpretation.
Hypochondria is as much a book about reading as it is about the experience of having a body. Indeed, psychoanalysis makes clear that the body and the text are not so far apart. Freud’s diagnosis of hysteria patients, who exhibited dramatic symptoms but with no clear physical cause, was that their symptoms were a form of somatic language. The task of psychoanalysis was to trace this somatic language back, via ‘the talking cure,’ to the root of trauma. But through reading the body in this way, psychoanalysis also helped to crystallise a mode of critique which treats the text as having an unconscious life, with a repressed meaning.
The task of the critic, as with the psychoanalyst, becomes overly reified in this understanding.
In both cases, ‘the subject supposed to know’ wields exceptional authority over their interpretative object. The hypochondriac, as an overly attentive, overly prescriptive reader of their own body, lays this shared terminology bare. Even the characterisation of ‘paranoia’ in contemporary academia, which ‘claims to doubt everything it sees while placing a huge degree of trust in the efficacy of doubt itself,’ gets tangled up in the hypochondriac’s ability to doubt even doubt. As such, Rees is refreshing a long argument in literary criticism; the fear that whilst taking apart your object of knowledge, you are simultaneously destroying it: ‘Our meddling intellect / Mis-shapes the beauteous forms of things,’ wrote Wordsworth in 1798, ‘We murder to dissect.’
If there are moments when the argument of Hypochondria can feel tautological, it’s because it is. We don’t know about hypochondria, because hypochondria makes us question what we know. Indeed, Rees’s style often mimics his own argument: ‘understanding a text may require us to give up our fantasies of understanding it completely’ or ‘at once a straight man and clown, a hypochondriac must take themselves seriously while suspecting themself to be a joke.’ Tautology is not a dead-end here but a mode of serious thought. Would it be possible to write about hypochondria without repeating the same, relentlessly cyclical patterns Rees perceives in the hypochondriac? Perhaps not. Perhaps this type of fixation is exactly what the doctor ordered. In his ability to live out the point, Rees is wholly convincing of our need, as ‘critics’ of our own bodies, to both pay attention and let go.
I do wonder, though, why this illness instead of that? Why do neurological conditions keep some people up at night, and for others, it’s unprotected sex? I have friends who have fantasised, fixatedly, about contracting HIV from one careless encounter. Surely, this is also a fantasy of punishment, speaking just as much to societal shame as to the unsolvable reality of never knowing exactly what (or who) is inside your body. Does the more distinct relationship between societal shame and ‘sexual hypochondria’ preclude it from the category? I don’t think it does, but it would be interesting to think further about how specific forms of bodily alienation manifest. This is hardly incompatible with Rees’s thought: Hypochondria is practically a mode of interpretation, and as such has a great degree of flexibility.
For my part, as a non-dispassionate reader, I might have been secretly a little disappointed I am not cured after reading a book which set into words so many of the things I recognise. But Hypochondria gifts its readers a peaceful kind of recognition, which I think will make life a little more comfortable when, inevitably, I next get tangled up in blue.