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Hypochondria is an almost instantly recognizable aspect of all of our lives. As the great anatomist William Osler noted: “The difference between men and animals is the desire to take pills.” Even so, hypochondria as a concept seems to have lost its pride of place. Psychosomatic phenomena, panic disorders, eating disorders, somatic delusions, body dysmorphias — all refer to more contemporary renderings of mind-body problems.
How to sort all this through?
For the moment, I'll propose that we will best find clues to the dynamics of hypochondria in its relation to various aspects of “the negative.” That is to say, the hypochondriacal reveals itself in relation to absence, to negation, to doubt, to negative hallucination, as well as to the paradoxical vicissitudes of what Andre Green (1999) terms “the work of the negative” — a complex mix of forces of psychic dismantling as well as creative destruction.
In one of his few direct comments on hypochondria, Green proposes that a “negativizing” of sensations linked to the body and to the affects may take place under certain conditions, which he somewhat vaguely describes as a link to a background of negative hallucination. Underlying this idea is Green's fundamental insight that the negative may function as an unbinding of representation, as well as a template for representability.
As the negative provides a framing structure, as well as a demolition, disruptions in this double process will do violence to the balance between perceptions of the body and those of thought. Somewhere in this imbalance, a hypochondriacal regime takes hold.
In Green's brief take, an enigmatic phrase occurs, a matter of translation perhaps, but the text refers to “hypochondria or certain passionate manifestations” (1999, p. 174, italics mine). What are these “passionate manifestations?” Perhaps a clue exists when Green distilled his reflection on the work of the negative into the following sentence:
The work of the negative come