Self-pathologising: The new hypochondria | psychotherapy | Blog

Working with the full spectrum of mental health issues, my feeling is that people who are prone to struggling emotionally have a tendency to view many of the daily challenges or frustrations of life (and how they cope with them) as  a reflection of the state of their mental health.

I might call this a hypochondria of the mind. We are all familiar with the popular trope of the hypochondriac who seeks medical advice/intervention for seemingly innocuous symptoms or reassurance that their "malaise" is not an imagined one.  An overt need (or demand) to be cared for, attended to - that  perhaps may not be forthcoming without the presence of physical symptomology.  Hypochondria has often been written off as "attention-seeking", especially in young children who repeatedly experience mysterious tummy aches the night before school. I think it is a fair demand that children and adults, for that matter,  want the attention of those around them.

We often speak of "somatisation" in psychotherapy, the notion that the body experiences the pain that the mind cannot bear to: tension headaches, back pain, digestive issues are all associated with emotional distress or turbulence. 

When I think about hypochondria of the mind, I'm specifically referring to those struggling with depression and anxiety feeling caught up in a cycle that revolves around the fear of sliding (or getting worse).  I often perceive "normative" levels of anxiety about something moderately stressful interpreted as a sign of "not coping".  For example, feeling angry or upset after a tense interaction with a work colleague or boss, might be translated as a measure of weakness, lack of resilience or inadequacy. 

If clients seek therapy to bolster their sense of self and to feel more adept at navigating the vicissitudes of life,  there is an on-going preoccupation with (and demand in therapy to address) the questions:  How am I doing? Am I doing better at living?

What is the difference between what might be called "good psychological house-keeping" in terms of watching out for oneself and obsessing about the state of one's mental health, being hyper vigilant in a way that fuels anxiety levels? Vigilance is essential when clients have already strayed near to their own emotional cliff edge. Breakdowns, self-harm and suicide attempts are more likely not just when loved ones (partners, siblings etc) are complacent but when the person in pain ceases to register or acknowledge the intensity of their own anguish.