What is hypochondria? And how should doctors treat people who suffer from excessive worrying about their health? The author of a book exploring this topic joins us on Chicago Tonight at 7:00 pm. Catherine Belling is the Assistant Professor of Medical Humanities & Bioethics at Northwestern University's Feinberg School of Medicine.Read an excerpt from her book:A Condition of Doubt: The Meanings of Hypochondria.

I originally meant to call this book “Swimming in the Dark.” In thinking aboutthe hypochondriacal experience of embodiment as anxious and dangerous, Ikept returning to a powerful popular image that is only figuratively a representationof the body’s interior but is very literally about swimming in the dark. Thisis the poster for the film Jaws, closely based on the cover illustration for PeterBenchley’s novel of the same name. It is an image that came to stand formid-1970s cultural anxiety as mass-marketing phenomenon, a clear and graphicway to represent uncertainty in the aftermath of massive sociocultural (and, aswe have seen, clinical and bioethical) change.

Depicting a woman suspended in water, apparently unaware of a giant sharkrising toward her, the poster gives us not only an image of danger but also, Ithink, a spatial-visual metaphor for the experience of embodiment. Imagine the water’s surface as skin, a membrane both separating and connecting water andair, the body’s inside and its outside. We look outward, upward from our bodies,from inside them, yet the inside we are in is largely invisible to us, the surfaceopaque. To visualize (imagine visually, that is, which is not the same as to see)what is down there, we must read sensations as symptoms. The subject or mindseems suspended in the body like the swimming woman in the ocean. Read figuratively,then, the poster is a psychosomatic kind of image, both of a patient, thewoman a Cartesian self, at sea in her body, and of the patient’s body as it existsin her mind, an image of self (itself, recursively, in a body of its own) suspendedin an opaque medium over an abyss where monsters lurk.Worse still, the woman is exposed to a terrible threat that we, in our impossiblyomniscient viewing position, can see—but to which she is oblivious. Wemay fear more because of her ignorance, which forces us to try and imagine theimpending dangers of which we are, presently and temporarily, ignorant. Herapparent complacency becomes a warning to the viewer. What is lurking beneathyour surface right now?

Some years ago, working on a talk about the fear of disease, I tested mymetaphorical reading of the Jaws poster. I said I thought it might capture theway it feels to be waiting for, say, a biopsy result. Several audience membersapproached me afterward to say that the image rang true to their own experiences.One person told me that it captured precisely how she had felt recently asshe awaited a possible cancer diagnosis, intolerably unsure about the possiblepresence of the monster that might kill her and which, despite the uncertainty,she could not help imagining, repeatedly, in all sorts of horrible detail. Noticethat such a viewer, in imagining herself in danger as the swimmer is, simultaneouslystops identifying with the swimmer, who appears not to considerherself in danger. Note, too, that such a viewer does not know there is a sharkbeneath her, or a malignant tumor in her body. The image’s potency comes fromthe fact that the danger is imagined—which need not mean that it not also (stillinvisibly) present.

To make the medical meaning of this suspense more explicit in my talk,I had juxtaposed the Jaws poster with a chest X-ray containing a looming whiteshadow that may—or may not—be a tumor. The chest X-ray seems differentfrom the poster in that, we assume, the patient must be aware of the ominous,asymmetrical, shark-like white mass. This is not necessarily the case. The patientis not the first reader of such an image, and the patient is not trained to read it;she cannot tell what a white mark might represent. This image, like that of the images. But I am saying that certainty is impossible, and that in the absence ofcertainty, of seeing the thing itself, some of us, or maybe all of us sometimes,see the full story entailed in the still image, see the woman eaten, the cancermetastasized, the patient dead. This projection of plot onto the single image isalso the kind of body reading that underlies hypochondria, endowing signs andsymptoms with meaning in the context of received, and therefore expected, diseasenarratives.

The image publicizing Jaws is a hypochondriacal one in two ways, then: it carriesits own worst-case scenario as a necessary part of its meaning, and it alsoprovokes that expectation outside the frame of the text itself. An image like thisone, then, actively provokes anxiety—and if we read the woman as suspended ina figurative rather than a literal ocean, in the opaque medium of her own body,it provokes hypochondria, which posits both danger lurking in the body and anurgent need to expose that danger, no matter how painful its discovery might be.The hypochondriac expects medicine to show us the shark, to render the bodytransparent as a glass aquarium or a specimen jar.

Excerpt from Catherine Belling, A Condition of Doubt (Oxford University Press, 2012)

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Chicago Tribune article on New book tries to explain the roots of hypochondria