Hypochondriacal Doubt: How It Devours Itself Despite its Seeming Consistence

Abstract

Hypochondriasis—currently split into the “somatic symptom disorder” and the “illness anxiety disorder” diagnoses— is characterized by the patient’s conviction that minor symptoms are signs of a severe illness, even after undertaking medical exams that could not detect any disorder. In this paper, I analyze the basic hypochondriacal doubt, that is, calling into question the practitioners’ reassurance that no evidence of serious disease has been found to account for his symptom. Specifically, I take as reference Ludwig Wittgenstein’s posthumous work, On Certainty, to explain how a genuine doubt differs from a behavior that merely seems to be a doubt. On this basis, I clarify in which respects hypochondriacal doubt turns out to be a consistent doubt. But then, I reveal why such doubt makes no sense. Lastly, I show how medical and nurse staff as well as the hypochondriac’s family can progressively help him overcome the aforementioned doubt.