For there are hypochondriacs who know their concerns are irrational, yet are still haunted by them. And there are those hypochondriacs who succumb to physical illness. Just as paranoids can have real enemies, hypochondriacs can have real diseases. The physically ill hypochondriac finally has indisputable evidence to back his fears. Freud once said that the paranoid is often right about many things, but wrong about everything.
Paranoids get many of the facts right, but the overall interpretation wrong.
Hypochondriacs are hyper-accurate observers of their bodily sensations and the ordinary cacophony of borborygmi. Studies also demonstrate hypochondriacs have low pain thresholds. Once they are in a medical setting, their tendency to amplify small bodily changes is extended to scrutinizing lab results, X-rays, etc. Understanding how to approach hypochondria in the physically ill is just one of the interesting problems addressed in a new book, The Psychology of Illness, in Sickness and in Health , published by the American Psychiatric Press. The author, Dr. Richard Druss of Columbia University, New York, is a distinguished psychiatrist and psychoanalyst.