Abstract
Illness narrative has often been found to play a positive role in both patients’ and providers’ efforts to find meaning in the illness experience. However, illness narrative can sometimes become counterproductive, even pathological, particularly in cases of medical mystery—cases wherein biopsychosocial factors blur the distinction between bodily dysfunction and somatizing behavior. In this article, the author draws attention to two examples of medical mystery, the clinical presentation of medically unexplained symptoms, and the popular reality television program Mystery Diagnosis, to demonstrate the potentially harmful effects of illness narrative. The medical mystery’s complex narrative structure reflects and tends to reinforce providers’ and patients’ mistaken assumptions, anxieties, and conflicts in ways which obstruct, rather than facilitate, healing.
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Endnotes
1 In the popular media (and perhaps in many clinical encounters), somatization is usually conflated with hypochondria, but while one can experience both, they are not the same thing. In the simplest terms, hypochondriacs fear that they are or will be sick; somatizing patients know that they are sick. In many respects, this distinction has not been a useful one; in the proposed revisions for the DSM, fear of illness which proves consuming and debilitating will fall under the category of “Illness Anxiety,” while “hypochondria” may be relegated to a symptom of multiple conditions. After all, who does not, at some point or another, fear that she is, or might be sick? Catherine Belling provides a fuller “poetics” of hypochondria, describing it not as a form of psychopathology but as a hermeneutic position in A Condition of Doubt: The Meanings of Hypochondria (New York: Oxford UP, 2012).
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Farkas, CA. Potentially Harmful Side-Effects: Medically Unexplained Symptoms, Somatization, and the Insufficient Illness Narrative for Viewers of Mystery Diagnosis . J Med Humanit 34, 315–328 (2013). https://doi.org/10.1007/s10912-013-9234-8
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DOI: https://doi.org/10.1007/s10912-013-9234-8