An Erotics of Hypochondria

“Limerence” — like “parasocial” — is a term with academic origins that people tend to learn about from their friends. In 1979, the American psychologist Dorothy Tennov coined it for the kind of burning, obsessive infatuation that some of us are chronically disposed to, while others never experience at all. Her book Love and Limerence received a mixed reception in professional circles — as she writes in the preface to its 1999 edition, responses tended to skew according to whether or not the reader had ever been “limerent” themselves — but it is canon among friend groups across the country and beyond. Crushed-out friends pass it along to crushed-out friends, who find its existence validating. It legitimizes a state that is both all-consuming and totally frivolous.

I thought of Love and Limerence while reading Catherine Belling’s A Condition of Doubt: The Meanings of Hypochondria. Belling, an Associate Professor in Medical Humanities and Bioethics at Northwestern University, reimagines hypochondria as a kind of methodology: a “hermeneutic position” that attends to, and reveals the gaps in medicine’s facade of certainty. I read it in March of 2020, and the premise seemed timely: At the time, the CDC was still recommending against face masks, and checking one’s body repeatedly for signs of illness didn’t seem at all paranoid.

“Hypochondria” is a tricky term. In 2013, a year after Belling’s book was published, it was replaced in the DSM–5 with “illness anxiety disorder” and “somatic symptom disorder” (which refers to distress around a particular symptom or set of symptoms). Belling notes that the term had been contested for years, both for its pejorative implications — the stereotype that hypochondriacs are hysterical pains in the ass — and for its application to those experiencing very real symptoms that, in absence of a clarifying diagnosis, might be dismissed by clinicians as imaginary. I want to be mindful of those objections; however, the term “hypochondria” has strong cultural resonances, and is “indispensable for doing a certain kind of cultural work,” as Belling says. I can only speak for myself, but the term’s colloquial meaning isn’t too far from my own experience of illness anxiety, right down to the shame of coming across as a hysterical pain in the ass.

I’ve been prone to hypochondriacal obsession for 20 years; it ebbs and flows according to external factors, but I can more or less index my life by suspected illness. Before coming upon Belling’s book, it had never crossed my mind that hypochondria could be anything more than a disruption to my life and a nuisance to my loved ones. I was receptive to her notion that the condition could be reframed as an almost poetic assignation to doubt.

Neither Belling’s nor Tennov’s texts are clinical accounts or works of self-help; Belling’s is “ultimately a work of literary theory,” as Lauren Collee wrote recently, in an essay about the fallacy of “closure” in pandemic narratives, as well as a cultural history, and an epistemological stroll. Tennov’s is a qualitative study of “the experience of being in love,” drawn from interviews with hundreds of subjects. The condition of limerence, she found, was fairly uniform among them, and the account she synthesizes seem dead-on to me.

In summary, when you are limerent, you will undoubtedly experience intrusive thoughts about your “limerent object” (or “LO”). These may crescendo into a single preoccupation that excludes all other priorities. Your moods will be subject to whether or not it seems they might like you back. You’ll experience periods of deep despair, followed by blissful, fleeting relief at the faintest hope that LO might reciprocate. And you will read into everything: every bird on the window sill, every song over the PA, and every word, gesture, or lack thereof that your crush provides directly. “Like a hunter for whom the crackle of a twig in the bush measures the presence of the hunted,” she writes, “you subject LO’s seemingly ordinary postures, movements, words, and glances to incessant analysis in quest of ‘true’ meanings obscured beneath an ambiguous surface.”

These basic components are also, in my experience, characteristic of hypochondria. Above all else, both conditions share the distinction, and the stigma, of being a lot over nothing.

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In his book Hands: What We Do with Them — and Why, the psychoanalyst Darian Leader provides the pithiest justification for smoking I’ve ever read: “Beyond the circuits of nicotine arousal, having the packet or cigarette itself in hand furnished for many a strange sense of self-sufficiency. The world might be an unpredictable, frightening and unjust place, but I have what I need right here, just this little object, the possession of which does not depend on anyone else.”

I quit smoking after a particularly disruptive hypochondriac episode. Almost immediately afterward I began a period of intense, cyclical limerence. Crushes replaced disease in the same obsessive apparatus, which tends to kick into gear when life feels relatively chaotic. Both limerence and hypochondria have tremendous organizational power, lining up all your cares under one major concern.

When you are limerent, the stakes of reciprocation are not just the bliss of consummation, but of “happily ever after.” As one young subject told Dorothy Tennov, “Problems, troubles, inconveniences of living that would normally have occupied my thoughts became unimportant. I looked at them over a huge gulf of sheer happiness. I even enjoyed the prospect of dealing with them — with Rick.” A suspected illness may hijack your thoughts, it may rumble under each moment of the day, but it comes with the possibility of a resolution, the hope that everything — everything! — might actually be OK.

The idea of an illness can give shape and form to more ambient and ineffable sources of dread. “The kinds of stories that produce hypochondria may be thought of as stories that convert general anxiety temporarily into fear of a particular object,” Belling writes. An object can, presumably, be removed. Likewise, a crush is often a focal point for loose longings — notions of love and care, impressions of a life worth living. In that way, every limerent obsession is its own work of art, whose living, breathing medium never offered themselves for the purpose.

Both Belling and Tennov describe their subjects — the hypochondriac and the limerent individual — as readers, at heart, in a state of narrative frenzy. In the absence of anything concrete, the ultimate “evidence” of LO’s reciprocation amounts to narrative satisfaction: Does your eventual union make story-sense? Does it feel “emotionally true”? For the hypochondriac, narrative clues can take on more significance than physical symptoms.

The syndromes themselves take on recognizable narrative forms. “Limerence enters your life pleasantly,” Tennov writes. “Someone takes on a special meaning.” The initial attraction may be minor, but given the right circumstances it “can grow to enormous intensity.” Belling refers to the poster for Jaws, showing a woman swimming unwittingly over the maw of a giant shark. The image is still, but we “emplot” the impending attack, and “this process of emplotment is very much the way hypochondria reads the body: each sensation is potentially the first sign, the first stirring in the water, that shows an attack is underway.” In the spring of 2020, I noticed that this process of “emplotment” had seemed to turn itself inside-out: rather than “reading” my body for seemingly innocent portents (a slightly irregular mole, a twitching finger), I was “reading” the minutiae of everyday life (an ill-timed decision to pop into the grocery store, the wrong choice of line at the checkout).

Both conditions provide something like a religious function. It’s not that you idealize your crush as a savior — Tennov distinguishes between “idealization,” where qualities are projected onto or subtracted from LO, and “crystallization,” where LO’s qualities are irradiated. You may accept that your crush is an ordinary, imperfect individual, without any godlike power. But LO provides something arguably spiritual in nature: a fixed point, a singularity, a way of being: “A constellation of features constitute an experience that has a certain ‘wholeness’ about it.”

A crush begets superstition and ritual. You might spend hours poring over the most forgettable words and gestures, counting text messages and their characters, asking friends what they think it all means. In the throes of hypochondria, you can spend hours scrolling through medical sites, studying symptom lists, checking your glands or palpating your abdomen, and asking friends what they think it all means. Proof is scarce in either case, but “evidence” is everywhere: a song you both love plays at the drugstore; a movie whose lead reminds you of them (everyone and everything does) gets together with a character who looks a little like you. These are “signs,” enough to sustain hope. Or maybe the song is “Seasons in the Sun,” or the actor died of the illness you’re worried you might be dying of. That’s enough to support your fears.

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A hypochondriac might experience relief upon receiving a negative diagnosis, or at the end of an incubation period. A crush can source moments of absolute bliss. At the end of either cycle, however, you are left with the shame of waste: wasted energy, wasted time. Ultimately, what both syndromes share is the appearance of unseriousness — “serious” meaning concerned with something “real.” Limerence is characterized by the absence of a “real” relationship, and hypochondria by the absence of a real illness. It is, at least colloquially, a retroactive designation: if you were to receive the feared diagnosis, your fears would not have been hypochondriacal.

Obsessions are often idealized as productive. This is sensationalized over and over again in pop culture: Take the legal procedural, where the dogged investigator painstakingly assembles the evidence, leading to an arrest or a verdict. This dramatic process, as Colin Dickey has written, casts narrative valor onto real-world (or real-time) conspiracy theories. Modern workplaces often encourage a single-minded preoccupation with the product being sold or brand being developed. This “obsession” is supposed to be generative. The limerent person or hypochondriac, assembling their evidence, has the stamina of a “creative” in the thick of a big project — “an enormous fund of energy to deploy in pursuit of the limerent aim.” But an obsessive infatuation, or obsessive fear of an illness, doesn’t generate anything but more of itself. “No time for obsessions other than capitalist productivity, disciplined subjectivity, and neoliberal self-improvement,” writes Tiana Reid.

Religious observance, whatever you think of religion, holds the potential for transcendence and communality — for getting beyond yourself. The fervor inspired by a crush only drives you deeper into yourself. “She is essentially invisible to me,” one of Tennov’s subjects said of his LO. “I see my own construction, and sometimes my image of Greta alters without her doing anything.” That a crush, or a hypochondriacal episode, is solipsistic is a matter of cliche. But these conditions are also isolating in practice. The greater the limerence, as Tennov points out, the lower the chance of actually getting to know LO, not to mention getting close to them. Moreover, it is very difficult to be around someone whose mind is caught in a loop. It’s hard to reason with them, and the wisest advice you can provide (“go see a doctor,” “there’s not enough here to go on”) is also the least satisfying.

At the nadir of my own obsessions, I’ve often found myself unable to stop instrumentalizing my friendships. Reporting new “signs,” asking for their assessments, litanizing my worries — these were my own compulsions, for which any friend was as good as any other. In a headspace like that, it’s hard to understand how draining and even disturbing your conversation can be. Your friends might as well not even be there. All you can see is that they seem to be backing away.

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Years ago I was briefly involved with someone who seemed, prematurely, like the partner of my dreams. We lounged around easily and had what seemed like brilliant, inexhaustible conversations. When we were together, I felt suspended in a spit bubble of total delight. The fling escalated quickly and, sensing that the intensity had outpaced his feelings, he pulled back. Naturally, that only intensified my feelings. One night, after spending too much time decoding an uninspiring text exchange, I went for a walk to cool my head. Somewhere near the Pratt sculpture garden I felt the stirrings of my intuition, telling me Try not to worry so much, this is going to be a significant relationship in your life.

The relationship skidded to a halt soon after that, and I was very sad, but more than anything I was disturbed that I had so misjudged things. It was a turbulent time in my life: I felt lost and inadequate, as though I had nothing to offer another person. But I still believed in my intuition — I’d thought that, deep down, I still had unimpeded access to a sense whose rightness I “just knew.” To find that it had been compromised by all the other shit in my head prompted a low-grade but lingering crisis of faith.

Looking back on this, I see that my intuition wasn’t wrong. It was a significant relationship in my life — at least, I am still thinking about it — just not the way I hoped it would be. Writing this, I am trying to figure out what was significant about it, and all I can come up with is that it happened, and I remember.

Here’s where the comparison diverges. Both limerence and hypochondria involve their share of anguish. But crushing comes with moments of great pleasantness, while nothing about hypochondria is pleasant at all. There is real relief in receiving a negative diagnosis, but to romanticize that feels glib and in poor taste. People do have the illness you don’t have. (And, as Belling stresses, almost everyone gets seriously ill at some point.) A hypochondriac episode can renew one’s love and gratitude for life. But this is an uneasy benefit, which requires a certain carelessness with an experience you haven’t actually undergone. Gratitude of this kind feels superstitious, incantatory.

For me, the feeling that most characterizes hypochondria at its worst is of being trapped — in my own body, a system that I will never fully understand, and over which I hold very little control. In these moments, projecting a dreaded diagnosis is a fantasy, if a terrible one, of closure. “The experience of chronic illness is at the opposite pole to hypochondria,” Lauren Collee writes. “The hypochondriac seeks closure obsessively, while those living with chronic illness know the word ‘cure’ to be a trap, an often violent term loaded with the medical system’s desire to have the story neatly wrapped up.”

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I have an impulse to wrap up this essay by “redeeming” hypochondria — by which I mean, to make it “productive.” What can we learn from these experiences? What do they say about our society, ourselves? It seems to me that both conditions uniquely resist that sort of approach. Limerence can generate material for artists (so can hypochondria, once in a while), but for the most part these syndromes don’t teach us anything, or “improve” us. They are not journeys of overcoming. You don’t come out the other end in better circumstances, or knowing better for next time. The next time is all but guaranteed to resemble the last. The idea of suffering as simply redemptive is a fallacy in any instance, but the “unseriousness” of these syndromes make that all the more pronounced.

One of my favorite lines in Belling’s book has nothing to do with hypochondria at all. Writing about David Cronenberg’s The Fly, and how it evokes the dread of a mounting illness, she writes: “This is not the same as simply reading the film allegorically, in such a way that what we see on the screen is thought of as reassuringly figurative, as not real. (‘It’s alright because it’s not really about a man becoming a fly — that’s impossible, it’s just about a man who gets sick.’) This allegorical reading of horror attempts to recuperate its excesses as respectable and even therapeutic… but the physical reaction most viewers have to such a film undermines this intellectualization.”

There is little I hate more than crudely allegorical horror. For me, it’s the same thing as sabotaging your own karaoke performance with forced laughter, or wearing pants under an evening gown. Allegory feels like a safe mode that clips the power of the story and reduces the rich and mysterious dynamic between fear and its representations to something as banal and unchallenging as X equals Y. Here I think of Susan Sontag in “Against Interpretation,” praising “transparence,” or “the luminousness of the thing itself, of things being what they are.” It seems to me these conditions are good emblems of the limitations of interpretation. The stories assembled by crushers and hypochondriacs, meticulous though they are, fall apart in the end. An “erotics” of hypochondria must simply take it seriously.