A little pain in the rib cage? Definitely a heart attack! A stain on the skin? Cancer, that's for sure! A headache ? You might as well go to the notary to arrange your will… And so on! If it is healthy to be concerned about the pains and other discomforts that trouble us, especially at an advanced age when these can indeed be indicative of serious pathologies, some have a tendency to rush into the stretchers (literally) and see the Grim Reaper arrive at every turn. Beyond a certain threshold of healthy questioning, therefore, we fall into hypochondria — and if this is sometimes derided or minimized, it is indeed a mental disorder that can ruin your life. And the elderly are not spared any more than the others:on the contrary, some even become so late, at an age when their body is increasingly regularly sending them signals that are quick to fuel their anxieties.
Some see hypochondria as the "evil of the century" — no offense to Molière who already laughed about it in his Malade imaginaire . It is that at a time when we are paradoxically in better health than ever, death and aging remain two horizons impossible to eradicate. Is this why more and more people are hypochondriacs? Be that as it may, up to one in three French people could at least become so, declaring that they are afraid at the slightest signal deemed worrying. If this does not correspond to a pathological definition of hypochondria, it is in any case a fairly widespread phenomenon.
But beware:"true" hypochondriacs, by definition, believe they are really sick. This means that if they are going to consult very – too – regularly, it is about their supposed illnesses, and not about their hypochondria. In other words, if you're the type to say, "oh me anyway, I'm completely hypochondriac, I'm afraid of having cancer at the slightest nothing"... you're probably not, at least from a clinical point of view. Because the hypochondriac, he knows he is sick, and therefore will never put him on the back of his hypochondria. A veritable vicious circle…
However, this disease is linked to genetic bases as well as to the contingencies of life, but above all in the first place to anxieties (although all these causes reinforce each other) — anxieties linked to the fear of aging and death. . Because the disease, for a hypochondriac, obsesses so much because of what it refers to the fallibility of the body, and its possible decadence. If hypochondria tends to appear in your twenties or thirties, there is therefore also something to become of it as this deadline approaches. We thus observe two reasons for hypochondria in the elderly:in the first case, it is about chronically hypochondriac people, for whom this one finally fits simply in the continuity and is reinforced with age and aging, as well as with the increased failures of the body which give free rein to the fantasies of illness. The second, on the other hand, is that of a later hypochondria — of senescence or aging, so to speak — which betrays a pain in the face of aging and its subjective effects and is a direct reaction to it.
Concretely, hypochondria therefore translates into an obsession with the disease - even if the medical examinations carried out attest to the good health of the patient. Freud, who considered it one of the "current neuroses", conceives it as a way of concentrating the libido withdrawn from the external world in a particular organ, becoming itself erogenous by the occasion. In its most severe forms, the patient may even actually suffer from the symptoms associated with the disease, in a purely somatic way. Again, this is only a minority of people. Only about 3% of older people could be considered truly hypochondriacs, according to the criteria established by the DSM-IV. And only a minority of that 3% will come to exhibit such an advanced form of this disorder.
It sometimes happens that hypochondria does not appear until the subject is relatively old. It's quite normal:transition periods, such as puberty or menopause for women, are conducive to the appearance of mental disorders in the face of disturbances or at least physiological transformations.
The hypochondria of the aging subject, if it is manifested by the same symptoms (that is to say the self-diagnosis of "imaginary" diseases), is nevertheless to be distinguished from hypochondria which could be described as "primary "(that is to say inscribed in continuity), because of this different process of emergence. Indeed, when it appears older, psychology tends to consider that hypochondria belongs to the domain of affect and a form of narcissistic injury inflicted by aging, which would thus push to pay more attention to the body. and the functional and subjective degradation of the latter. In other words, it would result from a process of mourning with regard to his body and his past life. It represents an alternative to depression and melancholy, and is thus a way of avoiding a psychic collapse, while nevertheless sinking into a form of psychic impasse. Moreover, in elderly subjects among whom hypochondria manifested late, there is much more insistence on affect and on a form of nostalgia for the past body than among simple "ageing" hypochondriacs.
However, if it is a form of defensive tactic implemented by the psyche to deal with the narcissistic wound that aging represents, it is perfectly normal for hypochondriac elderly people to be in denial when their illnesses manifest. are invalidated. To accept it would be to accept their need to carry out a "work of aging", while renouncing this mode of enjoyment that the repetitive hypochondriac complaint represents for them.
If there is little chance that a hypochondriac person realizes suffering from it on his own, since he is generally precisely convinced of suffering from another disease, it is therefore up to his relatives to try to intervene. . It is also significant that hypochondria manifests itself through a form of appeal to the other – whether the latter is a loved one or a doctor. This is indeed a way of signifying suffering (linked to the aging process in the case that interests us here) which only asks to be recognized. The doctors visited on a regular basis can also engage in dialogue in order to suggest such a diagnosis. Fortunately, hypochondria can be cured. Indeed, the hypochondriac subject is not a lost cause, since he testifies precisely to a form of defense attempt vis-à-vis his narcissistic wounds. It is both a way of expressing one's suffering about aging and of mourning one's aging body, even if in a roundabout way, all within a psychic organization that is ultimately quite stable. In short, a hypochondriac can be led on the path to a healthier way of dealing with their anxieties.
The most common way to deal with it is through behavioral therapy — that is, seeking to identify negative behaviors and thoughts that start the rumination machine, in order to learn to recognize them as such. and to respond to them in different ways when they arise. Other types of therapy may also be helpful, and even the prescription of antidepressant or tranquilizer medications in some cases. But for this, once again, it is necessary to have recognized the existence of this problem and to agree to consult in order to make efforts in the direction of its eradication.
Finally, it is important to change your relationship with your body to be able to get rid of it for good. It should no longer be perceived as a simple entity vulnerable to the outside world and condemned to senescence and decline — on the contrary, it is necessary to reconnect with a playful and sensory approach, to remember that the body can be as much a source of pleasure as of suffering. Depending on your state of health, a sporting activity can be very useful in this respect - it never hurts to maintain your body at an age when it tends to decline, and the effects of regular physical activity on well-being and morale no longer need to be demonstrated. We must not forget more holistic medical approaches, such as micro-kinesitherapy or shiatsu, which will also play a role in rebuilding a different relationship with the body. And since anxiety plays a major role in triggering hypochondria, any relaxing activity, such as meditation, can only have positive effects.
