Sam Wollaston describes patients featuring in the Channel 4 documentary on health anxieties - Hypochondriacs: I Told You I Was Ill - as "idiots ... that should be told not to waste doctors' time ... because they are totally fine" (Last night's TV, February 20).
He writes off evidence-based treatments as "rubbish ... that does not work". His freely admitted lack of scientific knowledge on the subject can be forgiven; but even though his comments were intended to be light-hearted, and he states that hypochondria is a serious condition, the article raises questions. Suffering from medically unexplained physical symptoms arouses many emotions, not only in patients but in people around them. It is, however, rare that sufferers and recognised treatments are so disparagingly labelled.
I acted as the psychiatric consultant for the programme, and it would be exceedingly tempting, on behalf of the brave people who agreed to be filmed, to call Wollaston's views ill-informed and offensive. But, in a funny way, his comments are helpful in understanding the origin of the symptoms in question.
Most of us have at some time felt ill without the doctor being able to find even the slightest physical sign of pathology, especially during periods of emotional distress and instability. But believing that you suffer from a life-threatening illness that nobody else will take seriously is a curse that only happens to a minority, whom we stigmatise by labelling them "hypochondriac". The patient will often, in spite of the lack of objective findings, frantically continue to seek reassurance from doctors, claiming that the previous examinations must have been faulty or incomplete.
The cost of the condition is exorbitant on many levels. A strained health service feels pressured to carry out expensive, unnecessary investigations to avoid medico-legal action, while patients are consumed by an intense fear that death is imminent, and believe that convincing others is their only slim hope of surviving. This behaviour has a deeply damaging impact on relatives, especially children.
So why don't these people simply realise that it is all in the mind? Well, this is where Wollaston's remarks are so helpful: because we live in a society where mental conditions are dismissed, the sufferers are branded as idiots, and the treatments are ridiculed. We are not exactly creating a permissive atmosphere that encourages people to say: "You know what, Doc, don't worry about that MRI scan, I think that headache is caused by anxiety rather than a brain tumour."
Knowing that Wollaston's attitude is rife, patients will continue their fruitless search for socially acceptable medical reasons rather than going to see a psychiatrist for cognitive therapy. From my clinical practice as a consultant psychiatrist I know this therapy often works, and offers hope to people whose lives have been shattered.
But using our body as a means of communication of mental malaise will still appear more legitimate as long as we have such negative opinions around. No wonder we are a nation of somatisers.
· Dr Lars Hansen is a consultant psychiatrist and was a contributor to Hypochondriacs: I Told You I Was Ill
