When you have a rumble in your stomach, do you conclude it must be stomach cancer? If you do, you may have hypochondria, a much ridiculed condition that at least in Norway is being taken very seriously.
Sympathetic doctors are curing people of ailments they don't really have
At the emergency room at the Deaconess Home Hospital in Bergen, people wait to be treated for broken legs, burns and other mishaps.
But next door, another doctor is receiving patients who he knows there is nothing wrong with -- at least not in the traditional medical sense. Because in Norway, it is possible for people who believe they are very ill to be referred to a specialist in hypochondria, who will help them be cured of what they haven't got.
Dr. Ingvard Wilhelmsen runs what is probably the world's only hypochondriac clinic in the coastal city of Bergen. Patients are usually referred to him by their doctor or a psychiatrist. Through cognitive therapy he tries to make patients realize and accept that their real problem is not a genuine disease, but the anxiety they feel about health.
"People with hypochondria - excessive health anxiety - always were told what they didn't have - they didn't have cancer, they didn't have heart disease," he said. "But seldom were they told what they actually had and what to do about it. So I wanted to focus on that one."
It takes some courage, it takes communication skills, to tell a patient 'we're going to shift from searching for disease to talking about the way you interpret symptoms,' he says
"I am afraid of dying"
In a Bergen suburb, Annette Hammersland plays with her 6-year-old daughter Emilie. Annette is a hypochondriac, and one of Dr. Wilhelmsen's patients.
"Now I have a pain in my arm, and I have to use a lot of energy and a lot of my brain to accept that this is not cancer," she said. "I'm very afraid of dying because of my children. I'm the most important person in their lives --I think that's why I'm very concentrated on myself when I'm ill."
So is Annette a typical hypochondriac? She certainly ticks a few boxes in Dr. Wilhelmsen's book.
It isn't this type of treatment hypochondriacs need.
"The underlying thing is that they have a demand not to die now," he said. "Maybe they've got a child, and they cannot die now, or they and believe they can't die before they do. Of course you're bound to misinterpret symptoms if you believe everything is very dangerous the moment you get them. You have to accept that you are mortal, and don't spend too much energy on controlling death. That's my advice to them."
"I was in a black tunnel"
In one of the lecture halls at the Bergen university hospital, Oddvar Aamdal is speaking to a group of psychology students. Thanks to the clinic, he's a reformed hypochondriac.
"I was in a black tunnel, and I didn't see where to go," he tells them.
Mr. Aamdal looks healthy. At seventy-two, he has the healthy glow and straight posture of a man thirty years his junior. In his head, though, he was a very ill man for all of sixteen years.
"I had cancer in my head, I also found out that my legs were very bad and there was something wrong with my stomach," he said. "So I always found something wrong. When the doctor said for example 'your head is OK,' then I found another part of my body was wrong."
Also in poorer countries
Some fifty thousand Norwegians have hypochondria. That's 1 percent of the population. Dr Wilhelmsen's treatment is covered by the state health service. But isn't all this the imagined problems of a rich, modern Scandinavian nation?
"In fact not," WIlhelmsen says. "The tendency to not be willing to die is something you find all over the world, also in less developed societies. In poorer countries, they have the same health anxiety -- but they don't have the same means to pursue it."
Annette Hammersland feels better after her treatment, but knows she has a way to go.
"I hope these thoughts will fade," she said. "I hope that when I look at myself in ten years, I will say 'yes I have these thoughts, but I don't have them every day.' Maybe it will be once a month. Then I will be satisfied."