In Jerome K. Jerome’s 1889 classic of English comic writing, Three Men in a Boat, the narrator describes his experience of reading a medical reference book in some detail. “I plodded conscientiously through the twenty-six letters,” he notes, “and the only malady I could conclude I had not got was housemaid’s knee”—for every single other disease from A to Z, he recognizes at least some of the symptoms in himself.43
In the century since Jerome’s gentle satire, self-diagnosis has swelled from being a neurotic habit of the middle classes to something far larger—a health obsession that the increasing availability of free information has swelled to epidemic proportions. In its digital incarnation, the trend is sometimes called cyberchondria—a digital variant on the term hypochondria, and an etymologically unsound one at that, hypochondria being derived from the ancient Greek hypokhondria, “upper abdomen,” the region of the body from which feelings of general melancholy without a specific cause were once thought to originate.
As a term, cyberchondria dates back at least to 2001, but it’s only more recently that it has begun to achieve specialist as well as public usage. An academic paper entitled “Cyberchondria: Studies of the Escalation of Medical Concerns in Web Search” appeared in 2008 from Microsoft’s research division, for example, highlighting the ways in which the deluge of both medical information and disinformation online can fuel the impulse to self-diagnose.44
Perhaps a more intriguing phenomenon than mere cyberchondria, however, is “Münchausen by internet”—a peculiarly contemporary variant on the mental illness Münchausen by proxy. Both conditions take their name from the legendary figure of the Baron von Münchausen, whose tall tales have provided a European archetype for the tendency to tell wildly exaggerated, attention-seeking stories.
Münchausen by proxy describes a psychological disorder in which someone seeks attention by telling false or highly exaggerated stories about someone else, giving it the “by proxy” label. A parent suffering from the condition might, for example, repeatedly claim their child is unwell, even going so far as to simulate the symptoms of illness in that child.
The term Münchausen by internet was coined in June 1998 in an article coauthored by psychiatrist Marc Feldman,45 but the behaviors it describes date back to the earliest days of the world wide web, and involve people seeking attention by telling false stories about their own illness and suffering online. A sufferer might, for example, construct an elaborate story about a terminal illness online, and seek out sympathy and advice via websites and forums devoted to helping genuine sufferers of the condition.
One early famous case of Münchausen by internet was perpetrated between 1999 and 2001, when an American blogger constructed a false identity called Kaycee Nicole, allegedly a teenager suffering from leukemia whose writings gained a huge following. Kaycee was in fact the creation of a forty-year-old healthy woman called Debbie Swenson, who wove together online research and others’ stories in order to create her fictional life—a quintessentially contemporary blurring of research, fact, fiction, and online interaction.46