In the field of medicine, every doctor occasionally encounters a patient who, to put it simply, refuses to believe they are healthy. The patient will come to the doctor with some complaint (a pain, an ache, a soreness) and ask to be examined. The doctor, to the best of his or her ability, will do this, and then may order blood tests and other diagnostic procedures. At the end of the process, the doctor may say to the patient, “We can can find nothing wrong with you. Go home, take care of yourself, and enjoy life.”
This lack of diagnosis disappoints or even enrages the patient, who demands more tests or makes an appointment with another physician. Again, nothing is found. There may be something imperfect about the person (after all, humans are exquisitely complex machines with trillions of moving parts, and medical science is limited) but the patient’s health profile can be said to be good. They are free of disease.
Such people are hypochondriacs, or more clinically, are afflicted with illness anxiety disorder, also known as health anxiety. The National Institutes of Health estimates that up to 10 percent of the general population can exhibit hypochondria at some time, with a lifetime prevalence of nearly 6 percent. A more serious condition, illness anxiety disorder (IAD), which is an intense fear of serious illness with minimal or no physical symptoms, affects about one person in five hundred. These are complex conditions with no obvious treatment other than calming them and validating their distress without feeding the cycle of panic or endless symptom-checking.
My Book Is Terrible and You Must Fix It
As a book editor with twenty years of experience, this syndrome presents itself among author/clients at roughly the same rate—maybe one in fifty. It’s difficult to detect initially because every new client comes to me with the same problem: They have a manuscript that’s rough and needs a skilled “doctor” to bring it up to a professional, “healthy” level. The first thing I tell them is that books are a form of art, not science, and there is no such thing as a perfect book. Any manuscript can be polished indefinitely. At some point, you just have to say, “This is as good as it can humanly be, so we’re going to publish it.” One hundred percent of my new clients tell me they understand this, and, having agreed to our expectations, we set to work.
The vast majority of authors work with happily me through the editing process, and then, after a few days or weeks (depending on the length of the book), they’re delighted and take their manuscript to the next phase, usually book designing or publishing. Mission accomplished!
But a very few are never satisfied. With every iteration or milestone delivered, they express initial excitement and gratitude, but as we pass the text back and forth, often many times, there’s always something new to worry about. Does this point belong here? Is this section boring? Does this part seem redundant? Is this transition strong enough? Can we move this paragraph? Do I need a footnote here?
I try to reassure the client that their book is excellent, deserves to be published, and can compete on the market. But the unease remains.
As the days pass, the problems become increasingly vague. The client will insist the text doesn’t “flow” well. When I ask them to point out specific problem areas, they cannot. They tell me it’s simply “not good enough.” I try to coach them and encourage them to focus on their mission and how they can help the reader, but my entreaties are ineffective. More ominously, they may express anxiety about how their book will be received, especially (for non-fiction self-help books) by their professional peers, whom they may describe as sharks. They may even say they fear being sued, even though such an event is extremely rare.
Often, as I think back, I remember the clients with author anxiety disorder will have informed me at the very beginning that they had worked with another editor who was terrible, and could I give it a shot? This can be a red flag. It’s like the hypochondriac who’s doctor shopping.
At some point, you realize you cannot assuage their anxiety and you have no choice but wish them good luck and step aside.
Author Success Syndrome
To be sure, there are wonderful clients who, with a positive attitude, work very hard to improve their books. I recently assisted an author from Los Angeles who had suffered a debilitating disease and spent years in treatment and therapy, until, frustrated with the medical establishment, she designed her own therapy that worked for her. In the process of writing and editing her book, we spent months passing drafts back and forth, rewriting sections, making changes, and adding new information. The task seemed endless, but she was enthusiastic and determined. Eventually she published her book and it became a category bestseller. She’s an example of someone with “author success syndrome”—conscientious, driven, and eager to tell her story to the world. For an editor, those are the clients who make you jump out of bed in the morning, ready to go to work!
