J Health Behav Med Hist 2025-7.
The Pathophile Society.
Robert C. van de Graaf, MD, director
MEDTCC Institute for Health, Behaviour, Medicine and its History, The Netherlands.
Adnan Mirza, director.
Heartbeat Ventures, Utrecht, The Netherlands
The Netherlands is making itself sick. That uncomfortable conclusion is central to the new report by the Council for Public Health & Society (RVS): Almost Everyone Sick (April 15, 2025). The Council describes how diagnoses are increasingly made more quickly and more broadly, often in response to mild complaints or even without a clear medical cause. The report identifies diagnosis expansion as a creeping societal problem. The free liver tests that were available last week at the RAI in Amsterdam illustrate what the Council means.
As far as we are concerned, it touches on a deeper, more existential phenomenon. We see a society that has become structurally out of balance. People genuinely feel chronically unwell – physically, mentally, socially, or existentially. We live in a context that undermines health: unhealthy food, lack of physical activity, social isolation, work pressure, poverty of meaning, and excessive psychoactive consumption.
The hunger for care is therefore not only cultural or psychological, but also a real reaction to a life that is becoming increasingly difficult to bear. Care has become one of the few socially accepted responses to this ongoing disruption.
Care has to be about something. And so, collectively, we’ve become increasingly skilled at naming complaints, seeking diagnoses, and adopting the role of patient. Not out of unwillingness or manipulation, but because the system requires it. Whoever wants access to care must demonstrate that this care is medically necessary. Thus, a culture emerges in which being ill – or showing illness behavior – becomes the ticket to help, recognition, rest, and direction.
We call this pattern pathophilia: a cultural fixation on consuming medical care – and thus on illnesses and being ill. Not only to get better, but to find a sense of grip. Care has become a systemic language for what we no longer dare or are able to express in other ways.
As with every form of consumption, habituation arises. The initial reassurance of a diagnosis or treatment is temporary. Soon, more is needed to experience the same feeling of control or safety. Another test, a second opinion, additional explanation. Care is repeated, the patient role prolonged. Not because people want this – but because the system makes it logical and necessary.
And it is precisely this system that fosters unhealthiness. Many chronic conditions are related to our way of life, and the healthcare system primarily focuses on symptom control. Medication and protocols replace meaningful contact, behavior change, and contextual solutions. In doing so, we keep people trapped in a medical ‘loop’: recurring, but rarely healing.
From an early age, we learn that discomfort is something that must be immediately resolved. Sadness? A comforting treat. Pain? A little pill. Not feeling well? Call in sick. We become conditioned to see every signal of disruption as a medical problem. The threshold to care lowers – and with it, the threshold to see ourselves as patients. We seek care not only for physical complaints, but also for relational tensions, identity questions, overload, or existential crises. Questions that belong in social, spiritual, or societal domains – but as long as care remains the only accessible channel, we keep searching through the medical.
We’ve come to see our bodies as defective machines. Doctors as mechanics. And health? Something you only have once a test confirms it. But that image is misleading. Health is not a status on paper, but something alive – relational, changeable, context-dependent. Not every dip is a diagnosis. Not every deviation a defect.
The consequences of this reflex are tangible. Absenteeism remains alarmingly high. Reintegration projects fail. The healthcare system is creaking and groaning – not due to staff shortages, but because of the immense and structurally growing demand for care as grip, as an answer, as reassurance.
The RVS report clearly shows how technology, legislation, and economic incentives reinforce this development. But the deeper layer remains underexposed: this is not just a policy issue – it is a cultural addiction to care, fed by a society that is becoming increasingly unhealthy, and a system that does not make people healthier. That is why we propose: recognize pathophilia as a societal disorder. Not to blame people, but to shift the conversation. Not about the number of diagnoses, but about the logic behind them: a society trying to make life manageable through medical consumption. Not because we seek nonsense – but because we lack a sense of grip.
Recovery from addiction begins with recognition and acknowledgment. Not with more care, but by honestly looking at what we truly need – as humans, as a community. Not another pill, another protocol, another ‘quick fix’ – but a different foundation. We will have to slow down. Learn to endure. And reconnect – with our nature, with each other, with the discomfort that is part of life.
That is where recovery begins. That is where trust emerges. That is where health arises.
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