Hypochondria: A new look at health anxiety, hypochondria, and pathophobia.

Hypochondria, what is it?

Symptoms of hypochondriasis or health-related anxiety disorder involve a concern about being potentially or seriously ill. This assessment is also usually made by the patient based on normal bodily sensations (such as a rumbling stomach), or mild signs (such as a minor skin rash). Hypochondriasis can become a debilitating obsessive problem and inhibit people in many ways, it can also consume almost entirely their daily lives and drag friends, co-workers, medical professionals and family into their phobia. Health-related anxiety disorder, sometimes called hypochondriasis, involves excessive worry about becoming seriously ill and may not be based on actual symptoms, but on perceived symptoms or fears. Patients may believe that normal body sensations or minor symptoms are signs of a serious illness, even though a thorough medical examination may reveal no health issues. Patients may experience extreme anxiety believing that bodily sensations, such as muscle twitching or fatigue, are confirmation of a specific or serious illness. This excessive anxiety - rather than the physical symptom itself - leads to severe distress that can disrupt the patient's life. This disorder can become a long-lasting condition that fluctuates in severity and chronicity. It can increase with age or in times of stress.


Symptoms of hypochondria:

  • Being concerned about having or contracting a serious illness or health problem.
  • Worrying that minor symptoms or bodily sensations are a sign of a serious illness.
  • Get easily alarmed about your state of health
  • Having little or no reassurance from doctor visits or negative test results.
  • Worrying excessively about a specific health problem or your risk of developing a health problem, because it's a trait in your family.
  • A high level of distress about possible illnesses prevents you from functioning.
  • Check your body repeatedly for signs of illness or disease.
  • You often make doctor's appointments for reassurance - or you avoid medical care for fear of being diagnosed with a serious illness.

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Society and hypochondria

In the modern age, the adoption of healthy lifestyles and the increased medicalization of society have unquestionably improved the health of most nations. Taking care of one's own health and taking responsibility for one's physical well-being is admirable and effective if managed correctly, but the obsessive focus on continuous medical check-ups, excessive exercise to avoid disease and hyper- vigilance to any kind of physical fluctuation, can have the direct and opposite effect and contribute to the establishment of an obsessive disorder. Overwatching our own health and well-being can end up causing a real sense of loss of control. It can lead to excessive fear and panic attacks.

How hypochondria works

What seems most surprising in the case of hypochondriasis is that each time the patient receives a negative diagnosis as a result of his continuous health examinations, he finds himself trapped in a continuous spiral of hypochondriac thoughts. and obsessions, usually the patient responding in disbelief that there is nothing sinister about him. In many patients we can also observe that they come for repeated examinations, one after another, to the point that they begin to doubt the specialized consultant they consult. These patients often seek an ever better consultant and even more accurate tests over and over again. This continual and obsessive search for dangerous or threatening symptoms, which begins first with self-monitoring of symptoms and then involves a procession of medical consultations and diagnostic tests for a few months, leads the person to create a generalized phobic disorder based on the fear of being sick or of dying a long and painful death.

The evolution of hypochondria

The patient's continual attempts to solve his problem by trying to control his own health, first develop from a series of obsessive doubts associated with his health and well-being. There follows increased self-monitoring of his symptoms and perceived physiological alteration, and then, through continual repetition of diagnostic tests, he builds up a truly phobic "certainty" that he is ill. As with many doubts, reiteration of doubt shifts it from doubt to certainty, a certainty that is even more real than "reality" (Watzlawick, 1974). At this point, the patient is trapped like a fly in a bottle, endlessly circling in smaller and smaller circles. Each failed attempt to fix the problem increases the current problem. Nowadays, patients most often search for information on the Internet or on "Dr. Google", each vague symptom described on the Internet is translated into a real certainty that they suffer from the described disease.

Understand the difference between pathophobia and hypochondria

What fundamentally differentiates a pathophobic patient from a hypochondriac is that the pathophobic is usually obsessed with a specific form of threat to his health, the hypochondriac, on the other hand, will panic at the slightest alteration in his body, transforming the slightest pain in a sure sign of serious organic disease. The real irony is that the hypochondriac's continual struggle with the slightest feeling of illness can actually weaken their immune system to the point of becoming the architect of their own illness.

 Treatment of hypochondria with brief systemic therapy

Treatment of hypochondria with brief systemic therapy

Systemicist Padraic Gibson sheds light on the treatment of hypochondria with brief systemic therapy. Padraic Gibson is a family therapist and supervisor. He works in Ireland, Italy and Malta. He is a Senior Research Associate and Lecturer at Dublin City University and Clinical Director of The OCD Clinic®.

Hypochondriasis triggers the following dysfunctional solution attempts: 

  • Permanent self-control of the body. The effect of this attempt at a solution is the paradoxical effect that the patient "controls his symptoms and the fear that causes him to lose control". The person becomes prey to an obsessive fixation that causes them to control something that is not controllable and in doing so their control becomes dysfunctional and triggers the vicious cycle that builds the disorder.
  • Medical consultations. This continual search for more complete and better quality diagnostic examinations with the most sophisticated technologies, initially soothing and reassuring for the patient, risks however confirming his problem, because no medical investigation is infallible or one hundred percent sure. cent, but it introduces a doubt that can only be removed by further medical examinations. And so on, in a vicious and obsessive circle.
  • Talk to others. It may be good to talk about our concerns and, after all, "a problem shared is a problem halved", but this common sense wisdom does not work in a positive way for health anxiety. On the contrary, it is resolutely counterproductive, because it serves to feed the hypochondriac disorder.  

LACT trainings to treat phobias and anxiety disorders with the systemic approach

The treatment of phobias and anxiety disorders by the systemic approach is taught in the third year of the LACT course of the Clinician of the Relationship and in the clinical master of Giorgio Nardone .

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