Hypochondria. The illusion of control and ultimate (medical) knowledge

Teenage girl visits doctor

Hippocrates and hypochondria
In the West we have been hypochondriacs for a couple of millennia: the term hypochondria goes back to Hippocrates who described the "disease of hypochondria", a disorder of the stomach and mind, which caused digestive problems, great melancholy and fear of dying. The conjunction of stomach and sadness is not surprising: the Greeks believed that the seat of human feelings and passions was located in the abdomen.
The hypochondria, in fact, are portions of the abdomen, located behind the last ribs and below the lateral portion of the diaphragm (the liver is located in the right hypochondrium and the spleen in the left hypochondrium).

What is hypochondria
In modern times, pathology has evolved: precisely because we have much more knowledge and increasingly precise diagnostic tools at our disposal, the illusory belief of controlling any disease has become so amplified that hypochondria is among the fastest growing disorders for a couple of years. decades now (Giorgio Nardone, Psicotrappole, 2013).

People with hypochondria are so worried about their health that they interpret any signs or changes in the body as confirming a serious illness; they are convinced that they are ill and, for this reason, they live constantly on alert, carefully checking their body and frequently resorting to diagnostic tests and / or undergoing therapy.

Try solutions
In Brief Strategic Therapy, in order to know how problems work, we use those “complexity reducers” called attempted solutions, that is, we study what the person does in an attempt to get out of the difficulty, which turns out to be unsuccessful.

The detection of attempted solutions is fundamental because it is precisely the ineffective behaviors that, if repeated, make the problem persist, risking to further aggravate it if they are structured in rigid and automated scripts of perception and reaction towards oneself, others and the world. . The attempted bankruptcy solutions, if exercised in an exasperated and combined way, can transform a problem into a pathology in a few months.

Try main solutions of hypochondriac disorder
Brief Strategic Therapy, according to the Research-Intervention model applied to thousands of cases in over 25 years of clinical activity, has highlighted some attempted main solutions in hypochondriac disorder:

  • Continuously listen and check for every signal from your body. The effect of this attempted redundant solution is the paradox of "control that makes you lose control": the person is prey to an obsessive fixation that pushes him to act an exasperated control over something that is not controllable; in doing so, the control becomes dysfunctional and triggers a vicious circle that builds the disorder.
  • Undergo frequent medical checks and / or often consult specialists / internet. Effect: if at the beginning the attempts of prevention, diagnostic investigation and the use of examinations with the most sophisticated instruments reassure and reassure the hypochondriac person, the exasperated exercise of this attempted solution can risk making her ill, precisely because of the fear and psychophysiological stress. Often hypochondriacs get so stressed by the constant struggle against every slightest threatening sensation that they lower their immune defenses and literally become architects of what they fear most (Giorgio Nardone, Psychotrap, 2013).
  • Talk to others about the problem. This attempted solution, if repeated, turns out to be counterproductive, as it feeds the hypochondriac disorder: the socialization of worries and symptoms perceived as signs of illness acts as an amplifier that increases obsessive worry; the attempts of reassurance by others, instead of reassuring the person, will insinuate new doubts that she will try to quell with new requests for reassurance, trapping herself in a dysfunctional and recursive vicious circle.

Treatment of hypochondria in Brief Strategic Therapy

In Brief Strategic Therapy, once the functioning of the problem has been investigated and the attempted redundant solutions have been recognized, we make use of the treatment protocol developed "ad hoc" for the specific disorder on which we must intervene. In the intervention phase, the first task of a Strategic Psychotherapist is to interrupt and neutralize the attempted bankruptcy solutions, precisely because they are responsible for the disfunctional, disabling and suffering-generating vicious circle.

In the case of the hypochondriac patient, the elective maneuver is aimed at “dismantling” the attempted solution of constant body control and is called a “hypochondriac check-up”. The therapist instructs the patient to self-monitor himself during the day (the number of times depends on the cases) and to note each time the perceived symptoms and possible diseases associated with these symptoms.

This "prescription of the symptom" generates various effects: first of all, the person regains a voluntary and functional control, ceasing to be the prey of obsession; moreover, the deliberate search for the signs of illness in the pre-arranged appointments and in the prescribed manner, will cancel the frightening sensations that those signals caused… as long as the signs are found !. At the same time it will be necessary to interrupt the incessant request for reassurance through diagnosis and specialist consultations.

"That pathogen, a thousand times more virulent than all microbes, the idea of ​​being sick"
(Marcel Proust)

Dr. Lara Ventisette (Official Psychotherapist of the Strategic Therapy Center)

Nardone, G. (2016). Panic Attack Therapy. Milan: Ponte alle Grazie. World Health Organization (2002). International classification of functioning, disability and health. Gardolo: Erikson Editions
Nardone, G. (2016) Psychotrap. The sufferings we build for ourselves: recognize them and fight them. Milan: Ponte alle Grazie.

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