Help, I’m sick and nobody believes me anymore!
Fear of getting sick
” When I woke up this morning I noticed a slight spasm in the left hand, like a tremor… I asked my wife what it could be but she liquidated me saying that in recently I have done more checks than anyone else, that would be nothing and that I have to stay calm. I try, but the thought that many serious neurological diseases start right from similar annoyances is tormenting me.I’m risking of underestimating a serious symptom and to end of our goalkeeper, who is now disabled and in bed, he also thought he had nothing serious… “
The fear of having or being developing a disease is a rather widespread problem. In the past it was called hypochondria, a word that survives today in common language.
In the new edition of the Diagnostic and Statistical Manual of Mental Deseases (DSM V), the American Psychiatric Association inserts this class of disorders in the category “somatic symptoms and related disorders”.
Inside this category we find the somatic symptom disorder and illness anxiety disorder. The first is when the person develops a strong stress and a decrease in functioning due to the fear associated with bodily symptoms. These symptoms are objectively present. Disease anxiety is characterized by an excessive fear of contracting a disease, in the absence of major symptoms at body level.
Passing over the manual definitions and the precise criteria necessary to put these diagnoses, let’s see what it is from a psychological perspective.
Somatic symptom disorder (ex hypochondria)
The person with somatic symptom disorder typically is very anxious about the presence of one or more symptoms (cramps, fasciculations, pains of various kinds and in different body locations, etc…) because it fears that these could be related to a serious illness, usually deadly or severely disabling.
The person spends much of the time worrying and brooding about this possibility, even when medical checks rule out the disease.
He/she spends hours sifting the hypothesis that could be this or that pathology, or another, that haven’t been correctly diagnosed by the doctor yet.
Often asking for reassurance from family and friends, as well as from doctors, about the possibility of being actually sick and about the hidden meaning of these symptoms. Vividly imagining the worsening and painful course of illness and their own death.
In constant alert, keeps track of every change in the body. Paplating, tpuching and checking for answers.
Those who suffer from this disorder present objective symptoms, so it would be incorrect to define them as “imaginary patients”, but their interpretation of these symptoms and the resulting stress are excessive.
It also cause a significant deterioration of the personal functioning and their relationships, because it is often so that they are called by friends or partner, exhausted by the constant requests for reassurance.
Illness anxiety disorder is characterized by the fear and anxiety to get sick of some serious pathology, along with many of the characteristics of the disorder just described. The difference is that the fear of illness is not related to the evaluation of a present bodily symptom, but to the possibility of developing a medical condition.
Both these anxiety disorders are based on a vulnerability, coming particularly from stories of childhood hospitalizations and history of diagnostic uncertainty over a medical problem. The conviction of being weak, on a physical and psychological level, may have formed in a familiar environment in which this characteristic was emphasized and explicitly attributed .
The person also lives in a condition of not accepting the risk of getting sick. A risk that concerns everyone clearly, but that in particular personalities would confirm the idea of weakness and therefore the inability to face a negative event, as a disease.
These conditions begin as a result of decompensating events, also of small magnitude, such as the need for a medical procedure for oneself or for someone close, or following the death by illness of a known person.
The conditions are in equally distrubuted between the man and women.
How the disorder works
The concern feeds and keeps itself active under the weight of vicious circle mechanisms that characterize the behavior of these people.
Controlling and directing attention to every body signal are some of them.
When visiting the doctor, they are able to select elements of the communication that could be misinterpreted. For example, the advertising of a longitudinal check is translated into the possibility that the clinician has doubts and wants to see him again because he fears there could be a pathology.
The continuous internal debate, searching for confirmations, aground in some cognitive distortions that end paradoxically in increasing the concern, in an attempt to solve it.
The search for information and diagnosis on the internet.
The “magical” belief that if you continually think of something that scares you then it can be prevented, or that you’lle be ready for the unpredictable.
Creating mental scenarios in which you see yourself sick and suffering also increases the state of emotional distress and has the effect of perceivig an event more likely than it really is.
There is often skepticism about doctors and health care professionals.
The psychologist in particular is the last hope.
The person goes into psychotherapy more often under the demands of others than for a true motivation, so these are patients very prone to drop-out of therapy .
The mental position with which these patients come to the psychologist is often to prove to everyone, and also to themselves, that there is a problem, which is not psychological, but in the body.
Cognitive psychotherapy aims to eliminate recursive mechanisms that feed the disorder, even through the sharing of its functioning to the person. When you establish a strong therapeutic alliance between client and therapist, then you can trigger a deeper change.
Through the reconstruction of life history and sensitizing events, the person finally understands the true function of his/her problem. This function is to protect some of its existential purposes of great value, such as being always healthy, not being in a position of weakness, physical and emotional, always be cautious and do not leave anything to chance.
Finally, of great clinical usefulness is working on risk acceptance . With a boomerang effect to lower the alert of the person and with it many of the behavioral and psychic factors of maintaining.