Hypochondria and Self-Recalibration

Abstract

Health anxiety is, among other things, a response to a universal epistemological problem about whether changes in one’s body indicate serious illness, a problem that grows more challenging to the individual with age and with every advance in medical science, detection, and treatment. There is growing evidence that dysfunctional metacognitive beliefs – beliefs about thinking – are the driving factor, with dysfunctional substantive beliefs about the probability of illness a side‐effect, and that Metacognitive Therapy (MCT) is more effective than Cognitive Behavioral Therapy (CBT). However, hypochondria is distinct from other forms of anxiety, I argue, in ways that make some reality‐checking techniques of CBT and MCT of limited usefulness. I propose a Re‐Calibration Technique (RCT) that complements these therapies by focusing on a metacognitive belief that has not been studied: the patient’s presumption of his own personal reliability in judging symptoms, an assumption exposed every time he disagrees with a doctor. I propose a technique whereby a patient keeps a long‐term register of every episode of alarm about symptoms and its resolution, possibly years later. When healthcare‐seeking impulses arise the patient then uses his own track record to re‐calibrate his confidence that medical attention is needed. The new technique allows one to improve self‐judgment about whether one has an illness or not by improving self‐knowledge of one’s own reliability.

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Sherrilyn Roush
University of California, Los Angeles

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