A hypochondriac visitor who registered for five departments at the same time

Description of the case: The visitor, Xiao A, female, 26 years old, with a bachelor’s degree, lives separately from her husband and works alone in a city outside her hometown, first visited the psychology department. After watching a health TV program 4 months ago, she noticed a strange sensation on the skin of the back of her neck, and since then, she repeatedly touched it and found that there might be swollen lymph nodes in the skin. Xiao A started to worry about this and kept going to the local hospital, but the doctor did not find any obvious organic lesion after the relevant examination. Xiao A did not believe in the doctor’s diagnosis and explanation, and thought: “I am not afraid of anything, just in case, so I strongly requested the doctor to remove the local suspected skin, and the doctor had to perform a simple surgery on the skin of her neck, but after the surgery, the visitor still thought that this part of the skin might become cancerous in the future, and developed to touch the skin of her rear occipital area frequently, convinced that there were swollen lymph nodes in the rear occipital area and that it might become cancerous. A few days ago, Xiao A caught a cold and had nasal congestion and a burning sensation in her mouth. Xiao A went to the Internet to check relevant information and worried that she might have nasopharyngeal and oral cancer, which made her anxious and worried again. She could barely finish her work during the day, but at night, she went online to check relevant cancer knowledge and could not control herself. As soon as she thought her body might have an incurable disease, she would have symptoms such as low mood, lack of interest, poor nausea and difficulty in sleeping, but if she intentionally controlled not to want to, her mood, eating and sleeping would not be significantly affected yet. But now Xiao A found that he could not help himself not to think about “physical diseases”, as if he had been controlled by “physical diseases”, Xiao A suspected a wide range of diseases, so once to a large hospital, at the same time registered for five departments. Diagnostic analysis: Xiao A has a super-priced perception of her physical health, which is manifested as follows: in Xiao A’s consciousness, minor nasal congestion, burning sensation in the mouth, abnormal sensation in the neck and other uncomfortable symptoms are greatly related to cancer or are very likely to develop into cancer in the future. And this wrong and one-sided overpriced concept dominated Little A’s consciousness. Under the dominance of this hyperbolic concept, Xiao A repeatedly visited the hospital. Xiao A does not yet have typical depressive symptoms such as depressed mood, lack of interest, early awakening, and sense of hopelessness. Xiao A’s condition is currently considered mainly as hypochondriacal. Psychological analysis and treatment: Xiao A and her husband live apart and spend only three or four days together every month. Her sexual demands cannot be satisfied, but her sexual energy exists, and this sexual energy cannot be directed to an external object or cathartically through other means, thus directing it to herself. And bet on the excessive attention to this discomfort symptom, when she meets with her husband for a short time, or goes to her mother-in-law’s house (she lives in the same city with her mother-in-law), this discomfort symptom and attention can be turned into invisible or obviously alleviated, which shows that her symptom latent love and sex need. Due to certain life experiences, personality characteristics and the development of information network, Xiao A developed a false cognitive pattern linking her somatic discomfort to cancer in the corresponding area, and this cognitive connection was reinforced by repeated internet inquiries and medical consultations, which gradually formed a hyper-valued concept of symptoms. This overpriced perception gradually dominates Xiao A’s daily behavior and life, affecting her social functions such as school, life and work, and further generating emotional symptoms such as anxiety and depression and generalization of somatic symptoms. The focus of the treatment is to make Xiao A understand the meaning of her somatic symptoms – secondary benefits (the need for love and sex) (under the condition of establishing a good counseling relationship and therapeutic alliance, otherwise it is a barbaric psychoanalysis), but causes the patient anxiety; to confront the visitor’s subjective feelings about somatic symptoms with the objective medical fact that there is no organic lesion on medical examination; to point out that The visitor could produce “symptoms” if he focused too much attention on the corresponding body parts, so that Xiao A could realize that these “symptoms” could be controlled by himself; and in daily life and work, Xiao A should try to ignore, disregard, and not confront the symptoms. In daily life and work, A should try to ignore, ignore, and not confront the symptoms, and develop constructive and growing behaviors in the natural way, including diversionary methods, such as sports and friendships, in order to break the mental interaction. If necessary, A can be put on anxiolytics, antidepressants, and low-dose atypical antipsychotics.