Hypochondriasis in which one suspects that one is suffering from a disease and has no disease
Pathological concept
When a person is in a bad mood, in addition to mental discomfort, he or she will also feel bad physically. For example, back pain, backache, headache, poor appetite, weakness of limbs, etc. If a person focuses his attention on these physical discomforts, he often complains to his family, friends, relatives or physicians, saying that he is not feeling well there, saying that he does not feel well here, and asks the physician to give him a checkup, and the result of the checkup is not good, he wants to do another checkup, or he is not satisfied or does not trust the physician, and seeks another physician to see him. The medical term for such a condition is “hypochondriasis” when you are always worried or suspect that you are sick. This is a common type of neurosis that can occur in women who are in a bad mood, elderly people who are lonely, patients who are often ill, or children who are weak and often overly cared for by their parents.
Clinical characteristics of hypochondriasis
When patients experience psychological difficulties, they focus their mental attention on their own bodies and become sensitive to physical reactions, complaining to physicians, family members or friends about various physical discomforts in order to arouse the concern of others. Even after the physician has given the required physical examination and stated that there is no good reason to consider a physical illness, the patient continues to suspect or worry that he or she has a physical illness, especially cancer or other serious illnesses, and continues to complain about physical symptoms. Hypochondriasis is similar to “somatization disorder” and is characterized by excessive concern for the body and constant complaints to others about one’s physical symptoms.
Clinical considerations
From medical experience, there are many real physical illnesses that present physical discomfort at the beginning of the illness, but there are no specific symptoms for physicians to speculate about the illness, and even with the use of various modern medical tests, the truth of the illness is often not found. Therefore, if a patient complains of discomfort everywhere, the physician should not just assume that it is the patient’s psychological effect, nor should he or she easily give the patient the name of “hypochondriac”. The physician must still make the necessary observations and examinations on a regular basis according to the medical judgment. However, on the contrary, patients suffering from hypochondria, go around asking for medical examinations, repeatedly doing some unneeded scopolamine tests is not only a waste of money, but also invariably makes the patients themselves stagnate in the state of hypochondria, unable to get appropriate psychological counseling, as patients, to consider what kind of situation should be complained to the physician of their symptoms, do not over exaggerate, and do not solid small things and loudly ask for help, performance “As a patient, you should consider what kind of situation you should complain to the physician about your symptoms. Therefore, it is very important for the patient and the physician to cooperate with each other so that the physician can pragmatically observe, pay attention and decide on the required tests.
For the typical, psychosomatic hypochondriac, the pathological understanding is that the patient is unable to face the psychological difficulties or frustrations and turns to his or her body, complaining about the physical symptoms and subconsciously trying to savor the physical problems in exchange for the concern of others, which can be described as a “cry for help. Young children often cry about physical discomfort to get their mother’s care and attention, so it can also be said to be a “regressive behavior”. If a child often uses ill health as a way to avoid school or chores, it is important to consider who is allowing the child to continue to use this excuse to avoid facing responsibility. Just like an opera singer who needs an audience, he or she needs to be heard and cared for in order to achieve the patient’s goal. Usually it is the soft-hearted and loving parents or grandparents who are “taking care” of the child’s suspicious tendencies. Therefore, treatment must include the family.
This kind of suspicion and complaint behavior is also common in older people, in patients who have been bedridden or disabled for many years, or in women who are left out and not cared for. Because it is not easy to solve problems in other ways, in order to obtain the care of others, they have to use physical problems to get the attention of family members or doctors.
In a special case, this psychological condition of complaining about physical discomfort and worrying about illness is the result of “imitation” or “identification”. For example, after her mother died of a heart attack, she became extremely sensitive to the discomfort in her chest, pressing her pulse all the time, often asking for an electrocardiogram to check her heart, and even rushing to the emergency room when she was slightly nervous about her heartbeat, fearing that she was suffering from a heart attack. In such a patient, it is not difficult to understand that her suspicious behavior is imitating her mother’s original symptoms, and that the symbolic maintenance of contact with her mother by playing the role of her condition is a manifestation of a psychological self-defense mechanism against loss, i.e., the identification with the lost person to eliminate the feeling of loss, which is called “identification with the lost person” in psychology.
The essence of treatment
People who suffer from hypochondriac tendencies should remind themselves not to worry too much about their physical condition, to see a physician, to do the necessary tests according to the physician’s judgment, to listen carefully to the physician’s advice and instructions, and to practice “proper” attention to their physical condition. It is best to do your own scopolamine discussion, study your own psychological state, consider what you need, what difficulties you have, what other ways you can seek psychological satisfaction, and how you can solve the difficulties you face. Do not rely on complaints of physical discomfort to face the problem.
When family members or medical practitioners want to help a patient who is suffering from resistance, they should grasp the pathology of resistance and slander the patient to use other, more mature methods to face the difficulties he or she is experiencing, instead of coping with the problem by suspecting or complaining about the disease. Although the principles of treatment are simple, it is important to pay attention to the patient’s psychology in terms of treatment techniques, especially how to explain and instruct the patient. If the patient is directly confronted with the problem in a straightforward manner, pointing out that the suspicious behavior is an avoidance of the problem and an act of begging for attention, it will cause the patient to react with resistance and refuse to admit that he or she has such a tendency. The focus of treatment should be on how to help the patient to solve the problem, not on talking through the crippled person’s hypochondriac behavior. If there is a child who complains of poor appetite every morning when he wakes up and does not want to go to school, we should help him to explore where the reasons for not wanting to go to school are and deal with the real reasons for the fear of going to school. As a parent, don’t be overly soft on your child, and don’t let your child stay at home and give extra care, so that your child doesn’t go to school and have extra pastoral care at home. Reducing the “collateral” benefits of suspicion and helping the child return to school as soon as possible is the key to treating the fear of school.
In the case of a wife who has been neglected by her husband or an elderly person who has been abandoned by her family, it is important to assist them in maintaining relationships with their spouse or family in a healthy way and to obtain attention instead of seeking care from others in a pathological way. The more suspicious or complaining a wife is, the less she will receive true “spousal” affection from her husband, and the more pity she will receive from the “sick” person, which will not be beneficial to the establishment of a lasting relationship. The same is true for the elderly, who rarely get liked by others when they complain too much about their illness. Some patients with hypochondriacal tendencies come to the physician with the subconscious intention of receiving the warmth and attention from the physician that they do not receive at home. The therapist must be able to see the motivation behind this behavior and provide appropriate professional care while helping the patient to get the care he or she needs in his or her own family or circle of life so that he or she does not have to rely on the physician for long periods of time to resolve the emptiness within. Needless to say, it is not healthy for the therapist to take care of such a patient with a “savior” mentality for a long time, as this not only does not help the patient to solve the problems he or she is facing, but also keeps the patient in the role of “patient” for a long time.
It is necessary to clarify the definition and concept of neurasthenia
Although the term “neurasthenia” is commonly used and people seem to be familiar with what it is, there is still debate among psychiatrists in the East and West about the name of the disorder. In terms of medical history, the name “neurasthenia” was given by an American psychiatrist at the end of the 19th century. This phenomenon was thought to be the result of long hours of monotonous work or poisoning by chemicals in factories, which weakened the facial nervous system. Based on this pathology, it is recommended that patients with such symptoms take physical rest and nutrition, including various vitamins or supplements, to help the “weakened” nervous system recover. It was also hypothesized to be related to excessive masturbation, and the regulation of sexual life was advocated. At that time, Western medicine believed that all diseases were caused by organic causes, and therefore, according to the knowledge at that time, it could be said that this was the natural explanation and advice. At the beginning of the 20th century, the concept of psychogenic Ichiru sprouted, considering neurasthenia as a psychosomatic disorder caused by excessive psychological tension and anxiety.
In recent years, psychiatrists in the United States believe that patients suffering from this disease are caused by long moving mental fatigue, and renamed it as chronic fatigue disorder. It is believed that the nervous system itself is not really weakened, so it is advocated to remove the name of “neurasthenia” from the disease because these patients often complain of physical problems, so they are also classified as “somatization disorder”. When the knowledge of early psychiatry was introduced to our country, the name “neurasthenia” was also introduced along with it. Since Chinese medicine in China has always had the pathological concept of organology, it believes that various diseases are related to the internal organs of the body, such as the heart, lungs, liver, spleen and kidneys, and also has the painful name of “kidney deficiency”. According to Chinese medicine, the kidney is the main energy organ, and if the kidney has a problem, energy cannot be preserved and weakness is produced. Since this old traditional concept coincided with the concept of “neurasthenia” introduced from the West at that time, the name and concept of “neurasthenia” was generally accepted and is popular today. In fact, in remote rural areas, psychiatrists diagnose 70% to 80% of outpatients as suffering from neurasthenia, so it can be said that the term “neurasthenia” is used to refer to various mild mental illnesses in general. In the psychiatric clinics of the more sophisticated medical schools, less than 20% of the outpatients were diagnosed with this disease, while the rest were carefully diagnosed with anxiety, depression, hypochondria, or hysteria. This can be seen in relation to the diagnostic habits of doctors.
Major medical condition
Psychiatrists believe that patients suffering from neurasthenia often have many physical symptoms, including poor concentration, poor memory, inability to think well, poor sleep, etc.; sometimes they also complain of various mood problems. Such as irritability, poor mood, etc. On closer examination, sometimes the patient has a tendency to suffer from anxiety or depression, and also has the characteristics of somatization disorder, which can be said to be a mishmash of various diseases, and it is difficult to make a clear diagnosis.
Direction of treatment
There are several directions to treat neurasthenia. Let the patient reduce excessive mental work and engage in light physical activities. For example, practice boxing, light exercise, or even regular running or walking to help recover from mental fatigue by physical activity. Especially for students or brain workers who are over-exerting themselves, a change of lifestyle can regulate the activities of the mind and body. It can be said that regulating the lifestyle is the main key. It is not necessary to take any drugs or supplements, as long as the nutrition is adequate. If you have internal worries, you can deal with them according to the principles of psychotherapy and solve the problems; if you are happy, you will get better quickly. In the past, the domestic “rapid integrated treatment method” is the use of these principles to achieve effectiveness. If the patient has a tendency to be hypochondriac, wants to rely on the symptoms of the complaint to seek the concern or sympathy of others, or needs to escape from the burden of study or work, we need to use different methods to counsel and treatment.