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Therapy Eases Hypochondriacs' Physical Pain

Cognitive Behavior Therapy to Teach 'New Ways' of Thinking Shows Promise

Hypochondria Not Well Understood continued...

"What's interesting and valuable about Dr. Barsky's study is that he has found you can use a form of structured psychotherapy to change the way people think. By changing the way they think, it helps them to understand their symptoms in a different way, and not be as frightened by them," says Steven Locke, MD, another Harvard psychiatrist who has studied hypochondria treatment options. "When their fear and anxiety associated with symptoms subsides, the symptoms themselves tend to subside because the nervous system quiets down."

Locke was not involved in Barsky's study, but his own research shows the benefits of therapy on those with medically unexplainable symptoms. In one study, Locke found that symptoms -- along with levels of anxiety -- noticeably decreased in a group of hypochondrial patients who underwent six weeks of group therapy in a classroom setting. "What we used had elements of cognitive behavior therapy," he tells WebMD. "And it was clinically effective."

In another study, Locke says that patients who had medically unexplained symptoms but were not diagnosed hypochondriacs had saved an average of $1,000 in medical costs one year after undergoing this therapy.

Still, despite these promising results -- "significantly lower levels of hypochondriacal symptoms, beliefs, and attitudes and health-related anxiety" among patients getting cognitive behavior therapy -- an important question remains:

How to convince patients who believe they are physically sick to get a thinking adjustment?

"Clearly, that is one of the major problems," Barsky tells WebMD. "From a patient's viewpoint, their problem is medical, so any kind of psychological approach doesn't make sense to them." His advice: This cognitive behavior therapy needs to be "imbedded" in the primary care process, rather than be an external referral to a psychiatrist.


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