A cognitive-educational treatment for hypochondriasis

Hypochondriasis may be conceptualized as a disorder of perception and cognition, in which somatic sensation is experienced as abnormally intense and is then incorrectly attributed to serious medical disease. We describe a therapy to modulate the hypochondriacal patient's somatic sensations, and to alter his or her cognitive appraisal of them, which focuses on four factors that amplify somatic symptoms: (1) attention and expectation; (2) symptom attribution and appraisal; (3) the context used for interpreting the symptoms; and (4) disturbing affect and dependency needs. This therapy, or selected portions of it, can be employed in clinical work with patients individually and in groups, in consultation work, and in more traditional psychotherapeutic settings.