Delusions and parasitosis: psychotherapeutic engagement

As with many psychiatric syndromes, there are multiple etiological factors which seem to play a role in the development of delusions of parasitosis. Our case report suggests that a psychotherapeutic approach may prove valuable in treatment. Acaraphobic and other monosymptomatic hypochondriacal patients, despite an extreme defensive stance, will adhere to and cooperate with a therapeutic process which enables them to voice psychic pain without challenging the validity of a somatic complaint. In finally sharing feelings of deprivation and hurt, the patient can, with some additional rather "concrete" advice, proceed to a point where he no longer must prove the legitimacy of his complaint. By the very nature of this freedom, he can then work with the therapist in a meaningful, rather than stalemated, psychotherapeutic process.