Hypochondria: The Impossible Illness

For millions, (t us said to take up 5 to 10% if Doctors' time in the US and in Britain for such patients encroaching on Doctors' time a sniffle is not merely the sign of a full blown cold, but influenza and then what, pneumonia and God forbid the man standing with that scythe announcing with a  doom laden drumroll, DEATH!
 Hypochondiacs  suffer from an intractable belief that physical symptoms are a sign of serious illness even when medical evidence indicates otherwise. 
And Hypochondria accounts for at least 5% of all general Health Service  consultations Some people are chronic hypochondriacs, while others regress to it after disappointments in love or work.  Divorce, unemployment, breakups and other disturbing life events can trigger somatic physical complaints and the fantasy of some almighty doctor who can cure them.

There are two kinds of hypochondriacs. The first type is those who tend to feel all sorts of bodily sensations more intensely than the average person. They attribute fatal diagnoses to everyday sensations like cold hands, indigestion, or a twitching eyelid. Then the read about symptoms  Internet and then imagine having them. The second category of hypochondriacs are somatizers. They have actual symptoms—what Freud called "conversion hysteria."  Psychological conflicts are converted into bodily experiences which can range from heart palpitations to paralysis of a limb.

In addition, getting tested for everything all the time does not work because the window of relief is brief.  Hypochondriacs, are not looking for a cure to their ailment, but rather a witness to their suffering. They are missing an internalized good mother who is concerned for the child's symptoms and expresses empathy for their pain. They go from doctor to doctor desperately seeking an omnipotent professional able to sort out all the disappointments of earlier doctors. But the inevitable disappointment of the idealized doctor results in criticizing his/her incompetence, making the doctor less sympathetic to their pain. Often the patent's perpetual dissatisfaction alienates spouses, friends, and relatives as well, creating a self-fulfilling prophecy.  
Doctors often try to refer hypochondriacs for psychotherapy, but find the patient is resistant to the idea that their problem is psychological rather than physical. The patient feels dismissed by an uncaring doctor. There are two things that the physician and/or psychotherapist must understand in order to maximize the chances of helping the hypochondriac or, at least, staying empathic. First, being ill may be a central part of the hypochondriac's identity. To give up being sick may be experienced as losing his sense of self. Second, the hypochondriac needs a witness to his pain or anxiety. He needs affirmation that it is REAL. You must demonstrate that you believe him and understand how pained and frightened he is--but the cause is not organic.