In the new DSM-5, illness anxiety is now added to what is known now as the “Somatic Symptom and Related Disorders” category, and according to DSM-5, illness anxiety disorder can be considered either in this section or as an anxiety disorder. Illness anxiety involves preoccupation with having or acquiring a serious, undiagnosed medical illness. Being insubstantially preoccupied of beliefs that one has, or is in danger of developing a serious medical illness despite of little to no somatic symptoms constitutes the main feature of this disorder. The DSM-5 categorizes the condition into two main themes or types: the care seeking and the care avoidant. With care seeking type, individual tends to frequently seek out medical assessments and care, and the avoidant type rarely seeks any kind of medical treatment.
According to Adler (1956), symptoms are product of self-handicapping strategy; when successful, a person can say that he/she overcomes a disability, and as for failure, he/she has a solid excuse. Also, becoming preoccupied with physical symptoms creates little time to deal life and deflecting attention away from the real or perceived failure. For this reason, one choses to suffer than experience the most feared failure. Adler’s theory about organ jargon provides us another lens to use, particularly on the conceptualization of hypochondriasis. Organ jargon is the somatic expression of our inner feelings: “To a certain degree, every emotion finds some bodily expression. The individual will show his emotion in some visible form”.
Moreover, symptoms are believed to describe the direct expression of the individual, however, in hypochondriasis, the symptoms are used to further goals of safegurading self-esteem rather than a direct physical action or expression. Adler views anxiety’s sole function as to exercise control through helplessness: “Once a person has acquired the attitude of running away from the difficulties of life, this attitude may be greatly strengthened and safeguarded by the addition of anxiety.” Consequently, Adler understood that anxiety is a conscious rather than unconscious symptom that helps an individual to safeguard their sense of existence: “It is not so much our concern that anxiety influences the sympathetic and parasympathetic nerves. We look, rather, for the purpose and end of anxiety.”
Johansen (2018) believes that lifestyle themes are the controller, the driver, and the need to be good/perfect/right is center of this neurotic condition. The primary goal of Adlerian Therapy for clients with illness anxiety disorder is to provide help or assistance in discontinuing withdrawal from or avoiding life and learn to accept the possibility of failure. Also, to help them deal and tolerate the uncertainty of life, and ultimately give up thoughts about having serious medical condition that significantly preoccupy them. AT also targets client’s inferiority complex and basic mistakes depending on the client’s lifestyle theme. Because many clients with illness anxiety disorder will experience strong underlying fears of death or sever disability, and helping them in learning to tolerate uncertainties sometimes feelings of inferiority breeds is also an important treatment goal.
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