perfectionism and - Obsessive-Compulsive Foundation

6/14/13
Cognitive-Behavioral Model of
Hypochondriasis/Health-Related OCD
A = Activating health
related event
D = Action taken
to reduce fear, worry
and uncertainty
B = Dysfunctional
appraisal of bodily
sensations
C = Heightened fear, worry
and uncertainty
• The human body is “noisy”
• Most bodily sensations are mild, transient and not
associated with any serious disease - for example:
– Dizziness, faintness, rapid heartbeat from not eating
for a long time
– Rapid heartbeat from eating a meal rich in
carbohydrates
– Arm and joint discomfort from sitting or standing in
one position for a long time
– Stomach pain from overeating or indigestion
– Headaches from being out in the sun too long
– Muscle pain after a lengthy workout in the gym
B = Dysfunctional Appraisal
• Blank-and-White thinking–
– “Bodily complaints are always a sign of disease”
– “I’m only certain I’m healthy if I don’t have any body
sensations”
– “Unless I’m absolutely sure that there is nothing
wrong, I must assume the very worst”
• Negative interpretation bias / disqualifying the
positive
– “Just because these doctors says I’m healthy doesn’t
mean I am. They could be missing something.”
• Catastrophizing- attributing horrible consequences
to minor events
– “I have a headache – I must have a brain tumor”
– “My back aches – I must have bone cancer”
• Intolerance of Uncertainty
– “I must have 100% proof that I’m not ill, otherwise I’m
probably sick”
– “I must frequently check my body and watch my
health carefully in order to catch the first signs of
serious illness”
– “If I stop thinking about my health, even for a short
time, it’s dangerous”
• Superstitious thinking
– “If I tell myself I’m healthy, I’m tempting fate”
– “Seeing a TV show about herpes by chance at the
very same time that I’m worrying about it is an omen
that I probably have it”
– “Worrying about my health will keep me safe from
illness”
• Emotional Reasoning: feelings = facts
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