perfectionism and - Obsessive-Compulsive Foundation

6/14/13
Sample Exposures For Health
Obsessions
CBT for Hypochondriasis
Obsession
HIV
Hepatitis C
Food
poisoning
Sample Exposure
Watch movie “Philadelphia”
Touch books on “how to manage your HIV” in
public library
Eating meal in restaurant frequented by gays
Sit in hospital waiting room chairs without gloves
Touch beef blood from meat section of market
Touch dried blood on used Band-Aid
Eat canned foods out of a slightly dented can
Eat meal from “unclean” restaurant
• Supported by a number of studies (Barsky and
Ahern, 2004; Warwick, et. al., 1996; Speckens,
et. al., 1995; Clark., et. al., 1998)
• Offering it as “stress management” more
acceptable to HC patients
CBT for HC – Do’s and Don’ts
CBT for HC – Do’s and Don’ts
Do:
– Acknowledge reality of patient’s bodily concerns
– Explore and validate the patient’s reasons for holding the
beliefs they have about their symptoms – “It’s
understandable that you’ve come to this conclusion”
– Acknowledge patient’s doubts about the role of
psychological factors in their symptoms. Present
psychological factors as “an open question to be further
investigated”
– Get to some agreement that psychological factors play a
role in the experience of pain – example of pain felt by
athletes competing; mothers/fathers rescuing a child in
danger
– Discuss pitfalls of “certainty seeking” strategies such as
doctor shopping, internet research, etc.
– Provide alternative, non-illness related explanations for
the patient’s symptoms
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