My cousin complains of being sick all the time, but the doctors say nothing is wrong

Dear Life Coach,

I have a twenty-five-year-old female cousin with whom I grew up and we have been really good friends since childhood. My cousin went away to college for three years and since she returned she has been different; six months after she returned she started working and since then she has been complaining of being sick every day – and every two weeks it is a different complaint – dizziness, headache, stomach ache, cramps, chest pain, numbness in the extremities, etc.{{more}} She is sure that something is wrong with her, although the doctors have found nothing on multiple tests over the last four years. My conclusion is that nothing is wrong with her and that it is all in her mind. For the past three and a half years she has been absent from work more times than she has been present, due to doctor’s visits or being at home on sick leave in bed. I am worried about her because she used to be such fun, but now she is just consumed with being sick and is always at the doctor’s.

Concerned Cousin (CC)

Dear CC,

You are worried about your cousin because she is always feeling sick, yet the doctors have found nothing, and she is no longer any fun due to her health related focus.

What’s Going On:

Here are some factors that contribute to your present situation: hypochondriasis, masked psychological problems, absenteeism from work, a sensitive/understanding doctor, family support.

Hypochrondriasis

Hypochondriasis involves a persistent preoccupation with health and the false belief that one is suffering from physical disease(s). This causes the individual to visit the doctor frequently in search of a diagnosis, but the doctor is unable to find one, since there is no physical illness. The individual also shifts from one complaint to another and insists that something is wrong when a diagnosis has not been found to support the present complaint.

Masked Psychological Problems

Psychological literature indicate that the individual with hypochondriasis is unconsciously focusing on illnesses as a way of shifting his or her attention from the real problem, which is psychological (e.g. depression, anxiety, guilt, feelings of failure, etc). In other words, emotional problems are being masked by physical illnesses.

Absenteeism from Work

Since your cousin’s “illness” started just shortly after she returned from studies and started working, it is possible that she experienced some kind of trauma, either during her period of studies away from home and or from some negative experience(s) at work. It is also possible that she may have experienced trauma during her early development as well.

What to Do:

Sensitive/Understanding Doctor

Since individuals with hypochrondriasis are generally looking for a cure that is non-psychological, your cousin is not likely to seek counselling and should not be so referred. As such, it may be important to get your family doctor on board with helping to treat your cousin. The doctor should be asked to do the following:

1. Not explain away the symptoms as delusional (imagined) to your cousin
2. Not treat with medication
3. Not refer to a psychiatrist
4. Instead the doctor should listen attentively to your cousin, and show care and concern in a kind but firm way
5. Schedule brief (15 to 20 minute) follow-up appointments in which the same is done.

It is important that these supportive visits with your cousin are kept in a medical setting, since she believes that she has a physical problem. According to psychologist David Benner, the person with hypochondriasis should be allowed to keep his or her ‘security blanket’, that is, the belief that he or she is physically ill and be allowed to see a physician. This physician should be willing to play the role of a ‘benevolent authority who uses a controlled, directive, yet patient approach’ with the individual. So, if you are able to get your family doctor to do this, the expectation is that gradually, over time, your cousin will be able to shift her focus from talking about physical complaints to talking about the psychosocial/psychological complaints which are presently being hidden.

Supportive Family

You and other other family members in the mean time should also avoid downplaying your cousin’s complaints of being ill. Family members should listen and show care and concern with respect to your cousins ailments with the hope that with time she will be able to come from behind the mask of physical illness and confront her emotional woes.

CC, it is wonderful that you care so much about your cousin. Hopefully she will be able to confront her deepest, darkest pain and be healed over time.

Life Coach

DYNACII

Need help with relationship and other problems? Ask DYNACII’s Life Coach. Email your questions to dynacii@gmail.com. To Chat with the Life Coach, visit: http://www.dynacinternational.com. Dynamic Action Center International Inc. (DYNACII) a non-governmental organization committed to social and spiritual empowerment.