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Dr. Michael
Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience:  Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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I live with my son and daughter in law who is a hypochondriac

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I live with my son and daughter in law who is a hypochondriac which has been intensifying each day. She will acknowledge she knows its in her mind but we know she doesn't believe it. I am 69 and went back to work to support them and a 7yr old grandson so I am at work every day. My son was laid off and can't find a job. They were evicted and so we moved in together. I am becoming concerned about the well being of my grandson. My daughter in law is constantly irritated at him. She has no patience with him. Do I have cause to worry about him. We have been urging her to see a therapist.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Michael replied 2 years ago.
Hello. I believe I can be of help to you with this issue.

It may be true that your daughter in law isn't getting help from antidepressants---only about 1/2 of people who take them do. On the other hand, it is also true that she needs therapy and would greatly benefit from it.

What you can do to further encourage her to seek therapy is to start LISTENING more closely (her husband can do this as well) to her complaints and especially, her physical symptoms. When you have a good, recent 'record' of her physical complaints, mentally tie them to her emotional distress and feelings of irritability, unhappiness. Second, locate a clinical or counseling psychologist who specializes in anxiety disorders or better still, what is called clinical health psychology. They work with hypochondriacs all the time and typically counselors and social workers etc., don't have specialized training in this area. So make some phone calls and pre-interview a dozen or so prospective therapists on the phone and assess whether they work with patients with what are called "SOMATOFORM" disorders. Now, typical counselors won't really know what you are talking about and may make the mistake of mentioning 'psychosomatic' illness or complaints. If they use this term, you know they don't have the training or experience needed to be helpful. Or, if the can't answer the question, "What do you do exactly, to help someone who has hypochondrias is?". If it sounds like 'talking therapy' or trying to 'understand what is underlying the complaints" you again, don't have the right therapist. But if they say that they focus primarily on helping the person see the relationship between their health symptoms, the fact that their symptoms change or get worse during periods of anxiety, stress or conflict, then you know you have someone who understands what is happening with hypochondriasis. So what you want to do is to identify1-2 specific names of psychologists you can give your son, whom you feel are pretty capable and could help.

Then, your son needs to sit down with his wife and explain that the relationship is deteriorating and that he is convinced that the health problems she is having start up and also, get much worse when she is feeling stressed, lots of anxiety, when they are having a conflict, or she is intensely unhappy. He can then explain that he knows of a couple of doctors who can help her with the stress, anxiety, depression and unhappiness she is experiencing and this in turn, is guaranteed to improve her level of physical symptoms and illness. It won't cure these symptoms necessarily, but her symptoms are having an effect on her emotional functioning and her emotional difficulties do make her symptoms much, much worse. So she can get quite a lot of help with the emotional symptoms that are tied to her health problems. it is helpful to give several examples of how her emotional symptoms are directly tied to her becoming more ill, an exacerbation of her symptoms, or are coincident with new complaints. He needs to think about the details of this, and rehearse to himself how he will present these examples and the connection between her symptoms and her emotional distress. He can even suggest to her that he thinks her main underlying problem is a combination of anxiety, unhappiness and clinical depression---he should use these terms in describing it.

He can also offer to go into marital counseling with her; he should frame the need to go to counseling together as a 'communication' problem and his willingness to try to improve their relationship. The marital therapy is a good idea because the PURPOSE of the therapy is to fix the relationship and communication. It is more tolerable to many people because they aren't specifically the 'identified patient' or the 'problem'----the problem is a relationship problem. If she doesn't want to have any of the above offers or suggestions, he may need to then, create an emotional crisis in her life by suggesting that the current situation cannot continue and if there is no therapy, he needs to consider a period of trial separation from the relationship to figure out "what to do next". Often (but not always) this threat to the existence of the relationship will prompt a resistive spouse to seriously reconsider these very reasonable suggestions, especially the marital therapy.

I'll pause here and solicit your feedback.
Customer: replied 2 years ago.
Your advice on how to select the proper therapist for my daughter in law is tremendously helpful. Our major problem is insurance. They have only state medical coverage which is next to nil. So not only finding the right therapist is critical but also the coverage for the treatment. I am also trying to find a support group, if that is advisable.
The doctor in ER yesterday did tell her that her physical ailments are all tied to her anxiety which will need to be fixed first so she's had a professional, actually more than one tell her its her anxiety that's causing her different ailments. A couple even told her "its all in your brain". None including the ER doctor yesterday described her problem as hypochondria. She acknowledges having OCD as she has had different "manifestations" such as cleaning the house constantly, believing food even those bought the day before are bad so she throw everything out from the frig. Today she admitted not wanting to be alone and asked I stay home since my son and grandson were going to a birthday party. Does her condition progress to aggressiveness? As I stated her irritability and impatience with my grandson has me concerned.
Expert:  Dr. Michael replied 2 years ago.
Another option is an on line support group e.g.,

http://www.mdjunction.com/somatoform-disorder

You can hunt down more online support group leads through Google; and continue to check locally for one----better still get free public service advertising on via AM radio in your area (they are obliged to carry free public service announcements) and START ONE OF YOUR OWN if your daughter in law is willing. Or, find a therapist who specializes in this, as I've noted above, and ask if they would facilitate a therapy group as the group leader---this would cut the out-of-pocket costs down per patient to a small amount of money. You could try to set this up for her and other people with somatoform problems in the community---quite a nice public service if you did.

As you are probably aware, both somatoform disorders such as hypochondriasis, and OCD are very closely related---they overlap a lot or are 'comorbid' as psychiatrists say. So Anxiety really is at the 'root' of her problems.

The condition shouldn't progress necessarily to aggressiveness, but the risk of this increases a bit if she actually becomes more depressed. If she is reaching out to you for support with her daily strains and responsibilities, this is a good thing because it can put you in a position to be helpful in the ways I suggested above, if you are willing to be patient and first, be a very good listener, be empathic, and when she has laid out enough complaints and problems, just tell her you have some ideas for helping her solve these problems (noted in last post).

I wish you well with this. Please let me know if I have overlooked any aspect of your original question. Please click on the green Accept button at the bottom of the screen. Thanks.

Dr. Michael, Psychologist
Category: Mental Health
Satisfied Customers: 2177
Experience: Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
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