P03-160 - Catastrophic scenario in the treatment of hypochondriasis, OCD and anxiety disorders

Patients with strong anxiety, especially health-anxiety, obsessions and GAD are very often not able to describe concrete consequences of their putative somatic diseases. They block their thoughts due to strong anxiety attended this thoughts. In some instances the health-anxious patients try not to think about illness at all, by attempting to control their thoughts or by distraction. Our method is based on therapeutic dialogue, using Socratic questioning, and inductive which force patient to think beyond the actual blocks. In second step, patients are asked to think out all other possibilities of newly discovered future. They are forced to imagine the worse consequences of all dread situations. Dialog is led through one's serious illness status, with its somatic, psychological and social consequences, dying experience to moment of death, which has to be described with all belonging emotions and details. Further, we ask patients to fantasize and constellate possible “after death experiences”. In next session patient brings written conception of the redoubtable situation previously discussed. Than we work with the text as used in imaginative exposure therapy. Gradual habituation after several reading sessions, due to our observations, leads to remarkable release of anxiety symptoms, safety and avoidant behaviour. Supported by the research grant IGA MZ CR NS 10301-3/2009