Contents of It's not All in Your Head by Asmundson and Taylor

1.1.4. Treatment
In the past many clinicians believed health anxiety was difficult to treat, treatment
resulted in only slight improvement in symptoms, and that it was challenging to establish
a therapeutic alliance with health anxious individuals (Martínez & Botella, 2005). This
belief may have arisen because early treatment techniques, such as psychoanalysis, were
mostly ineffective for treating the disorder (Asmundson & Taylor, 2004). Some clients
may have also been resistant to psychological treatments because they believed their
condition was purely somatic (Barsky et al., 1988). It was sometimes difficult for
clinicians to develop a therapeutic alliance with clients because, although the clients
wanted help, they often rejected or were skeptical of treatments and the professionals
who could not find the cause of their symptoms (Salkovskis et al., 2003). Some health
care providers also believed health anxiety was similar to factitious disorder or
malingering, and therefore, a waste of their valuable time (Salkovskis et al., 2003).
Furthermore, after a medical treatment had been administered, occasionally people with
health anxiety developed complications, worse symptoms, or new symptoms (Barsky et
al., 1988). This may be due to somatosensory amplification and a tendency to
misinterpret any new somatic sensations after medical treatment (Bleichhardt et al.,
2005). The 1980s and 1990s saw the development of several behavioural and cognitive-
behavioural psychotherapies for health anxiety (Asmundson & Taylor, 2004).
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