His preferred technique is cognitive behavioral therapy, in which patients are trained to force their attention away from the symptoms. "Just as focusing on a pain makes it seem more significant, ignoring it can make it seem much less," says Barsky. Patients are also instructed to counter panicky thoughts with self-reassurance, reminding themselves, for example, that stomach pain almost never means stomach cancer. Both cognitive therapy and medication seem to work, and at this point it's hard to say whether one is better than the other. "Nobody's done a comparative trial," says Fallon, "although Barsky and I are working on that."
Both men agree that their primary-care colleagues aren't very well attuned to the problem. "Things are improving," says Barsky, "but there's not a heck of a lot of education about hypochondria in medical school. We teach doctors that their job is to find disease and weed out those who are physically well. They have no time for hypochondriacs." It needn't take as much time as they think, though. "It's not hard to identify a hypochondriac," says Fallon, "if you have the right antenna out." And once a hypochondriac is identified and properly treated, no one is happier than his or her doctor.