PhronesisWe apply the Displacement Framework to Illness Anxiety Disorder (IAD, DSM-5; formerly hypochondria), formalizing it as W_IAD — a wrong attractor organized around the catastrophic illness belief: any bodily sensation is potentially a symptom of serious disease. The health monitoring ground state S⁰_health is defined as proportionate health monitoring with calibrated uncertainty tolerance: symptoms are noticed and evaluated proportionately, benign sensations do not generate disproportionate distress, and medical consultation is proportionate to genuine symptom concern.
W_IAD is maintained by the catastrophization-reassurance loop: sensation → catastrophic interpretation → increased bodily scanning (hypervigilance amplifier) → more sensations noticed → reassurance-seeking → temporary D(ξ) reduction → return with amplification. Reassurance-seeking is formalized as a W_IAD maintenance behavior structurally identical to OCD compulsions — each episode provides momentary relief while confirming health monitoring as a legitimate urgent activity, deepening the basin.
The medical system paradox: negative test results that should resolve D(ξ) instead confirm the validity of monitoring, and incidentalomas (genuine minor findings) trap patients in escalating specialist referral chains. Nine formal propositions cover: S⁰_health definition with uncertainty tolerance (P1), W_IAD catastrophic illness belief architecture (P2), the catastrophization-reassurance loop (P3), reassurance as basin maintenance (P4), bodily hypervigilance as attentional amplifier (P5), the negative-test paradox and medical system entanglement (P6), the care-avoidance subtype as non-disconfirmatory basin deepening (P7), CBT with ERP as the evidence-based return path (P8), and comorbidity with OCD and GAD on the anxiety-obsession spectrum (P9).
Cyberchondria, COVID-19 mass IAD induction, and physician communication are analyzed.