Short case example
A patient repeatedly asks whether the clinician is upset with them; each answer helps briefly, then doubt returns and more messages follow.
Loading
Formulation mechanism
Repeatedly seeking certainty, safety, approval, or relational confirmation to reduce distress or doubt.
What matters now
Fit, function, and alternatives
Use sequence, function, patient language, and disconfirming evidence to decide whether this hypothesis adds explanatory value.
Across the formulation
Short case example
A patient repeatedly asks whether the clinician is upset with them; each answer helps briefly, then doubt returns and more messages follow.
Formulation language
Reassurance seeking temporarily reduces doubt, but because the relief fades it can maintain dependence on external certainty.
Treatment implications
Map the reassurance loop and practise delayed reassurance, uncertainty tolerance, and internal anchors.