Do you experience chronic anxiety or worry about your health? Are you likely to jump to worst-case conclusions when you experience unexpected symptoms in your body? Do you become frustrated with physicians because you consistently report symptoms and they can’t provide a clear diagnosis? If you experience these issues, you may be experiencing health anxiety.
At CTWPS, we are psychologists and not physicians, and we can’t know the medical etiology of symptoms for our patients if a patient does not have a clear diagnosis from her physician. But our role as therapists can be to support the reduction of a patient’s health-related anxiety in the context of her symptoms, and to increase her coping in the sometimes grey area of our medical diagnostic system. Those experiencing health anxiety often have a difficult time differentiating between current symptoms and perceived danger. Our goal is to reduce any emotional suffering for our patient that occurs alongside her physical suffering, by working to change beliefs and behaviors that intensify a patient’s distress when she is symptomatic.
Let me briefly highlight some of the cognitive distortions and behaviors that contribute to experiencing health anxiety:
Emotional Reasoning occurs when a person concludes that her negative emotions prove something is true, regardless of other evidence. For example, “I am worried all the time that my recent exhaustion means that I have a debilitating disease. After a number of tests, my doctor believes the headaches are hormonally related, but I wouldn’t have these worries if they weren’t somehow true.”
The reality is the majority of our worries are not predictive of our realities. Thinking a thought doesn’t make it a reality.
All or nothing thinking involves drawing extreme conclusions that reflect a black-or-white view of the world, without allowing any space for ambiguity, uncertainty, or alternative explanations.
The belief that “bodily symptoms or sensations are always a sign of disease” is an example.
Bodily checking: This behavior includes repeatedly and excessively scanning one’s body for symptoms. This hyperawareness increases the likelihood of noticing benign bodily changes, further reinforcing the idea that constant checking is a requirement for health. Ironically, repeated checking of particular body areas sometimes also leads to overworking or irritating the site of sensation, potentially exacerbating physical symptoms.
Reassurance seeking: People experiencing health anxiety are likely to review their symptoms with one or more loved ones and physicians, seeking relief by being told that their symptoms are not serious. Reassurance seeking can also be expressed through requesting multiple medical tests and/or seeking numerous medical opinions from various physicians - also known as “doctor shopping.” While this behavior is intended to relieve anxiety and might do so in the short-term, if it is excessive, it can also increase stress and confusion for the patient.
Health anxiety can be extremely distressing, as our patients suffer from both physical and emotional discomfort simultaneously. Our ultimate goal is to reduce anxiety so that our patients can cope with their suffering, and can tolerate benign bodily symptoms, without committing to a negative health narrative without appropriate data. If you are experiencing health anxiety symptoms and are interested in reducing them, the highly trained therapists at CTWPS are ready to support you.