In this article, I discuss how the way a person thinks and behaves can affect the level of anxiety they have which is related to their health.
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Do have ongoing anxiety about your health even though your family doctor and one or more specialists has determined through extensive examination and testing that there is little to no evidence of health problems? Are you preoccupied with noticing and monitoring various parts of your body as possible signs or symptoms of illnesses or diseases? Do you regularly seek reassurance from people close to you, from information on the internet and from doctors that there is no cause for concern? Does this reassurance-seeking decrease your anxiety briefly only to have it return to the high levels you experienced prior to seeking reassurance?
If you answered ‘yes’ to one or more of the preceding questions, then you may be dealing with issues involving health anxiety. Fortunately, there are tried-and-true strategies which you can use to address health anxiety which focus on changing the way you think and the way you behave in relation to your health. I will discuss these strategies in the following sections.
When anxiety about your health does not indicate a health anxiety issue
Most of us will sometimes notice things about our bodies which we suspect are signs or symptoms of illnesses or diseases. These observations will activate our ‘alarm system’ in the form of anxiety as a signal that we should take action to deal with a danger we may be facing.
The action we would typically then take is to mention the concerns to our doctors. They would usually respond by examining us, possibly followed by tests and/or a referral to a specialist. The result would be either that there is indeed a serious health concern which must be addressed or that there is little or no evidence that serious health issues are present.
To this point, the anxiety we experienced about our health would not be considered an issue which needs to be addressed from a psychological perspective. That is, it is reasonable to have anxiety about our health when the available evidence indicates that serious health concerns may be present.
A fork in the road: Choices leading toward or away from health anxiety issues
Following the preceding scenario, consider the person who has been told by their family doctor (and possibly specialists) that examination and testing indicates that there is no evidence of serious health issues being present. Although the person is temporarily reassured by this news and their anxiety levels drop for a short time, it is not long before they notice the same signs and symptoms which led them to get checked out medically. Their anxiety increases as they consider again the possibility that they may indeed have serious health issues.
At this point, the person is at a fork in road in terms of how they respond to their recent increase in anxiety. One type of response involving their thinking and behaviour will result the anxiety subsiding while a second type of response in terms of their thinking and behaviour will serve to maintain their anxiety at a high level and create health anxiety issues which need to be addressed from a psychological standpoint.
Reminding yourself at this point that your anxiety is not indicative of serious health concerns and that the evidence indicates you do not have such concerns will eventually lead your anxiety levels to decrease without checking out your new concerns with more medical visits and tests. On the other hand, if you view your increased anxiety levels as proof that you do indeed have serious health issues and that these issues were ‘missed’ when you had your medical appointments and tests, your anxiety levels will likely stay high and lead you to book more medical appointments and request further testing.
These steps may reassure you and decrease your anxiety temporarily but worries and increased anxiety levels will return shortly thereafter. This latter chain of events depicts the choices in thinking and behaviour which lead to and maintain health anxiety issues which need to be addressed using psychological interventions.
How to address health anxiety issues: Use cognitive and behavioural strategies
If your thinking and your behaviour has led you toward health anxiety issues, the good news is that your thinking and your behaviour can help you to address these issues.
Cognitive strategies
Cognitive strategies entail interpreting the signs and symptoms you observe in a more accurate way rather than focusing on catastrophic interpretations. In this process, I encourage my clients to do experiments in which they examine the evidence supporting Theory 1 (dangerous/catastrophic) explanations compared with the evidence supporting Theory 2 (alternative/non-dangerous) explanations.
For example, if you suffer from a headache, list various Theory 1 explanations such as ‘brain tumor’, ‘internal hemorrhage’, ‘aneurysm’ and ‘stroke’ and then list Theory 2 explanations such as ‘slight dehyrdration’, ‘eye strain’, ‘tension’ and ‘fatigue’. Then, consider the evidence supporting each theory.
If the evidence clearly supports the Theory 1 explanation, this indicates that you are likely to have a serious health concern which needs to be checked out and addressed. On the other hand, if there is no clear evidence supporting the Theory 1 explanation or the evidence clearly supports a Theory 2 explanation, this will lead you to realize that your high anxiety levels do not point to impending danger. In turn, your anxiety levels should decrease significantly over time the more you engage in this experimental process.
Behavioural strategies
Behavioural strategies to address health anxiety issues should be implemented in tandem with cognitive strategies. These strategies entail refraining from regularly seeking reassurance from people close to you, from research on the internet and from medical professionals and tests.
Resisting the urge to seek reassurance may seem illogical given that the reassurance you receive typically reduces your anxiety levels. However, the reduction is short-lived as these behaviours fuel a ‘maintenance cycle’ for health anxiety issues.
On the other hand, ‘sitting’ with your anxiety and resisting the urge to temporarily suppress it with maintenance behaviours will ultimately lead the intensity of your anxiety to reduce significantly over time. But, unlike with the reduction which occurs by engaging in maintenance behaviours, the reduction which occurs by refraining from maintenance behaviours and sitting with the anxiety is a lasting form of reduction known as desensitization.
The challenge of sitting with your anxiety until its intensity reduces through desensitization is that this process takes time to run its course. The best way to patiently wait out this process while you resist urges to engage in maintenance behaviours is to continually use the cognitive strategies. Doing so will help you to reduce your anxiety to manageable levels while the desensitization process unfolds.
A psychologist who is skilled in cognitive behavioural therapy (CBT) can guide you in the implementation of the steps discussed in this article.
May you think and behave your way toward addressing your health anxiety issues,
Dr. Pat
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