Got Anxiety? Tips for managing health anxiety
Mary B. Barmann, MFT
Those with Health Anxiety respond to harmless bodily changes as indicative of a serious medical illness, thus creating a heightened state of anxious arousal. Let’s look at a couple of strategies for managing symptoms of health anxiety.
CHANGING HOW YOU THINK
In a previous article, we discussed several “core beliefs” endorsed by those who evidence health anxiety. For example, the belief related to “overestimating probability of danger,” triggers a tendency to engage in reassurance-seeking (e.g., scheduling numerous medical tests), for the purpose of lowering anxiety levels.
A prerequisite for changing thinking patterns is to first “think about how you think,” followed by behaving in ways that allow for discovering assumptions, interpretations, etc., which may be inaccurate.
Our frame of reference (how we view anxiety) is the window through which we see our world; it’s the very core of us and, at times, needs to change — because it’s NOT working.
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Changing one’s beliefs involves viewing thinking patterns as “predictions” or “possibilities” concerning a particular event, rather than being factual in nature. It’s important to occasionally shift our thoughts in a way that encourages looking at life through a different lens; one which expands our repertoire of possible interpretations.
Strategies for helping to create this shift when confronted with anxious thoughts and behaviors, related to health and illness, would include:
Consists of conducting “experiments” which involve intentionally thinking in ways that do not coincide with one’s beliefs concerning the meaning of bodily changes, and how these changes relate to illness.
The goal of behavioral experiments is to look for evidence that is INCONSISTENT with the meaning we place on sudden physiological changes.
Those with health anxiety place a strong emphasis on possibilities and probabilities related to coping with illness. For example, they consider the possibility of an illness as synonymous that the illness is probable, which leads to seeking the “perfect” explanation for their symptoms.
The inaccurate belief is, “I cannot function on a daily basis unless I am 100% certain of outcomes which are important to me.” Collecting evidence to the contrary is necessary for helping to dismantle this faulty way of thinking.
In order to test the accuracy of this belief, the individual would need to be reminded that he or she effectively manages uncertainty on a daily basis, regarding a variety of situations which are related to harm, injury, and even death.
For example, one would need to recall that on any given day he or she cannot answer, “Yes, I’m 100% certain,” to the following questions: “Is your spouse alive at this very moment?”
“Does there exist the possibility that you may suffer a severe injury, or even death, while driving to and from work one day”?
Although 100% certainty regarding the outcome of such meaningful situations does not exist, one must admit that he/she effectively managed daily routines, displayed the aptitude to focus on important work-related tasks, and successfully regulated emotional states; all based on assumptions related to probability regarding potential outcomes.
This evidence demonstrates the capacity to function productively, void of absolute certainty. Thus, those with health anxiety need to remind themselves that they frequently manage feeling uncertain across a variety of life domains.
The next step is to apply this ability when learning methods for tolerating uncertainty associated with concerns related to the possibility of dealing with illness.
CHANGING HOW YOU BEHAVE
Repeating the same patterns such as frequent reassurance checking and avoidance, directed at obtaining 100% certainty regarding one’s health, only serves to maintain health anxiety, as well as preventing learning that these behaviors are unnecessary.
The most effective method for changing these behaviors is the use of Exposure & Response Prevention exercises:
Exposure & Response Prevention
The goal of this approach is to provide experiences for confronting feared triggers (exposure), without exhibiting reassurance checking, avoidance, or safety behaviors (response prevention).
It is designed to weaken the connection between faulty thinking patterns (that mole on my arm is cancer), and their associated behaviors (frequent body checking). Exposure exercises involve constructing a hierarchy of situations (bodily sensations, illness-related objects, etc.) that trigger the need to consistently perform behaviors designed to convince the person they do not have a serious medical condition.
This hierarchy begins with situations which trigger the least amount of discomfort, culminating in experiences that trigger high anxiety. A sample hierarchy might include the following: (1) Reading books about a feared illness; (2) Visiting a hospital or cemetery; (3) Writing one’s own obituary; (4) Visiting a place where a family member died.
The most effective exposures are those which test (and disconfirm) illness-related fears (“I will become ill if I enter a hospital”), while also learning to increase one’s tolerance levels for uncertainty and anxiety related to illness.
Barry C. Barmann, Ph.D., is a Licensed Clinical Psychologist in Nevada and California. His wife, Mary B. Barmann, MFT, is a licensed Marriage and Family Therapist in California. Visit anxietytreatmentinclinevillage.com to learn more.
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