Got Anxiety? With health anxiety, what you believe matters |

Got Anxiety? With health anxiety, what you believe matters

Barry C. Barmann, Ph.D.
Mary B. Barmann, MFT

Editor’s note

This is the second in a three-part series regarding health anxiety. Click here to read Part One.

The strength of our beliefs about health varies along a continuum, from “lack of concern” to “excessive anxiety.”

We live in a world filled with health threats. But most of us don’t become so alarmed about such threats that we develop intense and faulty beliefs, fears and preoccupations with the possibility of having a serious disease.

So, what influences the intensity of faulty illness beliefs in those diagnosed with health anxiety?

Maladaptive and faulty beliefs about illness and health develop from a combination of the following learning experiences: traumatic or stressful illness event (suffering an illness or watching a loved one suffer or die from illness); observing health-anxious attitudes and responses of family or authority figures; and lastly, informational transmission by media sources such as the news, internet, and books.

Exposures to these experiences and activities can give rise to excessive intrusive thoughts, worries and images about ill health, usually catastrophic in nature. Individuals with health anxiety skip the part of the continuum labeled “lack of concern” and jump right to the other end of the scale called “excessive anxiety.”

Researchers have identified seven types of faulty beliefs that keep health anxiety alive and thriving:

1. DEATH AND DYING ARE ALWAYS DREADFULLY PAINFUL, FRIGHTENING, AND INVOLVE SUFFERING FOR EVERYONE INVOLVED: These unrealistic attitudes and beliefs take up an inordinate amount of time and energy, depleting happiness and enjoyment in the present moment. Examples:

“Death means I’ll be eternally aware of what I’ve lost.”

“If I die before my children are grown, it will ruin their lives forever.”

2. DOCTORS AND MEDICAL TESTS CAN’T BE TRUSTED: Refers to beliefs that medical tests and physicians are incompetent and invalid. Further maintained by family members who express doubt and concern over professional feedback. Also perpetuated by media: Successful, routine medical procedures are rarely newsworthy, but disastrous medical errors are regularly reported. Examples:

“Doctors can’t be trusted because they often make mistakes.”

“Remember what happened to your uncle – doctors said no heart problems and the next week he died of a heart attack.”

3. BEWARE BODY NOISE OR CHANGE – DANGER AHEAD: Assumptions that any physical sensations associated with anxious arousal are always dangerous. Information from the internet, correct or erroneous, provides health-anxious people with an inexhaustible supply of terrifying medical information and sensationalized outcomes. Examples:

“Unexplained symptoms are always serious.”

“Serious diseases are everywhere.”

4. HEALTHY MEANS BEING 100% SYMPTOM FREE AND ALL SYMPTOMS HAVE MEDICAL EXPLANATIONS AND DEFINED INTERVENTIONS: Beliefs that good health means few or no bodily sensations, medically unexplained symptoms don’t exist, and black and white viewpoints about diagnoses and interventions. Intensified by access to accessible over-the-counter home diagnostic tests and user-pay methods of diagnostic assessments (CT or MRI scans). Examples:

“I can’t go on with life unless I have a clear diagnosis of my problem.”

“If I don’t get to the doctor as soon as I notice anything unusual, it will be too late.”

5. MY BODY IS FLAWED, UNABLE TO TOLERATE STRESS, AND HIGHLY VULNERABLE TO DISEASES: Flawed beliefs that one’s general health is poor or susceptible to medical ailments and fragility despite evidence that symptoms are harmless. Interestingly, there are rarely concerns about being at greater risk for being the victim of an accident or crime. Examples:

“I need to avoid vigorous activity because I’m physically frail.”

“If I exercise and eat healthy, I can avoid all illnesses.”

6. ALL ILLNESS AND DISEASE ARE COMMON, CONTAGIOUS, DEADLY: Viewpoints that illnesses are more common, easily transmitted, and serious than they actually are. Threats and dangers of illness and disease are overestimated or exaggerated. People with health anxiety generally have a greater knowledge about illnesses and diseases, which provides more reasons for worrying about health. Examples:

“This headache is definitely a symptom of a brain tumor.”

“Deadly viruses are everywhere.”

7. IT IS POSSIBLE AND NECESSARY TO BE ABSOLUTELY CERTAIN ABOUT ONE’S HEALTH AT ALL TIMES: Erroneous beliefs that it’s possible to be 100% certain that negative outcomes will not occur. Beliefs are about intolerance of uncertainty. Result in taking excessive measures to protect oneself from feared diseases by “detecting early warning signs,” despite a lack of diagnosis. Use of Medic Alert bracelets, medication, portable medical equipment (cardiac defibrillators), home-use blood pressure cuffs are examples. Examples:

“What if I’m THE ONE? Worrying about my health will keep me safe.”

“I need to check my blood pressure every hour just to be sure.”

Too familiar with these beliefs? Read our next article to learn how to change these maladaptive thinking patterns.

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 to learn more.

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