As a therapist who specializes in chronic anxiety with adults, I will often visit virtual groups and forums to see what is going on for people who are struggling, and what they need for support. What I end up seeing a lot of is the presence of symptom checking and validation amongst group members. These posts often look like:

“Does anyone else get a headache every day?”

“Throat tightness in the far back of my throat… Anyone experienced this before? Very uncomfortable…”

“Anyone know, can acid reflux give a shortness of breath?? And I also heard hiatal hernia is the reason behind acid reflux that can give you shortness of breath .. is it right ???”

“Been to the doctors once again lost count how many times I’ve been I’ve been having pains all throughout my body thinking I’ve got a horrible disease that it’s going to be too late for me I thought I could feel swellings in my back…”

This is what health anxiety looks like. The fear and the discomfort are very real for each of these people. Each person is distressed and looking for validation and understanding.

A few of my own clients have shared they are constantly checking with others they know or groups on Facebook trying to determine if what they feel is normal, and these behaviors can also tend to take up a lot of time as they wait for others to validate them.

In order to counter health anxiety you have to look at this as more of a mental game against a clever opponent. We will explore the 3 strategies anxiety uses as a strategy to win the mental game and the rules that anxiety has created.

Strategy 1: Your health anxiety is going to lie to you.

In order to win the mental game anxiety will use the strategy of lying to us. Anxiety works hard to convince you of something that is untrue. Think of it as a bluff in a poker game. If anxiety can convince you that it has a good hand you may fold.

 In regard to health anxiety, often a lie that can often trick people in to feeling anxious is “I must be dying.” This thought, which is often related to chest pains, rapid heart rate, and shortness of breath, sends people to the emergency room often. Unfortunately the typical outcome is that people are told there is nothing wrong with them.

Strategy 2: Your health anxiety wants to engage you in a conversation, so your focus and attention is on the health symptoms rather than living your life.

This strategy of health anxiety makes sure that you are constantly thinking about, talking about, and worried about our health. You spend time looking for symptom validation, as we discussed earlier. You will avoid doing things because you’re not sure your body will cooperate with your. Your whole focus and attention is on the symptoms, subtracting from your quality of life.

Strategy 3: Your health anxiety will trick you into doing what it wants to do.

What does your health anxiety want you to do? It wants you to scan, check, ask for reassurance, visit your doctor(s), go online and research/ seek validation, and avoid anything that may trigger your health symptoms.

Health anxiety has a way to convince you that these will be the best strategies to keep your anxiety under control. And if this was not enough there are rules that have been established in order to play this game:

• You must be 100% certain. Meaning that if even if someone were to reassure you that what you are experience is, in fact, a symptom of anxiety and not something worse, if you are not 100% convinced it won’t be enough.
• Never believe your doctor or test results. Maybe you have had a doctor miss something before, or you see a test reveals even just one thing that seems a bit high/low it can send a wave of mistrust or concern that something isn’t right.
• If something bad happened to someone else, you must believe chances are high it will happen to you. We forget that we are all extremely different, in so many ways, and it is never guaranteed that if someone you know had a heart attack that you will have one as well.
• If something “feels” dangerous then you must believe it to be. “What ifs” drive the fear that if you don’t take it seriously then what. We trust our feelings more than the logic that would tell us otherwise.
• You must do everything I say! An echoing of the 3^rd strategy health anxiety uses to win the game.
• You must take “scary” thoughts seriously. Just like we take our feelings as fact, we will also take our thoughts as fact. Often leading us to irrational and inaccurate conclusions.
• You must believe that the worse possible outcomes are the most likely. There is a distinct difference between possible and probable. Lots of things can be possible. However, what is probable is  likely far different. It is possible that I am having a heart attack, but the probability of that would depend on a variety of variables.
• You must scan your body all day long for signs of illness. You wake up checking in with your body, you eat and then check your body, you feel a pain in your back so you scan your body, and it goes on and on.
• You must focus on your health to make sure you don’t die.

Can you imagine agreeing to play a game with these rules. Of course not! But if you struggle with health anxiety these are the rules you have been playing with and have been losing this game to a clever opponent.

So, what can you do?

In order to turn the tides on your health anxiety you have to externalize and personify your anxiety.

You have to make your opponent separate from yourself. When we can see that voice outside ourselves it becomes easier to dispute. Unfortunately, when we don’t do this we take this voice to be our own, but it is not. It is a voice of a fear-based memory or interpretation.  

Can you see what your anxiety looks like? I suggest creating an image of your opponent. Really get clear on creating a separation between you and your health anxiety.

Next, let’s get clear on your strategy:

1. Refuse to believe your opponent’s lies. You have health anxiety. Let this be your default. When you notice your heart racing, or your headaches and feel that anxiety start to creep in, just remind yourself that this is just your health anxiety.
2. Live without absolute certainty. You have to learn that “certain enough” will have to be our new strategy. To be free from anxiety you cannot be certain. Remember, that there are a lot of things that we aren’t certain about in life, and this is just that nature of being human.
3. Do not fall for the tricks to engage you in conversation. Don’t answer the questions. Replay with “That’s not true. What is true for me is….”
4. Do the opposite of what your opponent tells you to do.
5. Focus on living your life and not on your health.

These new strategies can be scary and foreign to you at first, but as you practice them you start to take back control in your life. This is a practice of rewiring your brain and how it reacts to your health anxiety.

If you are looking for more support with your anxiety reach out today to schedule an appointment.

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