How to cure Health Anxiety. "Yay" or "Nay" to another doctor visit?


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Recently Mark connected with me about his health anxiety. He asked "what should I do when everything I do does not seem to work?"

I have some answers, so let's jump right in.

Here are his questions. 

Do you find yourself stuck in the same loop with your anxieties - whether it's health anxiety or any other variate, connecting or scattered triggers?




"First of all I want to say that this website is amazing!
Thank you for doing it and helping a lot of people get their life back. I'm not there yet, I still have a long long way but I believe in the power of overcoming anxiety.

I'd like to ask you for tips how to overcome health anxiety with behavior changes. I can imagine not checking the stove again but just do something else, board the flight even if the mind says it's going to crash, going to the party although we feel we'll be embarrassed there. But how do you behave "normally" when the mind is occupied with some health issue and one is sure he is going to die.

It feels to me like health anxiety starts and ends in the mind. Like there is no counter-action to retrain the amygdala. Even if I'll go to a party or watch a comedy or talk to a friend, the mind is still occupied with health anxiety thoughts which keep alarming the amygdala, which produces hormones that trigger physical symptoms which in turn start another health anxiety issue...that never ending cycle.
I would like to hear some ideas from you."

I then asked Mark:

Hey Mark,

Tell me more about this health anxiety you have. When you say "But how do you behave "normally" when the mind is occupied with some health issue and one is sure he is going to die?".

I want to understand what you are dealing with?

I want to know if your health is diagnosed as currently impaired? Is it? Is there some real medical health issue? If so, how do you know this when you say "one is sure one is going to die"? Has some doctor told you the condition is terminal?

Or is it worst case scenarios that the mind is projecting which give you anxiety?

- Namita

He answered:

The health anxiety that I have is when the mind is projecting the worst case scenarios. I have a clear medical bill after too many doctors visits and medical tests. But anxiety leads to physical symptoms which lead to anxiety which leads to more new physical symptoms and IT'S IMPOSSIBLE FOR ME TO STOP THIS CYCLE.

This article describes it very accurately:
http://www.drheatherstone.com/articles/searching_for_bad_news.html

I've been dealing with health anxiety since I was 15 years old, I'm 34 now. I'm an HSP and has some OCD behaviors. As well at times I experience GAD as well. I have a feeling that it's all somehow connected and being an HSP with OCD leads to the anxieties.
Health anxiety is definitely, at least for me, a result of OCD and a very developed imagination.
"


- Mark (name changed for confidentiality), USA


I love this for 2 reasons.


  1. Mark has made my job 50% easier. He comes here in full awareness of his erroroneous thinking. He points to an article he read on the internet that describes very, very well the distorted ways in which he (or any anxiety sufferer) thinks. I don't have to convince him with long coaching sessions that his thinking styles are hurting him. Believe it or not, so many anxious people remain clueless in their lives about how exactly any of their responses to life are wrong!

  2. Mark also proves that insight, aha's and ephinanies do not always cure anxiety. Otherwise why would Mark (or you or me) be struggling so much? Lack of insight is not our problem. Heck no! In fact, often as HSPs, we have too much insight.



So, in a nutshell, Mark is asking

"If I know all this about myself, why isn't it working to stop this stupid cycle of anxiety?"


Hi Mark,

You’re almost there! You recognize that anxiety could just as well be a behavioral problem more than anything else.

But you feel that there is no credible behavior to do in your specific “health anxiety” to stop the thoughts.

There is.

And I'm going to show you what, why and how.

Here are 4 steps for you to consider as "behaviors".


Step 1.

Move on with your life WITH the thoughts. Give yourself no other choice. Your life doesn't have to wait until after your mind cleans up. Your life can start now.

 
 

Even if you your mind plays out worst case scenarios about how your health will fail, let it. In this kind of “letting it”, you will find the relief you’re looking for.

I know that popular advice, including professional advice, as well as good sense tells us that negative thoughts are a problem that need correction. And this is intuitive - negative thoughts are negative- not pretty - we don’t like them. “Let’s throw them away”

But if you are truly honest, you’ll admit that trying to control them like that have only given them more power.

Anxiety first comes in our lives when we distortedly fuse with thoughts without realizing we're doing so. Looks like you spent 20 years doing that. Now what? Now you recognize that you did so and have decided not to do that again. Great, awesome, wonderful! But the trap you may have fallen into is expecting that the oppposite of Thought Fusion is Thought Control.

Thought Control (1) is also just another version of Thought Fusion.

You’ve mentioned that with Social Anxiety and other OCD, it’s easier to find the "right" behavior. What do you mean by the "right" behavior? Do you mean the right behavior to "stop" the anxiety thoughts? Nope, it doesn’t work like that. If anyone does anything with the expectation and demand for thoughts to stop, that action will not work.

The people you quote as having overcome their Social or OCD anxiety did not try to do something (like not check the stove or go to the party) with the hope that this will teach the thoughts a strict disciplinarian lesson that will get the thoughts to shut up. Nope. They did the behaviors so that their life (of their choice and desire) could move on despite the thoughts.

You have to do the same. You have to “willingly” allow the thoughts. And if it helps, take comfort in research and science finally showing the futility, in fact the dangerous results of thought suppression.

It is true that once you allow thoughts “willingly”, the amygdala is no longer vested in protecting you from the so-called, perceived “danger” posed when you’re not in complete control of the situation. Once the amygdala isn’t triggered, yes it’s true that the thoughts also slow down and stop attacking.

But you CANNOT do this as another type of mind control strategy. The amygdala will know it. You cannot outsmart the mind like that. It never works.

So what is the mindset that you should do this work with?

Here it is.

How does it make you feel when I say “Mark, this thought/s may never go away. Are you okay with that? Do you still decide to move your life forward along with this possibility?”

If you answer this truthfully, you’ll know whether your decision to allow thoughts is true acceptance or another mind control strategy.

This is behavior #1. Stop trying to “stop thoughts”.

Behavior does not have to a be physical movement. It could simply be a mental decision to do (or not do) something.


Step 2.

How to measure mental health and a good life? By doing this.

Stop measuring your success and failure in recovery by the presence of your negative thoughts. Measure it by how well you guide your moment-to-moment choices from the place of your values and not your anxiety.

 
 

In other words, interpret/reframe the life from Step #1 as a recovered person, and not a pathological person.

For example, when you go out to a party, SO WHAT if one part of your mind is spitting out autoprogrammed words that it knows from the past? "You will die" "You better get that X-Ray" "You better visit Doctor #26".


SO F*$KING WHAT?


It doesn't matter. Because if you so choose, you can identify yourself as the person enjoying the party with these thoughts, and not as a person dismissed to doom just because you have negative thoughts.

Ok - I am a coach right? I’m teaching people to kick anxiety’s gentle behind. I must seem like a guru?

Now watch this. I’m going to instruct my mind to not think about a yellow jeep. Does that sound too stupid? Ok, I'm going to instruct my mind to not think about a hobo slitting my throat and throwing my body in a dumpster...Now we're talking.

What just happened? If you know anything about thought suppression(1), you'll know that this command to my mind did not work. And now here I am imagining the gruesome details of my own murder! Just like you, I'm an HSP with a highly developed imagination that is capable of picturing the worst details that seem to come out of nowhere and that I cannot control.

So what's happening with me as I type this? I could not be happier.

15 years ago I'd have lined myself up for a month's worth visits to the psychiatrists offices.


Right now, I am calm, committed and ready to go for a power run. I know I will then eat dinner, watch a movie and go to bed. Do I expect this thought to come again when I don't want it to? You betcha. Can I tell how long it'll keep coming for, for the rest of my life? I have no freakin' idea.

Is my amygdala triggered? Nope. Am I anxious? Nope. Will I show up at a doctor's office? Nope. Will I interpret my experience as anxiety, a disorder, a mental illness, a brain imbalance? Nope.


What could change my current state of comfortable calm to panic and paranoia? It's simple. All I have to do is reject my lack of control over the mind and start commanding my mind to stop producing thoughts I don't like. Or insist that unless EVERY detail of my mind's chatter is clean and unpolluted, my life cannot move on.

Is this what you've been doing?

Waiting for your mind to "spring clean" itself for you to call yourself as a "recovered" person? If that were the yardstick, no single person on this planet would escape the diagnosis of a mental illness.

If you accept this, your amygdala will not have a reason to trigger or stay triggered. And in the end, I think you know it all comes down to the amygdala.


Step 3.

Values - What are yours? Which ones are hurting you?

Values are intentional, chosen life directions that are suspended from evaluative judgments.

In my private coaching, we spend 3 weeks on the topic of Values - some of the deepest and most important work in recovery.

Here, on this page, this is what I'll say to you.

You value good health.

I get it.

And not once, are you being asked to abandon this value in a black and white way. You won't find me say "Come on, chill out, live a little, stop worrying, take it as it comes.."

You value good health. Period.

And so you’ve told yourself that you’ll do everything you possibly can to uphold this value.

But where does “everything possible” end?

Is it with one medical exam, or two, or two hundred?

The anxious cycle will insist “everything possible” is never-ending.

And that’s how you catch it.

That’s how you distinguish between whether your behaviors in response to your mind are smart, committed honorable actions..

..or obsessions.

And when they’ve got an obsessive quality to them, they’re not even serving the values that we think they’re serving.

“Hey, I went to the 17th doctor because I care THAT much about my health”

Nope. Instead and often, they’re serving these other secret, hidden values that we’ve adopted along the way that are ending up now hurting us than previously protecting us.

What are these?

→ I do not like (and cannot handle) ambiguity
→ I do not like (and cannot handle) the unknown
→ I do not like (and cannot handle) lack of control
→ I do not like (and cannot handle) lack of perfection
→ I cannot cope if things were to go as unplanned
→ I cannot cope with having regrets
→ I cannot change

When our actions are serving these values, then we find little relief in life. Because these values are forever rejecting a life and world that unfolds itself in an un-manipulated way. Their call to action is to constantly control life, pretending like that is possible without snatching away life itself in the bargain.

So what can you do?

Become brutually clear about which values aren't worth it anymore, and consider rejecting them.

People think that’s not possible for them because their values represent who they fundamentally are.

And that’s bullshit.

You have every right to reject everything you’ve stood for until a minute ago, if only you give yourself permission.

They way to start doing this is by learning to ignore (not control..don't forget step #1) that part of your mind that is no longer serving your new or revised values.


Step 4.

Celebrate your developed imagination.

 
 

I can promise you I know what you're talking about. The mind of an anxiety sufferer is nothing less than brilliant. The speed and force with which it jumps ahead and creates a plausibility out of nothing is remarkable.

There are plenty of studies that show the high IQ of people with anxiety. So there is absolutely not an iota of doubt in my mind that you have a highly creative intellectual mind that is capable of thinking anything, anywhere and anyhow.

It can also be terrifying.

It is NOT this mind that gives you anxiety.

It is the refusal to just let the mind travel its journey that gives us anxiety.

If you give yourself permission to accept yourself as the observer of such a mind rather than "the mind itself", then you will bypass the suffering.

Most people never give themselves permission to (non-judgementally) identify themselves as the observer.

It just doesn't feel rewarding enough. "I'm doing all this work observing and the anxiety STILL doesn't listen."

Why such an obsessive motivation to be the "bad" part of the mind and not the "good" part of your mind "observing" the bad part?

You know why? Because once again, hidden underneath is the expectation that "observing" should then go on to "remove" the bad part. When you put demands on your mind, you lose. And this is true for 100% of the people living on the planet.

When you start getting comfortable observing the process of your mind rather than the product of your mind, you've immediately protected yourself from anxiety. You are the one observing and you will not guide your choices from the place of your auto-programmed thoughts.

"You will catch an illness if you don't do...(insert anything here)"

Now use the very same developed imagination to picture yourself in the future sitting on a chair, reading your favorite magazine, coping just fine if your thoughts were to come true OR if your thoughts were to never stop.

Can you?

I think you can. Wasn't it you who said that despite 20 years of health/GAD/OCD anxiety and despite knowing that you have a long, long way to go, you STILL "believe in the power of overcoming anxiety"?

How come? After all, your mind can play another game, and give you every reason in the book to reject that hope, right?

But somewhere, somehow, another part of your mind and imagination are (correctly) working just fine by keeping you moving along with faith that in the end, IT IS POSSIBLE.

THIS is that path to stay on, and when (not if) you and I wander from it, our call to action, is to gently bring ourselves back. Every one of the 1000 times it will happen.

Good luck, Mark!

With love,
Namita


P.S. I thought it's a good idea to bring up your question again - now with my answers side-by-side against some of your comments. See it below.

 


"First of all I want to say that this website is amazing!
Thank you for doing it and helping a lot of people get their life back. I'm not there yet, I still have a long long way but I believe in the power of overcoming anxiety (Good for you!).

I'd like to ask you for tips how to overcome health anxiety with behavior changes. I can imagine not checking the stove again but just do something else, board the flight even if the mind says it's going to crush, going to the party although we feel we'll be embarrassed there. But how do you behave "normally" when the mind is occupied with some health issue and one is sure he is going to die.

(You behave normally by behaving normally. But you do not do this to stop thoughts. You do this because behaving normally is now your new goal and you don't care a damn whether the stops thought or not.)

The health anxiety that I have is when the mind is projecting the worst case scenarios. I have a clear medical bill after too many doctors visits and medical tests. But anxiety leads to physical symptoms which lead to anxiety which leads to more new physical symptoms and it's impossible for me to stop this cycle.

It feels to me like health anxiety starts and ends in the mind. Like there is no counter-action to retrain the amygdala. (There is. Just stop "stopping" thoughts. Behavior can be a mental action. It does not have to mean picking up yourself to go to a party.) Even if I'll go to a party or watch a comedy or talk to a friend, the mind is still occupied with health anxiety thoughts (not all of your mind is occupied of these thoughts. quit thinking in all-or-nothing ways. There is another part of your mind answering your friend's question. Another part is observing your anxious thoughts. Yet another part is observing the observing. Yet another one is planning your responses to your friend. You are all these parts. You are not that one single part that contains health anxiety thoughts. If you are flexible, you could reject identifying with the part you don't like) which keep alarming the amygdala (nope; acceptance of health anxiety thoughts will not attack the amygdala and you will right away stop the anxiety cycle), which produces hormones that trigger physical symptoms which in turn start another health anxiety issue...that never ending cycle.
I would like to hear some ideas from you.

I've been dealing with health anxiety since I was 15 years old, I'm 34 now. I'm an HSP and has some OCD behaviors. As well at times I experience GAD as well. I have a feeling that it's all somehow connected (Yes, it is. The cycle of fear is the same and so is the way out of it...see footnote) and being an HSP with OCD leads to the anxieties.(Being an HSP is not linked to anxiety. Not understanding the HSP trait may be. Also, all it could mean is that you are highly aware of your own thoughts. So what? High awareness is not always a call to action.)
Health anxiety is definitely, at least for me, a result of OCD and a very developed imagination.
"


- Mark (name changed for confidentiality), USA


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