Understand how our health beliefs develop and strengthen over time.
People with health anxiety hold abnormal beliefs about health and illness. These are called core beliefs. Core beliefs often stem from significant personal life experiences early in life. Maybe you have a health scare or have been diagnosed with an illness. Or maybe you watched a loved one die from a serious illness. Or, you may have felt unsafe in life due to adverse or traumatic experiences, and therefore learned to be wary of potential threats and dangers. No matter what happened to you, these experiences will lead you to view health and illness in a certain way.
Health Anxiety and Dysfunctional Core Beliefs
Researchers have found that many unhelpful core beliefs are common among people with health anxiety. Here are some examples:
- Serious illness is everywhere.
- Being diagnosed with a disease is likely a death sentence.
- I have to be 100 percent symptom-free to be considered healthy and safe.
- Doctors and tests should be able to provide explanations for every physical sensation and symptom.
- The field of medicine is completely inadequate and useless.
- I must always make sure that I am not sick or will not be sick.
- I am fragile and likely to die from most diseases.
- Anxiety symptoms are dangerous.
- I couldn’t accept the idea of dying one day and had to do whatever I could to stay alive.
How Dysfunctional Beliefs Reinforce Over Time
Once you develop these core beliefs, the process of reinforcement begins. Essentially, you begin to scan your environment and selectively focus on all the “evidence” that supports your belief system.
You may be particularly concerned about a loved one or acquaintance battling an illness. You may have read everything about various diseases online or in medical texts. You may have watched movies or videos on social media or read books about people battling the disease. In general, you may be more concerned with stories about illness and death than you are with all the people and situations around you that represent health and wellness.
The result of all this is that you develop a very biased and distorted view of health and illness. How could you not? In the world you created for yourself, everyone is getting sick and dying! Your dysfunctional beliefs will continue to strengthen over time as they are reinforced month after month and year after year through selective attention.
How Dysfunctional Beliefs Affect Your Daily Life
Your dysfunctional beliefs cause you to worry about illness, which leads you to engage in so-called body alert. Body alertness is when you pay close attention to all body sensations and symptoms.This kind of selective attention allows you to even notice more symptom.
You can then misinterpret unclear or benign symptoms as signs of some underlying health problem. This can lead to you “catastrophizing” or imagining the worst-case scenario for each symptom (e.g. This heartbeat is the beginning of a heart attack). Understandably, these conclusions can increase your anxiety, and you may then engage in avoidance or safety behaviors to reduce your anxiety (e.g., Googling symptoms, seeking reassurance, excessive body checking). This further reinforces your dysfunctional beliefs, and the cycle begins all over again.
How to improve health anxiety
The key to overcoming health anxiety is to disrupt this dysfunctional process. Through cognitive behavioral therapy (CBT), we target each of these components. We challenge distorted thinking through Socratic dialogue or logic-based questions. We perform exposure exercises to increase a person’s tolerance to physical sensations and reduce the use of safety and avoidance behaviors. We also reshape dysfunctional core beliefs into more accurate and adaptive beliefs.
As I always say, you can overcome health anxiety. But it won’t happen overnight. The key is to make small improvements in your thoughts and actions every day. CBT comes to the rescue!