You are brushing your hair and you suddenly notice a little bump on the back of your head. It seems to have come out of nowhere. What is this? Ugh. You feel both anxiety and frustration. You were just at the doctor’s last week for something else. And now this. Annoyed at the inconvenience, you pull out your phone to make another appointment.
But, what if you put off making that appointment? Just for a little bit.
I know what you’re thinking. If you don’t go to the doctor right away, it could be something serious that gets worse. If you wait, whatever illness is causing this bump could get worse. By the time you go, it could be too late. Game over.
This is the thought we want to target: “If I don’t go to the doctor at the first sign of illness, I will get really sick or die.”
With health anxiety, we tend to have all-or-nothing thinking when it comes to our health. We assume that, in order to be healthy, we need to be symptom-free at all times. By this logic, any symptom or bodily sensation is automatically a sign of a potentially serious health problem. But this is inaccurate. Our bodies are “noisy.” This means that, on an ongoing basis, we have symptoms that are not due to serious disease. Instead, these symptoms are due to normal self-regulatory processes, diet, emotional or physiological arousal (e.g. anxiety), and minor or benign medical conditions. Body noise is a real thing.
I wouldn’t expect you to take my word for it. I’d want you to see for yourself whether this new symptom is a serious disease or simply body noise. After all, how many times in the past have you been convinced a symptom was a sign of a serious disease, only to eventually realize it was nothing?
Let’s design an experiment.
If you were my client and you came to me concerned about this bump on your head, I might ask you to postpone going to the doctor or asking loved ones about the bump on your head for three days.
Before doing the experiment, I would ask you: What do you predict will happen?
You might have a couple of predictions:
- Prediction 1: Maybe this symptom is something serious and it will be deadly if I don’t address it right away.
- Prediction 2: If I have to wait three days to go to the doctor, the anxiety will be too overwhelming for me to handle.
It is important that you consider what you predict or expect to happen. These predictions are what we will be testing. The goal is to help you learn, through experience, that many of your predictions are inaccurate. This is because your health anxiety leads you to see the threat of serious disease as being more likely, and more severe, than it actually is.
Gathering the results of the experiment.
During the three-day waiting period, I would ask you to monitor your thoughts and anxiety and record them in a thought log (see below).
I would then check in with you after the three-day period is over to determine:
- Were you able to hold off on seeking help from doctors and loved ones for the three-day period?
- Was the anxiety unbearable, like you predicted? Did it improve over time?
- Did you eventually go to the doctor after the three days were over?
- What was the outcome? Was the symptom a sign of a serious disease? Was it benign/body noise? Or did it go away altogether?
The experimental outcome I often see is that my clients’ symptom goes away during those three days and they end up not having to go to the doctor after all. Or, they go to the doctor after the three-day period but the doctor determines the symptom to be some sort of benign issue. My clients are then able to recognize that, hey, maybe some symptoms are in fact just “body noise” and not indicative of a serious disease.
Another experimental outcome I see is that my clients learn that they are capable of waiting a few days to go to the doctor or seek reassurance from loved ones. Their anxiety about not going to the doctor dissipated as the days went on. They get to learn that their safety behavior of reassurance-seeking is actually not as helpful as they think it is. They do not need it to be safe. They just think they do.
The lessons my clients learn from behavioral experiments are so much more valuable than me simply telling them these things. Why? Because lessons of any kind are so much more meaningful and powerful when you learn them yourself. Nothing can be more convincing than your own experiences.
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