Learning to cope with health anxiety

Lorraine* had been going to her GP for years and, as she told me herself, had his heart broke.

Lorraine’s problem was that anytime she got a pain or an ache, she would convince herself that it was cancer or some other life-threatening condition.

Off she would go to the GP to be checked out. However, no matter how much he tried to reassure her that there was nothing to worry about, nor how many tests he did to back his opinion up, nothing he did switched off her anxiety that she was seriously ill.

I know in my heart that he is right and that I’m OK, but once I get the thought into my head, it takes on a life of its own

This had been going on for years. Lorraine lived in a constant state of anxiety that something bad was going to happen to her.

“I just can’t switch it off,” she told me.

“I know in my heart that he is right and that I’m OK, but once I get the thought into my head, it takes on a life of its own. I try Googling it, but no matter how I try to reassure myself, I end up convincing myself that I’m ill.”

I asked Lorraine to think about something: “Are you anxious that you have an illness or that you may have an illness?”

Lorraine thought about this for a while. She knew logically that she was OK. The more she thought about it, the more she realised, that it was that fact that she “may” have an illness that bothered her most.

It always amazes me when I ask that question, how quickly people realise that it’s the “may” that’s scaring them the most. By the time they get to me, nearly all understand that they are not ill but once they realise that all their efforts are in trying to convince themselves that they aren’t, a whole new world of understanding opens up.

When it came to anxiety, all her intelligence went out the window

This new insight brought Lorraine down a wonderful rabbit hole of awareness as to why she was doing this. You see, Lorraine was a mature, intelligent woman, as functional and rational as anyone else. Except in one area. When it came to anxiety, all her intelligence went out the window.

We looked at all the times she went to see her GP. Every time, she looked for reassurance, she was trying to achieve a demand that she must be 100% certain that she was not ill. The more certainty she looked for, the more uncertainty she found, until all she could see was the uncertainty.

Being in control

“I really don’t like uncertainty,” she said. “I always feel anxious if I’m not in control.”

And therein lay the problem. Since childhood, Lorraine had gone to great lengths to try to be in control of her life. And in a lot of ways, she had succeeded. However, by always trying to control things around her, she had never learned how to cope with things that she couldn’t control.

As with every other situation that she met in life, Lorraine either exercised control over it or avoided the situation altogether. Unfortunately, she couldn’t avoid her various aches and pains, which left her with only one option: to do everything she could to get 100% certainty that she wasn’t ill.

Over time, Lorraine – with a lot of practice – learned how to cope with the various uncertainties in her life without getting anxious

Which, as she had found out a long time ago, wasn’t possible.

Learning how to let go of trying to be in control of things she had no control over was our aim. Over time, Lorraine – with a lot of practice – learned how to cope with the various uncertainties in her life without getting anxious. In doing so, she was able to switch off her anxiety regarding her health.

One of the realities of living is that we have very little control over our lives. Sure, we might feel that we have control over certain aspects but if you look at the cereal that you had for breakfast then you’ll realise that even that was dependent on the farmer who grew it, the company that made it and the shop that sold it. We may have choices, but even those are dependent on a near infinite number of factors being in alignment.

The world, by its very nature, has a tendency to retain enough stability for long enough that you have a reasonable amount of certainty that if you plan something it will probably come true. But this is the nature of life, not because you are in control.

When we demand to be in control of everything around us then the more control we demand, the less control we feel we have.

[...] health anxiety has really nothing to do with your health

Control is demanding stability, certainty, security and order in our lives, which is not possible. The more you demand, the more instability, uncertainty, insecurity and disorder you find, until this is all you can see.

You can see this by watching how you get anxious over a million other little things. So, health anxiety has really nothing to do with your health. Your anxiety is just an example of where you are demanding 100% certainty in something that is not possible.

The secret to overcoming it is in learning how to accept the uncertainties of life without getting anxious. You can’t switch off your health anxiety without working on giving up trying to be in control of everything else.

So that is where you need to start. By practicing accepting little things as they are so your brain can learn how to accept everything as it is without getting anxious.

The great thing about Dr Google is that all the information you need is there. Unfortunately, you will only find what it is you are looking for. So, if you use Google to reassure yourself that you’re not ill, you’ll achieve the exact opposite and convince yourself that you are.

The more you Google it, the more you reinforce it and the worse you believe you are

“Confirmation bias” means that if we convince ourselves of something, then not only will we just see evidence that supports our belief, we will also dismiss any evidence that doesn’t.

When you Google while anxious, your brain isn’t able to balance what you are seeing. The more you Google it, the more you reinforce it and the worse you believe you are.

So, unless you are able to balance what it is you are seeing, then avoid Dr Google.

Trusting your GP means letting go of trying to be in control, which will mean feeling more anxious in the short term. But this allows you to practice switching off your anxiety to uncertainty.

To help this process, practice letting go of trying to control little things in your life.

Giving up trying to be in control allows us to feel and understand the vastness of our emotions but not be slaves to them

Take some simple thing that you are unsure of and make a conscious decision to accept it as it is. Practice diverting your brain into something like mindfulness that will help you soothe your nerves.

While you will feel more anxious at the start, it is like everything else in life: the more you practice, the better you will become at it.

Giving up trying to be in control allows us to feel and understand the vastness of our emotions but not be slaves to them.

As you get used to understanding the uncertainties of life without being overly anxious, your brain will adapt to not needing 100% certainty in order to feel OK.

*Name has been changed for anonymity

Enda Murphy is a cognitive behavioural therapist. For more details go to www.seeme.ie. Please email your own queries for Enda to advice@farmersjournal.ie

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