(for example globus sensation in the throat) and them Health Anxiety Treatment Cardiff

Health anxiety treatment: Health anxiety is the irrational and excessive preoccupation with having (or developing) a serious mental or physical medical condition. The condition is also known as illness anxiety disorder, (psycho) somatic symptom disorder and illness phobia (nosophobia). Health anxiety can be considered a category of OCD due to the obsessive nature of your health fears and ritualised compulsions to alleviate those fears.

In psychiatry, the terms hypochondria and hypochondriasis are also used to identify health anxiety. Unfortunately these terms have developed negative connotations. Being labelled a “hypochondriac” can be wrongly misconceived as being someone who is always ill or who has a tendency to “moan about everything that is wrong with them”.

In reality, health anxiety is a serious mental health disorder in which you can feel like a prisoner inside your own body. In a UK study, nearly 20% of those in hospital clinics met the criteria for having health anxiety. Accepting health anxiety can involve many challenges in your health anxiety treatment.

Health anxiety treatment: Types of health anxiety

There are two main categories of health anxiety. Each one tries to manage the discomfort of their symptoms. Some sufferers have traits in both categories however.

Health anxiety with avoidance behaviour: This type avoids attention, new information, diagnoses, and anything else that you have (mistakenly) connected as triggers for your symptoms e.g. exercise, drinking caffeine, television dramas, media articles etc. By playing silent or suppressing your thoughts, you believe that “not knowing” is a better way of coping with bad news. You don’t want to have your fears confirmed and go through the agony of major treatment. Instead, you deceive yourself that “it’s probably nothing”, hope that the symptoms will go away and potentially neglect your health for extensive periods. Some avoidant sufferers believe that your condition is (or that you are) not important enough to warrant treatment. You may be convinced that you are beyond help.

Health anxiety with reassurance behaviour: The category of health anxiety seeks attention, new information and diagnoses in order to be reassured, but the depth of reassurance is superficial. You hope that endless searching on the internet will give you the information that you want, but it rarely satisfies your need. Craving a certain kind of reassurance, this health anxiety sufferer is more vocal about signs and symptoms and this can be frustrating for your family members and friends to keep hearing about your ailments. Depending on your level of insecurity, you might complain to people close to you hoping that they can make an emotional connection or even open up to complete strangers in search of that novel reassuring response. They may have little or no medical knowledge, but their lack of medical authority is irrelevant. Those who have medical expertise could give you the release from your health anxiety but only if meets your specific emotional need in that moment. Frequent visits to the doctor complete the circle of help that is available to you. Yet the medical opinion you are offered is not convincing enough to give you long term reassurance, despite the tests showing negative results.

Is Munchausen Syndrome the same as health anxiety?

Munchausen syndrome (also called Factitious disorder) is a rare psychological condition in which the sufferer feigns or causes their illness in order to gain special attention or sympathy. You might impose it on yourself or somebody that you are caring for (also called Munchausen syndrome by proxy). Munchausen syndrome is characterised by manipulation of test results, lying about symptoms, harming yourself to create symptoms and seeing different medical staff who might believe that your symptoms are genuine. Health anxiety is different to Munchausen Syndrome because with health anxiety, you believe that you are ill but you do not manipulate your test results.

What is Malingering?

Malingering is similar to Munchausen syndrome in the way that the symptoms of illness are manipulated. Whereas Munchausen syndrome has no clear cause, malingering is motivated by personal gain. It might be financial gain from insurance claims, time off work, a reduction in work obligations, prescriptions for controlled medication or avoiding military duty and prison time.

Health anxiety treatment: What causes health anxiety?

There is no single cause of health anxiety. A combination of background factors, traumas and coping mechanisms are likely to contribute to developing this condition.

There are some factors that can make you more vulnerable to experience health anxiety. These include:

Genetic factors – Your genes may predispose you to develop generalised anxiety. This can influence the development of certain mental health conditions. This does not mean that you are destined to develop health anxiety however.

Personality factors – You may be a “born worrier” or develop traits to worry from parental conditioning. The tendency to worry or struggle with uncertainty will increase your potential to develop health anxiety.

Life experiences – Many beliefs, attitudes and behaviours are learned from your parents and other significant authority figures. You will learn their values from what they say, how they say it, what they do and how they react to situations, particularly with reference to medical situations. This may then influence how you react to your own (or their) medical experiences.

As a child, these experiences can include:

• Personally being ill or other family members being ill.
• People close to you dying suddenly from an illness. Being made aware of your family member’s illness-signs and symptoms (that was the cause of their death).
• Being overly protected from illness as a child which can then influence you to be more fearful and insecure if you then suffer illness as an adult.
• Developing negative definitions of your personal health and the general wellbeing of your body. This can be formed by the amount of illness you have previously suffered and comparisons that you make to other people’s health.
• The timing of when you have sought medical attention after being concerned about possible signs and symptoms and the outcome of that medical diagnosis. For example, health anxiety can be formed when you have initially suppressed your health concerns, believing your condition to be benign. Then some time after, you are diagnosed with a serious illness and attribute your delay to seek medical help as the cause of your serious illness. As a reaction to this situation, you may then consider the trauma as “proof” that a premonition or physical sensation in the future must be more serious than it actually is.

Adulthood vulnerability factors

As you move into adulthood, your life experiences may involve having a career in which the performance of your body is essential to your success. Musicians, singers, dancers, sportspeople, surgeons etc. are all involved in perfecting skills with the precise functioning of body organs and muscle groups to the level of professional peak performance. Your peak performance state of awareness can be instinctive. But the effect of injury, illness, stress, periods of under-performance and performance anxiety can cause you to become hypervigilant to bodily changes when performances aren’t perfect.

As you work on the solutions to your performance, you can be convinced that psychosomatic sensations or tightness in the body are more serious health conditions and problematic causes of your under-performance. The bodily sensations become the new focus of your attention during your performances. This distracts you even more from the demands of the immediate task and becomes another issue that takes you further away from your peak performance level.

Triggering events

In addition to vulnerability factors listed above, certain triggering events can also reinforce the development of your health anxiety.  Again, experiencing further personal illnesses and grieving illness-related deaths to someone close to you are important reinforcing events.

Other triggering events can include external stressful and anxious traumas like a relationship breakup that coincide with periods of illness. During this period of hypervigilance, both of these events can become subconsciously connected so that when there is say a future illness, it generates subconscious anxiety or stress symptoms. Or when you have future period of stress or anxiety, you feel emotionally “unwell” without being able to formally diagnose your illness.

Learning experiences can also act as triggering events in the development of health anxiety. Sensationalised or dramatised portrayal of illness in the media can influence certain viewers to believe that these traumas are factual. Without filtering your understanding of the content, you may be traumatised by the media viewing.

Traumatic learning experiences can also triggered during medical training. When studying medicine, you may not have anticipated the near-fatal consequences of certain signs and symptoms that you have personally experienced (and possibly ignored) before your medical studies.

Health anxiety treatment: What causes health anxiety to persist?

The health anxiety causes already discussed can lay the foundations of a negative belief system that is highly sensitive and receptive to bodily sensations. You are likely to (mis) interpret and (over) react to these bodily signs and symptoms thereby maintaining your health anxiety beliefs.

Some of the negative beliefs that become established and maintain your health anxiety include:

You overreact to your body sensations. This is a continuous cycle in which your hyper attention to your symptoms is amplifying your experience of the symptom. As you keep noticing it and give it more importance, the sensation is intensified.

You obsess over exaggerated health issues. Your health anxiety is now distorting your perception of your signs and symptoms. Your thoughts are illogical and your irrational handling of medical issues extends the uncertainty of a serious illness.

You have developed suppressive coping mechanisms. It’s normal to dismiss some issues that cause feelings of discomfort. Thought suppression is generally ineffective and can backfire with long term issues however. “Burying” important thoughts by trying to forget them can have the opposite effect and make them persist because the emotion pushes the issue back into your awareness. This ends up making the issue more pronounced in your mind when you aren’t busy focusing on anything particular.

You are compulsive in your checking and reassurance seeking. Objectively checking your body for potential problems and health changes can be a useful self help health tool. When you have health anxiety you are desperate to know that what you have is benign however. You will check your body because this method is easily available to you. But this can cause “false positives” with your feedback because you are already convinced that the situation is malevolent. The act of checking can also irritate the area creating sensations that you now believe must be serious. Stuck in this cycle of doubt and insecurity, you then seek external reassurance with a medical opinion, but this tends to only reassure you at the surface level. Checking your body and seeking medical opinion thus acts as a temporary release from your anxiety until the next issue surfaces. The reassurance-seeking process can be more harmful to your health anxiety if you become dependent on the reassurance to function.

You overuse avoidance and safety behaviours, and are convinced that they help you. Avoiding discomfort and finding a suitable “safety” distraction is a common defence mechanism to get you through your day. But these behavioural patterns are a short-term fix to overcoming health anxiety. Some behaviour can be superstitious without ever connecting with your return to good health.

Overusing these avoidance and safety behaviour can reduce your confidence to deal with the “real” anxiety issue in the long term. For example, drinking a moderate amount of coffee is not considered harmful. If you have health anxiety and are convinced that caffeine is the cause of your palpitations, you may avoid caffeine altogether yet still find that the palpitations persist. In this situation, avoiding caffeine is a type of “safety behaviour” because it gives you a feeling of control that you are acting on the issue. The actual issue of confronting the anxiety related to your symptoms still remains however.

Health anxiety treatment: Signs and symptoms of health anxiety

When you have health anxiety you may not have any physical symptoms yet you still worry about becoming seriously ill. Alternatively, you may be convinced that normal bodily sensations or minor physical symptoms (like a “gurgling” stomach, dull aches, a minor rash or feelings of weakness etc.) are signs of a serious medical condition. With or without a formal diagnosis your hyper-attention to these symptoms can persist.

Sometimes the stress and anxiety caused by your excessive worry can create additional sensations in your body e.g. twitching sensations or feelings of fatigue. These sensations can then become the new health anxiety focus as something more serious.

Signs and symptoms of health anxiety can include:

• Worrying that you have or will develop a serious illness.
• Feeling anxious about developing the same medical condition that a member of your family has previously had.
• Being preoccupied with bodily sensations or minor symptoms (for example globus sensation in the throat) and them developing into an acute medical condition.
• Overreacting to anyone’s analysis of your health.
• Struggling to function in your day e.g. to concentrate, relax or sleep because of your health worries. This can then impact negatively on your work, family and social life.
• Being immersed in self-examination for signs of a serious illness.
• Being overly cautious and avoiding certain people, activities or situations due to your fear of illness.
• Seeking reassurance from family and friends by frequently talking about health issues and your fear of developing an illness.
• Frequently consulting with medical professionals for reassurance about a potential illness, or…
• (Ironically), neglecting your own health and avoiding medical consultations and tests in case it confirms your worst fears of having a serious medical illness. You may even avoid medical television dramas since you struggle to separate fact from fiction.

  

• Giving minimal confidence to a medical diagnosis or being unconvinced about a negative test result in case something was missed. Worrying that a new symptom has developed since the test was taken and that it will need retesting.
• Constantly consulting with Dr Google by researching online for a medical diagnosis and confirming your fearful beliefs that what you have is a serious illness. This condition is known as cyberchondria and compuchondria.

Health anxiety treatment: How is Health anxiety treated?

Following a diagnosis from your doctor, treatment for health anxiety usually involves Cognitive Behavioural Therapy (CBT) to explore how your thoughts, beliefs and emotions are affecting your behaviour. In addition to therapy, anti depressant medication may also be prescribed to stabilise your condition.

How can hypnotherapy treat health anxiety?

Hypnotherapy is a viable and effective health anxiety treatment. This is how hypnotherapy can help:

Hypnotherapy can treat the anxiety behind your condition

When your physical sensations seem so real, it can be challenging to accept that this is being caused not from a serious “physical” medical illness, but from how you are worrying about your health. This shift in your perspective is fundamental to your treatment success. “Parts” hypnotherapy is an effective tool that can assist this change of perspective and deal with the subconscious emotional blocks hindering your progression.

Hypnotherapy can help you to confront your avoidance behaviour

Your avoidance behaviour is a temporary fix for your health anxiety. When you avoid something that reminds you of your illness like hospitals or medical television dramas, you feel better in the short-term. Avoidance has the long-term effect of prolonging your health anxiety however. An important part of your treatment is to build the confidence to face these situations. By confronting them, you will appreciate what coping skills are needed in those situations and acknowledge the accuracy of your imagined danger. Hypnotherapy can help you challenge your avoidance behaviour by visualising your confidence in those situations. Hypnotic techniques will enable you to break down the emotional structures that are keeping you in fear.

Hypnotherapy can reduce your reaction to bodily sensations

Your health anxiety is causing you to overreact to psychosomatic sensations. The attention that you are giving these sensations is a source of more distress. These sensations are benign, but the smallest change in feeling causes you to become more anxious about what this could be. Hypnotherapy can help you concentrate your attention into these sensations, changing how you perceive them. During hypnosis, you will appreciate that you have control over these bodily sensations. Visualisation work can be done to calm the alertness from these sensations and fade into the background of your mind.

Hypnotherapy can help you reframe the emotion from past traumas

Using regression techniques selectively, hypnotherapy can help you release the fear learned from the past traumas that are still influencing your negative emotions and behaviour. You will not be constantly dwelling on these past traumas but they act as stored “causes” in your subconscious mind. Contrary to other critiques of this approach, it is not necessary to trudge through every year of your life. Only the most relevant traumas are reframed for you to feel the emotional benefit from this approach.

Hypnotherapy can help you challenge your cognitive distortions

One of the many benefits of using hypnotherapy to treat your health anxiety is that it can be used in conjunction with other therapeutic approaches. Cognitive behavioural therapy (CBT) aims to help the client recognise and challenge the cognitive distortions that make health anxiety so distressing. They can include catastrophising events, struggling with uncertainty, being inflexible with beliefs and being convinced that your thoughts will cause future actions and situations. CBT hypnotherapy focuses on these cognitive distortions, retraining your mind to appreciate how these unhelpful styles of thinking are perpetuating your condition. Your mind can then embrace calmer and more rational ways of thinking about your health.

Hypnotherapy can help you reframe your beliefs about uncertainty

A major feature of health anxiety is your inability to cope with the uncertainty of your future health. When you believe that you are unable to control it, you adopt checking rituals and seek reassurance from others to alleviate your anxiety. These compulsions only give short-term relief however and rarely help you to tolerate uncertainty. When you can tolerate it, the compulsions can be abandoned. Hypnotherapy can help you increase your tolerance of uncertainty by helping you rehearse resisting your compulsive urges. You can learn to be comfortable “in uncertainty” without trying to excessively control it.

Hypnotherapy can help you to reduce your safety behaviour

Like avoidance behaviour, safety behaviours are (overt or covert) diversions that are carried out in order to prevent feared outcomes. They are useful when connected to an actual danger, but with a perceived danger, safety behaviours tend to prolong the anxiety; you do something else that helps you to feel better in the short term. An example can be casually asking non-medical friends (instead of speaking to a doctor) for their medical diagnosis, knowing that their opinion holds no authority and can be easily dismissed if their opinion causes you anxiety. Hypnotherapy can help you to identify and reduce your safety behaviours so that you can confront the fear behind your health anxiety.

Hypnotherapy can assist your graded exposure to health anxiety

Overcoming your health anxiety ultimately means confronting the fear that you have or will develop a serious health condition. Graded exposure is an approach that involves structured and repeated exposure to your fear. By getting acquainted with your fear you get used to the situations, bodily sensations or worries that are keeping you anxious. In the short term, it’s not unusual for your anxiety to elevate when taking a change in direction and confronting your fear. With persistence, your confidence will grow and you will be more in control of your health anxiety in the long term.  Hypnotherapy is an excellent method for using your imagination to confront your worries and alter how you perceive your bodily sensations. Exposure to the situations that you are currently avoiding can be discussed and built into your treatment programme.

For more information on health anxiety treatment contact Richard J D’Souza Hypnotherapy Cardiff