The Vicious Cycle of Health Anxiety


If you have severe health anxiety, you likely hold dysfunctional beliefs about health and illness. These are known as core beliefs. Core beliefs typically originate early in life through personally significant life experiences.

Perhaps you had a sick family member growing up or watched a loved one suffer from a disease. Or perhaps you felt unsafe in life due to certain experiences and, thus, learned to be on the lookout for potential threats and dangers. Your experiences led you to see health and illness in a certain way.

How Dysfunctional Beliefs About Health and Illness Develop

Now, once your health-related beliefs are solidified, then the process of reinforcement begins. Essentially, you began to scan your environment and selectively attend to all the pieces of “evidence” that support your belief system.

You may have paid special attention to situations when a loved one struggle with an illness. You might have read all about various diseases online or in medical texts. You might have watched movies or read books about people struggling with illness. You likely paid much more attention to the stories about sickness and death than all the people and situations around you representing health and wellness.

As a result of all of this, you developed a very biased and skewed view of health and sickness. Eventually, your dysfunctional beliefs strengthened because they had been reinforced for years through selective attention.

How Dysfunctional Beliefs Worsen Health Anxiety

There is a process by which dysfunctional beliefs about health increases health anxiety. Your dysfunctional beliefs make you worry about illness and, thus, engage in what is called “body vigilance.” Body vigilance is when you pay close attention to all your bodily sensations and symptoms.

You then misinterpret ambiguous or benign symptoms as being indicative of some potential health problem and subsequently “catastrophize” or come up with worst-case scenarios about said symptoms or bodily sensations (i.e., “this heart fluttering is the beginning of a heart attack”). These conclusions naturally increase your anxiety, and then you engage in safety behaviors to reduce the anxiety (e.g., googling symptoms, reassurance-seeking, excessive body checking), which only worsens the anxiety. This further reinforces your dysfunctional beliefs, and then the cycle begins all over again.

How to Improve Health Anxiety

The key to overcoming health anxiety is to disrupt this dysfunctional process. With cognitive behavioral therapy (CBT), we target each of these components. We challenge distorted thoughts with Socratic dialogue or logic-based questions. We engage in exposure exercises to improve one’s tolerance of bodily sensations as well as to reduce the use of safety behaviors. We reshape dysfunctional core beliefs into more accurate and adaptive beliefs. CBT to the rescue!

To find a therapist near you, visit the Psychology Today Therapy Directory.


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