hi everyone today's video is a continuation in our series of videos on understanding and managing
health anxiety and this video is particularly important in that it brings together a lot of
the information that I've previously talked about in other videos and brings it into a cohesive
model to help you understand why health anxiety happens and what's going on when you experience
high levels of anxiety about your health before I get into that just a couple of disclaimers to
go over I'm a registered psychologist in the province of British Columbia Canada and this
video is for informational purposes only it is not intended as a substitute or replacement for advice
from your doctor or mental health professional so with those things out of the way let's start
talking about a model of health anxiety now as I mentioned before this is a continuation in
our series of videos about understanding and managing health anxiety this video builds a
model that's based on information that I've talked about in another in a number of the other videos
and I want to link to them so that you can watch those videos if you're interested in learning more
so with that background let's start talking about a model for understanding what happens in health
anxiety and how health anxiety is maintained so it all starts with a trigger we all experience
internal or external Health triggers from time to time this could be things like unusual feelings
or Sensations in my throat a new mole that I've noticed reading a magazine article about
someone who developed throat cancer or finding out about a friend who developed some serious medical
disease or illness we experience these types of triggers all the time but not everyone who's
exposed to these triggers actually experiences high levels of anxiety about their health
in health anxiety though what the trigger does is that it activates unhelpful rules or assumptions
that the person has about their health and what it means to be healthy and what it means to be sick
these underlying rules and assumptions can develop from a variety of different
types of negative Health experiences in the past things like having experienced a medical problem
yourself in the past having had a family member experience a serious illness seeing a loved one
pass away from some health condition having family members who have health anxiety themselves finding
negative information about health and disease on the Internet or from other sources of information
these rules and assumptions are there and they lie dormant until some trigger happens and then the
rules and assumptions become activated it's almost like a light switch gets turned on and these rules
and assumptions begin to affect how I think how I feel and what I do in response to the trigger
so if one of my underlying rules and assumptions about health is that I must not have any physical
symptoms signs of pain or discomfort in order for me to be healthy or if I have
a belief that if I were to miss paying attention to some important symptom then it could kill me
so I have these beliefs imagine what would happen if I notice some pain and tenderness in the side
of my throat this activates my underlying beliefs and assumptions about my health and maybe one of
those beliefs is that any sign of pain or soreness is indicative of some illness or disease well how
do you think I would feel how do you think I would react if I thought those things about the pain and
tenderness in the side of my throat how would I feel every time I notice that tenderness how
would that affect what I think about what the pain and the tenderness of my throat actually means
so when the triggers interact with these underlying rules and assumptions these
this places a person had increased risk of experience of experiencing health anxiety
it's become it's because they become much more likely to misinterpret The Body Sensations or
the body symptoms as a sign of serious illness they may misinterpret health related information
and this may set off more physical symptoms and that causes me to worry more and more about it
so I noticed the pain and tenderness in my throat I think to myself that I
need to pay attention to this otherwise it could kill me and that leads me to start
believing that this could be throat cancer and so what I do is I go see my doctor who
takes a look at the area and says it doesn't look too serious but let's keep monitoring it
I interpret that to mean that my doctor doesn't really know what's going on and why
would I have to keep monitoring it unless it's something really bad or dangerous
so I have all of these unhelpful and negative thoughts about my health and what this soreness
and tenderness on the side of my neck means and these unhelpful and negative thoughts trigger all
sorts of anxiety things like increased muscle tension my heart might start racing I I might
be more short of breath or lightheaded I might experience dryness in my mouth I might experience
dryness in my throat these are all normal physical Sensations associated with anxiety but in this
context these physical sensations of anxiety just serve to act as another set of triggers that
activate my unhelpful rules and assumptions about health and cause me even more negative thoughts
about danger or threat related to my health that it just makes me more and more anxious
so as I'm starting to feel more and more anxious I want to do something to make the anxiety go away
I want to do something to alleviate the distress and to alleviate the discomfort of the anxiety I'm
feeling and through this process I it could feel like I'm spiraling out of control with my anxiety
and so there's three main things that I might try to do to try and get greater
clarification on what's going on or to try and make me feel less anxious or less fearful
about what's happening with my health first thing I might do is focus on the symptoms
if I'm afraid of what's going on with my neck and the tenderness and soreness I might be tempted
to pay really close attention to all of the sensations to notice if they're getting worse
if they're changing if the pain or soreness is spreading I want to know all of these things so
by focusing on it I'm now noticing every little minor change and new sensation in my throat area
I've also talked in a previous video about how paying attention to physical Sensations
and focusing on the sensations can actually make that physical sensation feel more intense
so think about the impact that would have the more I'm focusing on these physical Sensations the more
intense they're feeling do you see that the Trap that the health anxiety is setting setting up for
me now the second thing I might do to try to alleviate my anxiety is to engage in checking
and reassurance seeking I might check my throat or my mouth I may look at my tongue in the mirror
I may touch or probe and prod at the area on my my neck to see if it's getting more sore or less sore
I might go on to the internet and use Dr Google to try and find out what might be
the possible underlying cause of this soreness and tenderness in my throat
I may make an appointment with my doctor to get some reassurance or to get some testing
done to see what my doctor thinks is going on and this may take multiple appointments
because my doctor isn't giving me the certainty and the absolute answers that I'm looking for
the other thing I might do to try and reduce my anxiety is avoidance or engage in safety
behaviors I may start avoiding anything to do with medical information I might stop watching
medical dramas on TV or watching documentaries about health or hospitals if any news story comes
on TV that's talking about cancer I'll change the channel because I I don't want to hear about it I
might avoid any places that I might get sick out of fear that my immune system has been compromised
by whatever is going on in my throat I avoid all sorts of things to try and stop the worrying about
my health so let's think about what happens if we engage in these types of behaviors to
try and reduce our anxiety we hyper focus on the symptoms we check them a lot and seek reassurance
about them and we engage in avoidance and safety behaviors related to the physical Sensations and
are concerned about what they mean in the short term what this does is it gives me a temporary
sense of relief or control over the symptoms if I see my doctor and my doctor says at this point
it doesn't look like it's anything serious it's probably just an inflamed lymph node no big deal
that may give me a little bit of sense of relief in that moment
but then I start to think about what did my doctor mean by using the word probably so the short-term
relief from the anxiety by engaging in these behaviors is temporary and tends to be short-lived
but what are the long-term effects of these anxiety-reducing behaviors what are the long-term
consequences well there are a number of long-term consequences of engaging in these behaviors I've
already talked about how focusing on the physical Sensations can actually increase the intensity of
the physical sensation checking behaviors such as poking and prodding on the side of my neck to see
if the pain or tenderness is spreading that may lead to further inflammation and further
tenderness and it's the actual checking Behavior that's causing the more pain and tenderness
seeking reassurance or certainty from my doctor or seeking information on the internet all that
ends up doing is creating even more uncertainty about what's actually going on and I never get
the reassurance that there is nothing seriously wrong here in fact it might lead me to discover
all sorts of new and awful potential causes of the pain or tenderness in my throat
even though these might be extremely rare conditions I'm now aware that I might have
this super rare but extremely awful health condition by avoiding situations it limits my
opportunities to challenge my perceived threat in a situation if I'm concerned that my immune system
is lower because of what's going on in my throat I avoid all of the places where I could potentially
get sick and it never gives me an opportunity to actually see if I would get sick in those places
Maybe not maybe there's nothing that I should be fearing about being in those places
this avoidance also tends to make my world much smaller and leads to functional interference
and limitations in my life so what ends up happening is my worry about my health
and what's going on in my throat continues and probably increases which then increases my anxiety
which in turn brings on new physical sensations of anxiety which leads me to question what's going on
now it's just started in my throat but now I'm noticing pain and soreness in my shoulders and
my neck is it spreading this leads to an increased desire to focus on the symptoms to check and seek
reassurance about what's happening now why is it spreading and to avoid and use safety behaviors
to try and make me less anxious and it's just a vicious cycle that keeps going and going and going
so as you look at this model of health anxiety you might feel a little overwhelmed to see how some
of the things that you do to try and control or reduce your worry or anxiety about health
is actually making your worry and anxiety worse p is by understanding this process by understanding
what causes and maintains the health anxiety there are things that you can do to interrupt
this process and break the Vicious Cycles and that's what I'm going to be discussing in future
videos practical things you can do and new ways to think to interrupt this health anxiety process but
it's key and critical to understand what's going on because the tools and skills that we're going
to be talking about come directly from this model and if you want to learn more about health anxiety
I'd encourage you to check out this video as well that I've posted so that's it for today's video as
always thank you for making it all the way to the end of this video and I'll see you in the next one