Anxiety Toolbox: The Complete Fear-Free Plan. Gloria Thomas
you feel phobic about?
(0–1 = none, 2–3 = slightly, 4–6 = moderately, 7–8 = marked, 9–10 = severely)
CASE STUDY for Phobias
Lesley is a 28-year-old homemaker who has two young children. The children were taught to swim by their father but they were keen for their mother to join in on the fun too. Lesley, however, had a phobia about swimming pools. As a child, she was thrown in at the deep end but, as she couldn’t swim, she had to be pulled from the water – much to her shame and humiliation. Lesley never got over her aversion to swimming pools and even the smell of chlorine seemed to paralyse her with fear and nausea. She was terrified that she would not be able to cope if one of the children got into trouble and got upset just at the thought of taking the children to the local pool.
Thankfully, the TFT phobia cure (see chapter five) got rid of Lesley’s phobia about swimming pools and she was able to enjoy an outing to the pool with her children.
Health Anxiety (Hypochondria)
Another very common preoccupation of individuals is worrying about their health. Of course we all think about our health at times, but if you experience on-going anxiety about it or obsess about bodily sensations then you may well have hypochondria. Both men and women suffer from it and it can be found in all age groups.
Hypochondriacs are constantly on the alert for oncoming illness and are therefore hypersensitive to bodily sensations and any symptoms of illness. Once they become aware of any symptoms – and they often do find ‘symptoms’ because they are always engaged in body checking – they blow them out of all proportion.
Those who suffer from severe health anxiety are constantly on the look out for reassurance from the medical profession and are convinced they are physically ill, despite medical reassurance to the contrary. The hypochondriac will pay frequent visits to doctors and often go from one professional to another, never quite convinced by the diagnosis. Often, if the diagnosis is confusing or conflicts with another, they become even more anxious, convinced that there is really something serious wrong with them – a headache becomes a sign of a malignant tumour, a tummy ache could be cancer and so on.
There is a very mixed reaction to this type of anxiety from the medical profession. Some doctors recognize it as a condition in itself, while others are completely intolerant and dread the familiar face of the hypochondriac in their practice.
Health anxiety is more prevalent in western society – which, perhaps, is not surprising. When all your needs are taken care of, you have more time to be introspective and anxious about your health. However, when each day is a battle to achieve a basic standard of living, there is little time to be concerned with irrational worries.
Expressing Vulnerability
Research suggests that anxieties about health are a means of expressing vulnerability. This process, called Somatization, occurs when emotions that we find difficult to express are transformed into a physical expression of the psychological pain. It is now well established that mind and body act as one. Everything you think and everything you feel produces chemical changes in the body. Hence, anxious and worrying thoughts can be expressed through the physical body.
It is thought that this is a very common way for men to express their feelings. Whilst many men refuse to recognize that they are worried or anxious, because they see it as being indicative of weakness, they are much more open to accepting physical illness as a sign that something is not quite right. According to Dr Lipsitt, professor of psychiatry at Harvard Medical School, most of us somatize but people with hypochondria clutch at their physical symptoms to explain why their life is so painful. It isn’t the ‘illness’ that is painful, but the underlying psychological conflict that manifests in physical symptoms. Some anxiety disorders, such as depression and OCD, develop as a result of somatizing.
Illness is also a very useful way of getting support, attention or time out. If, as children, we got away with using a tummy ache or headache to get out of something that we didn’t want to do, then we may well use this strategy in adulthood (consciously and unconsciously) to avoid things we don’t like or have difficulty confronting. At such times, we can develop aches or pains or suddenly become incapacitated by nausea or a feeling of faintness. People can also sometimes hold on to or develop an imagined illness because it is a good excuse to stop them getting on with their lives.
Of course, the problem with health anxiety is that powerful, worrying beliefs can lead to poor health – they are often a self-fulfilling prophecy. High levels of anxiety and stress create wear and tear in the body. One study, which assessed how the immune system responds to anxiety and stress, found that of the healthy individuals subjected to the cold virus those who were suffering from high anxiety developed a weakening of the immune system and were far more susceptible to the virus than those with lower anxiety levels.
The Symptoms of Hypochondria
Spending hours obsessing and worrying about health
Never being quite convinced by a doctor’s diagnosis
Using illness to avoid the challenges of life or to get sympathy from others
Thinking that an ache or pain means the worst is going to happen
Bodily checking
Frequent visits to the doctor
A medical cabinet full of pills and potions
Frequent hyper-alertness to bodily sensations
Fixation and selective attention to bodily events
Imagined symptoms of headache, gut pain, dizziness, nausea and fatigue
Self-Assessment
– On a scale of one to 10, how much do you suffer the symptoms of health anxiety?
(0–1 = none, 2–3 = slightly, 4–6 = moderate anxiety, 7–8 = marked, 9–10 = severely)
– How often do you suffer from health anxiety?
– Not at all/a little/some of the time/a lot of the time/all of the time
CASE STUDY for Hypochondria
Amanda came to see me because she was convinced she had a life-threatening stomach disorder. She had come back from travelling with a tropical disease that affected her stomach, yet despite being cured of this, some symptoms began to return. Her doctor did endless tests, but he could find nothing wrong with her.
Amanda travelled from expert to expert, never feeling that she was getting an answer. When she showed me her medical notes there were repeated statements from her doctors that she was ‘catastrophizing’ her condition. We spent a few sessions working on her beliefs, as it took some time for her to realize that her illness was a figment of