Explaining Health Anxiety

Jamie would have agreed if you had said he was a bit of a Hypochondriac, but he was just being polite because deep down he really did feel that something was wrong.

He took pride in being healthy and so it when he spent longer in the bathroom each day checking for physical signs of illness it explained to himself as common sense.

When he used the internet to reassure himself that that spot on his arm was not skin cancer, he told himself it was better to be safe than sorry.

His girlfriend became frustrated having to constantly reassure him that he didn’t have a temperature even though he had several electronic thermometers; one was not enough: what if one wasn’t working properly?

As he waited for his second GP appointment that month, he was sure that even though the blood test results had come back negative, maybe they had missed something. His doctor had reassured him that there was nothing to worry about, but there was that nagging doubt.

A few days later there would be another worrying symptom that Jamie would focus on and the whole thing would start again…

Like all anxiety, an unhealthy preoccupation with our health comes from a misinterpretation of the situation. There is nothing wrong with Jamie’s desire to be healthy as well as being proactive in seeking help for troublesome symptoms, but he has become fixated on the belief he is ill. 

The outsider may look at the situation and decide that there is nothing to be concerned about, but Jamie would view it as a sign of potential danger. The headache will be misinterpreted as a warning sign of a brain tumour, while someone else may take into account that they haven’t had time to eat or drink much today because things at work were busy and stressful.

Even if you point out the logical explanation for the symptoms, they will be dismissed and justification will be given.

“My sister had a problem with headaches so

I’m bound to get the same…they run in the family.”

The justification is a way of mitigating the illogical reasoning for their belief they are ill and the physical symptoms/sensations they are experiencing. The problem, of course, is the justification helps to support the misinterpretation and the unhelpful belief continues.

Anxiety itself creates physical symptoms. When we are anxious our heart can race, we can feel a tightness in our chest or struggle to breathe. We might feel nauseous and clammy. The person with health anxiety may misinterpret these as evidence of the illness.

In a form of confirmation bias, they seek out and focus on the evidence which confirms their misinterpretation that they are ill.

They know that they may be jumping to conclusions, that’s why they seek reassurance from family, friends and their doctors. Unfortunately, the reassurance is short-lived. They are stuck in a cycle of misinterpretation and anxiety.

Information from www.adaa.org

The symptoms of an anxiety attack and a heart attack are very similar (tightness in the chest, increased heart rate, feeling faint, shortness of breath). Of course, these should be investigated urgently like all physical symptoms, but we can see how this is fertile ground for the person with health anxiety to misinterpret the situation.

Jamie’s Experience…

Noticing a sensation or learning of an illness: 

For several days Jamie had been experiencing a funny feeling in his chest. Sometimes it felt like a tightness and other times a fluttering feeling. The more he thought about it the more often it happened. He began to note in his phone how many times it happened and the circumstances surrounding each episode. Each morning he would wake and check how he felt, and he bought a new wristwatch so he could monitor his heart rate. On his commute to work, he would scan the NHS website too checking on the possible conditions.

Misinterpreting the potential danger: 

It isn’t too long before Jamie’s own diagnosis of a heart attack was becoming more clear to him. He thought back over the months before he had the symptoms and remembers a time when he had to stop football training because he was so out of breath, surely that was a sign he had missed. He decides he should stop football training for a while. He began to note down his heart rate at different intervals throughout the day. When he showed his girlfriend the readings, she pointed out that he was anxious when he checked his heart rate so that might explain why it was high, he felt reassured for a short while, but then felt anxious about not being taken seriously.

Anxious and Seeking Reassurance: Late one evening, while everyone is in bed, Jamie was watching television unable to sleep from the nagging feeling that he had a problem with his heart. He knew heart disease is common in his family, so he is sure he will suffer too. The more he thought about it the more he felt that strange tightness in his chest and the nauseous feeling returned. He began to develop a metallic taste in his mouth and he had to go outside to get some fresh air. He couldn’t seem to shake the idea that something terrible was going to happen, he didn’t want to worry his family so he began walking to A & E and every step confirms for Jamie that they are going to confirm his worse fears.

Reassurance and a Temporary Reduction in Anxiety: Two hours later after an ECG and blood test results, Jamie was sat in front of a doctor who patiently told him that it was good news, he was not having a heart attack. The doctor explained that it was quite likely he had had a panic attack, had he experienced those before? It was true that Jamie was now feeling better. The tightness had gone and he didn’t feel sick anymore, perhaps it was just anxiety after all?


As he walked home Jamie looked at his phone and the messages from his worried girlfriend. He called her back, but even as he waited for her to answer, he couldn’t shake the thought… what if they were wrong? Maybe the machines weren’t working properly? Maybe it’s a different sort of problem that the tests couldn’t detect?


Once again… It is absolutely right that Jamie should have urgently sorted out help if he was experiencing some of the common symptoms of a heart attack, but I’m sure you can see that his preoccupation of with the belief that something was wrong was distorting his view of the situation.

Even when his GP patiently explained the results from the tests again, Jamie still found he doubted that they were correct. He found it difficult to take in his doctor's reassurance that he was young, fit and healthy and his lifestyle was the best it could be to help prevent heart disease. Jamie couldn’t shake the thought that perhaps he was the exception.

How Can You Manage Health Anxiety Right Now?

While management techniques may not remove the anxiety, they can be used to control the physical and psychological symptoms in the short-term.

Make your focus what you CAN control in the seemingly uncontrollable situation

Remember that all anxiety is an exaggerated response to a perceived threat, so to rationalise the situation will help to keep anxiety from increasing.

Let’s use the example of someone being anxious during the pandemic…

What measures have you put in place to be safe?

You have isolated yourself and followed the guidance regarding lockdown. Remind yourself of the logic that this reduces your risk of coming into contact with the virus.

Where you have been outside (supermarket or daily exercise) you have ensured you followed social distancing.

You have regularly followed the hygiene rules, washing your hands and/or used sanitiser.

You journeys have been restricted to those that are essential.

Remind yourself of how you have followed the guidance 

so the threat to you and your health is reduced.

Seek out information that supports your feeling calm. Consider minimising your use of social media and news coverage. It can also be a good idea to have a friend or relative curate the information you read. They can ensure you see as balanced a view of the situation as possible, rather than you only seeking out the information that would confirm your anxiety.

Ask yourself: Where Might Have I Made A Misinterpretation?

General Rational Reminders

Just because you think something is true, doesn’t make it true. At moments of anxiety remind yourself it is not a permanent state, it ebbs and flows. Even when anxiety is at its highest point, experience tells you that it will subside.

Anxiety is an over-estimating of danger and an under-estimation of our ability to cope. Ultimately we should aim for a balance. Being cautious is a reasonable response but not so much that it interferes with your enjoyment of living.

How Does Hypnotherapy Help?

While Hypnotherapy using suggestion can be helpful when managing the immediate symptoms of anxiety, Hypnoanalysis aims to resolve the causes of anxiety permanently.

Anxiety is a manifestation of past trauma/experiences; an outward expression of inner anxiety. In reaction to health anxiety, the cause may be directly or indirectly related to health.

Experiences and traumas from our past have to be interpreted and understood by the person if they avoid them causing emotional problems in later life. Unfortunately, as children, we found it difficult to process unpleasant experiences because we didn’t have the life experience, so the negative effects remain.

Broadly speaking, talking therapy helps the person process the event. They are able to discuss, think through and feel the bottled emotions in a safe environment. The purpose of talking therapy is to understand events and the interpretations we made at the time.

Sometimes people will say: “I know that is was upsetting. What’s the point of talking about it?” Unless they have processed the interpretations they made of events at the time, they haven’t fully processed it and the symptoms are likely to continue.

We also have to understand how those interpretations, where once useful, may now be doing more harm than good.

Don’t we do that we friends and relatives anyway? Yes, and this is the way we deal with minor upsets. When an event is intensely distressing, just talking to our friends and family means they become mixed up in it. This is a problem…There is no escaping those thoughts when the discussion is over, those people are still there.

The time spent with your therapist is a place where those conversations can be parked and revisited in a controlled and useful manner.

Find out more about how Hypnoanalysis can help with Health Anxiety, here.

NB: Jamie is a fictionalised case based on the typical experience of clients with Health Anxiety