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
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 her imagination. I then used TFT for anxiety (see chapter five), and self-hypnosis and visualization to enable her to become more balanced physically, mentally and emotionally.
Post-Traumatic Stress Disorder (PTSD)
Whilst phobias and panic attacks are usually based on distorted or irrational fears, Post-Traumatic Stress Disorder, or PTSD, is caused by exposure to a real-life event that has a traumatic effect on the psyche. When traumatic situations deal your nervous system a real shock, the effects can last for years following the event. PTSD has been described as a normal human response to an abnormal condition. It is estimated that it affects approximately 1 per cent of the UK population and 5.2 million Americans. Women are more likely to develop it than men and it can occur at any age, including during childhood.
The original event that is at the root of the disorder can either be witnessed or experienced. Any reminder of this event triggers flashbacks and severe worry and anxiety. Such experiences can be very traumatic indeed and can be related to everything from witnessing the death of a loved one, to being involved in a car crash
