Overcoming Health Anxiety
Table of Contents
Chapter
3 Setting goals
Chapter
4 Dealing with distressing thoughts and images
Label
your thinking style
Decatastrophising
1
Physical effects of anxiety
2
Do a Survey of your friends
3
Trying to be certain is part of the problem
4.
Thinking bias
Responsibility
pie chart
Watching
your thoughts pass by
Chapter
5 Understand the process of worry
ABC
for Worry
CBA
for Worry
Worry
Beliefs
Chapter
6 learning to retrain your attention
What
is the motivation for being overly self-focused?
Chapter
7 Reducing anxiety by facing your fears
Dropping
safety behaviours
Exposure
Chapter 3 Setting goals
1.
Define short, medium and long term goals
2.
Establish your values such that you can spend
more time focussing on these and less focussing on your health anxiety
Chapter 4 Dealing with distressing thoughts and images
Label your thinking style
1.
Catastrophising
2.
Mind reading
3.
Mental filtering
4.
Disqualifying the positives
Monitor your thoughts and memories, do it for a day to
identify the main ones, then do it for a week and collect the number of
thoughts you have.
Decatastrophising
1 Physical effects of anxiety
Understanding the effect that anxiety has in terms of
physical symptoms
2 Do a Survey of your friends
Ask if they have similar symptoms as you do, or if they ever
have
3 Trying to be certain is part of the problem
To be certain that something isn’t the sign of an illness is
part of the problem, if you have continually treated abnormalities in a certain
way, what about treating it in a different way as if you have a worry about
your health problem
4. Thinking bias
If you have a thinking bias to assume the worst and you are
continually wrong, then why don’t you deliberately assume you are ok?
Responsibility pie chart
Think of an illness that you get, that you could prevent by
checking, work out who or what is responsible for you having the illness.
Watching your thoughts pass by
So imagine where you are, and you have a distressing
thought, how could you manage this, use a metaphor, look at where you are and
what you are doing?
Chapter 5 Understand the process of worry
Look at worry as something you do rather than suffer from.
ABC for Worry
Then do an ABC for worry, activating event, behaviour how
did you worry, then put down the intended and unintended consequences. There’s
a form on p103.
CBA for Worry
Worry Beliefs
Write down positive and negative beliefs about worry. Then
establish how true each of these beliefs are and how useful.
Chapter 6 learning to retrain your attention
In health anxiety, your attention is focussed on yourself,
on your body, on your mind, on you. The effect of this is that you become more
sensitive to small changes, you can make worse symptoms, If you focus on negative thoughts, they can be
magnified and increase their frequency and intensity.
What is the motivation for being overly self-focused?
What situations are you self-focussed
What are the benefits you think you get from being self-focused?
Maybe prevent illness
What is the motivation for being self-focused?
Challenges to use
1.
Would you recommend other people take this
approach
2.
Does this help you get things that are important
to you in your life?
3.
What is the cost of being self-focussed
Treatment
1.
Monitor where your attention is and what the
effect of this is on your anxiety and physical symptoms. Do this a couple of
times and compare when you have high internal focus and low internal focus, and
see what the difference is.
2.
Refocussing, any time you notice your attention
being on yourself refocus it on the environment or the task at hand
3.
Attentional training
a.
Get n sounds\locations
b.
Spend 5 minutes moving slowly between each
c.
Spend 5 minutes moving quickly between each
d.
Hold all together for 2 minutes
Chapter 7 Reducing anxiety by facing your fears
The fear in health anxiety is the triggers to it, these can
be thoughts, situations or sensations.
Theory A I have a medical condition
Theory B I have a problem with being excessively worried
about my health. Worrying about your health means you have become intolerant of
uncertainty about your health
Dropping safety behaviours
Safety behaviours are those behaviours that are used to keep
you safe, but prevent you from finding out that your fears are unfounded and
also have the unintended consequence of increasing your preoccupation with your
health and the intensity of the distress. Safety behaviours, increase physical
sensation, increase preoccupation, increase levels of distress and don’t get
you to find out that you would have been ok without doing them
Exposure
Expose to your triggers to health concern and stay with the
feeling until the fear drops by half without doing anything to reduce it, don’t
check, don’t reassure yourself just wait until the fear comes down. Write down a feared hierarchy and move slowly
up the list.
Use the exposure form on page 146 which is rather nice
Summary
Stages:
1.
Assess
a.
Early experiences
i.
Experience around illness
ii.
Experiences around people protecting themselves
from illness
b.
What are the triggers to worrying about health
anxiety
c.
What behaviours do you have to keep yourself
safe
d.
What do you avoid because of health problems
e.
What is your fear of having a serious health
problem, what do you think would happen, what makes you think you couldn’t cope
with it.
f.
What are your health based IBS, that underlie
each behaviour
i.
Checking can prevent me from having a health
problem
ii.
I’m likely to have a health problem
g.
What is your current preoccupation with health, i.e.
how much time do you put on it, how sensitive to news articles, to sensations
in your body etc., how has the preoccupation changed over the years
2.
Establish Theory A and Theory B
a.
Theory A I have a medical problem
b.
Theory B I am anxious about having a medical problem
3.
Conceptualise
a.
Do a functional analysis (have at the top both
the preoccupation with health anxiety and I have a problem with my health, i.e.
Theory a and b)
i.
Find a bump
ii.
Have a thought
iii.
Get anxious
iv.
Get physiological response which can provide
more evidence
v.
Do something to feel absolutely certain there is
no problem
vi.
Reduce anxiety
b.
List all the triggers, in a box on the diagram
of the functional analysis above.
c.
List all the behaviours, in a box on the diagram
of the functional analysis above
d. Establish what the short and long term
impact of the behaviours is
i.
This results in what the point of these behaviours
is and gives us a treatment option already, draw this on the conceptualisation
4.
Treatment
a.
Theory A/B
i.
Establish what you would need to do if theory
A or B is true
ii.
Rate theory A and Theory B
iii.
What is the back ground to supporting theory A\B
iv.
How much do you believe theory a/b.
v.
What gives us evidence to support theory A or
theory B
b.
Testing effects of various behaviours to prove
short\term long term effect
c.
Managing the triggers
i.
Exposure to triggers without response prevention
ii.
Finding body abnormality
1.
Do the thumb test
2.
Establish beliefs about abnormality and health
a.
Challenge, do nice recommend this, should
everyone operate this standard
3.
Try reducing checking to a tenth of what you do
at the moment and see the impact of how many abnormalities you find
iii.
Thoughts
1.
Challenge
2.
Mindfulness
3.
Best\worst\most likely case
d.
Managing behaviours
i.
Increase the behaviour see if it decreases
anxiety or provokes it
ii.
Deal with Worry (CBA, worry time,
decatastrophise)
iii.
Socratically question criteria for certainty and
its affect (You can never prove, with absolute certainty that something isn’t
the case)
e.
General
i.
Self-focussed attention
1.
Do the self attention focus monitoring to see
the effect then do the treatment
