Breaking the cycle of Health anxiety: safety behaviors
Health Anxiety, often referred to as Hypochondria, involves excessive worry about having a serious illness despite having little or no physical symptoms. People with health anxiety often believe that they are ill or that they will soon become seriously ill, even when there is no medical evidence to support this fear. To cope with this overwhelming anxiety, they engage in safety behaviors—actions that they believe will prevent illness or reduce the anxiety associated with it. These safety behaviors can offer short-term relief but, in the long run, can reinforce and perpetuate the anxiety.
What Are Safety Behaviors in Health Anxiety?
Safety behaviors are mental or physical actions that individuals with health anxiety use to prevent or avoid the feared illness or to reassure themselves that they are not ill. These behaviors may temporarily reduce anxiety, but they prevent the person from confronting their irrational fears and lead to a cycle of increased worry and avoidance. Over time, safety behaviors can actually maintain and even intensify health anxiety.
Common Safety Behaviors in Health Anxiety
Here are some examples of safety behaviors that people with health anxiety often engage in:
Frequent Checking of Symptoms or the Body:
Example: Someone with health anxiety may constantly check their body for signs of illness, such as feeling their pulse, checking for lumps, or examining their skin for any changes.
Why it’s a safety behavior: The person checks for reassurance, hoping to confirm they are healthy. However, this checking can reinforce the fear that their body is a source of danger and make them hyper-aware of normal bodily sensations.
Seeking Reassurance from Others:
Example: A person may ask family members, friends, or even medical professionals repeatedly if their symptoms are normal or whether they think they’re seriously ill.
Why it’s a safety behavior: Reassurance-seeking provides temporary relief but does not resolve the underlying anxiety. It can also make the person more dependent on others for reassurance and increase the cycle of worry.
Excessive Googling or Researching Symptoms:
Example: Someone with health anxiety might spend hours researching symptoms online or reading medical articles to confirm or deny their fears about certain illnesses.
Why it’s a safety behavior: This is an attempt to gain certainty about health, but it often backfires. Internet searches can lead to "cyberchondria" (excessive health-related internet searches), reinforcing fear and making health anxiety worse.
Avoiding Certain Activities or Places:
Example: A person might avoid crowded places or public transportation because they fear exposure to illness, like germs or viruses. Alternatively, they might avoid exercise or certain foods for fear they could trigger or worsen a perceived health condition.
Why it’s a safety behavior: Avoidance can provide temporary relief from the fear of illness, but it prevents the individual from living a full life and facing their fears, which would help them learn that their concerns are often unwarranted.
Reassuring Oneself via Mental Checklists:
Example: Someone might mentally check themselves every few minutes to see if they feel any pain or discomfort, asking themselves, "Do I feel okay? Is anything abnormal?"
Why it’s a safety behavior: This mental checking reinforces the belief that they need to constantly monitor their health, and this focus on bodily sensations can increase anxiety. It prevents them from accepting uncertainty and allows the cycle of worry to continue.
Seeking Frequent Medical Tests and Examinations:
Example: A person with health anxiety might regularly go to the doctor or visit the emergency room for tests (e.g., blood tests, scans, X-rays) to check for a condition they fear having, even if there is no reason to suspect it.
Why it’s a safety behavior: The goal is to get "proof" that they are not sick. However, repeated testing only provides temporary reassurance and can lead to unnecessary medical procedures, further entrenching the anxiety and fear of illness.
Avoiding Physical Exertion or Stress:
Example: Someone might avoid strenuous physical activity, such as exercise or even carrying heavy objects, because they fear that it will strain their heart or lead to other health problems.
Why it’s a safety behavior: This avoidance prevents the person from engaging in healthy, normal activities and reinforces the belief that their body is fragile or at risk of serious illness.
Wearing Protective Gear or Using Germicides:
Example: A person with health anxiety might use hand sanitizer constantly, wear a face mask, or wipe down surfaces obsessively to avoid potential contamination or infection, even if there’s no real threat.
Why it’s a safety behavior: These behaviors give the individual a sense of control over their health, but they reinforce the fear that the world is full of dangerous germs or illnesses and that the person needs to protect themselves at all costs.
Avoiding Media or News about Health Issues:
Example: Some individuals with health anxiety might avoid watching the news or reading articles related to health, illness outbreaks, or medical conditions for fear that it will trigger anxiety about their own health.
Why it’s a safety behavior: Avoiding such information may temporarily reduce anxiety, but it prevents the person from confronting their fears in a realistic way and allows the anxiety to persist by avoiding situations that might challenge their worries.
Engaging in Symptom Substitution (Self-Diagnosing):
Example: If someone with health anxiety experiences a new or odd symptom (e.g., a headache), they may convince themselves that it is related to a serious disease (like a brain tumor), even if it's something harmless like tension or fatigue.
Why it’s a safety behavior: This pattern of self-diagnosing helps the person avoid feeling helpless, but it strengthens the belief that they have control over their illness anxiety, even if that "control" is based on irrational thinking.
Why Safety Behaviors Are Harmful
While safety behaviors might seem helpful in the short term, they often lead to the following negative consequences:
Reinforce the Fear: Engaging in safety behaviors can strengthen the belief that the feared illness is real and that the person is not safe. The behaviors provide a temporary sense of control but do not resolve the underlying worry.
Avoidance Prevents Exposure: Avoiding certain activities, people, or situations means that the person never faces the anxiety-provoking experience head-on, making it more difficult to overcome the fear in the long run.
Perpetuate Anxiety: Safety behaviors only provide short-term relief, which reinforces the need for the behavior whenever anxiety arises. Over time, the person may become more reliant on these behaviors, leading to heightened anxiety and increasing avoidance.
Inhibit Problem-Solving: Safety behaviors prevent individuals from confronting and testing their fears. For instance, repeatedly visiting doctors may give reassurance, but it doesn't allow the person to challenge the belief that they are seriously ill.
Impair Daily Functioning: When a person engages in numerous safety behaviors, it can take up a lot of time and energy, leading to distress and reducing the person’s overall quality of life. It can also cause the person to miss out on life experiences due to fear or avoidance.
Addressing Safety Behaviors in Therapy
To reduce and eventually eliminate safety behaviors, therapy—especially Cognitive Behavioral Therapy (CBT)—is often the most effective treatment. The goal is to:
Challenge the Beliefs: Cognitive restructuring is used to help the individual identify and challenge the irrational beliefs that fuel health anxiety. This includes questioning the likelihood of illness and examining the accuracy of their thoughts.
Gradual Exposure: Exposure therapy involves gradually confronting situations that trigger health anxiety (e.g., going to a doctor's office without expecting to get reassurance, avoiding constant symptom checking) while resisting safety behaviors. Over time, this helps reduce the anxiety associated with these situations.
Learning to Tolerate Uncertainty: Health anxiety is often driven by the need for certainty about one’s health. Therapy helps individuals become comfortable with uncertainty and teach them that it is okay not to know everything, particularly when it comes to health.
Mindfulness and Relaxation: Mindfulness techniques can help individuals stay present and focused, reducing the constant monitoring of their bodies and alleviating anxiety without relying on safety behaviors.
Breaking the Cycle of Reassurance: Gradually reducing reassurance-seeking behavior and learning to trust their body and mind can help individuals overcome the anxiety caused by constant doubt and fear.
Conclusion
Safety behaviors in health anxiety may provide temporary relief but ultimately reinforce the cycle of fear and worry about illness. By engaging in these behaviors, individuals prevent themselves from facing their fears and learning that the reality is often far less threatening than imagined. With the help of Cognitive Behavioral Therapy (CBT) and other therapeutic interventions, individuals with health anxiety can gradually reduce their reliance on safety behaviors, challenge irrational beliefs, and regain a sense of control over their health and well-being.
Meghan Cromie LPC is a specialist in treating health anxiety and has helped many regain control of their life. Reach out today for your free 15 minute call and take the first step towards a still mind.
