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Stop Being a Hypochondriac

4 ways to trust your body more

Lilly was in her thirties and had experienced, in her mind, just about every major illness you've heard of (and a few you haven't). When I met her, she was almost permanently convinced that her immediate future held unspeakable medical horrors.

The hypochondriac doesn't want to be ill, but nor do they want to be dismissed as 'just imagining it'; it's a tormenting psychological catch-22. The paradox of hypochondria is that the sufferer often knows they are a hypochondriac even whilst maintaining they are justified in believing they are ill. This kind of 'double think' is at the heart of many obsessions. Merely trying to reassure someone directly seldom works.

Unsurprisingly, research shows that hypochondria runs in families. Family members 'teach' each other attitudes (or 'memes') (1) which then get passed on again.

It also won't surprise you that people are more likely to become a hypochondriac if they have witnessed serious illness (2). If you experience something horrible, your brain may wrongly tag the event as being much more likely to occur again. Probability gets all mixed up with possibility (which might be very small anyway) (3).

So, was Lilly's hypochondria typical?

Hypochondria; fearing the worst

A key feature of hypochondria is the inability to be reassured by relatives, friends, or even medical experts for any length of time. Medical tests can become addictive but only serve to reassure momentarily:

"What if they missed something?" or "What if they mixed up the results?"

Lilly was the same. She'd be okay for a time, but sooner or later the doubts would grow back like recalcitrant weeds blocking the sunshine from giving what a garden really needs to flourish.

Her hypochondria was classic. Her mother had always been extremely anxious about health, and when Lilly was twenty-five, her father had been diagnosed with cancer and tragically died a few weeks later. Predictably, this was a huge shock to Lilly and her fear of illness greatly intensified after this, rippling out to affect her family, social, and love life.

"My husband is being driven to distraction and I worry that my eldest son Sam is starting to talk about his health; he's only four!"

There is something I try to avoid when working with anxious obsessions and I think you should avoid it, too.

What doesn't work

The worst advice is: "Try not to think about it." Why? Because trying not to think about something is still focussing on it. Distraction is a great technique for diminishing anxieties, but it needs to happen in such a way that the distraction feels natural. Otherwise, it's just a case of: "I know I'm trying to distract myself from the fear of what that headache may be..."

Anxiety is like water. It needs a container, a thought to give it shape; a channel to flow through. That 'shape' may be insecurity in a relationship, fear of the boss, hypochondria, or anything.

If you try to take away the container (by advising they try not to think about what they fear), the water is still there. To cure someone of an overwhelming worry, we need to deal with the source of the worry (the feelings), not just the container (the thoughts).

How Lilly stopped being a hypochondriac

Cognitive-behavioural psychotherapists may try to treat hypochondria by getting sufferers to analyze and alter their thoughts.

And certainly, challenging negative thoughts can be extremely powerful, but it's not the thoughts so much as the feelings that are the problem. Once you deal with the feelings, the thoughts take care of themselves. I asked Lilly when she really worried.

"Well, now I'm terrified I've got multiple sclerosis, I have been back and forth having various checks for this - all negative. But it's weird; why would I be getting these symptoms?"

"Are you more likely to worry about your health when you are generally stressed?"

"Yes. We went on holiday last summer and it was great and I actually didn't think about it at all."

I talked to her about the fact that it doesn't matter what you think so much as what you feel when you think it. It's fine to think about horrible possibilities if you feel relaxed when you do so. Now that's a weird idea.

"You have a wonderfully powerful imagination!" I told her. "But you need to stop getting sucked in by it. Stephen King writes horror, but he can imagine and think about these scary things without actually being scared by them! I myself can imagine an earthquake and being swallowed up by it - and I can fanaticize about this without becoming scared."

Hypochondriacs (and all worriers) fantasize about bad stuff, look for any signs that seem to confirm the fantasies as real, then believe the fantasy. Next, Lilly told me exactly how she worried.

Learning to relax whilst thinking the worst

Lilly was awakening in the early hours, imagining her symptoms, and bringing them on 'hypnotically'. She told me she'd wake up and then get the symptoms, rather than being woken by them.

She'd imagine herself getting sick, ill, weak, becoming incapacitated; eventually she'd imagine her own death and how her children would be devastated and how her friends would describe the tragedy.

Wow! That's a lot to 'try not to think about'. So... I encouraged her to think about it. Psychotherapists call this a 'paradoxical intervention' - you can call it 'crazy' if you like, but it worked.

It's easier and much more powerful to disentangle feeling from thoughts than to try to stop the thoughts directly. So I encouraged Lilly to relax, profoundly and deeply and, whilst totally relaxed, to imagine her usual fears over and over as one possibility (of many) projected onto a white board.

She could then have the thoughts with the fearful feelings greatly diminished. Once the feelings are gone, the thoughts naturally become much less compelling because there is nothing left to 'power' them.

Lilly was amazed how she could relax whilst imagining this. I set her this 'exercise in imagination' as a therapeutic task. If she woke in the night, she was to relax and then think about what it would be like to become ill whilst remaining relaxed.

Pretty soon, she started sleeping through and she found herself misusing her imagination less and less as, well, without the fear... what was the point? This is just one strategy we used (I also helped her feel less traumatized by the sudden death of her father years before), but by focussing on the feelings rather than the thoughts, her therapy was rapid and effective.

If you are troubled by hypochondria, try these tips:

1) Relax, relax, and relax

Remember what I said above about the emotions driving the thoughts being like water needing to find a container to give it shape. Well, the more you relax, the less your imagination will need to conjure up stuff to give shape to anxieties. If you are new to relaxation, try one of our relaxation sessions.

2) Beware of self-diagnosis

The Internet is wonderful in some ways, but 'looking up' your symptoms to 'see what you've got' is not a great idea. I've actually done this when someone close to me thought they were sick. The fact is that just about any symptom you care to imagine can be linked to virtually any disease or condition.

What's more, when you know what symptoms to look for, you may well find them. That's right: people can bring on their symptoms (to some extent). So ignorance really can be bliss because 'knowledge' may be no such thing.

Leave the diagnosis to experts who can look at your health in a wider context. My friend was convinced he had bladder cancer from self-diagnosis via websites... turned out he'd been eating too much beetroot.

3) Trust your body to look out for you

Remember and reflect on the fact that your body is your friend. It is always looking out for you. Its purpose is to keep you safe. Have some faith in it and take care of it.

Research unexpectedly shows that hypochondriacs are less likely to look after their health (4). It seems that many hypochondriacs smoke, drink (perhaps in an attempt to calm frayed nerves), and take little exercise (for fear of injury?). Look after your body and trust it to do its best for you.

4) Give your body a break

During a flight, nervous passengers tend to be hyper-aware of changes in the sounds, the speed, the amount the plane rattles during turbulence, the expressions on the faces of the cabin crew: "Oh no, what does that mean?" Being hyper-aware of every little change and then assigning scary meanings to those changes is a fast track to self-torment.

Hypochondriacs will be hyper-aware of every ache and pain, a muscle stiffness here, a dizzy spell after standing up too quickly there. Your body is supposed to alter and have variation of feeling. It's a self-regulating system and there are going to be natural and harmless changes in the way you experience your physical self.

Your body is always sending messages to your brain and vice versa. The vast majority of these messages are innocuous. Aches, pains, dizziness, stomach gurgling, pins and needles, and headaches are the symptoms of being alive.

Most of the time, these sensations signify that your body is just doing its thing the way it's supposed to. Hypochondria happens when people assume that any bodily signal is a portent to disaster when it isn't at all.

As you begin to worry less, you'll start to focus outward, engage in life, and feel more connected to other people. Overcoming hypochondria will be a major step to developing as a person in all kinds of ways.


  1. Dr Russell Noyes and colleagues at the University of Iowa Medical School Department of Psychiatry have published a comprehensive review of the subject. Dr Noyes's research found that relatives of hypochondriacs were, on average, visiting their doctor once a month, which is twice the average frequency of visits made by relatives of those who are genuinely unwell. R. Noyes Jr., C.S. Holt, R.L. Happel, and G. Roger, et al. (1997) 'A family study of hypochondriasis'. Journal of Nervous and Mental Disease (April 1997), 185, 223-232.
  2. See: R. Noyes Jr., R.L. Happel, and S.J. Yagla (1999). 'Correlates of hypochondriasis in a non-clinical population'. Pschosomatics (Nov-Dec 1999), 40 (6), 461-469.
  3. Phobias often result after a traumatic event. The phobic person now feels and believes that what they fear is much more likely to happen than it really is.
  4. A.J. Barsky (1998). 'A comprehensive approach to the chronically somatising patient'. Journal of Psychosomatic Research (Oct 1998), 45,(4), 301-306.
Published by Mark Tyrrell - in Health Issues