Improve Your Health Anxiety With Behavioral Experiments

People with health anxiety tend to get tangled up in problematic behaviors, such as reassurance-seeking, excessive body checking and avoidance. These behaviors act like a vortex, sucking you into that vicious cycle that is so hard to break free from. There is an incredible sense of freedom that comes from learning to disengage from these behaviors. Let's talk about some baby steps you can take to accomplish this.

People with health anxiety tend to have similar patterns but we are all unique in our specific fears, triggers, assumptions and behaviors. In order to stop problematic behaviors, you need to first understand your own tendencies so you can tailor interventions to fit your specific health anxiety profile, so to speak.

Think back to times more recently when you have been anxious about your health. What did you do? Take a look at the list below for some common examples of things me and my clients have done.

• Seek reassurance from loved ones about symptoms
• Seek reassurance from doctors about symptoms
• Avoid the doctor, or the healthcare system in general, as much as possible
• Avoid reminders of diseases and/or death
• Seek reassurance from the internet about symptoms
• Seek information online after hearing someone's scary story or news update
• Obsessively poke, prod or evaluate a new symptom
• Conduct regular body scans to look for signs of a problem (e.g., lymph nodes, skin, heart rate)
• Do things to prevent potential medical disaster, such as staying close to medical facilities or going to great lengths to prevent disease

You might do all of these plus others. Don't beat yourself up. We all engage in more than one (often many) of these behaviors. Write your tendencies down so we can experiment.

Benefits of Behavioral Experiments

1. Experiments give you the opportunity to test out the accuracy of your beliefs. If you believe you need to see a doctor for every new symptom, try waiting three days for mild ones to see if it's necessary. If you avoid doctors out of fear of bad news, challenge this by scheduling checkups or tests. Experiencing the outcome firsthand is more powerful than relying on others' reassurances.

2. Behavioral experiments help you tolerate uncertainty without relying on safety behaviors—a key step in managing health anxiety. Health anxiety is often driven by the belief that uncertainty is dangerous. By gradually building tolerance through experiments, you can reduce anxiety and gain confidence in handling the unknown.

Ideas for Behavioral Experiments

Grab your list of specific behavioral tendencies when you get anxious about your health. We want to target your very specific behavior in a very specific way (see list below for ideas).

Behavioral experiment ideas for safety behaviors:

• Wait 3 days (or 1 week or 2 weeks) before scheduling a doctor appointment for a mild bodily sensation or symptom
• Don't do any internet research after noticing a new bodily sensation or symptom (for a designated period of time)
• Don't look up information about a disease after hearing about someone's scary or a news update
• Go to an event/place that is nowhere near a medical facility
• Go on a run, walk or bike ride without your cell phone
• Go a few hours or whole day without wearing your Apple Watch
• Go to the gym without checking your heart rate or breathing
• Refrain from asking any family or friends about what they think about a symptom for a period of time
• Avoid self-exams for a specific amount of time, such as a couple of days or a week (e.g., cognitive exam, lymph nodes, breast exam, checking stool, scanning your skin)
• Avoid checking vitals for a specific amount of time, such as several hours/days (e.g., checking heart rate, blood pressure, oxygen levels)

Behavioral experiment ideas for avoidance:

• Watch a clip (show, movie, YouTube, commercial) of someone getting a physical or exam
• Make an appointment to see your doctor for a check up/physical or a routine procedure (e.g., mammogram, colonoscopy)
• Read about health-related information or topics
• Visit a hospital
• Read the obituary section of a newspaper
• Read a movie or watch a book about someone struggling with a serious illness
• Make an appointment to get necessary follow up assessments or bloodwork
• Perform recommended self-exams at home (e.g., monthly breast exam)

Tips for Designing and Implementing Experiments

• Choose one (or more if you are feeling particularly ambitious) of these ideas to use for structuring your experiment.
• Pick the items that resonate most with you and then tweak it so that it fits you. Everyone is different. What is helpful for someone else will not necessarily be helpful for you.
• Make sure the experiment is challenging enough. I would say on a scale of 0-10, you want to do something that prompts anxiety because that will make the learning process more powerful (can shoot for at least a 6/7 out of 10).
• If you continue experimenting (which I recommend), gradually increase the difficulty as you build confidence. If you’ve avoided healthcare, start with small steps: first, imagine visiting the doctor (4/10), then watch a video of a physical exam (6/10), visit a waiting room without an appointment (7/10), schedule an appointment (8/10), attend it (9/10), and receive the results (10/10).
• Solicit the help and support of a trusted loved one. Getting support will help you to follow through with this and can be a great source of encouragement to help if it gets difficult.

Before, during and after your experiment, document the following in a thought log:

• Before the experiment: Document all the details of your upcoming experiment
• Before the experiment: Document your predictions about how the experiment will go. For example, if you are waiting 3 days to go to the doctor for a mild symptom, you might predict that: (a) the symptom will get out of control and will pose a serious threat to your health; and/or (b) you won't be able to handle the anxiety from this experience.
• During the experiment: Document your anxiety a few times throughout the process (0-10).
• After the experiment: Document what happened/the outcome (e.g., Did anything bad happen? How was your anxiety? Did your predictions come true?)
• After the experiment: For any bad outcomes or for any negative experiences (such as intense anxiety), how did you cope? What did you do? Did it help?
• After the experiment: What is your conclusion? Did you learn anything?

There you have it! This is just one step in the process. My clients and I design many experiments. Miracles aren't going to happen from doing this once. But my hope is that you will try this and feel empowered. You can then continue with additional experiments and build confidence slowly.