Yesterday I wrote an article about how you can misinterpret bodily sensations in Health Anxiety and today I want to expand on a point I touched on in article; where we make mistakes in our thinking or cognitive distortions which is exactly what it sound like – your brain distorts your thoughts. It’s a fundamental part of Cognitive Behavioural Therapy (CBT) and if I take time and explain the concept today, it will hopefully help some of you who may read this post.

Before beginning it is important that you fully understand Health Anxiety and how it works, having a thorough understanding of the condition will make the following easier to understand.

Yesterday I spoke of how a tiny twinge sends your mind spiralling into a whirlwind of “what ifs”. A headache becomes a brain tumour. A cough? can be lung cancer. And it cognitive distortions that are behind all of these scary thoughts; they are thinking traps that distort your perception of reality.

These distortions are like those funhouse mirrors at the carnival, making everything look bigger, scarier, and more warped than it truly is. They take ordinary bodily sensations – a flutter in your chest, a bit of dizziness, an ache that lingers a little too long – and transform them into terrifying threats.

But rather than getting caught up in the emotion of them, I want you to learn to spot them and work with them and we can get started on that now.

Catastrophising

This distortion is a real drama queen, always jumping to the worst possible conclusion. It’s like your mind has a built-in disaster movie generator, constantly churning out terrifying “what if” scenarios.

I remember Sarah, a client who came to me convinced she had motor neurone disease. Why? Because she’d been experiencing occasional muscle twitches. And Mark, who was certain his persistent cough was a sign of lung cancer, despite being a lifelong non-smoker with no other symptoms. Catastrophizing can make even the smallest sensation seem like a life-or-death situation.

Most of the time, these catastrophic predictions are completely unfounded. So how do you challenge these types of thoughts?

You can think of it as the thought police, or a scientific experiment where you have to find evidence for your thoughts. Start paying closer attention to your thoughts. Notice when you’re slipping into “what if” mode. Are you automatically assuming the worst?

Look for evidence, if it helps imagine a scientist with their notebook gathering the evidence. Ask yourself, “What evidence do I actually have to support this scary thought?” Is there a simpler, more likely explanation? Maybe that chest twinge is just heartburn from that spicy curry you had last night. Or perhaps that cough is just a lingering cold.

It’s easy to get swept away by fear, but try to take a step back and think about the actual likelihood of your worst-case scenario coming true. Serious illnesses are relatively rare, while everyday aches and pains are incredibly common. It doesn’t matter at this stage whether you believe your new alternative explanation or not, the important point is that you start to get alternative explanations.

Overgeneralizing

Overgeneralizing is like that friend who always expects the worst. You have one bad experience, and suddenly, it becomes the blueprint for the rest of your life. You feel dizzy once, and boom, you’re convinced you’ll be dizzy forever. Your grandma had arthritis, so naturally, you assume you’re doomed to have it too.

This distortion can be incredibly limiting, making you afraid to try new things or even enjoy the present moment. But it’s important to remember that one instance doesn’t define your future.

• Look for the Exceptions: Challenge those sweeping statements. Has there ever been a time when you didn’t feel dizzy? Are there people in your family who don’t have arthritis?
• Remember the Bigger Picture: Dizziness can be caused by many things – dehydration, low blood sugar, even just standing up too quickly. And while genetics can play a role in some health conditions, lifestyle, environment, and other factors also contribute. Don’t let one isolated incident dictate your entire health narrative.

Personalization

This distortion makes you feel responsible for everything that goes wrong with your body. Got a stomach ache? Must be because you ate that extra slice of pizza. Caught a cold? Clearly, you should have worn a warmer coat. I found this Harvard article useful on distortions when they noted that often we use our emotions to inform our thoughts

For example, I had a client who struggled with this constantly. A headache meant she wasn’t managing her stress properly. A cold meant she wasn’t looking after herself well enough. This constant self-blame only amplified her anxiety.

It’s important to remember that you’re not solely responsible for your health. Many illnesses are caused by viruses, bacteria, or other factors completely outside your control.

Shift Your Focus: Instead of beating yourself up, try focusing on what you can do to support your wellbeing. Eat nutritious food, get enough sleep, manage stress, and move your body. These are the things you can control, and they make a far bigger difference than self-blame.

Black-and-White Thinking

This distortion sees the world in extremes. You’re either perfectly healthy or deathly ill. There’s no middle ground, no shades of grey. If your blood test isn’t flawless, you assume you have a terrible disease.

This kind of all-or-nothing thinking can be incredibly stressful, making you feel like you’re constantly teetering on the edge of a health crisis. But the truth is, health is rarely black and white.

• Embrace the Nuances: Most health conditions exist on a spectrum. There are varying degrees of severity, and even serious illnesses often have treatment options. Don’t let black-and-white thinking blind you to the nuances of your health.
• Talk to the Experts: If you’re worried about your health, don’t rely on Dr. Google for answers. Talk to your doctor. They can help you understand the complexities of your health and provide accurate information and reassurance.

Jumping to Conclusions

This distortion is a bit of a mind reader and a fortune teller all rolled into one. It loves to make assumptions and predictions without any real evidence. The doctor hasn’t called back yet? They must have found something terrible. You feel a little tired? You’re definitely coming down with the flu.

This kind of thinking can create a lot of unnecessary anxiety. It’s like living in a constant state of anticipation, always waiting for the other shoe to drop. When you find yourself jumping to conclusions, take a moment to question those assumptions. Is there another possible explanation? Maybe the doctor is just busy, or maybe you’re tired because you had a late night. Don’t let your mind run wild with worries about the future. Focus on the facts you have right now, and try to stay present in this moment.

It’s important to understand that these cognitive distortions aren’t just random quirks of thinking. They often stem from deeper underlying factors, I mentioned these in yesterday’s article but worth reiterating here.

• Past Experiences: Perhaps you’ve had a frightening health scare in the past, or maybe you witnessed a loved one struggle with a serious illness. These experiences can leave a lasting impact, making your brain hypersensitive to any sign of physical discomfort.
• Intolerance of Uncertainty: Many people with health anxiety find it incredibly difficult to tolerate uncertainty. They crave certainty and control, and bodily sensations, by their nature, are often ambiguous and unpredictable. This can lead to a constant need for reassurance and a tendency to jump to conclusions.
• Core Beliefs: Often, beneath these distortions lie deeper core beliefs about vulnerability, control, and self-worth. For example, you might believe, “If I’m not perfectly healthy, I’m a failure,” or “I can’t cope with being ill.” These beliefs can fuel the anxiety and make it harder to challenge the distortions.

Cultivating Self-Compassion: The Antidote to Anxiety

When you’re struggling with health anxiety, it’s easy to fall into a pattern of self-criticism. “Why am I so worried all the time?” “I should be able to control this.” But this kind of harsh self-talk only makes things worse.

Instead, try cultivating self-compassion. This means treating yourself with the same kindness and understanding you would offer a friend. Here’s how:

• Identify the Inner Critic: Start noticing that critical voice in your head. What does it say? How does it make you feel?
• Develop a Compassionate Voice: Imagine what a kind and supportive friend would say to you in moments of anxiety. Cultivate that compassionate voice within yourself.
• Practice Self-Compassion: Use phrases like, “It’s okay to feel anxious, this is a difficult experience,” or “I’m doing my best, and that’s enough.” Repeat these phrases to yourself whenever you feel that inner critic starting to rear its ugly head.

Retraining Your Brain: Practical Tools for Transformation

Now that you have a deeper understanding of these distortions, here are a few practical tools to help you challenge them:

• Keep a Thought Journal: This is like having your own personal thought detective notebook. Whenever you notice a health worry creeping in, jot it down. Try to identify which distortion is fuelling that worry. Then, see if you can come up with a more balanced and realistic way of looking at the situation. Don’t worry if you don’t fully believe this new thought right away. The goal is simply to open your mind to the possibility that there might be other ways of interpreting what’s happening.
• Gather the Evidence: When you’re caught in a catastrophic thought, try this little exercise: grab a piece of paper and make two lists. On one side, list all the evidence that supports your fear. On the other side, list all the evidence that contradicts it. You might be surprised at how little evidence actually supports your worry, and how much evidence points in the opposite direction.
• Practice Mindfulness: Mindfulness meditation can be a real game-changer when it comes to managing anxiety. It helps you become more aware of your thoughts without getting swept away by them. It’s like creating a little space between you and your thoughts, so you can observe them without judgment. This can help you detach from those anxious thought patterns and see them for what they are – just thoughts, not facts.