When every headache is a brain tumour

Two Canadian physicians have an advice book for those with obsessive health worries
Julia McKinnell
When every headache is a brain tumour
Joos Mind/Getty Images, iStock; Photo Illustration by Taylor Shute

A bit of worry is a good thing if it motivates you to watch your weight or see a dentist. But if you’re convinced every headache is a brain tumour, your fears may be ruining your life and making your family angry. Overcoming Health Anxiety: Letting Go of Your Fear of Illness is a new advice book by two Canadian doctors aimed at those who want to gain control over obsessive health worries.

Authors Katherine Owens and Martin Antony give the example of “Eduardo,” a successful businessman, who became terrified he would keel over and die after learning he had a mild coronary heart disease. “Eduardo stopped sharing in the family meals, feeling it was better for his digestion if he ate bland items in quiet solitude. He quit drinking coffee, tea, and soda, because he experienced frightening sensations from the caffeine. He also started to avoid saunas, sex, and exercise. Eduardo’s world shrank by the day.”

Health worriers like Eduardo are urged to write down in a notebook their fears and behaviours. “Be as specific as possible. Instead of just writing, ‘My relationship with my kids is terrible,’ think about the details. How is it terrible? Perhaps you don’t spend enough time with them. You avoid them if they are sick. Maybe your children look at you as if you are crazy when you start talking about your fears.” Examples of worries include, “I think my doctor is starting to avoid me, she postponed our last two appointments.”

Next, the anxious are encouraged to write down “detailed and clear” goals. For instance, ignoring your heart rate is too vague a goal. A more specific goal would be “to take my pulse and blood pressure no more than once a week.” They should also track their thoughts, the authors advise. “The very act of recording a behaviour can lead to a change in the frequency of the behaviour. Here’s what one man cited in the book wrote down: “Situation: parked outside the airport to pick up my wife. Anxiety-provoking thoughts: airplanes are full of dangerous germs. I’ll get sick because my wife dragged these germs into my car, and it will drive a wedge between us. My wife doesn’t care if I get sick. Anxiety level (0-100): 85.”

In this kind of situation, the authors write, the worrier needs to start challenging the anxious thoughts. Instead of, “My wife doesn’t care if I get sick,” the focus should be on alternate thoughts such as “flying is not as germy as I think,” and, “My wife wants a ride home from me because it is cheaper and easier than taking a cab.”

The goal is to try to seek a more realistic conclusion. For instance, “My wife has flown before and I have never actually gotten sick from driving her home. Although I find it frightening, asking me for a ride home does not mean she doesn’t care about my health, and it does not mean I will get sick.” New anxiety level: 40 out of 100.

Next, worriers should log how often they ask for reassurance. The authors use the example of “Mario”: “February 18. Needed to know that my urine is perfectly clear, not cloudy at all. Source of reassurance: wife. Anxious thought: My urine looked like it might be cloudy: I may have a kidney or bladder infection. How the other person felt: angry, frustrated, sad.”

Mario, the authors report, then makes an effort not to ask for his wife’s reassurance. “He urinated as usual and really put his willpower to the test; he felt a strong desire to ask his wife the typical string of questions. Partly, asking had become a habit, but the main reason for asking was a rising level of anxiety and uncertainty. Mario felt that he couldn’t trust his own judgment. Despite that feeling, Mario chose not to ask his wife to check his urine.”

At first, Mario’s anxiety reached a level of 80 out of 100. But “he was surprised to find over the course of 90 minutes, his anxiety and need for his wife’s reassurance had decreased to a manageable 30 out of 100. After repeating this task for a week, Mario realized that he could completely stop asking his wife to take part in the process, which both of them found embarrassing.” The good news is, “not only can family relationships be improved as Mario’s did, but so can your relationship with your doctor.”