Working through the CCI self help series for health anxiety

I'm not sure if this is the right place for this on the forums. Hopefully it belongs under therapy.

I've been wanting to work through the health anxiety self help program at the CCI website, but I'm really bad at sticking with something like this long enough to finish it. I tried to get my therapist interested in doing the material with me, or at least checking in to make sure I was making progress, but of course she wants to do her own thing (non-structured of course, which is a whole 'nother story). So I thought to try to stick with the program, I would post about my progress, and thoughts about program, as I work through the modules.

I've started the program before, but never finished it. I'll start back at the beginning again, since it's been a while since I've read it. If you haven't seen it before, it is at:

http://www.cci.health.wa.gov.au/reso...cfm?Info_ID=53

Module 1

This module is mostly background information and questions about what your health is like, what your fears are, and defining when health anxiety goes beyond the typical experience and becomes a problem.

Answering the questions, I did not consider social functioning to be part of my health. I actually don't have much social contact outside of work. One of my co-workers years ago thought my health anxiety was an unconscious way of trying to make connections with people.

I checked Very Often for almost all the worries except for avoidance and sharing symptoms with family and friends.

This chapter does a good job in covering the negative affects of health anxiety, particularly the ones that may not be obvious to people who have never had HA - financial costs from doctors' visits and missed work, difficulty concentrating at work and lost work time due to appointments, and depression. One thing I think they missed in the category of negative effects on your relationships with doctors is the embarrassment. It's really hard to go back into the doctor with another concern, even when I've called to ask a question of the phone nurse and the nurse has asked me to come in for an examination as a result of the question.

When asked to write down how health anxiety has affected me, I listed the embarrassment, financial costs, depression, time spent on Google or body checking, and difficulty focusing at work and missed work time for appointments.

I remember starting these modules and got as far as module 3 or 4 but then lost the motivation to keep doing them. There is a lot of really good information in these modules so it's well worth the time and effort.

I did the modules with the help of a social worker. I found they helped a great deal. Good for you persisting and doing them on your own and using this forum to keep on track!

I found later in the modules there were some exercises that I didn’t like. But I did them and it just taught me what strategies were more/less effective for me for dealing with my HA.

That's great you had a social worker to go through the modules with you, EKB. I've even thought about hiring a woman I know does tutoring locally to work through them with me, because I just can't get an actual mental health professional to work with these. They all just want to talk about my parents.

Module 2

This module is about how HA develops. I think in my case it's not very hard to figure out. My father died when I was 12 of a heart attack, and although I was already an anxiety prone kid before that, that's when my health became a focus for my anxiety. Since then, some of my own real medical issues have made the problem worse. It's harder to figure out what is or isn't a reasonable worry when you've actually had some serious things happen to you.

Both of these experiences, the loss of someone in your family, and having a serious problem yourself, are listed in the module as possible causes. They also list as possible causes having someone in your family or other person you know with a serious illness, having a family member with HA, and "negative information from the media or internet". So while they don't specifically call out the Daily Mail by name, it is in there.

This is so important, I'm going to quote what they say here:

"The internet and media today allow us immediate access to a range of interesting health related stories and information. However, in an effort to “sell” their stories, media outlets must ensure that their shows or stories grab the attention of the public. Health stories in the media or on the internet can therefore focus on rare diseases, incurable health problems, and fatal conditions. Furthermore, they may report on the experiences of patients who were misdiagnosed, sometimes despite repeated efforts to seek medical help. While these cases do occur, the emphasis sometimes portrayed in the media on these unlikely conditions and events can lead us to question our medical care, to view benign bodily sensations and changes with greater suspicion, and to consider previously ignored and highly unlikely health problems as common."

For me personally, in addition to the Daily Mail phenomenon, I would add having people I work with or know in the community develop serious illnesses as another cause. I've had three co-workers diagnosed cancer in the past three years.

The module then talks about health rules that we create. Out of the list, I particularly recognize in myself:

If I don't report these symptoms, I could miss an important one
I must take all symptoms and bodily changes seriously
I must report all new bodily sensations to a health professional

It also talks about health assumptions. The ones I recognize most in myself are:

If I miss an important health symptom, it could kill me.
If I'm not vigilant, an underlying problem could be getting worse.
If I don't persist, my doctor may miss something important
If I don't keep checking, I could miss something really important

There are more suggested rules and assumptions, I just listed the ones that I recognize in myself.

The module points out that rules and assumptions in general aren't necessarily a bad thing, it's just when they are inaccurate or inflexible that they become a problem.

The module then asks you to consider how your rules and assumptions (I can see the CBT part here) are linked back to your past. I think in my case, I can see how I wasn't aware of enough of my own health risks, and wonder if I might have been diagnosed with my real problems earlier if I had been. I also can look back and see how several of the people around me had symptoms of their illnesses that they were too stubborn to follow up on earlier. I think these things have made me extra vigilant, even more than I was before.

Next, you are asked to consider how people with HA can become more sensitive or attuned to signs and symptoms of illness, paying closer attention to their bodies than others do. They point out the problem of amplification - how focussing on a symptom can make you more aware of it, make it stand out to your more, make you more aware of the details of it, and reinforces the focus itself.

For me, I tend to focus on skin stuff, I think because it is right out where we can see it. I think I tend to focus on anything that can be measured, which is why I don't let my doctor show me my labs, even though he says they are normal. I'd get all obsessed with the ones that were on the high or low end of the normal range. And I worry about basically anything new or unusual. I usually have several things I'm worried about at any given time, and sometimes have to keep notes so that I don't worry I'm going to forget something important! I can spend anywhere from an hour a day, spread out over the course of the day, worrying and checking, to an entire weekend.

I think you are doing a great job being honest about the challenges you face with HA, taking them on board and working towards being able to manage them more comfortably, Sparky.

These modules are extremely thorough and are something I need to devote time to as well. Thank you for sharing your battles with HA-it's great that you are working your way through these modules and I'm sure you'll really benefit from all the hard work!