Sunday, May 23, 2010

A Script for Fighting Health Anxiety OCD

I was reading one of my notebooks of scripts for doing imaginal exposure therapy, ie. listening to tapes of thoughts that cause me anxiety, until the anxiety starts to dissipate, and also including statements supportive to myself and who I want to be, what kind of woman I want to be. I thought I'd share one that I listened to for about a year, while walking at the gym, about 1/2 hour at a time, a few times a week. It really helped me clarify how corrosive the health anxiety compulsions were, and how much of my life was being consumed by them.

Health Anxiety Script 5-7-07

I'm not going to listen to your false promises anymore OCD. You tell me I can be absolutely certain what is going on with my body. No risk is acceptable to you, but to be alive is to be at risk. You always promise me that you will make my fears go away, if I listen to you. But whenever I listen I find myself deeper in hell, with you telling me you just want a little bit more. I am not a doctor. I can't definitively diagnose myself. Overcoming health anxiety is a scary process. I feel as though I am risking my life, but this is a chance I have to take to get better from OCD and get my life back. I've lost so much time already in fixating on my body. OCD, you truly torment me, suck up energy. I can't go on like this. I may get cancer and die a painful death, but OCD can't save me from this, only take away whatever enjoyment I have in my life. My rituals are useless anyway. I can't be vigilant about every body symptom. I don't know what is going in inside my body. Medical guidelines are imperfect but that is all humans have to go by. Maybe I'll get cancer, and my doctor will accuse me of being irresponsible, but I will have to learn to live with my regret at my negligence, so I can enjoy whatever time I have left. The alternative is to lose even more time than I already have to OCD.
Related Post:
OCD Toolbox: Listening to Scripts/Imaginal Exposure for OCD
Freedom from Obsessive Compulsive Disorder by Jonathan Grayson


  1. It's really fantastic that you posted your exposure/self-talk script! Some people are so scared to even get close to what treatment would look like & they stay trapped. This gives a window into what treatment options look like & the powerful truth that they can cling to. Be encouraged & thanks for encouraging.

  2. pebbleroad--thank you so much for your response. I am glad you saw my post as a window to what treatment looks like!

  3. For several years, my health anxiety was out of the park. I was dependent upon doctors to save me from my fears, yet I believed they were idiots when they told me nothing was wrong. Finally, in 2006, my worst fear came to fruition and I actually was diagnosed with the very illness I feared most! But I recovered. Interestingly, going through it was far less terrifying than the fear of going through it. I was free from the grips of OCD for three years, and boy did it come back with a vengeance (no longer health anxiety). What it helping me heal now is the realization that the fear is always present - that is the OCD - but the subject of that fear changes. That fact makes me realize that it is not WHAT I fear, which gives the OCD less power.

  4. I remember reading an article about fears "cycling" and that definitely gave me some insight--like you said, it's the same core fear, regardless of its outer manifestations.

    I hear you on the actual diagnosis being less terrifying than the fears. When I had skin cancer after years of obsessing about it, dealing with treatment for it was far less traumatizing than my OCD fears and self-loathing.

  5. This is so helpful to me as is your entire blog!! Ive done tons of CBT for health anxiety but didnt really help. I think the concept of accepting the uncertainty of whats going on in my body is the only way to try to control my anxiety. Scary, but I made an appt with a specialist in Exposure Therapy (next week) b/c of you. Thank you!

  6. Anon--I hope your visit to the ERP therapist was fruitful! I agree that CBT is very limited in it's help for health anxiety OCD--I always had one more "what if". . .

    1. I think CBT can be helpful in that it tries to get you to think more realistically, rationally, and more in a measured way about the magnitude of the fears. It has a lot to offer but you have to fine the right CBT tools that fit for you as an individual.

  7. At first, when I tried ERP years ago I did not feel it worked. Creating the imagined scenarios and reading them back to myself did not create the anxiety intended. It wasn't 'in vivo' like a real health anxiety episode is. To top it off, my therapist, a well respected Boston specialist in OCD, wanted my scripts to run the full gamut of having an illness, suffering and eventually dying from it. I was to imagine my funeral and the aftermath. All in great detail. This did not make me anxious, but rather just made me very sad. That's when I decided ERP was not for me. However, Grayson's versions of scripts seem more useful to me and I may try to go back to ERP. The CBT techniques I've used are designed to foster a more realistic and rational response to health anxiety and I do believe they work for hypochondria. But one has to be very vigilant in using any/all of these techniques every time the anxiety hits in order to rewire the way we think. Thank you for posting this script. Do you have any others you might be willing to share?