Sunday, April 17, 2011

Constantly Aware: OCD, the Body and Health Anxiety


This drawing by fisserman that I found in flickr is very true to my experience of the confluence of body sensations and mental awareness of those sensations, and my OCD. This week I've had tension and twinges in my chest, and my mind latched onto the symptoms. I find it very frustrating how certain bits of dialogue will shoot to the surface, like my doctor asking a few weeks ago if I was having any chest pain when I went in for a blood pressure check. What frustrates me is the almost immediate compulsing about whether I answered her question wrong, or that I have made a mistake, or exactly what do the sensations feel like?

And then I feel temptation to assign meaning to the symptom and the phrases both circulating within in me--a sign? a warning? a condemnation? My feared consequences are multiple, from fear of having a heart attack or dying, to fear of being judged harshly if I turn out to have ignored serious symptoms, and finally the fear that the vigilance about how my body feels will accelerate, get worse, and I will be haunted by the obsession, and that the vigilance will make me notice the sensations more, and it will snowball.

My compulsions range from checking my body--poking at my chest, watching how I sit or stand, to mentally checking my narrative of these sensations, ie. when did they start? What do they feel like? Am I really feeling them? I have resisted the impulse to search on the web, which is one reason this hasn't turned into a full blown OCD crisis, but more of a nagging, gnawing presence. What has helped is knowing that I can't establish what will happen in the future, that it's not my responsibility to do that. If the sensations persist or get worse, I will deal with it then. Or that it's too soon to know if the obsession will haunt me, or pervade everything I do and erode my enjoyment of life. I say this with gritted teeth, but it's true.

I am continuing to do things that I had planned to do, rather than retreating to reading, or otherwise freezing my life while trying to figure out the symptoms. I see my therapist on Thursday, so yay for support! Leonard is the first to say that having body sensations adds a layer of intensity to health anxiety OCD. There's something "there" and it intrudes on consciousness. My best guess is that all the time I'm spending bent over my worktable in my art studio is contributing to tightness in my chest muscles. My OCD would really like to know absolutely for sure that it's not a heart attack, and all the old "you are worthless and despicable" stuff gets mixed in as well, like "you'd better diagnose yourself perfectly or you are unredeemable."

I am feeling better the last couple days. I can tell I'm still vigilant--questions like Will the sensations come back? Get worse? but I know this pattern. I've experienced it many times how certain feelings in my body are more likely to trigger obessions than others. When I get a headache I do not usually obsess I have a brain tumor. If you have a desire to reassure me, I can understand that, but I'd rather hear about how you cope with health anxiety, and what has helped you.


  1. Wishing you strength to keep avoiding the internet searching. It sounds like you are doing remarkably well at living with the anxiety.
    I used to get the same way - my panic attacks always started with chest pains - and I instantly worried that it was a heart attack - it started in high school. I mean, seriously, what high schooler has a heart attack? But still I'd ruminate and worry and obsess, and of course the feelings would intensify as long as I held on to them trying to analyze them.
    The thing that would help me was to have my husband or someone else apply pressure to a different part of my body. Then I had something else to focus on and it helped to lessen the panic that was going on with the chest pains.
    It took lots of practice, and lots of time, but eventually I started being able to help myself. I'd sit on my hand and focus on the feeling in my fingers. Or I'd start pinching my foot, concentrating on the difference in how my feet felt.
    And ultimately, medication helped a ton too.
    Good luck. I'm rooting for you. You can do it!

  2. You continue to inspire me. I used to have health anxiety. Funny enough - that "fear/obsession" went away. When I had it - I was much younger and my mother had me at the doctor for every test known to man. So - I can't tell you how I overcame it, really. But - whether it's health anxiety or an obsession of something else (who cares what the content is really) - the pattern is all the same. Replace "sensations in the chest" with "sensations" (for me after I have an HOCD thought or situation that spikes me) and it all results in the same thing. Obsessing, feared consequences, checking, and I like what you say about having a "nagging, knawing feeling". It's not always panic, but it's almost a feeling of doom that won't go away. Keep up the good work!!! You are doing really well! Remember that because your OCD is focusing on your health at the moment - you have an extreme sensitivity to all of this - and less objectivity than those of us who DON'T have health anxiety have. Just do your best to NOT compulse and endure. It will pass. :o)

  3. I remind myself of these things:
    I'm nearly always overestimating the level of threat; bodies are noisy (especially when OCD is in control)so I will listen to my body when it declares something loud and clear; and the phrase 'get out of my head and into my life' really helps me to remember I've got to get involved in my life instead of wasting time worrying and obsessing.

  4. Thank you all for your thoughtful responses! Shana--this reminds me of Jon Kabat-Zinn's "body scan"--where you practice training your attention to take in the whole body, not just one symptom.

    Pure O--That is so true that the content of the obsession throws us off from seeing the bigger pattern all obsessions follow.

    Anon--Yes, the more I keep doing what I would've done without the symptom on my mind, the more chance I have to live my life!

  5. I just found your blog and I feel almost foolish that I did not know people like me were out there. I am 25 and have been struggling with OCD, mostly centered around health obsessions, since I was a child. I've been doing great since college-when I finally decided to do something about my anxiety and started taking meds and doing CBT. I used to have almost constant health anxiety. I used to obsess, poke, and prod if I had any little lump I could feel on my body. I remember many times sitting in school having an obsession running through my mind and constantly feeling a lump on my body that I had absolutely, positively convinced myself was a tumor. There was no convincing my mind that it was irrational to think that an 11 year old would have a tumor, or that it was just a little bump on my body that was supposed to be there. The tightness in my chest would come and I would know I was in for days, weeks, or months of constant anxiety. I always knew that what was going on in my head was chemical, I just didn't know how to fix it. Now that I am an adult, my anxieties are not as intense (I think that is the result of the meds I take), but they come up several times a day. My recent obsession started yesterday--there were mouse droppings on my desk at work and I (why?!?) googled "mouse poop diseases" because I had a momentary thought that they may carry some horrific disease. Guess what? They do! It's called hantavirus and it's serious. BUT it is extremely rare and has never been reported where I live. My mind has been trying to rationalize this for the past 48 hours--I keep going through the "what if's" as I always call them. What if I get sick? What if I go to the doctor and it's nothing and they think I'm stupid? But the biggest worry is that I don't know if I'm sick yet. I could wait for weeks to have symptoms of this horrible disease. And that's what I'm really afraid of--ambiguity, the unknown. Has anyone else experienced this? I've gone so long without a severe bout of anxiety and I'm desperate to get out of this one.

  6. Welcome Anon--I didn't know there was anyone like me until I was in my late 30's, so you are ahead of me! I recommend you find a copy of Jonathan Grayson's book Freedom from OCD--he talks about the uncertainty, and how OCD latches onto that, and demands we know for sure, even when it's not possible. Also, check out the International OCD Foundation, and their list of therapists and support groups. Seeing a therapist who was expert in OCD really helped. I identify with the fear of looking stupid at the doctor's office combined with fear of being negligent if I didn't go, and how all pervasive the severe bouts can be. Hang in there--with exposure therapy I have gotten so much better, and you can too.