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For adults
Health anxiety
Health anxiety is not hypochondria and it is not attention-seeking. It is a fear system that has learned to treat ordinary bodily noise as evidence, and it responds well to the right treatment.
What health anxiety is
Everybody worries about their health sometimes. Health anxiety is different in three respects: the worry is persistent, it is fuelled by ordinary bodily sensations rather than by evidence of disease, and — crucially — reassurance does not fix it. A clear scan buys you an afternoon. By the evening the doubt has found a new entry point.
People often arrive in my clinic apologetic, having been told by somebody that it is “all in their head”. It is not. The palpitations are real. The tight chest, the twitch, the swallowing difficulty, the lump you can feel — all real sensations, frequently produced or amplified by anxiety itself, then read as evidence of the disease you fear. That is the loop.
What it actually looks like
- Checking a mole, a lymph node or a lump several times a day, and noticing it has changed because you keep pressing it.
- Taking your pulse, your blood pressure or your oxygen saturation more often than any clinician would ever ask you to.
- Searching symptoms online, then searching for someone whose story ended well, then finding the one where it did not.
- Asking your partner to look at something, then asking again the next day in case they were just being nice.
- Booking a GP appointment, feeling better in the waiting room, then leaving unsatisfied because they did not examine the thing properly.
- Avoiding the opposite way: not going to the doctor at all, skipping screening letters, refusing to look at the results email.
- Scanning your body first thing in the morning to see how it feels today.
- Life decisions quietly shrinking — holidays away from good hospitals, exercise avoided in case it stresses the heart, a headache that ends the evening.
The two apparently opposite patterns — constant checking and total avoidance — are the same thing. Both are attempts to control an unbearable uncertainty, and both keep it alive.
Why reassurance stops working
Reassurance is not neutral. Every time you look it up, press it again, or ask someone to tell you it is nothing, you take a small dose of relief — and you teach your brain that the sensation was dangerous enough to warrant checking, and that you would not have coped without the answer. The relief is real and it is short, and the tolerance builds like any other.
This is why people can be investigated exhaustively, told repeatedly that they are well, and still be frightened by Thursday. The problem was never a shortage of information.
What treatment involves
Health anxiety responds well to cognitive behavioural therapy delivered properly, and NICE recommends CBT as a first-line psychological treatment for anxiety disorders. The version that works is not gentle discussion of your worries. It is an active piece of work with three strands.
First, we build an honest map. Not just the fears, but the full inventory of what you do about them: the checking, the searching, the questions, the appointments, the avoidance, the things you have quietly stopped doing. Most people are startled by the length of this list, because much of it has become automatic.
Second, we test the model. Rather than debating whether your headache is a tumour, we run experiments. What happens to a sensation when you monitor it closely versus when you leave it alone. What your throat does after ten deliberate swallows. Whether the feared catastrophe follows when you do not check. These are not tricks to convince you of something — they are ways of gathering the evidence your checking has been preventing.
Third, and this is the engine of the whole thing, we cut the safety behaviours. You stop checking, stop searching, stop asking, and deliberately approach what you have been avoiding — the health documentary, the hospital car park, the exercise that raises your heart rate. This borrows directly from exposure and response prevention, and it is done gradually, collaboratively, and with you choosing the steps. Anxiety goes up first. Then, without being fixed, it settles — and your nervous system learns what no amount of reassurance could teach it.
Where the body and the fear meet
A large proportion of the sensations that frighten people with health anxiety are produced by anxiety itself: adrenaline in the chest, over-breathing, muscle tension held for months, a gut that has been running on stress hormones. Understanding that mechanism does not make the sensations go away, but it does change what you do with them. Where the fear centres on the sensations themselves — racing heart, breathlessness, faintness — there is considerable overlap with panic and agoraphobia, and the treatment borrows from both.
The goal is not certainty
I will not be able to promise you that you are well, and I would be lying if I tried. Nobody gets that guarantee. What treatment offers is different and, in my experience, more valuable: the ability to notice a sensation, register it, and carry on with your day without the machinery starting up.
People usually describe the change not as feeling reassured but as the subject having become boring. That is what recovery actually looks like.
Working with me
I am a clinical psychologist and have worked in psychology since 2008. I trained at the University of Washington, a leading clinical research programme, completed my internship at Seattle Children’s Hospital and Harborview Medical Center, and a postdoctoral fellowship at the Evidence-Based Treatment Centers of Seattle, where I was Director of Training and Education and later Assistant Director of the Child Anxiety Center. I am board certified in Behavioral and Cognitive Psychology by the American Board of Professional Psychology, HCPC-registered, and chartered with the British Psychological Society.
I work with adults online across the UK and in person near Ravenshead, Nottingham and Mansfield, weekdays from 9am to 9pm. I am a psychologist and do not prescribe, but I work alongside GPs and psychiatrists where medication is part of the picture, and I would always encourage you to keep your GP in the loop. Fees and insurance details are on the fees page, and you can see the shape of a typical course of work on how I work.
The first step is a free 30-minute call. No commitment, no assessment forms — just a conversation about what has been happening and whether this is the right treatment for it.
Common questions
How do I know this is health anxiety and not a real illness being missed?
This is the right question to ask, and it deserves a straight answer. Health anxiety is not diagnosed by ruling everything out — no amount of testing will settle it, because the doubt regenerates. It is recognised by the pattern: repeated investigations that come back clear, relief that lasts days rather than months, checking and searching that has become daily, and a life increasingly organised around the possibility of illness. Keep your GP involved. But if you have been thoroughly investigated more than once and the worry always returns, the problem is the worry system, not the missing diagnosis.
Is health anxiety a form of OCD?
They are closely related and often behave almost identically. Both involve an unresolvable doubt, both are maintained by checking and reassurance-seeking, and both respond to the same core treatment strategy. The distinction matters less clinically than people expect. What matters is identifying every behaviour you use to reduce uncertainty — body checking, symptom searching, asking family, seeking repeat appointments — and systematically reducing them so your nervous system can recalibrate.
Should I stop going to the doctor altogether?
No, and I would not ask you to. The aim is normal healthcare use, not zero healthcare use. In treatment we agree in advance what an ordinary person would do about a given symptom — see the GP once, follow the advice, attend routine screening — and you do exactly that and no more. New or persisting symptoms still get checked. What stops is the repeat appointments about the same reassured symptom, the second opinions, and the private scans booked out of anxiety rather than clinical need.
What if I have already had a serious illness?
Health anxiety after a genuine diagnosis, or after a frightening episode in someone close to you, is extremely common and it is not irrational. Your body did betray you once. Treatment in that situation is not about persuading you nothing can go wrong — it is about rebuilding a life that is not organised around surveillance, and about learning to hold real, non-zero risk without scanning for it every hour. The approach is the same. The tone of the work is different.
How long does treatment take?
Health anxiety usually responds fairly quickly compared with some other presentations. A typical course is around 10 to 16 sessions after the initial assessment, weekly at first and then spaced out as you take over the work. Longer-standing cases, or health anxiety alongside panic or depression, can take longer. You should notice something shifting within the first several weeks — if nothing has moved by then, we change the plan rather than continue on faith.
Related pages
Not sure whether this is the right fit?
Start with a free 30-minute call. We will talk through what is going on, I will tell you honestly whether I think I can help, and if I cannot I will try to point you to someone who can. There is no obligation and no charge.