Safety-seeking behaviors- this is an actual thing. Safety behaviors are what we do to try and prevent or reduce the anxiety we are experiencing. Examples of safety behaviors related to health anxiety might be to scan your body for any concerning blemishes or checking your pulse multiple times a day. Safety behaviors can reduce anxiety in the short-term but they most definitely increase anxiety over the long-term. Why? Because we can learn to rely on them and rob ourselves of the opportunity to see that we never needed them to begin with. We tell ourselves, “Thank God I checked my pulse and slowed down my heart rate- I could have had a heart attack.” But we never learn that we likely never would have had that heart attack, whether we checked our pulse a gazillion times or not. We were never actually in danger to begin with. Also, the more we use safety behaviors, the more important we believe they are and, thus, the more we tend to rely on them. It can become a vicious cycle.
There are three main types of safety behaviors for health anxiety. Do any of these types of safety behaviors resonate with you?
Reassurance-Seeking Behaviors. To deal with the stress of a new symptom or sensation, you collect information to assess what kind of danger you might be in. You might ask a friend or a family member what they think. Do you think this twitch is something neurological? Do I look flushed to you? Or, you might go to primary care offices, urgent cares, hospitals or other medical facilities and consult with doctors and other medical professionals. Or you might read all about the potential causes on the internet and in medical texts. And of course in today’s world, all of this information is readily accessible. Let’s call it Google Doom. If the google search terms below look familiar at all, perhaps this is something you struggle with.
"types of skin cancer" "symptoms of full-blown AIDS" "breast cancer survival rate"
"difficulty swallowing AND esophageal cancer" "headaches AND brain tumors"
"how to distinguish between canker sore and mouth cancer"
"how to detect lung cancer early" "less common symptoms of MS"
"how do you catch brain-eating amoeba" "signs of unruptured aneurysm"
Checking Behaviors. If you engage in checking behaviors, you often monitor for symptoms, physical sensations or any kind of bodily function that might be “concerning.” You are like a little detective, always working hard to solve each case or new symptom. You might repeatedly push, pull, poke or pinch a part of your body or new symptom. You may compare two sides of your body to identify any differences.You may inspect your feces or urine, check your heart rate, blood pressure, weight or lung capacity. Or perhaps you give yourself examinations of some kind, such as visual tests, neurological or cognitive tests or physical exertion tests. Sometimes you are so on top of it that you even make you sure you are aware of all the potential future symptoms that may emerge. Some checking behaviors are subtle and sometimes not even easy to identify (e.g., paying attention to breathing patterns) and others are so overt and time-consuming that they can seriously disrupt your daily life. Again, although you are seeking a sense of safety, checking behaviors often result in your feeling more afraid. And how could it not? If you are constantly searching for abnormalities in your bodily functions, you are bound to find something that seems “off.” You often just find new things to worry about.
Preventive Behaviors. These types of safety involve preventing future health anxiety, illness or bad health. You might read up on health websites to find recommendations on how to prevent illness or improve your health. You might avoid a variety of types of foods for fear that they could contribute to the development of illness or disease. You might carry personal medical equipment or information “just in case” you need it. You also might keep “safe people” with you to always ensure someone else is present in case of a medical emergency. If you are going on a trip, you might make a habit of checking where the nearest urgent care or hospital is just in case something happens and you need medical care while on vacation. You might inform your friends or family of your whereabouts at all times or leave your door unlocked so that help can arrive in time if necessary. Or you may carry medication with you and always make sure your phone is nearby no matter what you are doing, such as going on a jog or taking a shower.
For all of three types of safety behaviors, the bottom line is this: they all stem from the overarching goal to feel safer. In some cases, you might want to identify whatever health issue you believe you had at the time, whether through excessive checking or reassurance seeking. You might think that if you gather all the facts, you could bring the summary of information to the doctors and have them address your health issue early on, before it is “too late.” In other cases, you might hope to discover that you don’t have the feared disease, perhaps hoping your google search will reveal you don’t have a majority of the symptoms.
But ironically, although you are aiming to feel safe in one way or another, you often feel worse afterward. Many times, you end up finding more “evidence” for the alleged disease or even learning about some new disease you hadn’t even thought of. It becomes a vicious cycle. In Cognitive behavioral therapy, one of the key interventions is to help health-anxious people reduce their use of these safety behaviors through exposure exercises. There is an amazing sense of freedom that takes place once you realize you don’t need these behaviors to be safe.
