Navigating the Complexities of Health Anxiety and OCD

Summary

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Breaking the Rules: A Clinician's Guide to Treating OCD

Episode: Navigating the Complexities of Health Anxiety and OCD

Release Date: October 20, 2025
Hosts: Dr Celin Gelgec and Dr Victoria (Tori) Miller

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Episode Overview

In this episode, Dr Celin Gelgec and Dr Victoria Miller dive into the intricate overlap between health anxiety (formerly hypochondria) and obsessive-compulsive disorder (OCD). Speaking candidly as clinicians and supervisors, they explore how these conditions intersect, the challenges therapists face in differential diagnosis, and practical approaches to evidence-based treatment. With a blend of clinical insight and personal experience, the hosts normalize the confusion around these diagnoses and offer grounding strategies for effective intervention.

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Key Discussion Points & Insights

1. Defining Health Anxiety vs. OCD

• Health Anxiety: Characterized by persistent fears focused on physical health, illness, or bodily functions, often leading to repetitive reassurance-seeking, checking, and avoidance.
  • “Health anxiety, previously known as hypochondria, is really just a fear that is focused on anything health related...” (02:49 - Dr Miller)
• OCD: Defined by intrusive, unwanted thoughts (obsessions) that are inconsistent with personal values, followed by compulsive behaviors (external or internal) to neutralize the distress.
  • “OCD is characterized by obsessions...then followed by a behavior that we do, whether it's internal or external...to alleviate that distress.” (03:21 - Dr Gelgec)

2. The Diagnostic Dilemma

• Health anxiety and OCD have a significant symptomatic overlap—checking, reassurance-seeking, avoidance—making it difficult for clinicians to definitively distinguish between them.
• The hosts debate the importance of precise diagnosis, ultimately agreeing that:
  • “The treatment is almost identical.” (06:17 - Dr Miller)
  • The drive to “get it right” is often more anxiety-provoking for clinicians than necessary, given similar treatment protocols.

3. Subtle Differences in Clinical Presentation

• Health anxiety: Clients are often more easily reassured and may shift focus from one health concern to another, without perseveration.
  • “People with health anxiety are also a bit more able to receive reassurance...then the health anxiety pivots to something else.” (07:04 - Dr Gelgec)
• OCD: Typically features more persistent "what if?" thinking. Reassurance provides only temporary relief, with compulsions growing more elaborate and entrenched over time.

4. Why Health Themes? Existential Roots & Death Anxiety

• Hosts reflect on why health is such a universal theme, citing existential vulnerability and mortality as root drivers.
  • “Ultimately...when we get to a certain point in our lives...we start to feel vulnerable in life...knowing that time is not forever.” (08:36 - Dr Miller)
  • “It comes down to that death anxiety.” (09:02 - Dr Miller)
• Anxiety serves as a defense against more primal feelings of grief and vulnerability:
  • “It's easier to feel anxious than it is to feel sad and vulnerable.” (13:48 - Dr Miller)

5. Impact on Functioning: When Health Anxiety Becomes Clinical

• Functional impairment, not just worry, is key to diagnosis: repeated doctor's visits, excessive money spent on tests, researching, sleep disturbance, and relationship strain.
• Notable behavioral “red flags” include rigid routines for health, inflexibility around food or safety, and significant daily disruption.

6. The “False Security Blanket” of Compulsions

• Compulsions (checking, avoidance, reassurance seeking) offer a false sense of security; the supposed “protection” they bring actually diminishes quality of life.
  • “The thing you're fearful of, which is loss of life, has actually already happened. You might physically be alive, but you're not living. You're just existing.” (27:12 - Dr Miller)

7. Treatment Approaches: What Works?

• Exposure and Response Prevention (ERP): The frontline therapy for both health anxiety and OCD.
• Scripting: Eliciting and writing intrusive thoughts to trigger urges and resist compulsions.
• Delaying or reducing reassurance seeking (with family and health providers).
• Behavioral experiments: Watching medical dramas or reading worst-case scenarios as exposure (e.g., “House,” “ER”).
• Values Work: Reconnecting clients with life goals and meaning outside of compulsions.
• Collaborative care with GPs, especially around medical test referrals.
• Clinicians should acknowledge the anxiety-driven urge to check or avoid and compassionately help clients sit with uncertainty.

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Notable Quotes & Memorable Moments

• On the diagnostic overlap:

  “Health anxiety can look almost identical to [OCD]...the reassurance seeking in health anxiety is very common...but they can also be OCD compulsions. So which one is it?” (03:55 - Dr Gelgec)

• On existential roots:

  “It comes down to that. Death anxiety...whether it’s being young and seeing a pet die or a grandparent pass away or a parent...It just cuts deeper.” (09:02, 13:48 – Dr Miller)

• On treatment regardless of label:

  “From a treatment perspective, you’re not losing out and you’re not doing the wrong thing. The treatment is almost identical.” (06:06 – Dr Miller)

• On the ‘preference vs. compulsion’ test:

  “It’s all about flexibility. If there’s flexibility around [health routines] versus rigidity and the impact on daily functioning...that’s when it’s not okay.” (16:35 – Dr Miller)

• On missed life experiences:

  “In attempting to live a longer life, we end up living a less meaningful life.” (27:09 – Dr Gelgec) “You might physically be alive, but you’re not living. You're just existing.” (27:18 – Dr Miller)

• When to actually seek medical advice:

  “If symptoms persist, then you can go [to the doctor]. But if they don’t...” (25:28 – Dr Miller, paraphrasing an old Panadol commercial)

• Clinician anxieties:

  “We want to get it right...give the right diagnosis...but health anxiety and OCD overlap so much that it actually can be really hard to tease apart. And that can generate a lot of anxiety for us as psychologists.” (05:11 – Dr Gelgec)

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Timestamps for Key Segments

• [02:13] — Introduction & episode theme
• [02:49 – 03:51] — What is health anxiety? What is OCD?
• [04:06 – 06:18] — Why the diagnosis is tricky and does it matter?
• [06:53 – 07:22] — Subtle distinctions in reassurance-seeking
• [08:14 – 10:54] — Why health? The existential and mortality roots
• [15:14 – 17:36] — Real-life functional impacts: rigid routines, relationships, and daily life
• [18:12 – 20:32] — Do health anxiety and OCD always overlap? Themes, comorbidities, and complexity
• [20:32 – 22:41] — Core treatment strategies and working with GPs
• [22:42 – 24:33] — Exposure ideas: TV, scripting, delaying reassurance
• [25:06 – 26:05] — Facing the “what if” dilemma: when to seek actual medical care
• [26:22 – 27:43] — Integrating values and meaning into treatment
• [27:09 – 27:43] — The paradox: lost life experiences due to compulsive safety seeking

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Final Thoughts

Dr Gelgec and Dr Miller candidly validate the clinician’s frustration and uncertainty around distinguishing health anxiety from OCD, citing that treatment ultimately focuses on the same core processes: exposure, response prevention, distress tolerance, and reclaiming life from the grip of compulsions. Their discussion highlights the universal human drive to control the uncontrollable—health and mortality—and how easy it is for that drive to become rigid, limiting, and ultimately self-defeating.

“The thing you're fearful of...has actually already happened. You might physically be alive, but you're not living. You're just existing.” (27:12 – Dr Miller)

By encouraging clinicians and clients alike to return to values and embrace uncertainty, this episode offers reassurance, strategy, and hope.

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Transcript

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[B]

Acast helps creators launch, grow and monetize their podcasts everywhere. Acast.com hi, I'm Dr. Celine Gelgich.

[A]

And I'm Dr. Tori Miller. Welcome to Breaking the Rules. On Breaking the Rules, we talk about all things OCD.

[B]

Obsessive compulsive disorder. OCD impacts up to 1 to 2% of the population. We are here to provide not just education, but to inspire clinicians, families, and people who are impacted by OCD to be able to access the treatment they need in order to get better.

[A]

Catch us every fortnight wherever you get your podcasts.

[B]

Hello. Hello again. Hi. What are we talking about today?

[A]

Health anxiety and ocd.

[B]

Oh, yeah. We get this a lot, don't we?

[A]

All the time. And I'm not gonna lie, I had to do a bit of prep for this one.

[B]

I know. We both had to refresh our memory. Yeah.

[A]

And I think it's because this is a tricky one. And I. I say that like I. I'm happy to say that even though I work in the space, you know, every day, it's still good to go back to fundamentals because these. These things trip us up.

[B]

Yes, they do.

[A]

Yeah, yeah, yeah. So let's.

[B]

There's a lot of similarities. Yeah, yeah, definitely. Definitely. Okay, so let's start with what is health anxiety?

[A]

Let's go.

[B]

Yeah. So health anxiety, previously known as hypochondria, is really Just a fear that is focused on anything health related from physical illness to food intake to all the things.

[A]

Yeah.

[B]

And it can create this real sense of uncertainty, anxiety, fear. How does it differentiate from ocd? That is a very good bloody question. If someone could answer that for us. How does that differentiate from ocd? Because if we think about ocd, it's characterized by obsession. So intrusive thoughts that pop in, that are unwanted, that are inconsistent with our values and beliefs, then followed by a behavior that we do, whether it's internal or external being, a mental compulsion or a compulsion we can physically see to alleviate that distress. Now, health anxiety can look almost identical to that.

[A]

Yeah. Because this is where it gets really tricky. Right.

[B]

Because the reassurance seeking in health anxiety is very common. The checking, the physical. Checking of physical sensations, the body scans, all those sorts of things are very common in health anxiety. But they can also be OCD compulsions.

[A]

Yeah.

[B]

So which one is it?

[A]

I know, I know.

[B]

Yeah.

[A]

I mean, one of the things that I suppose, I wonder about is how much does it matter from your perspective? Yes.

[B]

That is a great question.

[A]

Yeah. I mean, obviously, if we're. Okay, let's not this out, right? Yeah, okay, let's not this out. I'm going to backtrack. I think I'm jumping in too quickly because I think I. I think sometimes what happens in therapy, I know that this is an experience that I have and I've talked about with my supervisees is you've got a client. And we want to do right by our client, of course. And part of that is about discerning what diagnoses they have, what they're presenting difficulties are, and formulating those difficulties. And part of. Because then we can map an intervention. Yes. Right. And the appropriate intervention, we can make really specific choices about what we're going to do. And that is drilled into our training. And it's a really. I think it's a beautiful thing that we psychologists can do. I think we're really good at it.

[B]

I think so.

[A]

So then it's really tricky when you have a few things intersecting and it's not exactly clear is it health anxiety or ocd, for example. And we want to get it right. We want to have that certainty. We want to know for sure. We want to give the right diagnosis to our clients, we want them to understand themselves the best they can, and we want to provide the right intervention. And health anxiety and OCD overlap so much that I think it can actually be really hard to tease apart. Yeah. And that can generate A lot of anxiety for us as psychologists.

[B]

Yeah.

[A]

To want to get the right answer. And it can feel like a. I don't know, a bit risky to get it wrong.

[B]

Yeah. Because it gets drilled into us too at uni. Right. In terms of the importance of that.

[A]

Yeah. But I guess that is why I come to this question of, like, how much does it really matter?

[B]

I don't think personally for me, and what I tell my supervisees is I don't think it matters too much. Only because the treatment is almost identical.

[A]

Yeah.

[B]

So from a treatment perspective, you're not losing out and you're not doing the wrong thing. From a content perspective, it will. You will find that a lot of it looks and sounds a lot like health anxiety. I think for me, one of the ways I've. And I don't know if this is relevant or not, but one of the ways I've usually differentiated it is between health anxiety being a little bit more convinced and avoidant of wanting to know the answer, as opposed to OCD having more what if? Thinking and needing to know the answer.

[A]

Yes.

[B]

Does that make sense?

[A]

It does. And I reckon in my experience, people with health anxiety are also a bit more able to receive reassurance.

[B]

Yes. Where they might once or twice is usually enough.

[A]

Yeah. And then they can feel reassured, but then the health anxiety pivots to something else.

[B]

Yes.

[A]

So it goes from this spot to this spot, for example.

[B]

Yes.

[A]

But it doesn't perseverate on that one thing. Thing.

[B]

Yeah.

[A]

And that, that's.

[B]

Yeah.

[A]

Would you agree?

[B]

I agree. Yeah. Yeah, yeah, I see. I've seen that too.

[A]

Yeah. And so I think that there are some subtle differences, but you're right, ultimately, ultimately the treatment is.

[B]

Yeah.

[A]

The same.

[B]

Yeah, yeah, yeah, very much so.

[A]

Yeah.

[B]

And. And even the reassurance, like on the reassurance seeking, typically, when it's. You can have health, like OCD with. As a health subtype.

[A]

Yeah.

[B]

If that makes sense. Yeah. Or you can just have both.

[A]

Yeah.

[B]

Like. Yeah. Or health anxiety turns into ocd.

[A]

That's right.

[B]

Where the reassurance becomes more excessive, the checking becomes more excessive, the needing to know, like it just becomes a bit more than what you would typically see. Yeah, yeah, yeah, yeah. But you're right, like the. From a treatment perspective for me anyway, and it sounds like for you too, like it doesn't really make too much of a difference in terms of treatment being exposure response, prevention. Yeah, yeah. Well, why.

[A]

Why do you think health is such a common theme for people with anxiety and ocd? What is it about. Do you think about the. About us as human beings that. That trips us up so much that we end up being so focused on health and it can be so disabling.

[B]

I think there's at the end of the. Like, if we really.

[A]

Yeah.

[B]

Delve into it. I think ultimately when we get to a certain point in our lives, whether that's when we're an older child or a teenager or an adult or whatever stage we might be at, where it become. Where we start to feel vulnerable in life. Also knowing that time is not forever.

[A]

Yeah. And I think it's about mortality.

[B]

Yeah. So I have, like, for me, it comes down to that. Death anxiety.

[A]

Yes.

[B]

Around knowing and having a vulnerability to that. And anything can trigger that off at any age, whether it. It's being young and seeing a pet die or a grandparent pass away or a parent. Sadly for some people, it happens at a very young age or when you become a parent and you worry about your legacy and are you going to be available for your children and all that sort of stuff. I've mentioned this before as an intrusive thought, but I remember when my daughter was born being convinced that she had encephalitis because the nurse made a comment about her head circumference being on the larger side, whereas my husband was like, yeah, she's a genius. And I'm like, oh my God, she's got encephalitis. It's so common. It's so difficult. So. Yeah, it's just. I think it depends on the stage of life that you're at and that realization when you start to realize we don't actually have control over a lot of things. Yeah. We have control over some things. Like what are we going to eat, etc.

[A]

Yeah.

[B]

It depends on what. On which our good. Of it's bringing back. I'm going on a tangent now. It's bringing back our undergrad psych days of like, you know, do we have conscious awareness. Let's not delve into that. This is going to get really philosophical. Yeah. So I think, you know, we. We like to do these routines and have these things in place to make us feel safe and whatnot.

[A]

Yeah.

[B]

And health is really important to a lot of. To nearly just about every one of us. Because I think that sits deep down. Yeah. In terms of that realization, that vulnerability of shit, this is not forever.

[A]

And the fantasy that we can control that. That we can control our future and we can stave off death.

[B]

Yeah.

[A]

And it gives us a sense of. Yeah. Of control over the Inevitability.

[B]

Yeah, yeah. Or grief. That we can keep grief at bay.

[A]

Yes.

[B]

Like if we keep our fam. Like if we cook using non stick cookware or sorry, stainless steel cookware and don't use plastics and don't use this, I don't use that and all these sorts of things and I keep my family safe and I won't be responsible for giving them cancer later down the track or some other thing because then I don't have to go through the grief of losing a loved one.

[A]

Yeah, that's right. You know, even the terror of being a bad person or, or accidentally causing someone's ill health or death.

[B]

Yes, yeah, that's right. So I think when it looks like that, that lends more into OCD with health themes, because there's that sense, typical OCD themes, of sense of responsibility, causing harm to others, et cetera, versus what we were talking about before death, anxiety, or like you said, you might have a headache and go, oh, is that a brain tumor? But then move on quickly to the next thing.

[A]

Because I think that one of the things that's really hard about our bodies and our health is the amount that we can't see and the amount that we can't know as well as the degree to which we can't be reassured. Because we know that cancers grow, for example, and we can't see, see cancers. They are within us potentially or. And sometimes just as pre. Cancerous cells.

[B]

Yes.

[A]

And that there's this notion, you know, like it. I think a lot of people talk about how it's really hard to feel reassured by a scan that says you don't have cancer because like. Well, yeah, but yet. Yes, I don't have cancer yet.

[B]

Yeah. Or what if you miss something? What if I'm still coughing?

[A]

That's right.

[B]

Or whatever.

[A]

What if the machine was wrong? What if this, what if that. Yeah, but I do I, you know, I can really understand that that's notion that we can't see within our bodies, like so many aspects of our life where we can dissect it and we can get more certainty and we can know, like you can kind of look under the hood of a car and go, no, no, no, it's mechanically sound. Or you can look at your car tire and go, no, no, there are no punctures. You know, my car's going to drive safely today. But with our bodies. Yeah, we can't, we don't know. And weird shit happens all the time and, and bad things happen to good people.

[B]

Yeah, they do.

[A]

And people Die young.

[B]

Yeah, they do.

[A]

Yeah.

[B]

Yeah.

[A]

It's a really, really hard aspect of life that generates enormous amounts of anxiety for everybody. I know who's, you know, I love his writings about existential psychotherapy. Yeah. That he talks about this notion that everybody has death anxiety and someone says that they don't, it's because they're just avoiding it.

[B]

Yeah.

[A]

That it's an inevitable part of our humanness to be anxious about losing this beautiful life and to be grief stricken about the fact that we only get one shot at it.

[B]

Yeah, yeah. And I think that is a huge part of it, the grief around it, because I think the anxiety, like it's easy to feel anxious than it is to feel sad and vulnerable.

[A]

Yes.

[B]

Because anxiety is motivating.

[A]

Yes, it is.

[B]

Because it allows us to go, I need to do something.

[A]

Yeah.

[B]

It's a call to arms. I can do something about this. I can avoid this or I can prevent this or I can do whatever.

[A]

Yeah.

[B]

But truth be told, how many times have we. And this is going to be triggering for a lot of people even this conversation, do it, do it. But how many times have you heard about, like the fittest person dying from a heart attack.

[A]

That's right.

[B]

Or having a cancer diagnosis or something like that.

[A]

The person who's never smoked a day in their life gets lung cancer.

[B]

My uncle died from lung cancer's never smoked a cigarette in his life.

[A]

Really.

[B]

Like it's, you know, so you hear about these things. Right. So it's one of these things where. And then you've got like someone who chain smokes till they're 100 and they die at 101. What the hell? Please explain. Yeah.

[A]

There's a sense of injustice there and it's not fair. Yeah, yeah. But you're right that anxiety is much more palatable because it feels like we can do something with that. Right. Like we can. You know, there are. Our brain is very good at generating responses to anxiety and things that we can do to make ourselves feel better. Yeah, yeah. Which is much more comfortable than sitting in grief.

[B]

Yes. Yeah, absolutely. No one likes sitting in grief. There's sadness, there's anger, there's all sorts of things. There's bargaining that happens with that and it just cuts deeper.

[A]

Yeah, yeah, yeah. So health anxiety and health themed OCD make perfect sense. It's like they. I think they're really understandable anxieties. And of course, you know, just because people have anxieties about their health doesn't mean that they have health anxiety. We're talking about, you know, the clinical diagnosis where someone's functioning is really impacted.

[B]

Absolutely.

[A]

Because they're at the doctor every other day or their doctor shopping or they're spending.

[B]

Or they're more money than their card or. Yeah.

[A]

For tests that they don't need or they can't sleep at night because. Or they're, you know, not doing a good job at. At work because they're googling or redditing or chat.

[B]

GPTing or. You mentioned one earlier. I think your teens of the have this really cute rule you were talking about that if you get onto Cora.

[A]

Yeah.

[B]

You know, you've gone too far.

[A]

That's what you call the. Like this is.

[B]

That's where you draw the line.

[A]

You are composing now. Get off, get off, get off.

[B]

Yep.

[A]

Yeah.

[B]

That's your red flag.

[A]

Yeah.

[B]

Or.

[A]

Yeah, so. Or actually even damaging relationships. Because if this happens a lot, people get sick of being asked for reassurance.

[B]

Absolutely.

[A]

Or being asked, what do you think this spot might mean? Or, you know, the impact financially, this is where.

[B]

Or even doing things as like, you know, making sure the family is eating a certain way.

[A]

Yeah.

[B]

And putting limits and things. Which is fine. Within certain limits and boundaries. Right. It's all about flexibility. I think if there's flexibility around it versus the rigidity and the anxiety and the impact on daily functioning and the impact on other people's lives, that's when it's not. Okay.

[A]

The idea of preference.

[B]

Yes.

[A]

Versus compulsion. Yes, exactly.

[B]

Yeah, yeah.

[A]

If you need to. Can you shake it up? If you don't have enough money for certain foods one week, can you. Can you pivot?

[B]

Can you get KFC on the way home? Maybe not that extreme. Let's not go that far. I'm joking, please. Kfc. I'm joking. I freaking love KFC now.

[A]

I want KFC for lunch.

[B]

Maybe we could arrange that.

[A]

Yeah, yeah, yeah.

[B]

Like doing those sorts of things or just getting takeout for dinner because you're running low in the fridge or whatever.

[A]

Yeah.

[B]

As opposed to anxiously freaking out, having.

[A]

A panic attack and feeding everyone at nine o' clock because you've insisted that everyone wait until you can prepare and.

[B]

You'Ve made everything from scratch.

[A]

Yeah, yeah, yeah, yeah. So that you feel like you're not hurting your family. Yeah, yeah, yeah, yeah.

[B]

And there's a lot of anxiety that goes with that and it's very real for a lot of people, I think, too. Not that it's never real, like, you know, anyway, but. Yeah. Yeah.

[A]

No, it's a really understandable anxiety. And so I Think, you know, you're right to say, I think, you know, that sometimes health anxiety becomes ocd, that health anxiety exists first and then the compulsions feel so satisfying that they grow in intensity and then become so embedded that then you're looking more at an OCD framework.

[B]

Yeah.

[A]

Um, I think sometimes, I mean, do you think there's a possibility where someone might have health anxiety and ocd but none of their OCD have health themes, do you think? Have you ever seen that?

[B]

I haven't seen it, but I don't think it's impossible. Like, I think it's possible.

[A]

Yeah.

[B]

Yeah.

[A]

I could imagine that OCD would want to latch onto the health anxiety.

[B]

Yeah.

[A]

I'd be very surprised if it didn't want to make something out.

[B]

I agree. Which is probably why I haven't quite seen it.

[A]

Yeah.

[B]

Because it's hard for OCD not to latch onto stuff. Yeah. Because if we think about it, latching onto people's values and ideals and beliefs and what they care about the most. Yeah. That would be a field day for OCD to latch on to.

[A]

Yeah, agreed. Agreed. I suppose the other thing about imagining the sort of the OCD versus health anxiety is that one of the things that I reckon I've seen is where if someone has health themed in their ocd, it's very rare that they only have that theme.

[B]

Yes. Yeah.

[A]

That it's only about health.

[B]

Yeah.

[A]

That often there. There's might be maybe some contamination in there. Maybe it might also be to be a bit of harm.

[B]

Yes.

[A]

Which might present as health anxiety because the obsessions might be around food or about body checking, but underneath that might be some other fears around harm coming to others or. And things like that. But then also, I bet you find some not quite right ocd.

[B]

Absolutely. A lot of perfectionism.

[A]

Absolutely.

[B]

Into that.

[A]

And so I think you can see a sort of more complex picture, whereas.

[B]

Sometimes even impacting on eating behavior.

[A]

Yes, definitely. Definitely. Yeah. Yeah. Whereas I think when we're talking exclusively about health anxiety, it's much more contained to that.

[B]

Yes.

[A]

And it's. Yeah. It seems to be a little bit more.

[B]

You don't see other themes creeping as much.

[A]

Yeah, yeah. I mean, there might be generalized anxiety, but I think that that's. That's a way to kind of also think about how you differentiate that. I think if you did a Y box or. Or another OCD measure with someone, I think you'd see things pop up in other areas as well. Even if the health theme is the most prominent.

[B]

Yes.

[A]

But at the end of the day. You. You treat them the same you do. Yeah, yeah.

[B]

In a sense that, you know, we'd go down the pathway of providing. Educate. Like psycho education around it, lots of distress tolerance tools, reducing checking behaviors, reassurance seeking behaviors, any accommodations that might be happening, not just with family, but also with gp.

[A]

Yes, exactly.

[B]

And doctors and that sort of stuff, which is really hard for them to do because they have. They can't dismiss.

[A]

Yeah.

[B]

But then at the same time, with collaboration and that multi discipline approach in terms of working together and talking together collaboratively.

[A]

Yeah.

[B]

I think JP's feel more assured to go, okay, this is what we're dealing with. So.

[A]

Yeah.

[B]

I don't have to refer for every mri.

[A]

That's right.

[B]

Whatever.

[A]

We've done that test. We've done it once.

[B]

Yeah, yeah, yeah, exactly. So I think from that perspective and then working on gradually leaning into the uncertainty and discomfort and teaching distress tolerance skills and working on ways to come up with exposures to encourage our clients to practice those tools and resist.

[A]

Yeah.

[B]

But also. And you'll find this with your clients too, coming into. What's this really about? What's actually going on here?

[A]

Yeah.

[B]

Sometimes it's trauma. Yep. In terms of losing loved ones or worrying about that or being fearful of that.

[A]

I've got a young person who's. Who has fairly significant health anxiety and lots of sort of death anxiety. Yeah. Stemming from her mum having a breast cancer when she was young and her mom, her mum survived, she's in remission. You know, it was a fantastic outcome, but it's left a scar.

[B]

Yeah.

[A]

Of course, she learned at a very, very young age that awful things happen.

[B]

They do. And to you and to people that you love. Yeah, exactly.

[A]

Yeah.

[B]

And so that could be a trigger. So when you, when you peel that away, you're then left with what's driving the behavior. We've talked about form and function before in terms of what does it look like? We can see that, but when we deal with that and we reduce the symptoms.

[A]

Yeah.

[B]

What do we. What's left? What's the function of it?

[A]

Yeah, that's right.

[B]

So that's right. That's another question.

[A]

Yeah.

[B]

As well.

[A]

What kind of exposures have you done for health anxiety?

[B]

Oh, all sorts of healthy Mercedes, all sorts of stuff. House watching House.

[A]

Yeah.

[B]

Is a great one. And me chiming, going, what if that was you on the hospital beds for.

[A]

People who don't know House. Oh, yeah. It's a medical show where every week, House, who's the doctor? You know, specialist doctor. So it's almost like a sort of investigative show who. It gets called in to investigate the mo. The rarest, strangest kind of medical conditions where. And normally like, you know, death on the line and they're racing to find a. Find an answer. And so it's. I think it's a really good exposure show because it's, you know, it's not just your run of the mill, oh, there's a virus, you know, it's like.

[B]

Ah, you know, this is really rare and it's to the line.

[A]

Yeah, yeah.

[B]

As in, like. Yeah, death is very prominent in a lot of episodes.

[A]

Yeah.

[B]

Or talk about it anyway.

[A]

Absolutely, yeah. Also shows like, you know, er. Yeah, I think Anatomy. Any medical shows. Even some of the reality shows.

[B]

Yes.

[A]

About, you know, emergency department wards, things like that.

[B]

Yeah, yeah. Like what's the. Is it called, er. The one where they have like. Literally they're in the emergency department and it's real. It's a reality show. I don't know. Anyway, whatever. People might know what we're talking about or they might not.

[A]

Yeah. YouTube's also your friend.

[B]

Yes, definitely. YouTube's fantastic. Scripting is also one. Definitely talked about scripting before in terms of writing down, like eliciting, again, working with your client to elicit intrusive thoughts and that sort of stuff to trigger urges to want to check their body physically and then to sit and resist those urges after they've read the script and so on and so forth.

[A]

Yeah, yeah.

[B]

Also deleting chat, GPT or your Reddit app.

[A]

Yeah, yeah, it's another one I'm resisting the urge to research. Yes, definitely, definitely. Obviously reducing reassurance from family.

[B]

Yeah, yeah.

[A]

And also delay. So like delaying going to the doctor.

[B]

Yes, yeah, yes. Oh, that. But that's. This is where supervisees go. But what if something actually. Yes, what if that. One fucking time it's actually a brain tumor or something. Oh, God. Make sure you got good insurance. Yeah. Because it's really hard.

[A]

Because there are somatic symptoms.

[B]

Yes, it.

[A]

With health anxiety and healthy ocd. And how do you know that it's a somatic headache and not a headache because of a brain tumor.

[B]

Yes, exactly. So I always say, you know the good old Panadol. Was it Panadol? I don't know, some commercial where it's like, if symptoms persist, please call your doctor. So that's my tagline to my supervisor.

[A]

Yes.

[B]

If their symptoms persist, then you can go.

[A]

That's exactly right.

[B]

But if they don't. Yeah, then that's right.

[A]

That's right.

[B]

Yeah.

[A]

And it's also about coming back to values, about what is running to the doctor every time you have a symptom doing to your life.

[B]

Yes.

[A]

What. What are you missing while you're sitting in a doctor's weight room?

[B]

Yeah.

[A]

What. What are you not able to afford because you're spending money on medical bills.

[B]

Yes.

[A]

And a lot of people would say, well, they, you know, the reassurance is. Is so gorgeous and lovely that they don't want to. Yeah. Leave that out.

[B]

But so that it allows them to live their life. That's right. Yes.

[A]

But only for such a short period of time before the next comes up. And I think if people can, like helping our clients to connect with the life they could be living if they weren't always in a doctor's surgery or researching that give them sort of a sense of meaning and purpose.

[B]

Yeah.

[A]

That can really help with delay and that sense of, you know. Well, it's worth delaying a couple of days to see if the doctors persist, because that means that I can actually see, I don't know, my daughter speak at assembly on Monday where I would have to miss it because the doctors only got a time at that same.

[B]

Or I'm actually playing with my family rather than spending two hours on Reddit.

[A]

Yeah.

[B]

Or something like that. That's right. Or I'm actually able to go and catch up with my friends for dinner because I'm not, you know, worried about whatever else it might be.

[A]

Yeah, yeah, yeah, that's right. That's right. I know. I think that there's a lot that is missed in life when we're so focused on trying, which is the great irony and the great paradox of ocd. Right. Is that, you know, in attempting to live a longer life, we end up living a less meaningful.

[B]

Yeah.

[A]

Life. I often say to my clients, we actually miss out.

[B]

You do. I often say to my clients, the thing you're fearful of, which is loss of life, has kind of actually already happened.

[A]

Yeah.

[B]

You might physically be alive, but you're not living. You're just existing.

[A]

Yeah.

[B]

That's like. You're not living your life.

[A]

Yeah.

[B]

So the thing. So it becomes a false security blanket. The thing you're worried about has actually happened.

[A]

Yeah, that's right.

[B]

And that realization brings on so much grief.

[A]

Yeah.

[B]

For a lot of people. But it's also motivating change, isn't it, actually? Yeah. Let's. Let's do this.

[A]

Yeah.

[B]

Yeah.

[A]

I reckon that's a nice spot to finish.

[B]

Yeah, I think so, too.

[A]

That's a lovely way to wrap up here. Yeah, yeah.

[B]

Okay.

[A]

Lovely. Great discussion.

[B]

Thank you very much. Thanks, Lane. Thanks, guys for watching. We'll see you next episode. Acast powers the world's best podcasts. Here's a show that we recommend.

[C]

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[B]

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