Health Anxiety, Hyper-Vigilance, & Yes-And Thoughts (Turn Panic Into Peace Series #8)


You might be experiencing a lot of anxiety around your physical health right now due to the virus, and you’re most definitely not alone. I’ve spoken on a previous episode about brain habits, and so if your health was a concern before the pandemic, it’s very likely on your mind now too, and maybe even in overdrive. 

As a culture, death is something that isn’t talked about openly, so we tend to shove down or push away the truth of our progression from birth to death, and the fact that our deaths are inevitable. It’s the one thing that we are guaranteed, and yet, we operate under this illusion that we have full control over our bodies and how long we live.

With the existence of a new threat to our physical health, this reality is forcing us to see that we don’t have full control, and my goal today is to help you find the peace and calm that is available to you right now in this pandemic.

Listen in today as I offer you three tools that I have found to be very helpful in my own life and with my clients with their health-related anxiety. Acknowledging the reality that you are mortal is the first step in finding peace with our current situation, and I’m walking you through how you can use these techniques to stay out of frenzy and anxiety.

What You’ll Learn From this Episode:

  • Why our health, in particular, can create so much anxiety.
  • The link between diet culture and the pandemic.
  • Why trying to control something you can’t will make you feel insane.
  • How our health-obsessed culture gives us a false sense of control over our bodies.
  • What is at the root of our health anxiety.
  • The difference between pain and suffering.
  • 3 techniques that I have found effective in calming my health-related anxiety.

Listen to the Full Episode:

Featured on the Show:

Full Episode Transcript:

Welcome to Unf*ck Your Brain, the only podcast that teaches you how to use psychology, feminism, and coaching, to rewire your brain and get what you want in life. And now here’s your host, Harvard law school grad, feminist rockstar, and master coach, Kara Loewentheil.

Hello my anxious chickens. I hope that you all are getting better at managing your minds and learning how to deal with your anxiety during this time. I think one of the amazing things about being human is that humans are so adaptable – most of us. The things that we get used to and the things that we live with are just… run the gamut all over the world, in our personal lives, in our professional lives, in our global lives.

And so I just always think about how resilient humans are. Civilizations have risen and fallen. Even in our own personal lives, we get used to things that we thought we never could get used to. Positive or negative sometimes. But even after the first week or two of shock, we very quickly, I think humans just get used to a new normal.

And so knowing that and knowing that life is 50/50, you’re going to have positive and negative emotion no matter what, your brain is going to create moments of joy and connection and fun, and your brain is going to create moments of anxiety and fear and sadness, whether there’s a pandemic or not. Just really helps me remember that I can adapt to anything and I can find the meaning and the will to make the best of whatever situation I’m in.

And that’s what I really wanted this podcast series to help all of you do too because it’s not something that comes naturally to me at all. I was raised by neurotic Jews. I am not temperamentally naturally happy-go-lucky. I’m still not happy-go-lucky. I’m going to ask my boyfriend. I’m sure he would agree after a lot of thought work.

But the emotional resilience, the ability to cope when things aren’t going the way I want or to deal with my own negative emotion, to know that I can handle whatever is happening, that is a skill that I have built myself through doing thought work, through learning to coach myself, through getting coached.

And so what I really wanted for this podcast series was to give you all a little taste of that. And we’re about two thirds of the way through now, or maybe even a little bit more, and so I hope that you have been practicing what I have been teaching. I’m not trying to do the math in the head about what episode number this is and where we are.

We’re going to 11 I think, so whatever number this is, whatever fraction this is of 11. Anyway, so today I want to talk about health anxiety because obviously something that’s coming up for a lot of people right now. And I feel like a broken record, but I just think it’s so important to remember.

Like anything else, if you used to have anxious thoughts about your health, you probably have more now. And if you didn’t use to worry about your health, you probably aren’t super worried about it now. And I see that even in my own kind of family and friends and myself. I actually rarely get sick and yet, because I have a history of chronic pain or just being raised by doctors, I have thoughts about my own physical health not uncommonly.

And so of course, those are activated right now. And meanwhile, there are people in my life who actually get sick way more than I do and who seem to have less hearty immune systems maybe who are not worried at all because their thinking about their own health is just not particularly negative.

So whatever your patterns were before this are the base that you’re operating from. But I think that one of the reasons that health anxiety is so challenging for a lot of us and this pandemic is bringing it up so much is that it’s really illuminating what was always true for us, which is that we’re all going to die at some point.

We are very disconnected from our own mortality, most of us, especially the way that we live in modern life where children aren’t often told about death, don’t see death. It tends to be sanitized and kind of kept away. And we don’t really talk about it in our culture, and we don’t really – many of us don’t have rituals for it the way people used to.

So I just think we know that we’re sort of a mortality-phobic culture, and we – old people are more isolated, they’re not as part of daily life for young people as they are in other cultures. We just are more removed from the true cycle of life, which is the progression from birth to death and from youth to, if we’re lucky, age.

And we’re not always that lucky. And so this pandemic is really kind of shaking our illusion that we have control of our own mortality, that absent – it’s like we all know that particular kinds of catastrophe could always strike. Could be in a car accident, you could get cancer out of nowhere. It’s like we believe that we understand the risks out there.

And then it turns out that there’s this new risk that we don’t know about and all of a sudden everything feels completely destabilized because we were operating under this illusion that we knew what bad things could happen and which we needed to worry about.

And because it’s a physical illness that we don’t know that much about and that can be fatal, I think we are all being called to come to grips with our true lack of control over our own mortality and our own health. And I think health in particular can be so anxious for us because we want to believe that we can control our bodies and we live in a society that really emphasizes the idea that we can and should be able to control our bodies.

It’s like you probably didn’t think there was a link between diet culture and the pandemic, but there totally is. And it’s not just all the memes about how people might gain weight in quarantine, god forbid, like that’s the most important thing in the world. But diet culture is completely infused with the idea that our bodies are just these malleable objects that we can control at will.

And we live in a kind of health-obsessed culture where we are always being marketed and sold supplements and vitamins and nutraceuticals and all sorts of things that we’re supposed to be able to use to prevent illness, stave off death, be perfectly healthy, all under our control.

And that gives us a false sense of control, which is reassuring while we have it. The illusion gives us a benefit. That’s why we buy into it. But now we are being called to be present with the truth, which is that we can’t 100% control our bodies. They are not totally under our control.

And I think it’s really almost highlighting the relationship between body and mind, and how we live in our bodies but we are not just our bodies. And when we think of them as these objects we need to control, we create a lot of anxiety, whether we’re thinking about our weight or thinking about trying not to contract a virus.

Either way, whenever we are trying to control something we can’t totally control, we will feel anxious and we will feel panicked and freaked out. That’s just the way of the brain. Any time you try to control something you can’t control, you will feel insane. And that’s what’s happening a lot with people’s health and mortality thinking right now.

And of course, your brain is completely complicit in this because the primitive part of your brain exists just to keep you alive. So as I talked about in the very first episode, it’s getting a constant stream of information that you might be physically in danger, so it’s freaking out all the time.

And then a lot of us are trying to use our prefrontal cortex, the part of our brain that can reason, to engage in the same premise and reassure ourselves, to either take a bunch of action to control not getting sick and believe that we can have total control over it, or to kind of try to reassure ourselves or argue with ourselves that we probably will be fine. We’re doing all these logical dances and jumping around and all to avoid facing the truth, which is that we don’t have total control of our bodies.

We never know what is going to end our lives, but we all know that that’s going to happen. The only thing you’re guaranteed is birth and then death. And our refusal to acknowledge that and accept that and accept our lack of ultimate control over when we live or die, or when our loved ones live or die is what is at the root of all of this health anxiety.

So believing that we can control it and we should be able to control it is what makes it so much more painful. I’m not saying, again, that there wouldn’t be any fear or anxiety without that, but it’s the difference between pain and suffering. Several Buddhist traditions teach pain is inevitable, suffering is optional.

What that means is negative emotion is inevitable. It’s normal to want to be alive. It’s normal to feel fear of death or to feel sadness about the prospect of being sick or dying or someone you love being sick or dying. It’s a normal part of the human experience.

But when we resist that and we think it shouldn’t be there and we think that we can somehow outrun it or get away from it or that we don’t have to ever have those emotions, and so we try to prevent them, that’s the suffering. That is the drama on top of our emotions. It’s our thoughts and feelings about our emotions and are trying to get away from our emotions that cause so much suffering.

Again, I’ve talked quite a bit in the limited series and on the podcast as a whole about how deciding to accept that you are mortal, which is true, and that you can’t 100% control what your life looks like or how long you have or who’s going to get sick or who’s not doesn’t mean that you don’t make decisions based on trying to mitigate risks to the extent that you can.

But there’s a huge emotional difference between I’m going to try to do what I can based on my current understanding to keep myself safer than if I did nothing, but I know that those are just my best guesses and that I’m not in control ultimately of what happens. That will feel completely different than if I just do everything perfectly and do it all right, I can make sure that I never get sick and I never die and I’m never scared and I’m never afraid and I don’t have any negative emotion ever.

One of those will feel very frantic and agitated, and one of those is going to feel really peaceful and grounding and real, in touch with the eternal truth, which is that we don’t have complete control over our bodies, over illness, over life and death, for ourselves or anyone else. So that’s the big picture.

In terms of techniques you can use to deal with some of the health-related anxiety, don’t skip that first 10 minutes. You actually have to constantly go back to that deeper truth. But I do have some smaller kind of hacks you can use. They only work if you’ve accepted the bigger truth. Again, don’t try to skip that part.

But so here’s what will happen. If you don’t accept that bigger truth, you’re going to be anxious and ruminating constantly. If you do accept that bigger truth, you really do the work on that, you will have many more moments of being calmer and more peaceful, and then sometimes you will have a spike of rumination or freaking out.

That’s when you can use some of these other techniques. So if you don’t do the work on that essential premise about our own mortality and lack of control, you will just feel crazy all the time and these other techniques are not going to help. But when you have done that, it’s more like you’ll just occasionally lose your mind and that’s when these techniques are going to help.

So one of the things that I’m seeing in my own brain, in my clients’ brains is a lot of hyper-vigilance about physical sensation right now because our primitive brain has basically been told there’s a threat that you can’t see and the only way to know is if you start to feel a certain thing.

So then your brain is like okay, as opposed to like, scanning the Savanna for a lion, I’m going to scan my body constantly to look for the danger. And I found that my body and mind were, because of that hyper-vigilance, giving me just constant updated feedback about how I felt.

Because just like you, my brain was like okay, the danger is that I might get sick so let me just make sure she knows every time I feel anything in my lungs when I breathe or any time my throat feels a little dry, or any time that I feel a little tired, I was just getting this constant feedback.

And so what I decided to do was practice saying to my brain and my body, “Hey, thank you.” You’ll be shocked how often it works to just say to your brain, “Thank you for letting me know. I see why you thought that was important.” It’s like letting your brain know you heard it.

So I just think, “Thanks for letting me know, but I don’t need minute-by-minute updates. Nothing is going to change dramatically in two hours. I don’t need to know every sensation I’m having every second. I’ll check in with my body at 5pm and see how I feel then.” And that was actually super effective and helpful for me. It just let my brain know, okay, I hear you, I know you’re scanning, thank you. I hear you, but we actually don’t need – that’s not actually relevant information.

It’s like your brain thinks it’s relevant information and it’s bringing it to you. Your brain is like okay, you told me there was a danger, look, I’m finding all the indications and I’m bringing them to you. And just like if you had an employee who was well-intentioned but telling you stuff you didn’t need to know, you just have to be like, oh no, we don’t need all that information, it’s okay.

And by telling your brain, listen, I’m going to check in in two hours or whatever it is, you’re sort of letting it know like, you’re in charge, you’re paying attention, it’s safe, it doesn’t need to be quite so hyper-vigilant. So that’s one of the things I have found very helpful.

The other technique that I’m finding really helpful for myself and my clients in this time is what I call yes and thoughts. So if you have ever lived in New York like I have and been in your 20s, you have for sure had to go to numerous horrible improv shows that your friends were in. And you will have learned that the number one rule of improv is that you always say yes and.

So somebody says something like, “There’s a giraffe in the room,” and you can’t be like, no there’s no giraffe. You just have to say, “Yes and the giraffe wants to see your driver’s license,” or whatever it is. So when you’re having thoughts that – especially if they’re thoughts that are clearly true, they’re potential circumstances or at least your brain is very convinced that they’re true and you can’t see a way around them, or they’re very factual already, you’ve sort of already tried to – let’s say you had a negative thought and you’ve neutralized it, like I talked about in the second episode of this series.

You’ve come up with a neutral thought, but it’s still – it’s a little better, it’s a little more neutral, but it’s still a thought that is causing some negative emotion for you that’s not helpful, you can yes and the thought. So for instance, if your thought is, “I might contract COVID-19,” and that thought makes you feel very anxious, you don’t have to push away or resist that thought.

It probably won’t work to tell yourself, no I definitely won’t. Because again, what has this whole premise been? That’s not something you can completely control. But you can yes and it. So you can think when you hear your brain saying I might get it, you can think, “Yes, and I know my body has healed itself before,” or, “Yes, and the vast majority of cases are mild and most people recover,” or, “Yes, and I trust my body to be able to handle whatever happens,” or, “Yes, and I know I’ll be able to take care of myself and know what to do when the time comes.”

You’re basically allowing that original thought that’s causing the negative emotion. You’re not trying to reject it. You’re not trying to tell yourself it’s not true. And you may not be ready yet to just swap in a more positive thought. But you can attach them together. It’s like, the little attachments between trains. You can hook up another train car, hook up a caboose to that train car so that you are quickly thinking something else.

Now, it’s not about, again, shoving away that thought or not thinking that first thought or trying to get away from it. It’s just reminding yourself, that’s not the only thing that’s true. That’s not the only thought I could have. Yes, there’s this, and there’s this. So yes and.

Or if your negative thoughts are about having lost your job and the economic changes, it might be if you’re having the repeating thought of, “I don’t have enough money in my bank account now for what my bills are,” or whatever it is, or, “I’m worried I won’t be able to make more money,” or whatever your thoughts are, again, you can yes and it.

So I would try to get the more neutral circumstance of like, this is the amount of money in my bank account. That’s what would be the true fact. And yes, that’s true, and I’ve gotten through tough times before and I know I’ll figure out what to do. Or, yes, this is the amount of money in my bank account and I’m lucky I have a support network and I know that I have people who would be willing to help me.

Or yes, and I know that I figured out my financial situation before, I know I have a lot of talents and skills. If I turn my mind to it, I’ll be able to figure something out. So again, you’re not pushing away that fact, you’re not rejecting it. You’re just adding to it. Yes, and.

I’m finding especially right now when we’re having just – I think part of what’s going on right now is even though all the things that we are thinking or that we are now experiencing, the circumstances have always been if not this exact circumstance, it’s always been true that we couldn’t control everything that was happening. We don’t always know what’s coming. We can’t control our life and death. Those have always been true.

But we’re just having circumstances that trigger many more thoughts to deal with on a daily basis, and because it’s happening to everyone, it’s reflected everywhere around you, in the news, on social media, whoever you’re quarantined with may be talking about it.

So I think we’re just having – it’s like the quantity dial has been turned up. We’re just having way more of these thoughts on a daily basis and everyone around us is also, which means that there’s a lot of thought work to do, which is a wonderful opportunity. But it also means it’s a good time to use something like yes and where you just allow that first thought to be there but then you add on something else so that you don’t just stay myopically focused on that first thought.

My teacher is always saying, “Of all the thoughts in the world, you could pick anything you want. Why are you picking that thought?” And in this situation, okay, maybe you’re still going to think that first thought, but it just reminds you there’s so many other thoughts that you could be thinking about anything in the world.

Any thought is available to you. This is what’s so wild. No one can be in charge of what you think except for you. If you want to think a wildly pessimistic terrible thought, you can, and no one can stop you. But if you want to think a wildly optimistic positive thought, no one can stop you. You’re allowed to. You can think whatever you want.

So out of the whole universe of possible things to think, you want to remind your brain that what it just happens to have come up with that feels terrible are not the only options. And the yes and really helps with that in my experience, with my own brain and working with my clients.

So that’s basically three tools, the first one is the meta tool of acknowledging our lack of control over our physical bodies and of our health, giving up the illusion that we were ever in charge of and could completely control those things, and then one you’ve done that kind of foundational work, the sort of conversation with your brain about its hyper-vigilance and thanking it for what it’s been trying to do to help you but then giving it some structure, like a child.

We’re going to check in at five about this, we’ll have a meeting about it tomorrow, I don’t need any updates until then. Kind of running the room, being in charge, setting the agenda for your hyper-vigilant, anxious brain. And then using yes and thoughts. Those are kind of three tools that you can use in a whole variety of circumstances and a whole variety of types of thought patterns that I think can be particularly helpful for anxiety and worry about your physical health right now.

Alright chickens, I hope that was helpful and I will talk to you soon.

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