How to Stop the Negative Thoughts of Health Anxiety

Depending who you ask, you process between 12,000 and 65,000 thoughts per day. The most credible estimate I was able to find is 15,000, made by Dr. Dennis Gersten, MD and American Board of Psychiatry and Neurology diplomate. 

Regardless whose estimate is most accurate, consensus is you process a lot of thoughts - many of them automatically, in your subconscious mind. It stands to reason that some of them are negative (some estimates even suggest that up to 70% of your mental chatter is negative).

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Automatic negative thoughts (ANTs) exist to keep you safely coasting through your comfort zone, and they happen to everyone.

What varies is how you interpret, and respond to those pesky ANTs. 

ANTs you accept to be true, without challenging them, lead to anxious thoughts, and in time, can be a cause of health anxiety... but only if you let them.

Automatic negative thoughts typically fall into one of these common thinking traps:

  • Fortune-telling
    I'm anxious about today's doctor visit. My test results are back and I just know it’s going to be bad news.“
  • All-or-nothing thinking
    “I'll believe I'm healthy when all my symptoms are gone.”
  • Mind-reading
    “My doctor and family must think my symptoms are all in my head.”
  • Over-generalization
    “Physical symptoms are only caused by physical illnesses.”
  • Labeling
    “I’m sick, I just know it.”
  • Over-estimating danger
    “My heart is pounding - what if I’m having a heart attack?”
  • Filtering
    "I was feeling so much better lately, until this happened - now I'm starting all over again."
  • Personalizing
    “I met someone in a chat room who had the same symptom - I must have the same thing they do.”
  • Catastrophizing
    “I’m tired and I have a headache - what if it’s a brain tumour?”
  • Should statements
    I should try not to worry.”

How do I stop negative thoughts? 

Automatic negative thoughts (ANTs) are, well, automatic.

This means that while you can't eliminate negative thoughts entirely, you can:

  • Reduce their frequency.
  • Reduce their power over you.
  • Transform them into positive thoughts that promote calm and self-compassion, instead of anxiety and fear.

In time, the subconscious mind will move away the negative thinking patterns it learned as your health anxiety developed.

Try using the Cognitive Behavioural Therpy (CBT) based strategy I applied during my 60-day health anxiety recovery. The exact steps I followed are outlined below.

Step 1: Trap negative thoughts

The first step to transforming automatic negative thoughts is to switch off autopilot and become consciously aware of them, the moment they occur.

The next time you experience an automatic negative thought, slow down, take a few deep breaths, and trap it by asking yourself these questions (verbally, if necessary):

“Self, how valid is this thought - is it based on fact or worry?"

"By interpreting it this way, am I promoting calm and self-compassion, or anxiety and fear?"

The answers will stop the negative thought in its tracks, preventing it from progressing unchallenged into an anxious behaviour.

Not only will this reduce the automatic negative thought’s power over you, but also, in time, patterns (in certain sensations, situations and stimuli) will emerge that you can target to begin reducing the frequency of your automatic negative thoughts. 

Step 2: Confront negative thoughts

 Take automatic negative thoughts to court. Cross-examine them to cast doubt on their validity and build evidence supportive of a new, positive interpretation.

Take automatic negative thoughts to court. Cross-examine them to cast doubt on their validity and build evidence supportive of a new, positive interpretation.

Second, instead of accepting automatic negative thoughts as fact, put them on trial - prove them guilty of misleading you, and give yourself permission to cast them aside.

Cross-examine your negative thoughts by asking yourself these questions:

”Is this thought a repeat offender?”

”Which thinking trap does it fall into?”

"What must I believe in order to interpret it differently, in a positive way?”

”What evidence do I have to support this new belief?" 

Don't rush the process. Pause, breathe, and take the time you need to answer each question (verbally, if necessary).

Step 3: Transform negative thoughts

Now the fun part! 

Third, substitute the pesky anxious thought with a one that promotes a healthy, fearless life, free of anxiety.

Ask yourself:

”Based on this belief, what new positive, rational thought will replace the original negative, irrational thought?”

Write down the new positive, rational thought, and say it back to yourself with great conviction.

Step 4: Complete your next action

Finally, reinforce the positive, rational thought and its supporting belief by directing your energy toward a next action that will yield immediate gratification.

Ask yourself: 

"Given this new belief, what’s the most worthwhile next action to focus my energy on, right now?" 

Follow through by mindfully completing the next action identified above.

 Make a list of worthwhile next actions to help disrupt negative thinking patterns by reinforcing your new, positive, rational thoughts.

Make a list of worthwhile next actions to help disrupt negative thinking patterns by reinforcing your new, positive, rational thoughts.

It doesn’t have to be related to the original thought - it can be any activity that moves you forward, and contributes to a healthier, happier, more productive, more mindful you!

For example:

  • Make dinner
  • Get the kids ready for bed
  • Call your mom
  • Go for a walk or run
  • Work on a project
  • Clear your inbox
  • Meditate
  • Enjoy a favourite hobby

I recommend making a list of next actions in advance - that way, there are no excuses for not following through with this critical last step next time you confront an anxious thought.

Add them to your Reminders app, or write them in a notebook, or on a sticky note to keep it in your wallet.

Example: How to transform negative thinking.

Original thought: I'm anxious about today's doctor visit. My test results are back and I just know it’s going to be bad news.“

1. Trap

“Self, how valid is this thought - is it based on fact or worry?"
Worry.

"By interpreting it this way, am I promoting calm and self-compassion, or anxiety and fear?"
Anxiety and fear.

2. Confront

”Is this thought a repeat offender?”
Yes.

”Which thinking trap does it fall into?”
Fortune-telling.

"What must I believe in order to interpret it differently, in a positive way?”
That there's an equal or greater chance my test results are negative.

”What evidence do I have to support this new belief?"
My doctor didn't seem worried. My physical exam was normal, and she ordered the test mostly to provide me with reassurance.
I have no family history, and few risk factors, of the illness I fear.

3. Transform

”Based on this belief, what new positive, rational thought will replace the original negative, irrational thought?”
Original, negative, irrational thought: “I'm anxious about today's doctor visit. My test results are back and I just know it’s going to be bad news.“
→ New, positive, rational thought: "My test results are back. Of course, there's a chance they'll be positive, but most of the evidence indicates it'll be negative. Whatever the result, today's doctor will make me better - by providing either a treatment for the illness I fear, or the reassurance I need to put my fears behind me and begin living a healthy, fearless life, free of anxiety."

4. Complete

"Given this new belief, what’s the most worthwhile next action to focus my energy on, right now?"
The most worthwhile next action to focus my energy on, right now, is completing the project I'm managing at work. It's an important project - others are counting on me to deliver, and it'll help me get that promotion.

Now, apply.

 📗 If you don't have a journal, get one. Documenting what you learn, and your progress, is critical to your recovery. I recommend Day One (Download for iPhone or iPad | Android) because it's easy to use and I can take it with me everywhere I go. If you prefer pen and paper, that's fine - any journal will do.

🗒  Make a list of at least 10-15 worthwhile next actions.

✏️ Record each automatic negative thought, the thinking trap you fell into, the positive, rational thought that replaced it, and the next action you completed as a result. In time, patterns (sensations, situations, stimuli) will emerge, that you can later target to further reduce the frequency of automatic negative thoughts.

🎯 Practice, practice, practice. In time, your thought transformation skills will rise, and what feels tedious at first will become instant, effortless - almost automatic.

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