Home / Blog / How Black-and-White Thinking Increases Health Anxiety
How Black-and-White Thinking Increases Health Anxiety

How Black-and-White Thinking Increases Health Anxiety

We all experience a continuous flow of fleeting, evaluative thoughts or images throughout the day. These are called automatic thoughts, and they tend not to be deliberate but to emerge spontaneously. Our minds are flooded with these thoughts constantly; we might have thousands in a given day:

  • "Why is this lady talking so loud?"
  • "I love this song."
  • "I need to wash my car."

These thoughts pass through our minds quickly, often without our awareness. When we are aware of them, we tend to accept them uncritically. And this is where the trouble begins. Our thoughts are not always accurate. Often, without realizing it, we engage in thinking errors or cognitive distortions:biased or inaccurate thoughts that can lead to unpleasant and unhelpful feelings and behaviors.

Thinking Errors and Health Anxiety Are Besties

Research shows that those with health anxiety tend to have a lot of distorted thoughts. When someone has health anxiety, they might experience a trigger of some kind (e.g., a physical symptom or bodily sensation upon learning about someone else's scary health situation), and then they make an interpretation. This is often when thinking errors make their grand entrance.

One type of thinking error is black-and-white thinking, also known as all-or-nothing thinking. This involves viewing situations in absolute black-and-white categories instead of taking a more balanced approach and seeing things on a continuum. In the context of health anxiety, it involves viewing oneself as either perfectly healthy or deathly ill.

Take Ericka, for example. She is driving home from a doctor’s visit after receiving the results of a physical. The doctor told her that everything was normal and she was in good health. Of course, this put her in a grand mood. She bounced along the highway, singing loudly, smiling at her fellow commuters, and even happily welcomed in a couple of extra cars into her lane. Life was good. After all, she was healthy.

But then, at home, a few hours later, she noticed redness in her eye. All the relief and gratitude from earlier started to drain. She thought to herself, See? This is why I shouldn’t get so comfortable with the idea that I am healthy. Because it turns out I am really not. It was as if she viewed her health status like a light switch: on or off. There was no middle ground. She was either a model of health or a sickly old bag. Pap smear results came out fine? Healthy category. New mole? Sickness category.

Thoughts Are Not Facts

The key to learning to think in healthier, more accurate ways is to acknowledge that just because you think something, that doesn't make it true. Sometimes thoughts are accurate. But other times, they are inaccurate, even harmful. It is crucial to question the validity of your thoughts rather than just accepting them as truth.

Beginning a New Journey

The first step in improving unhealthy thinking patterns is to develop an awareness of the types of distorted thinking you engage in. At the beginning of therapy, I help my clients get well-acquainted with the most common cognitive distortions or thinking errors. They then begin to develop "thought awareness," in which we have them record their thoughts in a thought record to determine their own unique thought patterns.

Once they build thought awareness, they learn how to challenge these thoughts through Socratic dialogue. Cognitive behavioral therapy (CBT) can be a very helpful treatment for health anxiety.

Remember this: you are not alone, and there is help available.

If you are ready to take the first step toward improving healthy anxiety, get my free guide on how to get started! 



Leave a comment