The body keeps the score, and so does the diary

Specialist CBT therapy for anxiety, OCD, depression and more in West London

A headache before a difficult meeting, a tight chest on Sunday evening, nausea before an appointment, a stomach that drops after a message: it is understandable to look for a connection between the body and what is happening around us. Patterns can be useful to notice. They do not prove that a physical symptom was caused by stress, anxiety, trauma or a particular thought. Physical symptoms can have many causes. New, severe, changing or concerning symptoms may need medical advice or urgent care. A reflection cannot assess chest pain, breathing changes, fainting, neurological symptoms, pain, medication effects, pregnancy related symptoms, infection or another health concern. It should not tell someone that a symptom is “just anxiety”. Once relevant medical questions have been considered, some people find it useful to notice context alongside symptoms. This may include what was happening beforehand, what the person noticed in their body, what they thought it meant, what action followed, sleep, food, medication, activity, pain, stress, safety and support. The aim is not to become more vigilant or to collect evidence against oneself. It is to create a more accurate account with appropriate professional support. A diary can be helpful for some people and unhelpful for others. For someone who is already checking, monitoring or seeking reassurance repeatedly, additional tracking may intensify distress. For another person, brief notes can support a medical conversation or a therapy assessment. There is no universal format and no requirement to record every sensation. An assessment can consider whether attention to the body is helping, whether it is becoming consuming, and what other explanations or services may be relevant. It can also explore patterns involving panic, health anxiety, trauma, low mood, physical health, medication, sleep, work or daily demands without assuming one cause. CBT based therapy may be considered after assessment where clinically appropriate. It can explore the relationship between sensations, thoughts, emotion, behaviour and context. It cannot determine a medical cause, replace healthcare or guarantee that symptoms will stop. Where behavioural work is appropriate, it is planned collaboratively with a qualified clinician. A blog is not a self directed instruction to provoke symptoms, stop checking abruptly, dismiss a health concern or use exposure based work alone. Pace, consent, medical information and safety matter. For related information, see <a href="/therapy/health anxiety/">health anxiety support</a>, <a href="/guides/health anxiety in the age of google/">the guide to health anxiety and online searching</a> and <a href="/therapy/trauma/">trauma informed support</a>. If distress includes crisis, thoughts of self harm or an inability to keep safe, urgent appropriate help is needed.