The post pandemic body

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

The pandemic asked people to pay attention to their bodies in a way many had not done before. Temperature, breath, proximity, coughs, tests and changing guidance could all carry meaning. For some, that intense attention settled as life became less restricted. For others, the habit of scanning has remained, even when they would prefer it not to. This does not mean that every concern about a physical sensation is health anxiety, or that a body which feels unfamiliar is simply responding to stress. New, severe, unusual or concerning symptoms should be discussed with an appropriate medical professional. A blog cannot establish the cause of fatigue, breathlessness, pain, sleep changes, altered sensations or other physical experiences. Medical assessment and psychological support can both have an important place, depending on what is happening. What some people describe is a change in the attention they give to ordinary bodily information. A heartbeat after climbing stairs, a sensation in the throat, a period of tiredness or a change in appetite may now prompt a chain of questions that once would not have started. They may search online, inspect their body, ask a loved one for reassurance, arrange another check, or avoid an activity in case it makes something worse. These actions can be understandable attempts to feel safe rather than evidence of a particular diagnosis. The difficulty is that reassurance can have a complicated role. A clinician’s advice may be necessary and appropriate. So may a medical test or follow up. At the same time, a person can find that the relief from certainty lasts only briefly before the next doubt arrives. They may start to feel embarrassed for asking again, while also feeling unable to stop. That is not a personal failure. It can be useful information about how fear, attention and coping behaviour are interacting. In an assessment, the question is not whether a person is being rational enough about their body. The question is what has changed, what medical guidance has already been given, what the person fears and what they do when the fear appears. It can include the impact on work, sleep, family life, exercise, travel and ordinary decisions. It can also make room for the fact that health concerns during and after the pandemic have not been experienced equally. Illness, bereavement, caring responsibilities and previous experiences with healthcare can all shape the meaning of a sensation. There can be a strong wish to return to the version of yourself who did not notice every sensation. That wish makes sense, but it can create another demand to monitor whether you are “better” yet. A more useful starting point may be to identify the moments when body checking, online searching or reassurance seeking takes over a day, and to consider what each behaviour is trying to prevent. The aim is not to dismiss the body. It is to respond to it with appropriate medical care and a clearer understanding of the anxiety that may be gathering around it. If CBT is appropriate, work is collaborative and tailored. It may involve mapping a cycle of trigger, interpretation, feeling and response, then considering what changes are realistic in the person’s circumstances. It does not mean ignoring symptoms or cancelling medical care. Nor does it mean practising exposure or response prevention alone from an article. When clinically indicated, structured behavioural work is planned with an appropriately qualified clinician after assessment. Some people are concerned that therapy will tell them their physical experience is not real. That should not be the frame. Physical sensations are real. The uncertainty is often about their cause and what response is proportionate. A thoughtful assessment can hold both things at once: the need to take health concerns seriously and the possibility that constant monitoring may be making life smaller. It can help to bring a few examples to a first conversation. What happened before you first noticed the symptom? What medical advice have you received? What do you tend to do next, and how long does any relief last? You do not need to have the answers neatly arranged. The point is to begin building an individual picture rather than drawing a conclusion from a single experience. The related /therapy/health anxiety/ page and /guides/health anxiety comprehensive guide/ offer further information. If you are in Chiswick, Ealing and the Richmond venue or prefer online sessions, /start/ is a route to discuss current options and decide whether a fuller assessment may be useful.