Body Checking and Health Anxiety: Assessment Led Guidance

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

Body checking involves repeatedly examining or monitoring the body for signs of illness. This can include physical palpation, visual inspection, monitoring heart rate, breathing or digestion, or searching for sensations that might indicate a problem. It is a common pattern in health anxiety and is usually driven by a wish to reduce uncertainty about health. A guide cannot determine whether a person's checking pattern is clinically significant, whether it is related to health anxiety or another difficulty, or whether physical symptoms need medical attention. New, severe, persistent or changing physical symptoms should be discussed with an appropriate medical professional. A psychological explanation and a medical question can both need attention at the same time, and a website cannot determine which applies. The cognitive behavioural model of health anxiety describes how checking can maintain rather than resolve worry. In broad terms, a person notices a sensation, fears it may indicate something serious, checks to seek certainty, experiences temporary relief, and then notices the next sensation. Over time, the checking can increase attention to bodily sensations and reduce the person's confidence in tolerating uncertainty without checking. This is a general model. It does not apply uniformly to every person or every pattern of checking. Reassurance seeking is a related pattern. It can involve asking a partner, family member, GP or specialist to confirm that a symptom is not serious. Like checking, it can provide temporary relief and then leave the person needing the next reassurance. A guide cannot advise on whether to seek or withhold reassurance in a specific situation. That is a clinical question that depends on individual assessment, health and safety. CBT is one evidence based approach that may be considered after individual assessment for health anxiety. It can involve exploring the links between a sensation, the thought that follows, the emotion, the checking behaviour and the short and longer term effect. Any work on checking, reassurance, attention or uncertainty should not involve delaying or avoiding necessary medical care, and should not be copied from a guide. Behavioural experiments, where they are clinically appropriate, are planned collaboratively with a suitably qualified clinician after discussion of the rationale, alternatives, safety and pacing. For related information, see health anxiety therapy at https://lyceumclinic.co.uk/therapy/health anxiety/, the health anxiety guide at https://lyceumclinic.co.uk/guides/health anxiety/, health anxiety and relationships at https://lyceumclinic.co.uk/guides/health anxiety relationships/ and health anxiety subtypes at https://lyceumclinic.co.uk/guides/health anxiety subtypes/. If there is immediate danger, thoughts of self harm, an inability to stay safe or an urgent medical concern, call 999, attend A&E or use urgent local crisis or medical support.