Health anxiety – Why giving false hope is worse than no hope

Health anxiety is normal and often part and parcel of serious health issue. Being able to separate the real from the unreal – that’s what matters.

I wrote this article before the start of the coronavirus pandemic. Now many more (most?) people feel some kind of health anxiety? At least fear of

• catching the virus,
• having other health concerns not attended to, because other health services are being impacted,
• going to see a medical professional with unusual symptoms we are experiencing.

In this piece I focus on being given false hope, because people may try and ‘save us’ from health anxiety. But false hope is worse than no hope. Why? Because it does not help us learn to live with difficult truths. Yet some people think giving or receiving false hope is better than no hope. I disagree.

Let’s look at hope and health.

1. False hope vs reassurance

Once my GP told me that “things will get easier”. Then it had been 6 years since my diagnosis and treatment for breast cancer. For many this means, things will get easier: fewer worries about the cancer coming back and less chances of the cancer coming back. One of the oncologists even said I had been “cured”, while another said that all that can be done had been done.

I know comments like my doctor’s are meant to reassure, made with the best of intentions, and probably conviction. But I also know, they are often meant to pacify what is interpreted as health anxiety, hopelessness, pessimism and cynicisms.

What I feel is all of the above and yet none of it.

How to turn hopelessness into hope

2. Health alertness vs health anxiety

If you have been diagnosed with cancer or another life-changing or life-shortening illness, you too, may know the feeling of living with what I call constant ‘subtitles’:

Nothing is what it is. Nothing is like it used to be. Nothing is like we thought it would be. And we call much into question.

Comments like “but you look so well … you must not worry so much” can be unhelpful and dangerous. They can lure us into a false sense of reassurance, when we need to remain alert to changes in our bodies.

There is a very fine line between health awareness, watching out for red flag signs as well as irrational health anxiety.

And there is nothing right or wrong about it. There is no blue print or manual that can tell us, how to do it ‘right’.

You, too, will probably have had moments of health concerns and feeling unwell. Since my initial cancer treatment I have had many. Thankfully, the symptoms turned out to be related to other things. Yet these are intensely frightening and dare I say traumatic moments in our lives.

How to overcome cancer self exam anxiety

Each time (and increasingly so) I have to check in with myself, whether I am over-reacting, whether I will be thought of as a time waster, as someone overcome by health anxiety.

3. Coping with health anxiety: professionally and personally

And what do I do for a living? I am a psychotherapist, and I specialise in supporting people affected by cancer and loss. And people ask me, how do I square that?

• Is it healthy for me “to work with cancer”, when I have been affected by cancer?

• Is that not too close to home?

• Does that not make things worse for me?

My truthful answer? No.

Like any other therapist or counsellor, cancer or no cancer, I too, have to monitor myself constantly, to see whether I am emotionally and physically fit to do the work.

But how can I help others deal with their health anxiety, when I too experience it?

There would be a problem, if we were to assume (wrongly in my view), that there needs to be a way of having health or cancer anxiety “sorted … done and dusted … ticked off the list”.

No. Health anxiety is normal and human. What matters is knowing how to face up to it and being able to live with it, without it standing in our way and becoming disproportionately irrational.

Feeling under siege: How to separate reality from anxiety

4. If you are tempted to give someone hope that you don’t believe in

It is understandable that we may want to reassure others – for so many reasons. Depending on how close we are, others’ despair can be hard for us to cope with. It is upsetting, especially when we don’t know what to say.

Why not knowing what to say can be helpful

Then we may be tempted to give false hope, anything, to reassure them and us. As I said, it is understandable. But does it really work and help you and the other?

5. False hope vs meaningful hope

Coping with health anxiety is about accepting our anxiety and learning to regulate it, so it does not work against our wellbeing. False hope gets in the way of that process.

Instead we need to learn to find meaningful hope in ourselves and in our ability to be able to do the best we can, whatever may happen – illness or no illness.

Why putting the pieces back together does not work

It’s about hope, that somehow, somewhere we will find a way out of the dark moments and places.

We must not sugar-coat the truth, that we cannot know what is around the corner.

There is no point in giving false hope, like it will get easier, because it happens to have been ‘x’ number of years.

Meaningful hope and reassurance can be hard to give and hard to receive:

• The belief that despite what has happened, we can cope and live well with the here and now and with whatever may come, or not.

• The fearlessness of facing up to difficult possibilities in our lives and not shying away from naming them.

• The supportive silence and acknowledgement that living with sub-titles of fear and mortality is not easy and requires constant focus and honest acceptance.

To be able to acknowledge that hope is hard to come by and to keep, that is more helpful than any false hope can ever be.

My cancer did return. A local recurrence was eventually identified, after I continued to insist on further investigations. I just had not felt ‘right’. At the moment I feel ok.

I consider myself as living with cancer. And I don’t consider that as giving in to health anxiety.