Health Anxiety and the Need for Control: A Client Story
This client story is based on real therapeutic work. Identifying details have been changed to protect confidentiality.
When “Elena” first came to work with me, health anxiety had become a significant part of her life. She had previously experienced a serious health diagnosis and treatment. Although that period was behind her and she continued to take appropriate care of her health, the experience had left her struggling with uncertainty. A bodily sensation, lump or change could quickly pull her into fear and analysis.
Her mind would begin searching for answers:
What if this symptom means something?
What if something has been missed?
What if something happens to me or someone I love?
On her intake form, Elena identified health anxiety as her main problem and rated its impact on her life at 8 out of 10. She was also experiencing persistent fears, looping thoughts and patterns that felt increasingly difficult to interrupt.
Elena recognised that Googling symptoms was feeding the anxiety, but the urge to know remained powerful. She described feeling as though she had “died a thousand times” through all the outcomes her mind had imagined. Not knowing felt dangerous. Her mind tried to protect her by analysing every possibility, anticipating the worst and remaining prepared for whatever might happen. At one stage in our work, Elena rated both her health anxiety and looping thoughts at 10 out of 10. Her ability to remain calm was only 3 out of 10.
As we explored what was happening beneath these fears, it became clear that Elena was not only afraid of illness. She was struggling with the impossibility of knowing and controlling what might happen.
Health Anxiety Was Only Part of the Pattern
The same need for certainty appeared in other areas of Elena’s life. She described herself as perfectionistic, controlling, analytical, organised, overachieving, people pleasing and always planning. She often felt responsible for making things happen for other people and found herself juggling multiple demands.
Elena had also been required to become independent very young. She felt as though she had been forced to grow up before her time. Being capable, organised and prepared had helped her manage life. Over time, however, these qualities had become closely connected to how she created safety. This gave us a different way of understanding her health anxiety.
If you have learned that staying one step ahead helps you remain safe, uncertainty can feel threatening. Yet health is one area of life where absolute certainty is impossible. You cannot predict every bodily sensation, anticipate every change or guarantee every outcome.
Elena’s mind responded to this uncertainty in the way it had learned to respond to many other challenges. It scanned for potential problems, imagined what could go wrong and tried to regain a sense of control. Then we noticed something that helped us understand the pattern even more clearly. When Elena was away from her usual environment and responsibilities, her fixation on health dramatically reduced. Thoughts about something being wrong with her or her family barely entered her mind. She was absorbed in what she was doing and more engaged with living.
This suggested that her anxiety was not being driven solely by bodily sensations. The responsibilities, structure and pressure present in her everyday life were also creating the conditions in which vigilance could flourish. Elena wanted more spontaneity, freedom, ease and enjoyment, yet much of her life had become highly controlled. Her mind remained busy anticipating what needed to happen, what might go wrong and what she needed to organise.
Health anxiety had become one expression of a much broader protective pattern.
Changing the Pattern Beneath the Anxiety
This insight changed the direction of our work. Rather than focusing only on stopping individual health-related thoughts, we explored why Elena needed to anticipate problems and control outcomes before she could feel settled. Her perfectionism was not simply about preferring things to be done well. It had become connected to safety. The more she tried to eliminate uncertainty, the more mental energy she spent searching for anything that might threaten it. So, we worked on loosening the relationship between control and safety and strengthening Elena’s trust in her ability to respond to life as it unfolded.
The goal was not to convince her that nothing difficult could ever happen. That would have been another attempt to offer certainty where certainty was impossible. Instead, the work helped her recognise that she could feel capable and secure without predicting every possibility in advance. When we discussed what meaningful change would look like, Elena did not say that she simply wanted to become better at reassuring herself. She wanted to feel normal and free.
She wanted to stop scanning for problems and expecting danger. She wanted to become more spontaneous, allow other people to do things differently and let situations unfold without feeling compelled to control every detail. That distinction was important. If the deeper belief remains I need to stay vigilant because something bad could happen, reassurance can provide only temporary relief. The mind may soon find another symptom, possibility or uncertainty to investigate.
For Elena, change meant developing an internal sense of safety that did not depend on knowing what would happen next.
The Change Extended Beyond Her Health Anxiety
Over the following months, Elena began to feel much happier and more engaged with her life. One of the clearest signs of change appeared in an area that initially seemed unrelated to her health anxiety. Elena had been frightened of driving on the freeway for years and had avoided it since 2017. By March 2024, she was driving on the freeway again without a second thought. She had also begun a new area of study and was enjoying having something different to focus on and look forward to.
These changes showed us that something deeper was shifting. We had not spent our sessions helping Elena drive on the freeway. We had been working with the fear, hypervigilance, need for control and expectation that something could go wrong that appeared across different areas of her life. As those underlying patterns began to change, Elena became more willing to do things that fear had previously kept beyond her reach. She was not simply thinking less about her health. She was participating more fully in her life.
Her experience illustrates why I do not assume that two people with health anxiety need the same therapeutic approach. A frightening medical experience can understandably increase someone’s awareness of their body, and genuine or concerning symptoms should always receive appropriate medical attention. However, persistent health anxiety can also become intertwined with older protective patterns.
For one person, that may involve a need to remain prepared. For another, it may be a belief that staying in control prevents bad things from happening. It may also involve anticipating the worst, struggling to tolerate uncertainty or believing that constant vigilance is necessary for safety. The symptom tells me where the anxiety is appearing. It does not always explain why the pattern developed or what continues to reinforce it.
For Elena, health anxiety was not an isolated problem. It was part of a wider protective pattern that had taught her to prepare, anticipate and remain in control. As she developed greater trust in her ability to respond to life without predicting every possible danger, she became freer to participate in it.
Looking for Help With Health Anxiety?
I am Julie Chal, a Rapid Transformational Therapist, anxiety specialist and Clinical Hypnotherapist based in Perth, Australia. I work with clients in Perth and online across Australia and internationally.
My approach combines Rapid Transformational Therapy®, clinical hypnotherapy, conversational hypnosis and Somatic Trauma-Informed Coaching techniques. Rather than relying on a generic health-anxiety script, I explore the beliefs, emotional responses and protective patterns underneath the anxiety and adapt the work to the individual person.
If you repeatedly check symptoms, Google health concerns, seek certainty, imagine worst-case scenarios or feel you must remain vigilant to stay safe, my Tranceform Anxiety to Thrive program may be an appropriate next step.
The first step is a 50-minute Consultation Call, where we explore what you are experiencing, what may be driving the pattern and whether my approach is right for you.