Now, what, you might ask, does hiking have anything to do with hypochondria?  Hear me out.    

When I started therapy for my hypochondria, my husband and I had recently returned from a trip to Northern California. The area is beautiful, and, although my husband and I are not particularly athletic, we decided to go on a few hikes in the Big Sur area.

I like “the idea” of hiking.  But in practice, I find it to be overly stressful.

Heart Attacks, Broken Ankles, and Death, Oh My!

Let me walk you through my thoughts the day of the hike.

“Yay, hikes!  The weather is gorgeous and this hike ends with a waterfall!  And it’s only 1.5 miles, so it won’t even be too strenuous.  We’ll get lots of great photos too.”

We pay for our admission to the park and get a map guidebook.  I look at the “elevation” change indicated for the waterfall hike we were planning.  It seemed steep.  And it used the term “uneven terrain.”

My stomach started to churn.  (Remember when my therapist asked me during my first appointment if I experienced any physical manifestations of anxiety?  And I told her about my body’s seemingly uncanny ability to produce instantaneous diarrhea?  Well, I knew where that churning would quickly lead to an urgent need of finding a bathroom)

My internal dialogue starts going a million miles a minute as I re-think the hike.

“Oh.  1.5 miles of STEEP hiking.  Maybe that’s not a good idea.  What if I have a heart attack while on the trail?  I wonder if there will be cell service available?  Well, the parking lot looks crowded here, so even if there’s no cell service, I’m sure someone could run as fast as they could to get a park ranger or to find a cell phone signal.  But I dunno, seconds count in those types of situations.”

My internal dialogue continued as we looked for a parking spot.

“Ugh, and uneven terrain?  You know how clumsy you are!  You’re going to end up with a broken ankle on this hike.  And guess what happens these days when people break bones?  They almost always need surgery.  And you are clearly not healthy enough to have surgery, I mean, with all these medical problems you have?!?! “

My obsessions really started going strong here.

“If I have to have any surgery, no matter how minor, I’ll certainly die on the operating table.  And is this hike and a few good pictures of a waterfall really worth DYING over?  Seriously, breaking your ankle and DYING in the surgery that will inevitably follow??!  And not only that, they’d probably make you have the ankle surgery here in California, even though you’re just here on vacation. And even if you did survive the surgery, you’d have to recover here for a long time.  Would they let you fly home on a 5-hour-flight so soon after surgery?  DOUBT IT!  And you’d probably get a blood clot on the plane anyway, so they definitely won’t let you fly. So, where would your husband stay while you were recovering in the hospital?  How long would we have to stay here?  How much work would we have to miss (if I didn’t end up dying, after all), stuck here in California while I recover?”

It is at this moment of mental rumination that I decide to audibly articulate my concerns to my husband.

“You know, maybe we shouldn’t go on this hike.  It seems like it might be really difficult, and there’s lots of other things to see here in the area.”

I leave it at that, keeping all the “crazy talk” to myself. 

He encourages me that the hike will be fun, and we’re already here.

“Okay, I have to go to the bathroom first,” and I walk to the pit toilets in the parking lot.  Anxiety-induced diarrhea empties from my bowels, and I exit the bathroom, my heart pounding as we find the trailhead.

The anxiety does not end on the trail.  It is a steep hike, and I take every step with such caution that the hike takes us probably three times longer than it should have.

“I can’t be too cautious!  Gotta avoid that broken ankle!”

I overthink each step, and watch people of all shapes, sizes, and ages, zoom by me on the trail.  I feel the need to explain to each of them that I’m clumsy and so I’m taking my time. I apologize for taking up so much of the trail as I do things like sit on my butt and “scoot” down steeper parts of the trail instead of trusting my legs to propel me down the hill.

I finished my hike with no broken ankle. No surgery. No dying.

Learning in Therapy that “Catastrophize” is a Verb

Since this trip was still so fresh on my mind when I started my therapy, I told my therapist this story of my hike.

And she, in turn, introduced me to the term “catastrophizing.”

In other words, I take any situation, no matter how minor or innocuous, and create catastrophic scenario sequences out of it.

• Going on a hike?  Might break an ankle.
• Broke an ankle? Going to need surgery.
• Having surgery? Going to die on the operating table.

She instructed me to start to observe when my brain starts to catastrophize other scenarios.

I’ll talk more in future posts about the techniques that she suggested for handling catastrophizing. But one of the better ones that worked for me was simply “Acceptance and Commitment.”

Now, when I have a catastrophic thought, like “If I go on this hike, I might break my ankle,” I just repeat to myself. Yes, if I go on this hike, I might break my ankle.  That’s just something I have to accept, so I’m going to go on the hike anyway.”

And, “Yes, if I had to have surgery, I might die.  That’s just something I have to accept, so I’m going to listen to my doctors and have the surgery on my ankle.

Now, some of you might be saying, “Uhh, yeah, like THAT’S helpful.  I already know it’s a possibility and that’s why I’m worried about it.  I’m certainly not going to be accepting of it!”

Again, there were many techniques that she suggested. But, it’s weird. After repeating this to myself many times about scenarios I catastrophize, it really does start to help over the long term.  One important realization for me is that any one of these techniques might seem incredibly stupid in the moment.  But, after repeated practice, I found that my brain truly is becoming “re-wired” to be calmer.