The 'Emotional Reasoning' Thinking Error and Health Anxiety

Picture this. You are on the phone with your significant other, having an important conversation, and the phone suddenly cuts out. You wait five minutes or so and call them back, but there is no answer. How do you feel?

Well, it depends. You might feel guilty if you thought something you said hurt their feelings. If you thought they hung up on you because you pissed them off, then perhaps you feel angry. You might feel annoyed if you thought their phone died because they forgot their charger yet again. If you thought the phone call dropped because a car plowed into them and they were being airlifted to a hospital, you might feel afraid. If you thought some hanky-panky was going on, perhaps you would feel sad, angry, or jealous.

See where I’m going with this? (a) Something happens, (b) you have thoughts about it, and (c) you react to those thoughts. Essentially, the exact same situation can elicit a different reaction, depending on what you are thinking. The point here is that your feelings and behavior will always make more sense once you know your thoughts. Since our thoughts play such a critical role in how we experience life, we must learn how to deal with them in order to improve our feelings and behavior. The first step in dealing with thoughts is learning how to identify them.

Automatic Thoughts and Thinking Errors

Let’s talk about the process that takes place in our minds. We all experience a continuous flow of fleeting, evaluative thoughts or images throughout our daily activities. These are called automatic thoughts. Automatic thoughts tend not to be deliberate but emerge spontaneously. Our minds are flooded with these thoughts constantly, and we might have thousands of them in a given day. Some thoughts are neutral, and others are more judgmental.

"Why is this lady talking so loud?:

"I love this song."

"My neighbor had a sore throat like me, and it turned out to be cancer."

"My thighs look big."

"He thinks I am dumb."

"I think I am having a heart attack."

Automatic thoughts pass through our minds quickly, often without our awareness. When we are aware of them, we tend to accept them uncritically. And, comrades, this is where the trouble begins! Our thoughts are not always accurate. Often, without realizing it, we engage in what is called thinking errors.

Research shows that those with health anxiety tend to have a lot of distorted thoughts. When we engage in thinking errors about our health, we experience a lot of unnecessary anxiety. It is crucial to identify thoughts so that we may question their validity rather than just accept them as truth. The research has identified several common thinking errors experienced by people with health anxiety. Today, we will briefly talk about one type of thinking error commonly experienced by health-anxious people: emotional reasoning.

The "Emotional Reasoning" Thinking Error

When we engage in "emotional reasoning," we believe something must be true because it feels true, even without substantial evidence or when facts support the contrary. In my practice (and in my personal life), I have seen this manifest in a couple of different ways.

The first way I have seen this manifest is when one assumes that anxiety (or any other emotion) is predictive of health outcomes. On countless occasions, when clients are telling me about their latest health concern, they say things like, "No, this time, I just know there is something wrong. I feel it." Or they will try and make connections that aren't necessarily there.

One client experienced some tingling in her foot after working out. She said that something felt "off" and was convinced that the "off" feeling was a sign or premonition that, this time, something was terribly wrong.

Another way I have seen emotional reasoning manifest is, ironically, when my clients' health anxiety has improved. The more their health anxiety improved, the less anxious they would become over bodily symptoms and sensations. On many occasions, the absence of anxiety itself made them feel more anxious.

One client noticed a blemish on his skin and was able to shrug it off (a cause for celebration!). But then, a little while later, he started stressing about the fact that he didn't feel anxiety. He said to me, "This is how it happens. Someone gets a symptom and doesn't think anything of it until the doctor tells him it's cancer." He was so used to feeling the anxiety that the absence of it felt wrong. He couldn't even let himself enjoy his few minutes of freedom.

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In reality, dysfunctional thoughts, beliefs, and behaviors are all working "behind the scenes" in a health-anxious person's life. But this is all modifiable! You do not have to live with health anxiety for the rest of your life. And you shouldn't! Health anxiety can deteriorate one's quality of life.

To treat and improve health anxiety, you want to: (1) target these unhelpful thinking patterns; (2) reshape core beliefs about health and illness; and (3) target problematic behaviors that are making health anxiety worse.

I promise it's worth the effort. Ask yourself this: are illness and death really so bad that it is worth living the rest of your life crippled by the fear of it, whether you live one more month or 65 more years?

To find a therapist, visit the Psychology Today Therapy Directory.