compulsive blood pressure checking

[LWS2009]

Dear Doctor,

I check my blood pressure whenever I sense the feeling of fear in my body and have white coat at the doctors and at home.  Medication did not give me any relief. I had CBT from 2 therapists but I got more obsessed about my blood pressure as the focus of the theraphy was how reduce checking. The more I focused on my problem , the worse it got.  

So I began checking less on my own but sometimes I gave in due to the compulsion being too strong. I had quite a good run for the past 2-3 months. Then I began checking more frequently again and even though the numbers are so low, I would be doing an activitity and feeling okay and then a thought will come where I had experienced a similar feeling of comfort  and when I checked my pressure was high. So I get scared with this thought and feeling and check.

So really the destructive thought is " What if your pressure is high and you don't even know it", then the fear feelings and panic sets in and that is when I usually go and check. As I said for the past 2-3 months , these thoughts came but I just dismissed them and carried on but now that I have given in to these thoughts , the compulsive behaviour is getting a bit stronger.

For over 10 years when I was diagnosed with an illness that could lead to cancer, I developed a fear that I was going to choke to death when eating. Nothing helped and now that fear is gone only to be replaced by this fear of blood pressure and stroke and checking. I don't fear any other diseases just the blood pressure in my mind is so over rated since all the doctors pull out that stupid cuff and measure it and I know that mind goes really up with anxiety. It is just the image of shock and horror on my doctor's face 4 years ago when she told me my pressure was very high and my heart rate was very high. How can I overcome  this problem are there self help measures since theraphy and doctors are making the problem not go away.  I have reduced doctor visits and that has helped.

[LWS2009]

Dear Dr Grossbart,

Thank you for the 2 suggestions. I shall definitely try the 1st approach and see what happens.

With the 2nd approach, I had done the biofeedback thing but it ended up working against me. You see I learned to attach too much emphasis on the feelings of relaxation that I paid too much attention to how I felt most of the time . So I stopped using the bp meter for biofeedback purposes. When I feel all tensed up I try my best to relax somehow. As I mentioned earlier, sometimes my compulsion kicks in too strongly and I might check when I am tensed up. Well I can't win the battle always!

Thank you

[Ted A Grossbart, Ph.D.]

I'd like to suggest a couple of very different approaches:  The first would be to relentlessly ask yourself. "What would I be thinking about if I wasn't focused on blood pressure?"  As with many obsessions, they become a sort or filler or buffer between you and the real pain of your life.  Are there deeper concerns that you need to find the courage to face directly?  If you can go directly to the 'fuel' underneath the obsession will stop.

The second is a variation on the technique of flooding.  Use your meter to learn to raise and lower your blood pressure at will.  This is not so hard using the meter for biofeedback.  Think anxious thoughts and see it rise, use calming thoughts and images to bring it down.  Once you see you can turn it up and down at will it will lose its hold over you.

Let us know how these go.

tg