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5 Things You Should Never Say to a Hypochondriac, According to a Therapist

Does your best friend take to WebMD at the slightest ache or pain? Does your sister watch a movie with a character who has a rare illness and immediately convince herself she has the same rare illness? They might struggle with hypochondria (sometimes referred to as illness anxiety disorder), which the Mayo Clinic defines as, “Worrying excessively that you are or may become seriously ill.” If you know someone with severe health anxiety, it can be difficult to know how best to support them, so we spoke to Dr. Kathryn Smerling, an NYC-based psychotherapist, for her tips on what not to say to a hypochondriac, from telling them you’re sure they’re fine to insisting it’s all in their head. As for what you should say, Smerling tells us, There is not much that can be said to a hypochondriac that will make them feel better, but something one should be sure to do is have compassion and lend a listening ear for someone with health anxiety.” The bottom line is, be supportive and kind and avoid phrases like the five below.

What Not to Say to Your Therapist (According to a Therapist)


1. “It's in your head.”

No matter how outlandish the scenario might seem, Smerling stresses that you shouldn’t say that a hypochondriac is making up what they believe is wrong with them. “This negates the validity of their feelings and will make the hypochondriac feel as though they are being judged, and no one wants to be judged by a supposed friend,” she explains.

2. Don't commiserate with them

“Have compassion, but do try and pivot the conversation,” Smerling advises. “Don't ruminate with a hypochondriac on what's making them anxious.” Let them know that you have their back and gently try to lead the conversation in another direction so as not to dwell on the issue and potentially add to their anxiety.

3. “I'm sure you're fine.”

This is another way to negate the validity of their feelings. Smerling tells us it’s very dismissive to hear this, and even if you’ve never struggled with illness anxiety, everyone can agree that feeling dismissed by your friends feels pretty horrible.

4. Don't be judgmental in what you say

The last thing a person with any kind of anxiety needs is to feel judged by someone they’ve opened up to. “To do anything other than listen and try to change the topic to something healthier and more interesting can be judgmental,” Smerling notes. “You don't want to indulge their line of thinking but also don't want to judge it—it's a fine line to walk.” Again, the main thing is to make sure they feel supported and not dismissed without indulging their line of catastrophic thinking.

5. “Maybe *this* is what's wrong.”

“Don't play doctor,” Smerling urges. Instead, she recommends suggesting that they talk to a mental health professional. This can also be a tricky line to walk, since some people might take offense to the suggestion that they need mental health help. To do so gently, try to tell them about how much therapy has helped you or offer to look for a provider with them.

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