Dr Karen Bowles
Internal Medicine Physician
Penn Medicine, University of Pennsylvania
Dr Karen Bowles is an internal medicine physician and assistant clinical professor at the University of Pennsylvania's Perelman School of Medicine, with over 30 years of experience in primary care.
She trained with Jon Kabat-Zinn, the creator of Mindfulness-Based Stress Reduction (MBSR) — one of the most studied interventions for anxiety — and has taught in the Penn Program for Mindfulness since 2004. Her practice bridges conventional medicine with mindfulness-based approaches, a perspective that's particularly relevant for health anxiety, where the mind-body connection drives much of the distress.
We spoke to Dr Bowles about what health anxiety looks like from the other side of the consultation — what doctors actually think when a patient comes in with anxiety-driven symptoms, why reassurance doesn't last, and how a mindfulness-informed approach can change the dynamic.
Health Anxiety Explained: Why You Think You're Dying (When You're Not)
25 minutes
Key takeaways
- • Health anxiety is closely related to OCD. Intrusive thoughts that can't be reassured away. More tests often perpetuate the problem rather than solving it.
- • Anxiety causes real physical symptoms. "You really are having chest pain, you really do have a headache" — but the cause is anxiety, not an underlying disease. The treatment is different.
- • Most doctors aren't trained to spot health anxiety. Patients present to GPs, urgent care, and emergency rooms — not psychologists. Many doctors lack confidence diagnosing it, and some therapists even send patients back for more tests.
- • The pandemic made health anxiety worse. Less trust in science, difficulty seeing a doctor, and a flood of conflicting health information all made it harder for patients to get the right support.
- • How doctors should talk to patients with health anxiety. Be direct — name what it isn't and why, then shift the conversation toward the anxiety itself. Leaving room for uncertainty makes it worse.
Preparing for a doctor's appointment with health anxiety? Our doctor visit tool helps you plan what to say. Or learn more about the evidence-based approaches discussed in this conversation.