How to Cure Your Doctor Phobias
Scared of the dentist’s drill? Queasy when it comes to needles? Five strategies to help you cope.
You’ve probably experienced unrealistic fear in your life, like acrophobia (fear of heights) while you’re on the top floor of a skyscraper, or claustrophobia when you’re stuck in a crowded elevator. These fears have no logical basis. Yet, fear of your doctor, dentist, or medical care in general — known as iatrophobia — is grounded in reality, considering it’s associated with actual painful procedures and potentially life-altering diagnoses.
People with iatrophobia tend to worry obsessively before a visit to the doctor or dentist. They might postpone appointments in an act of avoidance. Or they can have symptoms of White Coat Hypertension, a well-documented phenomenon whereby the stress of seeing a doctor causes an increase in blood pressure. People with iatrophobia may also feel extremely uncomfortable in the waiting room and often describe difficulty talking when the doctor is asking questions.
What causes iatrophobia?
Iatrophobia is a relatively common condition in today’s society, affecting at least 3% of the population. Mara Hollander, a health services and policy researcher at the University of Pittsburgh, was the lead author of a 2019 article that discusses a framework for understanding iatrophobia. In her article, she lays out three categories that determine fears in patients: fear of illness and the medical exam itself, fear of physician reactions, and fear related to barriers to care. “The reaction that patients have is perfectly reasonable,” says Hollander. “What we need to do is finally address those fears.”
While you might think the fear of a serious diagnosis or painful procedure would cause the most anxiety, according to the article, many patients also dread the reaction of a potentially biased physician. They are concerned they might be judged based on their gender, sexual orientation, substance abuse history, unhealthy lifestyle choices, weight, noncompliance with medications, nontraditional medical treatments, or when asking for a second opinion.
How to overcome your fear of a doctor’s visit
1. Don’t avoid it.
Avoidance is an innate protective mechanism. By avoiding situations that cause you to be afraid, you prevent yourself from being scared. It may seem counterintuitive, but according to Debra Levine, a psychologist who treats iatrophobia at the Anxiety and OCD Treatment Center of Ann Arbor, “avoidance of the things that make you anxious maintains and heightens anxiety.”
If it’s needles that terrify you, causing you to avoid shots, try to remember a shot you received that was not painful and then revisit this memory in your mind for a number of days before your appointment. Levine says that by visualizing the experience when you were not afraid, you reaffirm that the bad expectation will not recur, lessening the fear response.
Another way to help you get to the doctor when you are scared to go is to have a family member or friend hold you accountable for going to your appointment. Even just the act of telling someone that you have a dentist appointment on Tuesday makes you feel more obligation to actually attend it. Friends or family can also provide in-person support when you need to get blood taken, are having a procedure done, or when you’re facing a scary diagnosis. Use them as your crutch when your fear tells you to run.
2. Distract yourself.
Learning how to relax and preoccupy yourself before shots or procedures can also be beneficial. Try breathing exercises, mindfulness, and meditation — you can learn these techniques without the help of a therapist. Positive self-affirmation can help, too, such as “I’ve had shots in the past and they weren’t so bad,” or “if the worst happens and I receive a serious diagnosis, I can deal with the anxiety.” When the fear is worsening even with self-improvement strategies, it’s probably time to find a therapist who can help guide you.
3. Be open about your fears.
For patients afraid of physician reaction or judgment, social anxiety may be the culprit. People with social anxiety often feel uncomfortable in social situations. In a health care setting, that may even lead to being afraid to simply talk on the phone with the doctor’s office.
It always helps to explain one’s fears to the doctor. In my experience as a physician, knowing what a person is afraid of allows me to tailor my care to make the patient comfortable with their treatment plan or procedures. This way, we are able to talk through what scares them and allow them to mentally prepare.
One way to practice that conversation with your doctor is to role-play with your friends or family members. Have them act as the physician in an environment where you are not afraid to communicate your fears.
“Generally, it always helps to explain one’s fears and concerns to the doctor. In my experience as a physician, knowing what a person is afraid of allows me to tailor my care to make the patient comfortable with their treatment plan or procedures.”
In the end, finding a trusting physician that allows you to engage in a discussion about what makes you afraid is one of the most important steps. “Physicians should ask patients about their fears,” says Hollander. “This can open the door to what patients are afraid of and allow physicians to address the fear in the best possible way. It seems logical that a better relationship between a patient and a physician would lead to better trust and less fear.”
In my own practice, when a patient seems apprehensive in our initial discussion, I let them know that they are in a safe environment to share anything they think might be important to their care.
For example, I have had patients who were afraid of discussing herbal supplements. Once they realize that I encourage them to discuss these alternative treatments, they tend to open up about a plethora of other information that might be crucial to their care.
4. As a parent, manage your child’s fear early.
Preparing your child for the visit can make a big difference — setting up expectations for what might happen, perhaps even reading childrens’ books about doctors’ offices and procedures. Tell your child the truth: If they are going to get a shot, let them know. Depending on your child, this might be best accomplished a number of days before the doctor’s visit or right before the visit. Be compassionate and comforting to your child and then offer them a reward after the visit.
Avoidance is just as prevalent in childhood phobias as it is with adults. “When you allow your kid to avoid medical care [i.e. an appointment or procedure], you’re giving the message that they can’t handle it,” says Levine.“If the parent sits with their child and helps them through the anxiety, it can be very powerful. It shows that the parent believes in them, that they can be brave, and that anxiety doesn’t dictate our lives.”
5. For extreme cases of iatrophobia: Try exposure therapy.
Exposure therapy is a type of cognitive-behavioral therapy that works by subjecting patients to their fears. This is done in a stepwise manner by creating a fear hierarchy. Anything that triggers the fear is written down and rated on how much it causes an emotional response. Patients start with the item that causes the least emotional response and progress to more intense triggers.
Levine says the key is slow and progressive steps. If a patient has a fear of the doctor’s office, Levine might first talk about the office. Next, she’ll drive with the patient to the parking lot of the office without entering. On another occasion, they’ll sit in the waiting room, and then talk with the receptionist. Only when the patient is ready will Levine accompany the patient into an exam room to talk with the physician.
