"Get the F*ck Away From Me, Doc!" Iatrophobia, Hypochondria, and Ways to Cope With Medical Phobias

Monday, May 18, 2015 by Meg   •   Filed under Anxiety

Most people have some fear of medical procedures. We are preprogrammed to be squeamish at the sight of blood or to be upset if we see someone else bleeding. Though we tell ourselves we’re being silly, it isn’t unreasonable to be anxious about going into a room so someone can stab us with a needle. We see it as being threatened. You say, ‘I need to get this test done,” your amygdala says, “What the fuck are you doing!? RUN! She’s trying to attack us with a sharp metal object!” 

This is normal, rational, and okay, particularly because we do it anyway and feel fine about it afterwards. 

But not everyone has it so easy. For some, phobias make medical situations unbearable. Luckily there are a number of ways to cope. First, the basics.  

Symptoms of Phobias

The symptoms of phobia are those of panic, AKA the fight/flight response. These include:

  • Heart palpitations
  • Sweating
  • Vomiting/diarrhea or nausea
  • Shaking
  • Numbness or tingling in extremities
  • Feeling faint
  • Trouble catching breath
  • Feelings of not being there or of being “unreal”
  • Chest pain or heaviness in the chest
  • Racing or scary thoughts
  • Dry mouth or throat
  • Feeling like you can’t breathe

With a phobia, these symptoms usually come up when we are exposed to the thing that scares us. 

So what scares you? 

Do I Have Hypochondria or Iatrophobia?

Medical phobias are different from the getting-a-shot jitters. If you’re iatrophobic, you might have panic symptoms when you go to the doctor or even when you think about going to the doctor. In some cases of iatrophobia — or fear of doctors — people are so afraid of anything even moderately medical related that they let their health deteriorate and are so upset when they must go that they have panic attacks or cannot sleep for weeks before the appointment. If you have iatrophobia you may also obsess about upcoming doctor’s appointment, leading some to think that they might have hypochondria. 

But this is often not the case. 

In hypochondria, people obsess about their health, constantly look for lumps or become convinced that they have some medical condition that hasn’t yet been diagnosed. But unlike those with iatrophobia, hypochondriacs often go to their physicians multiple times for imagined illnesses.

Hypochodria = fear of having a medical condition

Iatrophobia = fear of doctors or of going to the doctor

In extreme cases, those with iatrophobia panic when they see a physician, either in person or on television. For hypochondriacs, things that indicate illness trigger panic. It is ill advised for those with hypochondria to watch House reruns, Mystery Diagnosis or other medical shows if it clues them in to the next new illness they probably need to watch out for. For iatrophobics, watching these shows can serve as a type of mild exposure therapy, but it depends on the content. 

But both iatrophobics and hypochondriacs panic when they have something medical going on. 

Hypochondria = “My stomach hurts. Maybe I have cancer! I'm going to die! Better make a doctor's appointment so they can save me...”

Iatrophobia = “My stomach hurts. Maybe I have cancer! Oh please don’t let me have cancer because then I have to go see a doctor where they will confirm my worst fears and make everything hurt worse until I die...”

Both can involve obsessive doctor-related thoughts and sleepless nights, but the root of the fear is different if you look closely. I have seen a few people convinced that past exposure therapy wasn't effective because they had tried it for the wrong phobia. If you have iatrophobia, making a series of doctor’s appointments can help desensitize you and reduce the fear. If you have hypochodria, you can make those fears worse by doing the same thing because it reinforces the idea that there's something wrong with you and deepens the cycle. 

Know what bugs you, people. It matters.

How to Combat Medical Phobias

For medical phobias, I love the book Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors, and Dentists. But while you're waiting for that one, try a few of these:

Identify the Underlying Issue 

If the underlying fear is hearing bad news, that needs to be dealt with differently than a fear of being poked by a needle.  Were you there when the doctor told your mother she had cancer? You might have a little added something to deal with. If you are afraid of the doctor after having a traumatic birth experience, you might have PTSD as opposed to a simple phobia that needs to be dealt with separately. 

If you need help identifying the issue, you can also try the What-If Technique, where you ask yourself, “What if that were true?” for every scary thought until you get to the root of the issue.

  • “I might have cancer!”
  • “What if that were true?”
  • “I will get sick!”
  • “So?”
  • “I will have to get all kinds of treatments! They might not even help!”
  • “So what?”
  • “I’ll be bedridden and be a burden like my mother was.”

Obviously there are a number of ways for these to go depending on what scares you, but you get the gist. Once you’re sure of the underlying fear, you can attack it the way Rush Limbaugh attacks a sandwich.  

But in the end the most effective treatment for phobias is exposure.

Exposure Therapy

Exposure is a cognitive behavioral technique that is the gold standard for phobias. 

When using exposure for a fear of doctors, don’t wait until you’re sick; make appointments with the doctor, the dentist and the chiropractor when you are feeling just fine. If you only go when you are feeling ill, you are already uncomfortable and stressed and are more likely to have procedures such as blood draws. And who would want to go back to a place that sticks you every time you go? Creating experiences free of uncomfortable procedures is a good start towards reducing fear. Don't even get checked out the first time; just go in to talk to your doctor. 

If you tell your physician that you have either of these conditions, they are likely to respond with a gentler approach. They want to help you; god knows you won’t go back if they are a dick. And if your physician is a jerk for some reason, switch. As in any occupation, not all professionals are created equal.

You can also try cognitive desensitization techniques by thinking about a hospital, picturing yourself entering the building and experiencing the feelings that go along with that. By staying with the vision of the doctor, and getting as riled up as you can while in a safe place inside your own head, the process may short circuit. This is also the technique that will be more helpful for hypochondria, since you can’t exactly get cancer just so you can be diagnosed and face your fear. See more on how to do both of these here in this post on Exposure Therapy.

Using Humor to Combat Medical Phobias 

Find things about the experience that could be construed as funny. This works for fear of zombies and other imaginary creatures as well as phobias. It might work for a fear of doctors if the thought or image is ridiculous enough. Tell jokes about doctors such as:

A man speaks frantically into the phone, "My wife is pregnant, and her contractions are only two minutes apart!"
"Is this her first child?" the doctor asks.
"No, you asshole!” the man shouts. "This is her husband!”

If you’re a dark humor person you can go with: 

A surgeon went on an African safari. When he came back, his colleagues asked him how it had been. “Oh, it was very disappointing,” he said. “I didn't kill a thing. I'd have been better off staying here in the hospital.”

Either way, find jokes that make doctors or doctor-patient relationships appear as ridiculous as possible. You can also visualize doctors with high squeaky voices, or wearing ridiculous hats, anything that strikes you as funny. And feel free to take a list of jokes with you to your appointments and break the ice with a few of them. If you’re used to using humor on your own, it will likely translate to additional comfort when in the doctor’s office. (More on CBT and Humor here and more on dark humor in It’s Good to be Bad.)

Mindfulness and CBT

Mindfulness is great for everything from phobias to depression to anxiety. This is a practice of observation. Watch your thoughts and your physical reactions without judging them. See your thoughts and all those scary physical responses like bubbles on a river that will pass by you. See your emotions like a rowboat above on a stormy sea while you are a silent observer deep in the water looking up, where the storm can’t reach. Check out Mindsight or The Mindfulness Solution for more on these practices because there are tons. 

If you have trouble staying with the thoughts or letting them go, you can also try active thought replacement or visual substitution where you replace the thoughts every time they arise. 

“Oh no! I have to go to the doctor!” can become, “Not today, and if I do have to go, it won’t be so bad.”

“Oh no! I have cancer,” can become, “ I just had a check up and I am fine.” 

Replace the Smells

When in a fight/flight state, we remember things we don’t even consciously recognize, which can cause panic when we are exposed to them again. These can include sounds, smells or even tastes. (More in Pre-language Learning). 

Aromatherapy has been shown to enhance relaxation, but there might be more to it in these cases. If antiseptic scents make you gag or you suspect subconsciously remind you of past frightening experiences, short circuit that part of the response by wiping lavender oil under your nose on your way into the office.

Deep Breathing

This is a good one for anyone to learn. Try abdominal breathing by inhaling into your stomach for the count of four and exhaling for the count of eight. You can also try square breathing where you inhale for a four count, hold for a four count, exhale for four and hold for four again. For more, see Deep Breathing: You’re Doing it Wrong.

Get Help

As with any issue, enlist the assistance of friends and professionals to help you work through these issues. Friends and families can help by driving you to the doctor’s office or by staying with you and providing comfort while you are there. If they’re super awesome, they might even tell you ridiculous jokes or show you their bad ass sprinkler dance moves while you wait in the exam room. That might be a true story. I do a mean sprinkler, you guys, for realz. With a “z”. So you know I’m serious. 

As far as professionals go, they won’t all do the sprinkler but they will be able to help you work through the underlying issues and give you more cognitive behavioral ideas so you can kick your phobias to the curb for good.

Related Posts:

Topic-Relevant Resources

Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors, and Dentists
Medical phobias, causes and treatments. A must read for anyone dealing with medical phobias.

When Panic Attacks
Detailed overview of cognitive behavioral techniques for changing negative thought patterns

From Panic to Power: Proven Techniques to Calm Your Anxieties, Conquer Your Fears, and Put You in Control of Your Life
Techniques for reducing anxiety and living a happier, healthier life.

Brain Lock: Free Yourself from Obsessive-Compulsive Behavior
Useful information and tools for addressing obsessive or scary thoughts and the behaviors that go with them.

The Mindfulness Solution
Meditative and cognitive techniques for everyday use

Mindsight: The New Science of Personal Transformation
New techniques for mindfully altering the wiring of your own brain, leading to increased happiness.