What is Iatrophobia? (An Overview)

In this blog we will deliberate the symptoms, causes and treatment for Iatrophobia. 

The fear of doctors is known as Iatrophobia. This is a type of specific phobia, which comes under the anxiety disorders in the DSM-V.

Someone suffering from this phobia undergoes extreme anxiety upon the mere thought of visiting a doctor, yet alone visiting them physically.

People with Iatrophobia experience extreme anxiety when they see a doctor or have to visit them.

This is mainly because they are fearful of being diagnosed with a certain disease if they get their medical checkup done by them. 

To the sufferers, being ignorant of their body’s condition/physical health is better than living a life with a certain diagnosed disease. 

Normally, children or even adults are anxious of visiting a doctor, while they anticipate suffering from a disease or health issue.

One nervously waits outside a doctor’s clinic, for his appointment.

This anticipation and nervousness might give rise to anxiety and or a feeling of discomfort.

But, this is quite normal as the person is able to control his emotions. 

In Iatrophobia, one becomes extremely anxious at the mere thought or site of the doctor/his clinic.

He might not be able to drive past a doctor’s clinic because his anxiety, as the DSM-V suggests, affects the social and occupational functioning. 

Apart from the anxiety being out of touch with reality, one can also suffer from full-blown panic attacks if it intensifies.

The social occupational dysfunction caused by Iatrophobia can be for example, one might not be able to visit a family member or talk to him, if he’s a doctor.

This can make him loose contact with family or friends who belong to the same profession. 

Other possibility can be, that the sufferer’s family might not be able to cope with his medical condition or health deteriorating.

A wife might divorce her husband or the children might leave their parents because they find coping with their health as troublesome.  

In some cases, one may also live in a place which is away from a doctor’s clinic or in a rural area where doctors are very less likely to be found.  

In terms of occupational dysfunction, a student might miss his days at school if a doctor was to visit for a medical camp.

An adult will not drive to his job, if a doctor’s clinic comes on his way to the office.

These acts of avoidance, one does due to their extreme levels of anxiety can also lead to the onset of depression and or OCD in the future. 

Iatrophobia is an irrational fear of doctors or visiting them.

It is a type of specific phobia and one suffering from it experiences abnormal and persistent levels of anxiety. 

Symptoms of Iatrophobia

People with Iatrophobia, like in all other specific phobias experience intense anxiety on having an encounter with a doctor or by just thinking about visiting them.

They’re unable to control this anxiety and thus, end up feeling more anxious.

This anxiousness, in extreme cases can give rise to full-blown panic attacks. 

Sufferer goes into flight or fight mode because of an adrenaline rush.

In this state, the body’s physiological responses help one make decisions when in fear causing situations.

They either decide to escape the situation (flight) or stay and combat their fear (fight).

Iatrophobia can also occur along with other disorders, such as Nosophobia (fear of diseases) or Dentophobia (fear of dentists).  

One can also suffer from ‘white coat hypertension’. In this phenomena, one’s blood pressure rises’ to a significantly high level upon seeing a doctor. 

According to the DSM-V, one must suffer from anxiety lasting for at least 6-months. 

Symptoms one suffers from in Iatrophobia, including anxiety are as follows:

• Extreme anxiety when seeing a doctor 
• Extreme anxiety when thinking of visiting a doctor 
• Ignoring signs of an illness 
• Claiming to be healthy in order to avoid a doctor’s visit 
• Refusing to see a doctor 
• Inability to control anxiety 
• Full-blown panic attacks 
• Increased heartrate
• Muscular tension 
• Hyperventilation 
• Nausea 
• Excessive sweating 
• Screaming/crying when being taken to a doctor 
• May get anxious at every small injury/illness, fearing it to be something serious

Out of these, one should experience at least 3-5 symptoms, including anxiety, to be diagnosed with Iatrophobia.  

Causes of Iatrophobia

Iatrophobia, like all other specific phobias has no known cause.

These types of phobias can be a result of a number of factors such as biological (genetics) and or environmental (past experiences or social learning). 

Genetics refers to the genes and neurotransmitters in our body.

Someone with a family history of a phobia/mental disorder has a higher chance of having the same or different disorder in the future.

This is because the genes of the parents are transferred to their children, thus any alteration in the genes of ones’ parents is inherited by the child.

This genetic tendency to develop a mental disorder/specific phobia can also be referred to as a Diathesis-stress relationship.

According to this, one with a genetic predisposition will not develop symptoms of Iatrophobia until and unless there is some trigger event, instigating anxiety or fear of doctors.

A trigger event can be for example, an unpleasant childhood experience with doctors.

As a child, one might be scared of the injections or medical tests a doctor does in order to check his patient.

Or, in the past, one might’ve had an incident where these tests caused some sort of physical or mental harm to the child.

Thus, they fear doctors. 

May be, one is afraid of doctors because of their association with hospitals.

The place where many people, with different diseases come and some also die.

The same way, one might’ve developed fear for doctors because they lost a loved one due to the negligence of a doctor or the sufferer blames the doctor for this. 

In the worst case scenario, media reports or movies also often show how some doctors play with the person’s health in order to gain personal benefit, like taking someone’s organs during surgery and then selling them. 

However, doctors are an asset to this world because they’re responsible for curing and treating people.

One shouldn’t be afraid of them because they are the ones who can help someone in getting better, physically or mentally.

Doctor is a highly respected profession. 

Therefore, it is evident that Iatrophobia can be caused by both genetics and or environmental factors. 

Treatment of Iatrophobia

Iatrophobia, like all other specific phobias has no exclusive type of treatment that is specifically designed to treat it.

Like all the other specific phobias, Iatrophobia is treated by a number of different therapies including, Exposure Therapy, Cognitive-behavioral Therapy (CBT) and or medications that lower downs the anxiety or other physical symptoms. 

• Cognitive-Behavioral Therapy (CBT) 

It is one of the most frequently used treatment for patients with almost all kinds of mental disorders.

Iatrophobia is defined as the irrational fear of doctors.

Thus, the therapist helps the patient in replacing these irrational thoughts with more rational ones. 

The patients are helped out in analyzing and justifying the way they feel about visiting a doctor.

Therapists assist them in uncovering the reasons behind their fear and later they provide them with alternate, pleasant thoughts. 

The patient is told to maintain a thought diary (with ABCD column) which provides them a replacement for every irrational thought they have, when thinking about a particular situation.

The ABCD stands for: 

i. A (antecedents) a situation or triggering event.

ii. B (belief) the thought that comes to one’s mind when in that triggering situation.

iii. C (consequences) the symptoms/feelings caused by that event/thought 

iv. D (dispute) alternate, rational thoughts provided by the therapist in an attempt to        dispute/challenge those irrational beliefs.

This last section of the thought diary is what really plays a role in helping the person feel good/less anxious.  

• Exposure Therapy 

It is one of the most frequently used ways of treating patients with Iatrophobia (or any other kind of specific phobia).

In this therapy, the patient is exposed to the source of his fear over a certain span of time.

To begin with the therapy, the therapist exposes the patient to the least triggering stimuli, a picture of a doctor/doctor’s clinic for example. 

As the therapy progresses and the patient is able to control his anxious feelings, imagery can be used to take the treatment a step further.

In this part of the treatment the patient is asked to visualize/imagine a situation in which he is seeing a doctor.

During this process of imagery, one actually feels being in that particular situation or place, experiencing various senses.

 Once the person successfully, without feeling anxious clears this step of the therapy, he is then exposed to a real doctor in a clinical setting. 

While the patient is being exposed to different intensities of stimuli during the various stages of therapy, the therapist simultaneously teaches them coping exercises.

These include, breathing techniques or muscle relaxation methods to lower their anxiety, when in an actual fear/anxiety causing situation.

This teaches them how to remain calm when exposed to the fear stimuli.

Before actually starting the exposure therapy, the therapist needs to figure out the intensity of the patients fear, as to deduce whether they will be able to undergo this treatment, without any physical or psychological harm caused to them during the exposure processes. 

However, these steps desensitize one to their fear of doctors, by exposing them to that stimuli repeatedly, until they learn to undergo the situation without anxiety/panic attacks.

• Mindfulness-Based Stress Reduction (MBSR) 

MBSR is a meditation therapy, is used to manage stress or anxiety. It is an 8-week program which includes group sessions.

Mindfulness meditation and Hatha yoga are practiced in these sessions.

Lectures and group discussions are also done to talk about mental health and increase interactivity.

In mindfulness meditation the person is told to, for example to focus on the sensations felt while breathing or the rhythm of the chest rising and falling during the process.

This distracts the person’s attention from something stressful to something which is neutral and soothing. 

For quick and effective treatment, patients are also given a set of home works, for example 45 minutes of yoga and meditation sessions for 6 days a week and to record their results/feelings in a book or diary for 15 minutes a day.

• Dialectical Behavior Therapy (DBT) 

This is another effective therapy used to treat Iatrophobia.

It is more commonly used with people suffering from personality disorders, but is also useful with patients suffering from this type of specific phobias.

Coping skills are taught in the DBT group which lasts for about 6-months and can have a number of people (depending on how many join the group). 

            i. Half-smiling is the first module of DBT. It is a technique that is used with patients who are distressed because of their irrational thoughts.

The technique is known as ‘Half-smiling’ because the person is first advised to think about the stimuli that fears or upsets them, and while doing so they are told to lift the corners of their mouths by subtly smiling.

Smiling is not that will help one get rid of these unpleasant thoughts, it is the person’s ability to constrain itself from thinking about those thoughts while half smiling.

          ii. Mindfulness, the second module, is another technique used in DBT groups which helps the individual in getting rid of those negative thoughts.

Individuals are told to focus on the present and be attentive to what is going on around them at the moment.

This helps in breaking the link between their mind and any negative thought that might come to them then. 

For example, a person is told to focus on his breath or on the smell of a certain food presented to them, making use of their olfactory sense. 

         iii. The third technique or module of the DBT is distress tolerance skills.

This module teaches people to calm themselves down in healthy ways when they are distressed or emotionally overwhelmed.

Individuals are allowed to make wise, rational decisions and take immediate action, rather than being captured by emotionally destructive thoughts that might make the situation worse.

Reality acceptance skills are also learnt under this model so that people fully accept reality and later make plans on how to address the problem.

• Yoga/Meditation 

They are not just one of the many treatment therapies used for Iatrophobia, instead they are one of the most common ways of relaxation used by many people.

Yoga tends to stimulate the meditative state of one’s mind while the person is in a particular yoga posture.

Through yoga/meditation the mind is diverted towards something more productive and calm, allowing the person to escape the negative, distress causing thoughts.

Out of a number of yoga types, one can benefit from any yoga type/pose they like. Hatha yoga is one of the different types of yoga.

The breathing techniques or the imagery one creates while in a yoga posture are the real factors that makes the person feel less anxious and diverts their mind, away from the thoughts about doctors.

• Drug Therapy 

Drugs are used to reduce the physical symptoms caused by Iatrophobia.

Drugs are very quick in effectiveness, as they start showing progress in the patients’ health at least 2 weeks after the medicine is taken. 

This type of biological treatment is usually more effective if the cause of the phobia is only genetic.

However, these drugs/medicines are not to be taken without a doctor’s prescription or consultation. 

Two types of drugs are used in the treatment of this phobia:

                       i. Anti-anxiety Drugs

Medicines like Klonopin are anti-anxiety drugs.

They are most commonly used with patients who experience panic attacks and also lowers their anxiety by binding to receptor cells of the brain that cause these unpleasant symptoms. 

                      ii.   Antidepressant Drugs

These drugs, as the name suggest don’t only treat depression but are also very effective in treating phobias.

Medicines like Paxil reduce the anxious feelings of a person and makes him feel calm.

They need to be taken on a daily basis but not without a doctor’s advice.

Whether the cause of Iatrophobia, or any other type of specific phobia is genetics, environmental or both, the best and the most effective way of treating them is by using a combination of both biological treatments (drugs) with cognitive treatment (for example CBT/exposure therapy).

Titles to read 

• Be Comfortable Around Doctors Subliminal Affirmations: Overcome Fear of Doctors & Iatrophobia, Solfeggio Tones, Binaural Beats, Self Help Meditation Hypnosis

by Subliminal Hypnosis, Joel Thielke, et al.

• Stop Fear from Stopping You: The Art and Science of Becoming Fear-Wise

by Helen Odessky

• Badass Ways to End Anxiety & Stop Panic Attacks! A counterintuitive approach to recover and regain control of your life

by Geert Verschaeve

• Science of Yoga: Understand the Anatomy and Physiology to Perfect your Practice

by Ann Swanson

Frequently Asked Questions 

Citations  

• https://psychtimes.com/iatrophobia-fear-of-doctors/
• https://www.verywellmind.com/fear-of-doctors-2671863
• https://www.fearof.net/fear-of-doctors-phobia-iatrophobia/
• https://www.nbcnews.com/better/health/real-reason-going-doctor-gives-you-anxiety-ncna795566