What is Nosocomephobia? (A Summary)
In this blog we will discuss symptoms, causes and treatment of Nosocomephobia.
An intense fear of hospitals is called Nosocomephobia. It is a type of specific phobia which comes under the category of anxiety disorders in the DSM-V.
Someone suffering from this type of phobia feels extreme anxiety when exposed to hospitals.
One will suffer anxiety not only when exposed to hospitals, but just the thought of visiting them can instigate extreme anxiety and fear.
If the anxiety worsens, a sufferer will also have full-blown panic attacks.
In order to lower these unpleasant feelings, one avoids their fear stimuli (hospitals). They will make painstaking efforts to eliminate anxiety.
These efforts are repeated, thus can turn into compulsions. Someone suffering Nosocomephobia can also develop OCD in the future.
According to the DSM-V, this excess anxiety and repeated acts of avoidance affect one’s social and occupational functioning.
For example, one will be hesitant in visiting a hospital, even if the sufferer requires medical help.
Individuals can develop more severe symptoms of any disease/illness they might be suffering from, still they will refuse to visit a hospital.
This can aggravate their illness, affecting one’s career and social relations.
Someone suffering from Nosocomephobia will avoid driving past a hospital or live near it.
In situations where they need to pay a visit to a relative at a hospital or accompany them for a medical checkup can also instigate anxiety, leading one to avoid it.
Nosocomephobia is an irrational fear of hospitals.
The name of this specific phobia originates from a Greek word ‘nosokomein’ meaning hospitals and ‘phobos’ meaning fear.
Symptoms of Nosocomephobia
People with Nosocomephobia, like in all other specific phobias experience intense anxiety about visiting a hospital or by just thinking about visiting them.
They’re unable to control this anxiety and thus, end up feeling more anxious. This anxiety, in extreme cases, can give rise to full-blown panic attacks.
Sufferers go 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).
According to the DSM-V, one must suffer from anxiety lasting for at least 6-months.
Symptoms one suffers from in Nosocomephobia, including anxiety are as follows:
- Extreme anxiety when visiting a hospital
- Extreme anxiety when thinking of visiting a hospital
- Ignoring signs of an illness
- Claiming to be healthy in order to avoid a hospital’s visit
- Refusing to visit a hospital
- Inability to control anxiety
- Full-blown panic attacks
- Increased heart rate
- Muscular tension
- Excessive sweating
- Screaming/crying when being taken to a hospital
- 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 Nosocomephobia.
Causes of Nosocomephobia
Nosocomephobia, 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 one’s 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 Nosocomephobia until and unless there is some trigger event, instigating anxiety or fear of hospitals.
A trigger event can be for example, an unpleasant childhood experience at a hospital.
As a child, one might be scared of the injections or medical tests a doctor does in order to check his patient at the hospital.
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 going to a hospital.
One might be afraid of the fact that if they visit a hospital, they won’t come out alive.
Maybe because they’ve experienced an incident where they lost someone/heard of someone’s death at a hospital.
Maybe, one is afraid of hospitals because of their association with doctors. Hospitals are a place where many people with different diseases come and some also die.
Therefore, one can develop Nosocomephobia because of other phobias linked to it.
Phobias like Iatrophobia (fear of doctors), Mysophobia (fear of germs), Hemophobia (fear of blood), Nosophobia (fear of developing a certain disease) and or Trypanophobia (fear of needles).
Therefore, it is evident that Nosocomephobia can be caused by both genetics and or environmental factors.
Treatment of Nosocomephobia
Nosocomephobia, like all other specific phobias, has no exclusive type of treatment that is specifically designed to treat it.
Like all the other specific phobias, Nosocomephobia 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 treatments for patients with almost all kinds of mental disorders.
Nosocomephobia is defined as the irrational fear of hospitals. 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 hospital.
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 Nosocomephobia (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 hospital 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 inside a hospital.
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 hospital.
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 patient’s 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 hospitals, 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, 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 Nosocomephobia.
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.
They are not just one of the many treatment therapies used for Nosocomephobia, 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 hospitals.
• Drug Therapy
Drugs are used to reduce the physical symptoms caused by Nosocomephobia.
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 suggests 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 Nosocomephobia, 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.
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
by Ann Swanson
Frequently Asked Questions
Q1) What causes Nosocomephobia?
One develops Nosocomephobia as a result of some genetic predisposition or an unpleasant past experience.
This environmental trigger, along with genetics can cause this irrational fear of doctors.
Q2) ) How do you overcome Iatrophobia?
By taking some psychotherapies like CBT or DBT, one can be treated from Nosocomephobia.
Additionally, medicinal drugs can also be prescribed to a patient if his fear is severe or to reduce the physiological symptoms of this phobia.
Q3) How common is Nosocomephobia?
Nosocomephobia is a very common type of specific phobia.
Q4) What is it called when you are afraid of doctors?
Iatrophobia is the irrational fear of doctors.
Examples of other interesting phobias