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The doctor's visit as a horrortrip: Iatrophobia and how to overcome it

The doctor’s visit as a horrortrip: Iatrophobia and how to overcome it

The doctor’s visit as a horrortrip: Iatrophobia and how to overcome it

Svenja K. always makes the stomach again, she has been suffering from pain in the upper abdomen for years, loss of appetite, nausea and heartburn. In the pharmacy she has already left a fortune for over-the-counter stomach medications; there she has been advised to go to the doctor for a long time, to have the cause of her symptoms clarified. And she also knows for herself that she has to be examined – after all, something serious could be behind her constant stomach problems. But to see a general practitioner or an internist – no, she can not do it with the best of intentions. Even at the thought of her, her knees tremble. She would rather live with her complaints, which not only physically torture her, but also increasingly worried and unhappy.

Svenja K. not only suffers from stomach problems but also from a mental illness: iatrophobia. That is, she has a morbid fear of going to the doctor. The term is composed of two ancient Greek words: iatros = doctor, phóbos = fear. Many sufferers, who are concerned with their own suffering, also speak loosely of “tunic”. Amongst the Iatrophobics there are more men than women. And it is not clear to a great many people that their strange panic has a name and can be treated well.

What Svenja K. perhaps does not (yet) know is that she shares her phobia with about two million other people in Germany – this has resulted in a recent survey of the professional association of general practitioners. For those affected, their panic before the encounter with a doctor by one or more of the typical symptoms noticeable: panic attacks with heart rashes, trembling and perspiration already at the thought of an imminent practical visit, nausea until the vomiting in front of an appointment with the doctor. It can be the fear of the examination or treatment in the foreground but also panic before possible companionships such as syringes, blood or a bad diagnosis.

The fear creates avoidance-avoidance increases the fear

Correspondingly, the behaviour that follows from such symptoms is: control investigations are also avoided or delayed as well as necessary treatments of acute complaints. This inevitably leads to a devil’s circle: diseases are possibly carried away, the symptoms worsen, the treatment becomes more difficult and more complex. This, in turn, increases the fear, the avoidance behaviour continues. In the worst case, people affected in life-threatening situations, if a serious illness could not be detected in time. If an appearance is actually inevitable in practice or in the hospital, treatment or examination of the patient is often only possible with a soothing agent or anesthesia. In addition, the complaints are often played down against the doctor; the so-called “white coat syndrome” is also very well known: the stress of a doctor’s visit affects even the blood pressure. Measured in practice, the value is significantly increased – if you measure the blood pressure again at home, it is again within the normal range.

Fear of the dentist – sometimes anything but “normal”

In addition to surgeons and gynecologists, it is primarily dentists who are most anxious about Iatrophobics. Studies show that almost one in five Germans are clearly afraid of the next dentist’s appointment. It is assumed that at least half of these are pronounced dentist phobics – who have to live with partly massive consequences: for them, it is not only to bear sometimes violent toothache longer than necessary. Often, the teeth become damaged or fall out, mouth odor occurs. Then the shame is getting bigger, many are barely laughing to hide their teeth and are increasingly retreating, sometimes even developing marked social disturbances, that is, more phobias.

Not every “white-collar panic” is morbid

The panic of those concerned goes far beyond the “queasy feeling” that most people surmise at the latest of the dentist’s chair and of the “cutlery” before that. If a panic patient with acute pain in the dental practice appears, it is often extremely difficult to treat the tortured in his anxiety at all. However, in the meantime dentists, in particular, are clearly sensitized to the needs of their panic patients. There are more and more dentists who offer treatment specifically for this group of people: the methods range from hypnosis and meditation to the application of nitrous oxide and acupuncture to general anaesthesia. Moreover, these dentists are usually specially trained to deal with panic people; they are correspondingly empathetic, respect the people,

It is important to distinguish the largely “normal” fear of doctor’s visits from an iatrophobia. Especially when it comes to particularly unpleasant things such as gastro- or intestinal reflexions, throat swabs, gynaecological examinations and root treatments, or the suspicion of a serious illness, many feel in the run-up to the doctor’s appointment. Trembling, sweating and panic feelings can occur. A real phobia is, however, only present when the person concerned does not simply make the doctor anymore (or only with the bad symptoms described above) with the best will and against all reason.

Where does fear come from – and how can you prevent it?

Experts believe that the causes of a pronounced iatrophobia are usually found in the childhood of those affected. Many phobics report the corresponding traumatic, untrained experiences in the past. Some had to experience that close relatives died because of a treatment problem, others were sick as children themselves and were in the hospital for a long time; if a trusted person were missing at the side, they felt helpless and helpless, so that this fear-inducing situation burned into the memory. Even later in life, unpleasant experiences with unsensible physicians, great pain during treatment and examinations, or shame because of their own body, perhaps because of their overweight, rashes, or distortions,

Physicians and psychologists point out that it is especially important in children to make their first medical visits as comfortable as possible in order to prevent a later medical panic. Especially paediatricians are very careful not to use any instruments that might or might cause anxiety in some way. Parents should also not bring their child to the doctor until they are sick and thus weakened and especially thin-skinned, but already in a healthy state. Then it can calmly “friends” with the doctor and the practice environment “and” next time probably much less frightened into the consultation hour come.

Also highly recommended are specialist pediatric dentists – they are not only specialized in the treatment of first teeth, but also to treat very anxious children at times and to give them a trustworthy relationship with the dentist at an early stage. This pays off in every respect – not only as a foundation stone for lifelong dental health, but also as the basis for later fear-free dental visits!

And if it is too late for fear prevention?

Once the fear of the doctor has settled deeply in a human being, in most cases only a psychotherapy helps. With good prospects: For most phobics, behavioural or confrontational therapy – the form of psychotherapy displayed in these cases – can at least curb their panic so far that they can in the future visit a doctor without any major problems.

However, it is tragic in the nature of things that people with panic before the doctor’s visit are very difficult to go to the psychotherapist because in him they see a doctor. It often needs support from a close person until a person decides to go that step. In the treatment, the therapists often accompany their patients during medical visits, their present, as well as relaxation and other exercises, help to cope with the emerging unpleasant feelings. It is cautiously practiced, step by step, to face the fears – and in doing so repeatedly to experience that one does not kill the fear or one faints, but on the contrary becomes smaller and smaller as soon as one is no longer out of the way. At the same time, one’s own fears in the acute situation are being checked again and again: Does this treatment really hurt so much? Does this study actually intensify my heartbeat, or is it even a little better during treatment? Of course, only gentle and sensitive doctors should be consulted during these “exercise units”; a physician without empathy could easily trigger a relapse into the familiar panic.

Fearless to the doctor? That is possible!

It is especially important that people suffering from iatrophobia do not feel ashamed of their suffering or permanently hide it from others. You should always remember that this is about two million people like you. In self-help groups and forums on the Internet, one can meet fellow sufferers, exchange experiences and give each other mutual encouragement. Many therapists offer help with this particular problem. And last but not least, more and more doctors are aware that not a few patients need their sensitivity and caution. So: Only courage on the way to the anxious doctor’s visit!

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