Obsessive compulsive disorder - OCD treatment and therapy from NOCD

Fear of doctors (Iatrophobia) and how to overcome it

By Elle Warren

May 29, 20247 minute read

Reviewed byApril Kilduff, MA, LCPC

You know you should go to the doctor, but when you think about being there—sitting in the waiting room for what might feel like hours for them to call your name, then hoisting yourself onto the exam table—your thoughts might begin to spiral. And it brings so much fear that you just can’t do it.

You might have had poor experiences with medical professionals in the past, or worry about being around sick people, or have a fear of getting bad news. It’s normal to not exactly look forward to going to the doctor. But if your fear is stopping you from seeking the care you need, there are a couple of possible explanations to know about: one is a phobia called iatrophobia (it’s a strange word, but we’ll explain), and the other is health and contamination OCD

The good news is that both of these conditions are highly treatable with the right therapy. “These fears can be conquered. Maybe you won’t ever love going to the doctor, but you can at least get to a point where you can go when you need to,” says April Kilduff, LMFT, a clinician at NOCD, the leading provider of treatment for OCD and related conditions, like specific phobias.

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When fear of seeing a doctor is a mental health concern

There’s a phenomenon called white coat syndrome, which is when you get so nervous about being at a doctor’s office that your blood pressure spikes, and you may break out into a cold sweat. But that’s not what we’re talking about here. 

“If you totally avoid going to see a physician when you know you need to, or if you are having a lot of anxiety symptoms, physically and mentally, or if you are thinking about it way too much, then those are things that would cause a fear of doctors to cross the threshold into a mental health disorder,” explains Tracie Zinman-Ibrahim, LMFT, CST, another NOCD therapist.

So let’s take a closer look at what could be going on.

What is iatrophobia?

Iatrophobia is a fear of doctors, medical care, the medical care system as a whole, or all three of those things, according to research. You may also have related phobias, such as a fear of needles or taking medication. But based on the diagnostic criteria from the American Psychiatric Association, iatrophobia includes the following symptoms:

  • An intense fear of doctors or medical tests that persists for at least six months
  • Symptom onset when you see a doctor, get a medical test or think about these scenarios
  • Extreme fear or anxiety that makes you avoid seeing a doctor or getting medical tests, even when you feel unwell
  • Symptoms that affect your health and quality of life
  • Severe fear, anxiety or dread that don’t match any real danger

“Usually, people with phobias try to avoid things they’re afraid of. So, you might go out of your way to not see a doctor, and you might cancel your appointments,” says Zinman-Ibrahim.  

Usually, people with phobias try to avoid things they’re afraid of. So, you might go out of your way to not see a doctor, and you might cancel your appointments.

In some cases, iatrophobia can be triggered by a very real, valid event. For example, marginalized populations have historically received poor attention in the healthcare field. Researchers have seen a phobia of doctors fairly common in the Black and transgender communities, both of which have a long history of receiving suboptimal and even traumatizing healthcare experiences. 

Could a fear of going to the doctor be OCD?

Health concern OCD and contamination OCD are two closely related subtypes—or themes—of OCD. Health concern OCD involves obsessions and compulsions about having or developing a serious illness. (This could include being afraid of a mental health diagnosis, too.) Contamination OCD has to do with obsessions and compulsions surrounding getting sick, or a fear of being contaminated or dirty. The fears themselves can look really similar to those at the root of iatrophobia, but OCD more often brings fears that are highly specific, such as being afraid you’ll “magically” get someone’s illness. The primary thing that sets OCD apart from a phobia is how you respond to these fears.

Obsessions about going to the doctor can look like:

  • What if I touch the door handle to enter the office, get a deadly bacteria, and bring it home to my family?
  • What if the dirt and bacteria on the waiting room chairs seeps through my clothes and into my skin?
  • What if I go to the doctor and then can’t get clean enough afterward?
  • Maybe the doctor will give me a virus she got from another patient when she examines me.
  • Maybe someone in the waiting room will get too close to me. 
  • I’m probably going to get horrible news about a serious disease I have if I go to the doctor. 

These thoughts bring you extreme distress — fear, anxiety, worry, panic, guilt, embarrassment, shame. You take them seriously and feel the need to solve them, get rid of your distress, or prevent a bad thing from happening. The mental or physical actions you do with this intent are called compulsions. 

Compulsions in response to obsessions about going to the doctor can look like:

  • Asking loved ones for reassurance that you seem healthy and have nothing to worry about.
  • Going online to research an illness or bacteria you’re worried about, consuming article after article to try to find certainty. 
  • Always getting a second, third, or fourth opinion on any health concern you have.
  • Having rituals when going to the doctor, such as repeating certain words in your head that make you feel safe and reassured.
  • Avoiding the doctor.
  • Distracting yourself or dissociating when you see a doctor, such as scrolling social media or watching YouTube.

Do I have iatrophobia or OCD?

The bottom line here is: if you engage in repetitive, specific, urgent-feeling mental or physical behaviors in response to your fear thoughts about going to the doctor, that’s most likely to be OCD. “For example, maybe your doctor said, ‘I’m gonna run some labs,’ and now you’re Googling who runs those labs, and why, and what it could mean,” says Zinman-Ibrahim. 

You may have noticed that avoiding the doctor can be a symptom of both iatrophobia and OCD. In the case of OCD, there are usually compulsions happening on top of your phobia. But again, because these conditions do have a lot of similar presentations, the best way to understand your experience is to talk with a therapist who can treat both OCD and phobias. (The treatment is the same, so most clinicians trained in one are also trained in the other.) 

Get your life back from OCD

How can I overcome my fear of going to the doctor?

If you think you might have iatrophobia and/or health concern or contamination OCD, both conditions are highly treatable. A type of therapy called Exposure and Response-Prevention (ERP) is so effective that 80% of people with OCD see major improvements with ERP, as do 80-90% of people with phobias.

Before we get into how ERP works, you need to know that not all therapists are trained in ERP. So you’ll need to find one who explicitly states that they have this specialization. Many therapists practice typical talk therapy or generalized cognitive behavioral therapy (CBT), and with OCD and phobias your condition not only won’t improve, it will likely get worse over time.

So, once you’ve found an OCD specialist who practices ERP, you can begin this life changing treatment. It works by gradually exposing you to things that trigger your fears. In the beginning, you may start with simply looking at a photo of a doctor’s office, for example, or saying the name of an illness you’re afraid of. Over time, you will work your way up to more challenging exposures, like making a doctor’s appointment and actually going to the doctor.

All the while, your therapist will teach you strategies for resisting compulsions or avoidance behaviors. Slowly, you become desensitized to your fears. By the time you conquer your most challenging exposures, you’ll have a full toolbelt of ways to sit with discomfort and uncertainty. You learn that thoughts are just thoughts, and that fear does not have to dictate your life.

Zinman-Ibrahim says she’s watched the freedom that comes for clients when they’re finally able to seek medical help. “I had a client with a number of health concerns going on, and she was afraid to go to the doctor out of fear she would get more sick and pick up other things there. We were able to work on getting her to go in, and she did finally go, and she got her problems fixed,” she says. 

That same hope exists for you, too. 

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