Help my wife not fear the doctor's office

October 2, 2007 11:46 AM

My wife has a strong phobia of all things medical (with a few strange exceptions), and I'm wondering two things: 1) if anyone here has had a similar fear, and successfully overcame it, and 2) how should we go about helping her cope with her phobia?

From what I've directly observed over the last seven years, her phobia works like this: hospitals, doctor's offices, and conversation about medical procedures make her light-headed, especially so if you're talking about pregnancies, or difficulties related to being pregnant. When faced with these scenarios, she'll work herself up, all the blood will drain from her face, and she'll pass out (momentarily). She'll come to in a matter of seconds, drink some water, and usually be okay.

The unusual part is that we used to work for one of the world's largest medical textbook publishers, and one of her jobs was to review and create lesson plans from detailed medical books. Amazingly, seeing pictures of amputees, scabies, and the like didn't seem to phase her (she would, however, quickly skip past sections that got too graphic, or focused on pregnancy). Also, seeing simulated gore and guts in movies and TV doesn't seem to bother her either, unless it's too realistic, or, again, dealing with pregnancy (a big reason we haven't seen KNOCKED UP yet).

You might think this all revolves around a fear of pregnancy, but that's not really the case. Those situations have been multiplying solely because our friends and family are currently experiencing a baby boom, thus drastically increasing the probability of a pregnancy-related conversation to occur.

She's had a little bit of therapy to try and ease her fears, but it didn't seem to have much of an effect (which may be due to the fact that it didn't last long). I'm wondering if this might be a good case for hypnotherapy. She claims it all stems back to her childhood when she busted her chin and had to go to the hospital, and while there, they secured her to the gurney (or bed) and her mom started crying. I'd buy that, and I'm sure it has something to do with the innate fear, except for the fact that her twin sister (who's pregnant) has the exact same phobia, yet didn't have a traumatic medical experience as a child.

We'd like to have kids in the future, but I don't know how she'd react to the barrage of constant doctor visits. She thinks she'd get used to them in time, but I'd rather help her iron out these fears before we reach that point. Any suggestions, related stories, or advice would be greatly appreciated.

(and, yes, I've read all the askMeFi threads on hypnosis)

posted by bjork24 to health & fitness (10 comments total)

Thoughts of pregnancy can be very scary. Women love to tell horror stories and scare other woman. I never understood that.

I'm at 8 months, and I can tell you that my personal experience has been so much easier than I thought. Dr appts up until about this point are easier than dental appointments for sure--they hear the heartbeat, measure your belly, ask you questions, occasionally do an ultrasound.

Before pregnancy, I used to occasionally get awful bouts of nausea and the worst thing about them was I would think "oh, I can never get pregnant, I would feel this way ALL THE TIME." But I didn't. I feel kinda dumb for making assumptions.

Obviously every woman's experience is different, but the best advice I ever heard was "only listen to your mother and your sisters about labor," not to anyone else. Not only are their experiences (supposedly) more likely to mirror yours, but they're less likely to tell you horror stories.

I guess this really doesn't help with her reactions now, but I'm sympathetic to her feelings.
posted by GaelFC at 11:56 AM on October 2, 2007 [1 favorite]

I think the early childhood trauma may be significant, with the pregnancy issue being added later.I t sounds exactly like the kind of thing Hypnotherapy or NLP would be useful for.
A friend with a lifelong and quite severe needlephobia (she once grabbed a phlebotomist by the balls when he tried to take blood having not taken her seriously) and who seriously neglected her own health because of this fear, recently started hypnotherapy. It's early days but I'm amazed at how much easier it is for her to talk about incidents than it was in the past and hope this improvement continues.
posted by Wilder at 12:04 PM on October 2, 2007

I know someone with 'White Coat Hypertension'. She has had counselling to deal with this.
posted by popcassady at 12:12 PM on October 2, 2007

How is the pregnant twin dealing with her dr appts? Seems to me she's the best example your wife can look at...how is she making herself go? Is there any way your wife can force herself to go along as a supporter to see that the appt itself is not that bad? Sometimes we can make ourselves do heroic-seeming things for others that we could never do for ourselves alone.
posted by GaelFC at 12:21 PM on October 2, 2007

The twin has had a few pass outs, but otherwise she seems to be handling it pretty well. Unfortunately, she lives about 1,000 miles away, so going along on an appointment is out of the question.
posted by bjork24 at 12:27 PM on October 2, 2007

Am I secretly married to you?

I share many of your wife's issues. I've never fainted, but I've had to work very hard at not throwing up. And it stems very much from an incident when I was four, being hospitalized and held down by four nurses while they tried to put an IV in. This was followed up by an experience in my teens when my mother was in and out of hospitals for about four months, and that's when I developed a really full-blown phobia.

I'm curious whether or not she is able to go to the doctor for normal checkups or whether those also trigger issues (they do for me; I have to work very hard to convince myself to see a doctor, even for fairly bad problems. It's taken me six months to screw myself up to see a GI doc for some ongoing issues.). You also say that she faints, has some water, and then is "okay"--does that mean that she's able to go on with the appointment, or is that a no-go? Does it help when you (or a friend) accompany her? Secret: I take my battered old teddy bear in a purse when I have to go to the doctor. It helps!

Does she like her doctor? It's been very helpful to me to find a good, considerate doctor who *listens*. It doesn't make the panic go away, but at least I'm not panicking and trying to deal with a bitchy person too. I also make a point of telling them about my phobia, which I think helps them deal with me a bit gentler.

I will often give myself a treat of some nature afterwards. (Yes, I'm really a six-year-old.) Warm chocolate chip cookies make things better. So do spousal hugs (hint hint).

I don't have any terribly helpful advice for you, mostly just sympathy. I can hardly count myself in the "successfully overcome" category. I will say that being an adult and being able to have a say in what happens to me has helped a lot--the knowledge that I can refuse any treatment or procedure is a comfort. Most of my problem is from the lack of control of my early experience, so that knowledge helps me cognitively. I have a sort of mantra: "I am strong, I am smart, and I can say no to anything."

Being supportive of her is a big thing (I'm sure you are, based on this question), and sometimes it helps when someone *asks* me to go see a doctor. I can put up with a lot of crap when it's only affecting me, but I'm much more inclined to go see a doctor if someone else tells me they're worried about me. For what it's worth, this might ease your wife's mind during pregnancy: if she can think of dealing with things for the baby, not for herself.

Anecdotally, my sister (mother of three) has said that having kids grounded her immensely in terms of anxiety. Hormones are wonderful things.

I'd be happy to talk more about this, with her or you. My email's in my profile.
posted by fuzzbean at 12:45 PM on October 2, 2007

An alternative to hypnotherapy is graduated exposure. It is best done with a professional therapist but the general idea is (1) make a list of anxiety provoking situations and rank them in terms of how distressing they are (from zero to 100). You want to make sure you have a wide range of stimuli - no gaps of more than about 10 points. It could include thinking about things, seeing pictures, actually going to an office (without seeing the doctor) to seeing a doctor to getting shot or having procedure done. (2) The therapist has the person relax and then be exposed to something moderately distressing (maybe a 30) It should raise her anxiety level but not enough to provoke passing out. She should not try to relax or tune out the anxiety - just notice it. After a few minutes, she should notice that anxiety level drops - our bodies start to tune out repeated stimulus. When it gets to a 10 or 20, stop and take a break, relax.(3) Repeat until the first reaction is mild (say 20). (4) Go to the next, slightly more distressing item on the list and do the whole process again. It may take quite a few sessions to work through the problem a the right pace so she makes steady progress but doesn't get overwhelmed.

Anyway, it is a very direct way to tackle the problem. You would be looking for a therapist experienced with CBT (cognitive behavioral therapy) to help her through the process.
posted by metahawk at 12:52 PM on October 2, 2007

My dad got over this (obviously not the part about getting pregnant). He worked on meditation and affirmations to help find peace for himself when he needed a knee replacement.

As for pregnancy fears, what about contacting a midwife either for suggestions or for help to work through these issues? My interactions with midwives in the past would place them well to handle such a situation.
posted by kch at 9:07 PM on October 2, 2007

I too had a reaction like your wife's, but to a different stimulus: needles. When I was 7 I almost died of Scarlet Fever. They gave me a giant shot of penicillin and I remember being paralyzed for two weeks, as in, I laid in bed and looked at the ceiling while my mom played Disney records for me to keep me entertained. I remember them carrying me and holding me on the toilet. I remember thinking I would never play again.

Until I was 13, I vomited every time I went to see the doctor, saw a needle, or was faced with an upcoming potential for needles (blood drives, tetanus shots, etc.). Over the years I have gotten a grip on the fear; believe it or not, I have three tattoos on my back. For some reason, not SEEING the needles helped me realize they were not the root of all evil and I grew acclimated to the pain through tattooing, so now, when I know I have to have blood drawn or get a shot, I just focus my energy on remembering that it wasn't that bad when I got the tattoos... and it helps if I ask the attendant to give me a moment of silence to pray, which I definitely also do.

Now, I am also seconding the suggestion of Cognitive Behavioral Therapy. The point of it is to help figure out why an emotion and a behavior are tied together, and give you a physical and/or mental exercise to do when you feel the "trigger" happening.

Cognitive-Behavioral Therapies for Trauma, Second Edition is a book that I think you would find extremely helpful, as it deals with intervention techniques to help women who were traumatized as children deal with the fear of being re-victimized, which sort of sounds like what your wife is dealing with; it'll help both of you find a way to gradually wean her off the panic-response she feels when recalling certain situations and emotions. Best of luck to you!
posted by Unicorn on the cob at 8:56 AM on October 3, 2007

(Unicorn on the cob, THANK YOU for pointing out that book. Just what I've been looking for.)

I have needle phobia due to a history of traumatic childhood experiences with being lied to, forcibly restrained, etc. The treatment that's working for me uses CBT techniques and graduated exposures. "Overcoming Medical Phobias" is a short read, but remarkably helpful. It explains what this technique is, and gives very practical examples for a range of medical-type phobias. If she's not comfortable going to a therapist, that book gives some good tools for doing CBT/exposure work on a DIY basis.

But I have to admit that having the therapy group of other people dealing with each of their own fears and phobias has been much more helpful than any book (there have been many) or individual therapy session. Having failed at both those routes before, this is MUCH more productive. You get to notice the common ground among such different problems and gain some obectivity by hearing the tortured logic of fear coming from someone else (when it's something that doesn't push your own buttons, you actually get to do that, instead of short-circuiting and fainting). You get to hear really smart, insightful feedback and ideas from compatriots who "get it" far better than any medical expert (including the therapist). We support each other when the going gets tough, and gain strength from witnessing each others' incremental victories over issues that you know are as hard for them as yours is for you. When someone needs to cry, the therapist only can offer tissues and sit there impassively; while the rest of us offer hugs, a shoulder to cry on, or a reassuring hand squeeze. When I needed to do a particularly hard exposure, a several people immediately offered to go with me for moral support, or do it themselves first and let me watch. When I couldn't find a critical item for a certain exposure, a group member tracked it down. It's the kind of thing we do for each other. Boy does it feel great to start to believe that you can master the terror, and get to help a friend conquer theirs.

Getting over phobia is a process. If she feels comfortable trying hypnotherapy, absolutely encourage her to commit to giving it a real try. Though if it doesn't pan out, she should NEVER GIVE UP. Try something else. Try multiple something elses. Nearly everyone in my therapy group is approaching this from more than one angle. One also is getting help learning not to anesthesize the fear with alcoholism. Another supplements with meditation. Another with alternative medicine. Etc. When one recently graduated, after finally shaking free of profound claustrophobia, it was after two and a half go-rounds through the program.
posted by nakedcodemonkey at 10:41 AM on October 3, 2007