Iatrophobia is characterized by an overwhelming fear of medical doctors, tests, and institutions.1 The most common signs of iatrophobia include avoiding routine medical visits or refusing to seek care when sick.1 Iatrophobia is generally treated through therapy, most commonly exposure and response prevention (ERP) or cognitive behavioral therapy (CBT), to address underlying negative thoughts and gradually lessen someone’s medical fears.11
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What Is Iatrophobia?
Iatrophobia is a specific phobia characterized by an intense fear of doctors, medical settings, and tests. Researchers divide causes of iatrophobia into three categories: fearing the reaction of their doctor, fear related to obstacles to healthcare, and fear of illness and medical examinations or tests.1
People with iatrophobia may avoid seeking medical attention even when it is necessary, sometimes leading to hospitalizations that may have been preventable. People with past experiences of medical trauma may be more likely to have a diagnosis of iatrophobia. People who face racism and stereotyping, such as BIPOC and overweight individuals, also are more likely to have a phobia of doctors. One expert estimated the rates of iatrophobia to be around 3% of the population.3
Signs of Iatrophobia
Not everyone with a phobia of doctors will display the same signs of iatrophobia, but common signs include avoiding routine medical appointments or delaying seeking care when sick. Other signs of iatrophobia include being less likely to ask medical follow-up questions, refusing to take prescribed medications, or experiencing white-coat hypertension. In extreme cases, people can sometimes faint when their symptoms peak.
Common behaviors of people with iatrophobia include:
Avoidance Behaviors
Some individuals with a phobia of doctors use avoidance behaviors to cope with their distress. Avoidance behaviors might include not going to routine check-ups, seeking care while sick, or even speaking about medical-related subjects. Individuals with iatrophobia feel relief in the short term through using these avoidance behaviors, but in the long term, the avoidance allows their fears and anxiety to grow more intense.
Refusing Routine Medical Care
Refusing routine medical care is a common sign of iatrophobia. Routine medical care is avoided for a variety of reasons, including the fear of being sick, being prescribed medications, or being asked to have medical tests done. Some individuals with iatrophobia feel so much distress that they are not able to allow healthcare professionals to perform basic examinations, as might be completed at yearly physical check-ups.
This may seem trivial, but it can affect someone when they have underlying conditions that are missed because they did not attend routine physicals, optometry, or dental visits. Conditions can worsen over time without early diagnosis and proper treatment, so refusing routine medical care can be dangerous.
Delaying Education About Medical Issues
Individuals with a fear of doctors often avoid prolonged discussions of their symptoms. It is common for healthcare professionals to provide patients with education and advice about their conditions. People with iatrophobia may disengage during these discussions because of high levels of anxiety. They may also ask fewer questions to clarify information, in part because the conversation is uncomfortable, or they might find out certain medical facts that provoke anxiety.
Fainting
Some individuals with a phobia of doctors may faint during a visit. Fainting often coincides with other phobias, such as the fear of needles or the fear of blood.4 Experts believe that fainting may have something to do with the vagus nerve overreacting to the feared situation.4
When someone with iatrophobia experiences their feared situation, they might experience a sudden drop in blood pressure.4 This sets off a complex interaction between the cardiovascular system and nervous system, where the vagus nerve sends signals that can result in fainting.4
White-Coat Hypertension
Some people with iatrophobia also experience white-coat hypertension, where their blood pressure is higher in the doctor’s office than it might be in a neutral setting, like home. Experts believe white-coat hypertension might account for up to 30% of people diagnosed with high blood pressure.5
When iatrophobia and white-coat hypertension occur together, it can lead someone to become more fearful of negative outcomes in their treatment. They may even be put on blood pressure medications that are unnecessary and cause more harm than good.
Refusing Prescribed Medication
People with a phobia of doctors sometimes refuse to take their prescribed medication. Some research indicates that 30-50% of the population does not adhere to pharmacological treatment due to pharmacophobia and the fear of taking medication.6 One major predictor of pharmacophobia is the belief in conspiracy theories.6 Sometimes, this may lead a person to fear medical institutions and lead to mistrust in prescribing professionals.
Ruminations About Doctor Visits
People with iatrophobia often ruminate before or after doctor visits. Rumination often includes painful predictions about what horrible outcomes a doctor visit could have. Rumination might include thoughts about what pain might be experienced, fears of diagnosis, worries about contamination, or obsessing about whether doctors will judge their condition.
When someone with iatrophobia engages in rumination, their fears about doctors and medical settings tend to worsen. Rumination often results in new and more intense fears about the given subject.
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Symptoms of Iatrophobia
Someone with a fear of doctors generally exhibits certain physical and emotional symptoms. Some symptoms might be easier for people around them to see, while others might be hidden. Common visible symptoms during appointments include fidgeting, sweating, and panic attacks. Symptoms that might be harder to see include tightness in the muscles and nausea. Sometimes, people with iatrophobia can faint when their symptoms peak.
Common symptoms of iatrophobia include:4
- Extreme panic or panic attacks
- Rapid breathing
- Racing or negative thoughts
- Fast heartbeat
- Sweating
- Nausea or stomachaches
- Fidgeting
- Tightness in muscles
- Breathlessness
- Fainting
Causes & Triggers for Iatrophobia
Iatrophobia is likely caused by a mixture of genetic and environmental factors. Although iatrophobia tends to run in families, certain experiences like medical trauma or medical gaslighting can increase someone’s chances of experiencing a phobia of doctors. Other experiences, like watching a loved one go through sickness or a painful diagnosis, can also trigger iatrophobia.
Causes and triggers for iatrophobia include:
- Genetics: Phobias tend to run in families. Although no case of iatrophobia is entirely genetic, you may be more likely to experience a phobia of doctors if someone else in your family also does.
- Medical trauma: Past negative experiences at the doctor can lead to medical trauma. When this happens, a person’s biological system is primed to expect only the worst outcomes from doctor visits and tests.
- Medical gaslighting: When a healthcare professional minimizes or invalidates their patient’s symptoms, this is called medical gaslighting. Medical gaslighting can lead to iatrophobia when someone feels unsafe or unheard in medical settings.
- Poverty: Poverty is a barrier to accessing necessary medical care. Someone who is experiencing poverty may develop a fear of doctors related to fears of not being able to afford care or feeling judged or shamed for their life circumstances.
- Fear of blood, injections, or needles: People who are afraid of having blood drawn or receiving shots or vaccines are more likely to have a general fear of doctors. Medical settings become associated with these feared experiences, and a person is less likely to put themselves in the same settings where they may see blood or needles, even if they are not the ones experiencing it.4
- Observational learning: Some people may have picked up their fear of doctors from watching friends or family members go through negative medical experiences.4 When this happens repeatedly, a person is less likely to seek their own medical care because doctors become associated with pain and other negative experiences.
- Personality: Personality is influenced by genetics and the environment, but people who are generally more anxious than others may be more likely to develop iatrophobia.4 When anxiety is a typical way of responding to your environment, you are more likely to respond this way in general.
- Frequency of exposure: People who grow up in families where seeking medical care was not the norm may have had less experience overall with doctors and medical settings. A lack of exposure to these situations can lead to a fear of doctors because a person is unsure of what to expect.4
BIPOC Community & a Phobia of Doctors
Research documents the implicit bias of healthcare providers to favor white patients and exhibit negative attitudes toward BIPOC.7 Although implicit bias is an unconscious process, research documents how these biases cause damage to health care and outcomes for BIPOC.7 Overall, BIPOC may find it difficult to trust and seek care from medical institutions because of their experiences of receiving lower-quality care than their white counterparts.8
One study documented people of color’s experiences of racism in the healthcare industry, finding that language barriers, stereotyping, financial misperceptions, lack of respect, and improper diagnosis or treatment were some areas where providers exhibited bias.8 When people of color repeatedly experience racism in medical settings, they lose trust and respect for healthcare providers, sometimes leading them to become iatrophobic.
Overweight Individuals & a Phobia of Doctors
Research documents the negative experiences of overweight individuals who seek healthcare and the weight bias and fat shaming they encounter during visits. These experiences of weight bias include disrespectful or patronizing treatment, assumptions about weight gain, and unfounded attribution of all health issues to weight gain.9
When weight bias occurs, it can lead overweight individuals to have low trust and poor confidence in providers, doctor shopping behaviors, or avoid or delay medical services.9 Some overweight individuals may become so afraid of the unfair stereotyping they experience that they develop a phobia of doctors and stop seeking healthcare services at all.
How Is Iatrophobia Diagnosed?
Mental health care providers such as therapists, psychiatrists, and doctors can diagnose iatrophobia. Early intervention is key to beginning treatment, which can positively influence your ability to seek healthcare in the future. Treatment includes therapy and, sometimes, psychiatric medication.
A general diagnosis process sometimes happens when an iatrophobic person seeks medical care and their provider notices how panicky they are during the visit. Other times, a person may recognize a pattern of extreme fear on their own and seek the help of a therapist or psychiatrist for diagnosis and treatment.
To be diagnosed with iatrophobia, someone must:10
- Have a marked and persistent anticipatory fear of the situation
- The feared situation must result in immediate anxiety
- The fear or anxiety is out of proportion to the actual danger of the situation
- The feared situation is actively avoided or, when endured, causes extreme distress
- The fear or anxiety has lasted at least 6 months
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Impact of Iatrophobia on Daily Life
A fear of doctors and medical institutions can impact a person’s health, education, and self-confidence. Not seeking medical care when you have underlying conditions can lead to a lack of intervention. When someone avoids going to the doctor, they may not receive accurate and appropriate medical education. Feelings of constant anxiety can affect someone’s self-confidence and doubt their capacity to handle future medical encounters.
8 Ways to Overcome Iatrophobia
There are a variety of phobia treatments that can help a person deal with iatrophobia. In addition to treatment, there are coping strategies that include mindfulness, making peace with fear, education, minimizing surprises, and stopping the use of safety behaviors. Also, practicing exposure in various locations and situations can help you become desensitized to your phobia of doctors.
Here are eight ways to overcome iatrophobia:
1. Challenge Negative Thoughts & Feelings
Someone with a phobia of doctors often has certain negative thoughts that lead to their experiences of anxiety, which then cause them to avoid or delay healthcare. Cognitive behavioral therapy (CBT) for anxiety helps with iatrophobia by encouraging a person to challenge and reframe negative thought patterns about medical institutions and doctors. A person can experience more neutral and positive emotions about healthcare.
2. Gradually Expose Yourself
Exposure therapy for anxiety is a highly recommended treatment for iatrophobia because of its high success rates. An exposure therapist helps someone by developing an exposure hierarchy, where a person identifies and confronts each level of their feared situation.
Examples of exposures for iatrophobia might include googling images of surgeries, using a blood pressure cuff or other simple healthcare supplies at home, watching medical television shows, or practicing sitting in waiting rooms.
3. Practice Mindfulness & Acceptance Strategies
Mindfulness for anxiety can be used during feared situations, like doctor visits, to help focus attention on the present moment and accept fear as a natural response to an uncomfortable experience. There are a variety of ways to use mindfulness and acceptance strategies for a phobia of doctors. Mindfulness apps can be useful in exploring innovative ways to practice, such as mindfulness podcasts, mindful breathing exercises, body scans, or guided imagery meditations for anxiety.
The ability to notice and make peace with uncomfortable physical sensations is an example of how to use mindfulness and acceptance for iatrophobia. For example, noticing your racing heart and accepting that you are afraid while using a mindful breathing practice to reduce distress while you are in the waiting room.
4. Make Peace With Your Fear
There is a lot of power in riding out your anxiety, letting the physical and emotional symptoms come and pass without engaging with the fear.4 The problem with fear is that it often demands an immediate reaction. For someone with iatrophobia, learning to tolerate that distress without “doing” anything about it can help them learn fear is a normal reaction that does not need an immediate response in a neutral situation like a doctor’s visit.
5. Stop Using Safety Behaviors
People with iatrophobia often use safety behaviors to manage the intensity of their distress.4 Safety behaviors are behaviors that help a person feel some short-term relief from the feared situation. The problem for people with iatrophobia is that every time a safety behavior is used, it reinforces the belief that the person is in a dangerous situation.4
Examples of common safety behaviors include lying about symptoms to avoid uncomfortable medical tests, excusing yourself to use the bathroom just to leave the exam room, or looking away while having blood drawn or a vaccination. As treatment progresses, a person may find it helpful to gradually expose themselves to feared situations without using their usual safety behaviors. A therapist can help you identify and plan how to stop the use of these behaviors.
6. Minimize Surprises Through Planning
Exposures are best when they are somewhat predictable for the person.4 Feeling as if you can go at your own pace without any surprises is an important part of creating and using exposures.4 As you progress through treatment, you might want to test yourself by making exposures less predictable. For example, allowing yourself to feel the distress of not asking your doctor how long the appointment will be.
7. Educate Yourself
Psychoeducation in itself can be a helpful exposure for those with iatrophobia. For example, let’s say you are afraid of an upcoming procedure. Asking your doctor to discuss the steps of the procedure, researching facts about the procedure, or asking others who have also gone through the procedure can help you differentiate between negative thought patterns and actual facts about the feared situation.4 Additionally, education can help you become desensitized to your scary thoughts about the procedure.
8. Consider Medication Intervention
Occasionally, someone might need medications to help cope with peaks in their iatrophobia symptoms. Beta-blockers for anxiety and benzodiazepines are medications sometimes prescribed for as-needed situations where panic attacks occur.11 These medications can help someone by biologically minimizing some of their distress so that they are able to use learned coping skills more effectively.
When to Seek Professional Support
Seeking help at the first sign of a phobia of doctors is likely the best approach when it comes to iatrophobia. When iatrophobia is causing someone to avoid routine medical tests, it can delay diagnoses and medical education. For people with underlying conditions, this can be a dangerous and slippery slope where the fear becomes more intense over time and keeps them from needed treatments.
An online therapist directory or online therapy platform can help you find a therapist who is familiar with treating a phobia of doctors. If it is appropriate to your situation, online psychiatrist options can help with assessment and medication management. Medication may be necessary, at least at the start of treatment, if you are experiencing severe symptoms like panic attacks and fainting.
In My Experience
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I’m Constantly Worried I Have Cancer. Do I Have OCD?
From time to time, it’s normal to worry about having cancer or any other illness. Many people wonder if they are sick or ill somewhat regularly, especially after an unexpected changes in how we feel or random twinge of pain. However, if your thoughts of having cancer are impacting your day-to-day activities, it may be a sign that you have OCD.
Fear of Allergic Reactions
Fear of having an allergic reaction involves intense and excessive concerns about eating certain foods or encountering certain situations in the environment (for example, seeing a bee). People who tend to suffer from this subtype of OCD find that these fears are extremely distressing and anxiety-provoking. People with allergy themes in OCD tend to think of worst-case scenarios that involve food allergies.
Frequently Asked Questions
Is iatrophobia a form of OCD?
Iatrophobia is not a form of OCD but rather a type of specific phobia. Specific phobias are fears centered on the complete category of something, such as the phobia of doctors and hospitals. OCD, in contrast, is more about a cycle of obsessions and compulsions.
OCD obsessions are specific and connected to the feared meaning behind obsessional content.2 People with OCD generally fear specific things for specific reasons, sometimes unique to just that individual. Additionally, OCD is within its own category of obsessive compulsive and related disorders in the DSM 5, whereas specific phobias are categorized as anxiety disorders.
Iatrophobia Infographics