Imagine this: You get a message reminding you that it’s time for your regular check-up. Your doctor’s office would like you to call for an appointment.

If the thought of making that call makes your heart race and your blood pressure rise, you may have iatrophobia: fear of doctors and medical care.

It’s a very real problem that causes real harm, including potentially dangerous delays in medical care. Think of the cancer that’s found too late, the high cholesterol that goes untreated, the minor infection that spreads.

Understanding phobias

Data suggest that 12% of adults suffer from a phobia some time in their lives. Medical phobias, which can include fear of hospitals, dentists, blood, needles, or anyone wearing a white coat, are among the most common.

All phobias are forms of anxiety, but they differ from generalized anxiety disorder, a broader kind of persistent and excessive worry. Here, the fear is triggered by something specific.

Once that trigger is pulled, the symptoms can be intense. Physical symptoms may include increased heart rate, fast, shallow breathing, spikes in blood pressure, sweating, nausea, and feeling faint. Emotional symptoms may include fear and thoughts of impending doom and disaster.

In the grips of such strong feelings, which are rooted in the fight or flight responses our ancestors relied upon for life-threatening emergencies, people typically respond in one of two ways.

The first response is often avoidance. In the short term, avoidance can feel great, but it’s a trap: The sense of relief you feel over canceling one medical appointment makes you even more likely to cancel another. Some people end up going years without care.

People with phobias also may engage in safety behaviors, things they feel they must do to make a threatening situation endurable. A person with a medical phobia might go for a check-up only if they take a sedative first.

How to reduce the fear

While such crutches might help ease anxiety in the short term, they don’t solve the underlying problem. In fact, they can make it worse because they reinforce the idea that going to see your doctor is a scary situation.

So how do you make it less scary? If your symptoms are fairly mild, you might be able to break the cycle of fear one uneventful appointment at a time.

But if your symptoms are more severe—especially if they are causing you to skip needed care—you may need assistance from a psychologist trained in cognitive behavioral therapy, a kind of talk therapy. If possible, you should see someone specializing in anxiety and phobias.

Exposure therapy

At your first appointment or two, the therapist will learn about how your fear of medical care affects your life and which situations trigger your symptoms. Then, you will likely begin something called exposure therapy.

The idea is to expose you, in a safe, supportive setting, to a carefully selected series of images and experiences, presented in order from the least to the most threatening. At each step, you will likely feel some anxiety. But if you stick with each exposure long enough for the anxiety to subside, you will gain the experience of facing your fears and getting past them.

An early session might involve looking at pictures of a red cross then a stethoscope. You might move on to pictures of an ambulance, a doctor’s waiting room, and a doctor in a white coat. Next, you might watch videos, starting perhaps with a funny cartoon followed by a scene from a medical drama and then a scene of a real doctor at work. Finally, you may work through the steps of a real medical encounter, including a visit to the doctor’s parking lot, then the waiting room, and then the exam or consultation room. Some therapists may invite a doctor to participate in the session via video conferencing.

The process typically takes eight to 12 sessions. Most people who complete it will overcome their fears and find a doctor’s office to be a truly safe space.

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