Let’s be honest—no one really enjoys going to the doctor. From sitting in the waiting room for what seems like hours to worrying about bad news regarding your health, there’s a lot to dislike about visiting the doctor’s office. But what happens when that dislike becomes a fear so intense that you avoid medical care entirely?
You know you should go to the doctor, but when you think about being there, your thoughts begin to spiral, and it brings so much fear that you just can’t do it. While it’s completely normal to have a fear of going to the doctor, if you’re flat out avoiding health care, you could be dealing with a specific phobia known as iatrophobia (fear of doctors) or a subtype of obsessive-compulsive disorder (OCD) known as contamination OCD.
Keep reading to get a better understanding of what’s considered a “normal” fear of doctors and when there’s possibly an underlying mental health issue causing a heightened level of distress.
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Why do I have a fear of doctors?
Having a fear of going to the doctor is fairly common, as most people have a bit of health anxiety. “A lot of people have a fear of needles, so they might avoid going to the doctor because they don’t want to get a shot,” says Taylor Newendorp, MA, LCPC, Network Clinical Director at NOCD. “Other people might have a fear of bad news from the doctor, such as a chronic condition, terminal disease, or something that would be completely debilitating, so it feels safer and easier to just not to go.”
Trauma and discrimination
A fear of doctors can also develop if you’ve experienced medical gaslighting, or if you’ve been dismissed, misgendered, or discriminated against by a healthcare provider. For example, marginalized populations have historically received poor attention in the healthcare field. Research has shown that a phobia of doctors is fairly common in the Black and transgender communities, both of which have a long history of receiving substandard and even traumatizing healthcare.
“As a result of these experiences, people feel devalued and that their problems weren’t taken seriously,” says Newendorp. “Now they’re reluctant to see other doctors.” If this has been your experience with the healthcare system, know that it’s completely understandable to have this fear of doctors and of the healthcare system itself.
It’s also crucial to know that there’s a stark difference between the fear of doctors that comes from trauma and discrimination versus phobias or OCD. If a healthcare provider has physically, mentally, or emotionally harmed you in the past, your fear is a normal response to a real threat. Phobias and OCD, on the other hand, are often tied to irrational fears.
How do I know if my fears are 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. However, 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, 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, MA, LMFT, CST, Chief Compliance Officer at NOCD.
So, let’s take a closer look at what could be going on.
Iatrophobia
Iatrophobia is the fear of doctors, medical care, the medical care system as a whole, or all three of these things. There are also medically-related phobias, such as a fear of blood or taking medication.
Based on the diagnostic criteria from the American Psychiatric Association (APA), 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.
- Severe fear, anxiety, or dread that doesn’t match any real danger.
Iatrophobia can also cause physical symptoms, including:
- Nausea
- Dry mouth
- Heart palpitations
- Breathlessness
- Excessive sweating
- Dizziness
Because of the anxiety iatrophobia can cause, you might perform “safety behaviors” to ease your fears. “Safety behaviors are any kind of distraction to try and not think about facing the doctor,” says Newendorp.
These safety behaviors can include:
- Completely avoiding the doctor’s office.
- Not watching movies or TV shows that involve doctors.
- Lying about symptoms to avoid undergoing medical tests.
The issue with safety behaviors is that every time they are performed, they reinforce the belief that the doctor’s office is an unsafe place.
Contamination OCD
An intense fear of doctors could also be a sign of contamination OCD, a subtype of obsessive compulsive disorder. OCD is a mental health condition characterized by intrusive thoughts, images, urges, sensations, and feelings known as obsessions that cause fear and anxiety. To cope with obsessions, you may perform physical or mental behaviors known as compulsions for temporary relief from distress.
Contamination OCD involves intrusive thoughts about becoming contaminated and/or contaminating others. “With contamination OCD, you may start doing all kinds of compulsions just to try and get this sense of feeling like you’re clean and healthy, and you’re not going to get others sick,” says Newendorp.
What’s the connection between this type of anxiety and doctors? According to Newendorp, people with contamination OCD are “very scared to put themselves in situations where they might be exposed to any kind of illness, so they start to fear the doctor’s office because people go to the doctor when they’re sick,” he explains. “They think, ‘If I go to the doctor’s office and I’m in the waiting room, it increases my chances that I will get sick, and then I can spread that around.’”
To help you get a better idea of what contamination OCD looks like, here are a few examples of obsessions related to doctor visits:
- What if I touch the door handle to enter the office and bring deadly bacteria home to my family?
- What if the dirt and bacteria on the waiting room chairs seep through my clothes and into my skin?
- What if I go to the doctor and can’t get clean enough afterward?
- Maybe the doctor will give me a virus they got from another patient when they examine me.
- If I go to the doctor, I’m probably going to get horrible news about a serious disease.
Because intrusive thoughts can cause extreme distress, you may feel the need to get rid of your distress and/or prevent a bad thing from happening. The mental or physical actions you do with this intent are called compulsions.
Compulsions revolving around a fear of doctors can look like:
- Asking loved ones for reassurance that you seem healthy and have nothing to worry about.
- Avoiding the doctor.
- Having rituals when going to the doctor, such as repeating certain words in your head that make you feel safe and reassured.
- Excessively researching online for home remedies or treatments you can do without going to the doctor.
- Distracting yourself or dissociating when you see a doctor, such as scrolling social media or watching YouTube.
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Is it iatrophobia or OCD?
At this point, you might still be wondering what the difference is between a specific phobia and OCD—and that’s completely understandable. The bottom line here is: if you engage in repetitive, specific, urgent-feeling mental or physical behaviors in response to your fears, it’s probably OCD. “For example, maybe your doctor said, ‘I’m gonna run some tests,’ and now you’re googling who runs those tests, and why, and what it could mean,” says Zinman-Ibrahim.
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 similar presentations, the best way to understand your experience is to talk with a therapist who can treat both OCD and phobias.
“We always recommend getting a formal diagnostic evaluation done by a psychologist or a therapist that specializes in OCD and anxiety disorders,” says Newendorp.
How to overcome your fear of going to the doctor
If you think you might have iatrophobia and/or contamination OCD, both conditions are highly treatable with a type of therapy known as exposure and response prevention (ERP). ERP is very effective, with 80% of people with OCD and 80%-90% of people with phobias seeing major improvements with this evidence-based therapy.
Working with a therapist who specializes in ERP, you gradually expose yourself to things that trigger your fears, which, in this case, might be looking at a photo of a doctor’s office. Over time, you will work up to more challenging fears, like making a doctor’s appointment and actually going to the doctor. Your therapist will also teach you response prevention techniques for resisting compulsions or safety behaviors. Slowly, you will become desensitized to your fears, and by the time you face your most challenging triggers, you will have a full toolbelt of ways to cope with discomfort and uncertainty.
Zinman-Ibrahim says she’s seen the freedom that comes when people with OCD can finally seek medical help. “I had a patient with a number of health concerns, but she was afraid to go to the doctor out of fear she would get sicker and pick up other things there,” explains Zinman-Ibrahim. “We were able to work on getting her to go in. She did finally go, and she got her health concerns resolved.”
If you have severe health anxiety but are too scared to go to the doctor, know that there is help available. Connect with an ERP specializing in iatrophobia and/or contamination OCD to learn strategies to resist engaging in safety behaviors or compulsions. By doing ERP therapy, you can overcome or manage your fears to ensure you get the medical care you need.