Most of us have some fear of medical procedures. Whether it’s worrying about the outcome of a test or thinking about seeing blood during a blood draw, being concerned about the state of your health is normal.
But for some people, that fear can become excessive and lead to avoidance of certain medical procedures, such as surgery. When this happens, their doctor may suggest being evaluated for a phobia called tomophobia.
Tomophobia is the fear of surgical procedures or medical intervention.
While it’s natural to feel fear when you need to undergo a surgical procedure, therapist Samantha Chaikin, MA, says tomophobia involves more than the “typical” amount of anxiety expected. The avoidance of a medically necessary procedure is what makes this phobia very dangerous.
Tomophobia is considered a specific phobia, which is a unique phobia related to a specific situation or thing. In this case, a medical procedure.
While tomophobia isn’t common, specific phobias in general are quite common. In fact, the National Institute of Mental Health reports that an estimated 12.5 percent of Americans will experience a specific phobia in their lifetime.
To be considered a phobia, which is a type of anxiety disorder, this irrational fear must interfere with everyday life, says Dr. Lea Lis, an adult and child psychiatrist.
Phobias affect personal relationships, work, and school, and prevent you from enjoying life. In the case of tomophobia, it means those affected avoid necessary medical procedures.
What makes phobias debilitating is that the fear is out of proportion or more severe than what would be reasonably expected given the situation. To avoid anxiety and distress, an individual will avoid the triggering activity, person, or object at all costs.
Phobias, regardless of the type, can disrupt daily routines, strain relationships, limit the ability to work, and reduce self-esteem.
Like other phobias, tomophobia will produce general symptoms, but they’ll be more specific to medical procedures. With that in mind, here are some general symptoms of a phobia:
- strong urge to escape or avoid the triggering event
- fear that is irrational or excessive given the level of threat
- shortness of breath
- chest tightness
- rapid heartbeat
- sweating or feeling hot
For someone with tomophobia, Lis says it’s also common to:
- have situation-induced panic attacks when medical procedures need to be performed
- avoid the doctor or potentially lifesaving procedure due to fear
- in children, scream or run out of the room
It’s important to note that tomophobia is similar to another phobia called trypanophobia, which is an extreme fear of needles or medical procedures involving injections or hypodermic needles.
The exact cause of tomophobia is unknown. That said, experts have ideas about what may lead to someone developing a fear of medical procedures.
According to Chaikin, you can develop tomophobia after a traumatic event. It can also surface after witnessing others reacting fearfully to a medical intervention.
Lis says people who have vasovagal syncope can sometimes experience tomophobia.
“Vasovagal syncope is when your body overreacts to triggers due to the overwhelming response of the autonomic nervous system mediated by the vagus nerve,” says Lis.
This can result in a rapid heart rate or a drop in blood pressure. When this happens, you may faint from fear or pain, which may cause trauma if you injure yourself.
As a result of this experience, you may develop a fear of this happening again, and therefore a fear of medical procedures.
One other potential cause, says Lis, is iatrogenic trauma.
“When someone is accidentally injured by a medical procedure in the past, they can develop fears that the medical system may do more harm than good,” she explains.
For example, someone who’s had a needle injury that caused a skin infection and great pain might have a fear of these procedures in the future.
Tomophobia is diagnosed by a mental health professional, such as a psychologist.
Since tomophobia isn’t included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), an expert will likely look at specific phobias, which are a subtype of anxiety disorders.
Specific phobias are broken down into five types:
- animal type
- natural environment type
- blood-injection-injury type
- situational type
- other types
Since experiencing fear isn’t enough to indicate a phobia, Chaikin says there must also be avoidance behaviors and signs of impairment.
“When the fear or anxiety is unable to be controlled or when the fear affects your ability to function in daily life, impacting your ability to receive adequate medical care, an anxiety disorder can be diagnosed,” she says.
If tomophobia is affecting your health and causing you to refuse necessary medical procedures, it’s time to get help.
After being diagnosed with a phobia, and more specifically, tomophobia, Lis says the treatment of choice is psychotherapy.
One proven method of treating phobias is cognitive behavioral therapy (CBT), which involves changing thought patterns. With CBT, a therapist will work with you to challenge and change faulty or unhelpful ways of thinking.
Another common treatment, says Lis, is exposure-based therapy. With this type of treatment, your therapist will use systematic desensitization techniques that start with visualization of the feared event.
Over time, this could progress to seeing photos of medical procedures and eventually advance to watching a video together of a surgical procedure.
Finally, your doctor or psychologist may recommend other methods of treatment, such as medications. This is helpful if you have other mental health conditions, such as anxiety or depression.
If you or someone you love is dealing with tomophobia, support is available. There are many therapists, psychologists, and psychiatrists with expertise in phobias, anxiety disorders, and relationship issues.
They can work with you to develop a treatment plan that’s right for you, which may include psychotherapy, medication, or support groups.
FINDING HELP FOR TOMOPHOBIA
Not sure where to start? Here are a few links to help you locate a therapist in your area who can treat phobias:
While all phobias can interfere with daily activities, Chaikin says refusing urgent medical procedures can have life threatening outcomes. Therefore, the outlook depends on the severity of the avoidant behavior.
That said, for who receive professional help with proven treatments such as CBT and exposure-based therapy, the outlook is promising.
Tomophobia is part of a larger diagnosis of specific phobias.
Since the avoidance of medical procedures can lead to dangerous outcomes, it’s critical that you see a doctor or psychologist for more information. They can address the underlying issues that are causing excessive fear and provide appropriate treatment.