Overcoming Fear of Touch and Anxiety During Medical Visits: A Guide

Fear of physical contact with others and anxiety during medical visits?

Hello, Doctor.
I have two concerns I would like to consult you about.
The first issue is that I have a strong aversion to physical contact with others or being touched by them.
For example, in public places, I always maintain a safe distance from others.
If someone enters what I consider a safe distance, I feel extremely uncomfortable, and being touched makes me feel frantic.
I start to obsessively think about what that person’s hands have come into contact with, and the more I think about it, the dirtier it feels, which worsens my emotional state.
Even with close friends, I cannot accept sharing a chair or even a hug or a shoulder touch.
In such situations, I usually gently push the person away.
This is the same with family members; I am very reluctant to have direct physical contact with others, especially skin-to-skin contact.
The second issue occurs when I visit a doctor.
Just thinking about it makes me very anxious, especially when I go to the dentist.
When I enter the examination room and start talking, I stutter.
Once I lie down in the dental chair, no matter how much I try to convince myself to relax, I cannot.
My shoulders remain tense, my legs cannot rest flat, and they stay extended and rigid.
My breathing becomes increasingly rapid.
Two years ago, I unfortunately had to go to the emergency room, and while the doctor was performing an ultrasound to check for internal bleeding, a nurse suddenly came over to hold my hand.
This action made me so tense that I bit my lower lip and almost couldn't suppress the urge to run away.
I felt incredibly foolish, but I just couldn't relax.
I have tentatively asked classmates and friends if they experience similar issues, but no one else seems to have this problem.
Moreover, I am not a child anymore, so it is really difficult to talk about my fear of seeing a doctor.
I am not sure if this is related to my childhood experience of being hospitalized, but memories of being restrained and having a group of medical students surrounding my hospital bed still appear in my nightmares.
Is it possible to improve this situation through treatment? Would counseling be the approach? I am genuinely afraid of seeing doctors, and when I look at them, I stutter and my mind goes blank.
Therefore, I would like to know if it is possible to avoid face-to-face interaction with the doctor or maintain a certain distance during psychiatric consultations.

Wu Tongxue, 20~29 year old female. Ask Date: 2017/04/23

Dr. Ding Shuyan reply Psychiatry

Hello, first of all, I want you to know that almost no one is completely free from psychological distress.
The fact that we cannot accept, or even reject, certain aspects of our personality or particular habits is often the source of our greater suffering.
So, try not to feel strange or think that others are not experiencing similar issues; in reality, everyone has their own problems, and like you, they might feel embarrassed to speak about them or may not want others to know.
Fears of dirtiness or being in situations that are difficult to escape from are quite common.

You mentioned connecting your current feelings to negative experiences from childhood, which indicates that you may benefit from psychotherapy.
If you have the opportunity to pursue it, that would be excellent.
As for seeing a doctor, psychiatrists generally do not physically examine you.
Eye contact is necessary to some extent, as it shows concern and is essential for observing your emotional state and other symptoms.

It’s normal to feel anxious about seeing a doctor; sometimes we fear exposing things we are embarrassed about or worry about making a fool of ourselves.
In reality, psychiatrists have encountered a wide variety of individuals, and you are unlikely to disturb them, no matter what your situation is.
Honestly, doctors are often busy and tired, and we should be more concerned about whether they might become desensitized from seeing too many patients, which could affect their attentiveness to our concerns.

We should not fear that the doctor will see through our flaws or judge us negatively because of our issues.
Sometimes, finding the right doctor is a matter of fate; you might find that you connect well with a psychiatrist and feel relaxed, realizing that your previous worries were unnecessary.
Alternatively, you could do some research, ask others, or check online reviews about the psychiatrist you are considering to see if they have a compassionate approach and a friendly demeanor.

Wishing you all the best,
Dr.
Ding Shuo-Yan

Reply Date: 2017/04/23

More Info

Overcoming the fear of touch and anxiety during medical visits can be a challenging journey, but it is certainly possible with the right approach and support. Your experiences reflect a common issue known as "touch aversion" or "tactile defensiveness," which can lead to significant discomfort in social situations and during medical encounters. Additionally, your anxiety during medical visits, particularly in situations where you feel vulnerable, is not uncommon and can be linked to past traumatic experiences, such as your childhood hospital stay.

Understanding Your Fears
1. Fear of Touch: This fear can stem from various sources, including past experiences, cultural factors, or even sensory processing issues. The discomfort you feel when someone invades your personal space or touches you may be a protective mechanism. It's essential to recognize that this fear is valid and can be addressed through therapeutic means.

2. Anxiety During Medical Visits: Your anxiety, especially in medical settings, can be exacerbated by previous negative experiences, such as being restrained during a medical procedure. This can create a cycle of fear and anxiety that makes future visits increasingly daunting. The physical symptoms you describe—rapid breathing, muscle tension, and difficulty speaking—are typical manifestations of anxiety.

Therapeutic Approaches
1. Cognitive Behavioral Therapy (CBT): This is a highly effective treatment for anxiety and phobias. CBT helps you identify and challenge negative thought patterns and beliefs that contribute to your fear. By reframing your thoughts about touch and medical visits, you can gradually reduce your anxiety.

2. Exposure Therapy: This involves gradual exposure to the source of your fear in a controlled and safe environment. For example, you might start by discussing your feelings about touch with a therapist, then progress to practicing touch in a safe context, such as with a trusted friend or family member. This method can help desensitize you to the fear over time.

3. Mindfulness and Relaxation Techniques: Incorporating mindfulness practices, such as deep breathing, meditation, or progressive muscle relaxation, can help you manage anxiety symptoms. These techniques can be particularly useful before and during medical visits to help ground you and reduce panic.

4. Psychoeducation: Understanding your fears and the physiological responses associated with anxiety can empower you. Learning about the body's stress response and how to manage it can provide you with tools to cope better during medical visits.

Practical Strategies for Medical Visits
1. Communicate with Your Healthcare Provider: Before your appointment, consider discussing your fears with your doctor or therapist. They can help accommodate your needs, such as allowing you to remain seated during discussions or providing reassurance throughout the examination.

2. Bring a Support Person: Having a trusted friend or family member accompany you can provide emotional support and help you feel more secure during medical visits.

3. Prepare for Appointments: Familiarize yourself with the medical environment beforehand. If possible, visit the clinic or office to get comfortable with the surroundings. Knowing what to expect can reduce anxiety.

4. Focus on Breathing: Practice deep breathing exercises before and during your appointment. This can help calm your nervous system and reduce physical symptoms of anxiety.

5. Set Boundaries: It’s okay to express your discomfort with touch or close proximity. A good healthcare provider will respect your boundaries and work with you to create a comfortable environment.

Conclusion
Your fears and anxieties are valid and can be addressed through various therapeutic approaches. Seeking help from a mental health professional can provide you with tailored strategies to overcome these challenges. Remember, you are not alone in this journey, and many people experience similar feelings. With time, patience, and the right support, you can learn to manage your fears and approach medical visits with greater confidence.

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