Nosocomephobia (hospital Phobia): Symptoms, Causes and Treatments

All of us have been sick at some point, and we will have gone to a hospital or medical consultation in order to improve our situation and regain health. Going to the hospital is not exactly a leisure or fun activity, but in general and unless we are facing a serious problem, most people do it with a certain calmness.

However, it is also not uncommon for it to cause us some concern: we go there to see a doctor to evaluate if everything is okay… or not. Additionally, some tests can be painful or uncomfortable, and some people feel apprehensive about visiting certain units.

But for some people, going to the hospital is not something neutral or only slightly disturbing, but rather an ordeal and terrifying. We are talking about people who feel panic and enormous anxiety at the mere idea of ​​going to or even seeing a hospital, even causing physical symptoms and greatly limiting their life and maintenance of their health. This is what happens to people with nosocomephobia which we are going to talk about throughout this article.

What is nosocomephobia?

A relatively rare phobia is called nosocomephobia and can have dangerous implications for the lives of those who suffer from it: It is about the phobia of hospitals and health centers in general

As a phobia, it implies the existence of a deep level of panic and anxiety that appears irrationally and excessively in the presence of a specific stimulus or situation. These sensations appear uncontrollably and generally the subject himself recognizes that his sensations are disproportionate to the possible danger that the stimulus in question could imply.

Exposure to it will trigger anxiety up to levels that the person considers unbearable and that can generate symptoms such as anxiety attacks in which tachycardia, hyperventilation, cold and profuse sweat, tremors, dizziness and/or the feeling of dying or going crazy appear. The degree of discomfort is such that the person will have to flee or escape from the situation, something that will lead them to avoid the phobic situation or, if necessary, remain in it with great suffering and wishing for it to end.

In the case of nosocomephobia This stimulus or situation that generates anxiety and will be avoided is hospitals, the idea of ​​entering or approaching them or any type of element that can be associated with them. Thus, not only will it be the image of a hospital or the idea of ​​approaching it that will generate anxiety, but it is also likely that the subject will feel panic if they see an ambulance appear on the street, see bandages, surgical instruments, stretchers. or waiting rooms, encounters health workers, doctors or nurses or in some cases even simply at the sight of white coats, injuries or illnesses that may require assistance in one of said centers.

Although it is not necessary for them to occur together, it is common for nosocomephobia to appear linked to latrophobia of doctors, nosophobia or fear of diseases or falling ill, or even phobias of blood-injections-harm. In fact, sometimes the presence of one of them can become generalized and expand to the medical center, being, as we will see later, one of its possible origins.

However, this is not necessary for its appearance, and technically it is possible to suffer from nosocomephobia without suffering from any of the others and vice versa. There may also be a link with hypochondria while the fear and conviction of being sick can lead some people to avoid going to the hospital (although it is more common for them to go very frequently) for fear that their diagnosis could be confirmed.

A dangerous phobia

Most phobias can be very disabling for people who suffer from them, especially if the stimulus that generates anxiety is frequently present in the environment around them. Active avoidance of the stimulus and what is related to it will cause you to avoid certain areas, get close or interact with certain people or even be unable to enjoy certain types of leisure, work or studies. In some cases it can even make it impossible for them to leave their home.

However, in addition to the anxiety and discomfort felt and the disabling that it results in at different levels and areas of life, in the case of nosocomephobia we are faced with something that can pose a direct danger to the life and survival of the affected person. And those who suffer from this phobia are going to avoid going to hospitals and medical services, something that could cause them not to seek medical treatment in dangerous conditions, such as heart disease, trauma or infections, among many others.

Although it is true that there is the possibility of calling the doctor and having him come to the home, in many cases instruments or technologies that are not easily transportable, or a sterile and watertight environment, may be required. And some people may even ignore this option due to its association with the medical and hospital context.

In addition to your own survival, it can also have repercussions on a socio-affective level: there will be difficulties visiting people around you who are hospitalized for some reason, attending labors or births, or saying goodbye to loved ones in their last moments. It is also possible that the fear that they could catch a disease taking them to the hospital may result in the avoidance or rejection of sick people even outside the center. This can cause quarrels and misunderstandings on the part of the environment and society.

Possible causes and explanatory hypotheses

The causes of nosocomephobia are not completely clear and are generally not found in a single element but in a cluster of variables, and has a multi-causal origin However, different hypotheses can be established in this regard.

First of all, it should be taken into account that hospitals are establishments where people with health problems go in order to be cured or to find out what is happening to them. It is also a place where people sometimes spend their last moments before dying. We all know it, and it is an idea that can be transmitted socially. In this sense, one of the possible explanations would be the fact that the center or what reminds it on a cognitive level has been conditioned with a stimulus that in itself is aversive: pain and suffering

This same principle also explains the fact that in the event that there are phobias of doctors, blood, harm, injections or illness, or even germs, it is possible that sometimes the fear of said stimuli can be generalized and condition our response to the center in question. In this way, a stimulus that is initially neutral (the hospital itself) is related to what terrifies us (harm, death or another phobic stimulus) and ends up provoking in us a conditioned response of fear and anxiety.

Linked to this hypothesis we can propose that another possible explanation can be found in the experience of anxiety-producing situations in the past within a medical or hospital context: the experience of the illness and death of a loved one, the diagnosis of a serious illness, a long hospitalization in childhood, a painful medical treatment or test (for example chemotherapy)… These situations can generate great discomfort and can trigger anxiety towards the environment in which it was produced. It would be a conditioning of the response, as in the previous point, although in this case derived from past experiences.

In addition, it should be taken into account that we are dealing with a type of phobia mainly linked to the idea of ​​damage. In this sense, it results in a phobia whose origin, in the same way that can occur with others such as the phobia of spiders or snakes, may have a biological meaning.

As proposed by Seligman’s preparation theory, some phobias may have been inherited at a phylogenetic level given that in the past avoiding such stimuli protected us and helped us survive as a species. Although it may not be a direct case, we must keep in mind that there are cognitive factors that can link hospital with damage: although we can go to the hospital to be cured, deep down this fact implies that we are suffering from some illness, which at a cognitive level can be difficult to accept.

Another possible cause can be found in the existence of worry or fear of losing control over oneself: in the hospital you become a patient, a passive being who is subjected to the criteria of another human being with decision-making power over us.

Treatment of fear of hospitals

Treating nosocomephobia in those who suffer from it is highly recommended, due to the profound impact or even risk it can have on their life. Fortunately, there are different alternatives that allow you to treat both these and other phobias with great success.

The first and most successful of them all is exposure therapy In it, a series of objectives and a hierarchy of stimuli or anxiety-generating situations are established between professional and patient. This hierarchy will be ordered according to the degree of anxiety it generates, and in a structured way and little by little the subject will be exposed to each of the items or stimuli (starting with intermediate levels) until the subject sees his or her anxiety reduced. anxiety until it disappears or becomes controllable.

As you pass each item at least twice without anxiety or at least it does not exceed a certain level, you will move on to the next item.

This technique is usually used live (in reality), but if this is not possible it can be used in imagination (in which, although it has less effect, it has also shown some usefulness). It is also possible to use virtual reality exposure, generating a virtual environment in the form of a hospital or consultation in which the subject is exposed to various stimuli in a highly controlled manner (although it is generally somewhat less effective than live exposure, it is effective and could even serve as a preliminary step to live practice)

There is also systematic desensitization whose main difference with the previous one is the fact that in the second, instead of waiting for anxiety to be reduced, it is proposed to carry out an activity incompatible with it, such as relaxation exercises.

In addition to exposure, it is necessary to take into account that in nosocomephobia there may be very powerful cognitive factors that mediate or include the basis of the anxiety felt.

In this sense, it may be of great interest to carry out various cognitive restructuring techniques in which aspects such as beliefs about what a hospital is, the evaluation of the real risk it entails, the link between hospital and pain, and possible cognitive biases can be worked on. or dysfunctional beliefs or fear of loss of control or health and what that loss might entail. They can also strengthen themselves and undergo training in stress management, self-esteem or perception of control.

Finally, practicing relaxation techniques can be useful to reduce the anxiety felt before exposure. Sometimes the use of tranquilizing drugs can also be useful, although some of the reasons that may lead us to need to go to a hospital may require not taking drugs.