White Coat Syndrome

The white coat here refers to the white coats worn by doctors, and the associated reaction some people may have to them. White coat syndrome may also include a fear of dentists.

Primarily white coat syndrome is a fear or anxiety response to doctors and things medical. Often there will be a past cause such as a traumatic childhood vaccination or stay in hospital.

White coat syndrome is not always clearly defined, and may sometimes be confused and used as a general term to include other medically related fears, such as fear of needles, fear of vaccinations, fear of sharp or pointed objects, fear of pain, or fear and anxiety relating to other specific medical procedures.

The problem of white coat syndrome has grown with the increasing emphasis on preventative medical care.

Health screening and exams are now more commonplace and even relatively non-painful procedures such as cholesterol checks, mammograms, colorectal and digital rectal (DRE) examinations can be cause for concern.

One of the simpler responses and a symptom of white coat syndrome is an increase in blood pressure during testing, which requires the individual to understand and implement one of a wide variety of ways to relax and unwind.

I had one client who came to see me because he needed dental treatment but found it almost impossible to visit the dentist. On the face of it this seemed like a fairly straightforward phobic response, until further questioning revealed his fears were much more involved and complex.

Whilst still very young he had needed a stay in hospital. His parents had not explained in any detail in advance that this was going to happen, and during his stay he felt alone, frightened and isolated.

There had been a need for various medical examinations by white coated doctors, and blood had been drawn for testing. This proved to be very traumatic for the small boy.

Not surprisingly the small boy grew into an adult who not only experienced extreme anxiety whenever faced with a white coated professional, but his fear also extended to almost any medical procedure: dentists, blood tests etc. . Indeed, on the few occasions he had been forced by necessity to visit a dentist he had found it almost impossible to allow the dentist to examine his teeth as a combination of fear, tension and having various instruments in his mouth caused a gag reflex and a danger of vomiting!

Another related problem is that many people will keep their fears under wraps. They may feel embarrassed and be unwilling to discuss it. They may go to considerable lengths to avoid treatment or health screening procedures, claiming either a lack of time or minimising the importance or impact of their condition or actions.

For some people just going to their GP can be enough to cause panic, however all and any aspects of this syndrome are treatable by a trained professional.

Hypnosis can be particularly effective for the treatment of fears and phobias.

Here are a few suggestions which may help you deal with anxieties related to medical procedures:

  1. Identify your concerns
    As has already been discussed anxiety relating to medical procedures may be simple and restricted to one thing, or they may be more varied and complex.
    Many people have never taken the time to really understand what they are frightened of. Be specific and identify what makes you nervous or afraid. When you identify your fears it makes them easier to manage. Then you can start to plan how to deal with your fears in the best and most effective way possible.
  2. Face up to your fears and deal with them rationally
    The problem with phobias is that they are not rational and we can panic regardless. However some fears once identified and acknowledged do become easier to cope with. For example a DRE or digital rectal exam may be seen by some men as a threat to their sexuality, yet it is simply an important, usually non-painful way of detecting prostate cancer before it becomes a serious problem. Like a mammogram it may be uncomfortable for a brief time, but when balanced against a potentially long term, life threatening illness is it really so bad?
  3. Make your fear known
    Share your anxiety with your doctor. This may not only help you to feel better but it will alert them to take a little more time and consideration and to make allowances for your anxiety. Always bear in mind that if you find your doctor to be unhelpful in this regard you can always change them or ask to see someone else.
  4. Ask for more help with your anxiety
    Find out if there is anything more that can be done to make you feel more comfortable. Perhaps a local anaesthetic or a sedative could help?
    (Although I always recommend an easily learnt relaxation exercise).
  5. Breathe and relax
    There are any number of relaxation or self-hypnosis exercises you can use.
    I regularly teach these types of strategy to my clients who find they very effective. However they all start with deep breathing which is the simplest relaxation exercise there is:
    Focus on your breathing and allow yourself to relax whilst thinking about something pleasant.
    Try counting 10 breaths in and out.
    Probably the procedure will be over before you get to 10, and you won’t have noticed it!
  6. Make sure you are well informed
    People usually respond best if they know what to expect. Find out what the procedure involves and what level of pain or discomfort to expect. Most people seem to have unreasonable expectations where pain is concerned and knowing that a blood test will only involve a ‘brief sting’ may help to relax you.
  7. Distract yourself during the procedure.
    Be prepared and follow these simple steps:
    a). Don’t look! Do not focus on the needle, or think about the process of getting the injection, drawing blood etc. Do not worry about the size of the needle, and do not stress over the pain. Think about something pleasant instead! If you keep stressing yourself out thinking about the needle before anything actually happens, then you are just building up anxiety and the pain will be more intense.
    b). Do not watch the medical professional during the procedure. They may involuntarily signal when they are about to use the needle, causing you to tense up. Look away and focus on something distracting and engaging.
    c). Bring a friend with you. Talk and joke with them. Ask them to hold and squeeze your hand during the procedure. This physical stimulus will help distract you from the procedure and any resulting physical discomfort.
    d). Think about something else. Think about an event that is coming up that you can look forward to, or that special somebody you are fond of. If you know how to do it you might take yourself away to your Inner Sanctuary.
    e). Listen to relaxing sounds. Bring an MP3 player or something similar with you and listen to music to take your mind off the needle (your phone may have a music player built in). You can also use some sounds or sound effects as a trigger to take you into trance and a state of deep relaxation. You will need to practise this before you have the procedure. You will find some relaxing audio downloads here.

I hope these suggestions will help you dealing with white coat syndrome and fears and anxieties relating to medical procedures. However the most effective way is to seek help from a trained professional. I have over 20 years experience working with anxiety disorders, fears and phobias. Request a call back or contact me and make an appointment.