Q. I was informed that my phobia relating to consulting a psychiatrist might have a classification in DSM. Do you have any information on whether this is a common complaint?

A. I'm not sure what you--or whoever informed you--mean by the term phobia. Lots of people don't want to consult a psychiatrist. The very idea is often tinged with the same stigma that surrounds mental illness. Many people fear that seeing a psychiatrist means--or will be interpreted by others to mean--that they are crazy. This doesn't necessarily mean that these persons have a phobia or any other kind of mental disorder that would be classified in DSM-IV.

When we speak of a phobia, we usually imply a condition of extreme anxiety that renders the person nearly or completely incapacitated in certain circumstances. For example, somebody with arachnophobia--phobic anxiety related to spiders--might break out into a cold sweat, experience palpitations, feel dizzy, and experience a full-blown panic attack in the presence of spiders. I suppose if you were having these reactions each time you saw--or anticipated seeing--a psychiatrist, I'd say you had some kind of phobia?.maybe, iatrophobia (fear of doctors) or psychiatrophobia. This is not listed in DSM-IV, but might fall under the rubric of social phobia or social anxiety disorder.

Social phobia involves intense anxiety in certain interpersonal situations in which harsh judgment, criticism, or humiliation is the anticipated outcome. On the other hand, if you have actually had some traumatic experience related to a past encounter with a psychiatrist, you may have a form of post-traumatic stress disorder (PTSD).

I think the most important question is: do you actually need to see a psychiatrist; and if so, what exactly is stopping you from doing so? Are your fears based on an actual traumatic experience, or on irrational fears? Do they stem from some imagined horrible consequences, such as being committed to a mental institution, medicated against your will, etc.? If you feel comfortable exploring these issues with another type of mental health professional--such as a psychologist or social worker--perhaps you can move beyond your fear and get the help you need. We don't bite, by the way!

January 2004

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