Your patient is scared of you—here’s why
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“It might come from an emergency room visit, a surgery, a misdiagnosis, or even just being talked down to or ignored by a provider when [they] were suffering or scared for [their] health." — Claudia Giolitti-Wright, MA, LMFT, founder of Psychotherapy for Young Women, New York City
“Medications and psychotherapy—such as cognitive behavioral therapy or exposure therapy—can minimize the hold medical trauma has on people’s lives and ability to function." — Brian Zachariah, MD, psychiatrist, Mindpath Health
Many patients feel a bit jittery or nervous leading up to medical appointments. However, for some who’ve experienced particularly devastating health issues, doctor’s visits can be downright traumatic.
Understanding this should be a priority for all physicians, because medical trauma—a psychological or physiological reaction developed due to a negative experience a patient had with a health condition in a healthcare setting—can be debilitating.
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It’s more common than you think
Claudia Giolitti-Wright, MA, LMFT, founder of Psychotherapy for Young Women in New York City, says medical trauma can emerge when a medical experience leaves a person feeling shaken, overwhelmed, or emotionally unsafe.
“It might come from an emergency room visit, a surgery, a misdiagnosis, or even just being talked down to or ignored by a provider when you were suffering or scared for your health,” says Giolitti-Wright.
Brian Zachariah, MD, a psychiatrist with Mindpath Health, says people can also develop medical trauma after witnessing a loved one battling a severe illness like cancer and then later receiving their own diagnosis of the same condition. Other patients may feel negatively about a specific care facility or healthcare clinic where they—or a family member—underwent prolonged or intensive treatment, he adds.
Know these invisible signs
"Patients may feel panic, emotional numbness, or hypervigilance leading up to an appointment—they may even avoid receiving care entirely. But medical trauma often flies under the radar. A person may recover physically or appear calm while receiving treatment, but, inside they may feel emotionally shattered. “People end up carrying around that distress, and because it doesn’t always ‘look like’ trauma, it often goes unvalidated,” Giolitti-Wright tells MDLinx.
Why does the brain react this way? According to Giolitti-Wright, our brains are designed to protect us. When we go through a threatening event, the brain essentially says, “Let’s remember this, just in case we need to stay safe next time.”
Small moments of empathy make a huge impact
So, how can doctors help their patients struggling with medical trauma? The first step is to slowly and empathetically explain what is happening, medically, to the patient step-by-step, says Giolitti-Wright. Then, ask for consent at every stage of the process—not just at the beginning.
Giolitti-Wright also recommends acknowledging that your patient’s condition or treatment can feel scary or exposing. “Validate emotional reactions, [and] don’t rush past them or minimize them.” Finally, if you notice your patient is struggling, encourage them to seek emotional support—ideally, with a certified therapist—without shaming or judging them.
Medications and psychotherapy—such as cognitive behavioral therapy or exposure therapy—can minimize the hold medical trauma has on people’s lives and ability to function, says Dr. Zachariah.
Taking these steps can change the whole dynamic, according to Giolitti-Wright, and help people feel seen, cared for, and respected. “That trust really can be lifesaving,” she says.