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What Causes Health Phobias?

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Posted on Thu, 26 Oct 2017
Question: Hi,
I'm currently in therapy for health phobias and I would like to ask for some advice. My therapy sessions have been based on learning how to calm myself and also trying to understand how I developed these phobias. One thing that I do not get from these sessions are rational explanations of why I should not be afraid of my surroundings.

This started as a blood phobia, being frightened at the site of blood and fearful of "theoretical" risk related to blood borne diseases. A couple months back I established services with a family doctor and did a full panel blood test so I could be assured that I'm healthy.

Once I knew that I was healthy my fear of having a disease passed but I have now become afraid of surfaces in general....which is a very difficult issue. I've read about which viruses do and do not live outside the body and now my phobia seems to be focused on hepatitis C because it lives outside the body.

A doctor explained to me that I should not worry about Hep C unless I have unprotected sex, inject drugs, or have a blood transfusion. I have had a difficult time accepting this because of "theoretical" risk.

The theoretical risk I have obsessed over in the last couple of weeks have been about entry points for a virus. I haven't learned where to draw the line between a superficial cut that gives access to my bloodstream and an open wound or open sore. I play guitar a lot and I work with my hands a lot so I develop a lot of cracks in my skin. I also get tiny blisters in my mouth sometimes from spicy food or crunchy food. I'm not talking about large canker sores but just small blisters on the inside of my lips that heal within a week. Maybe that is a canker sore.

What I think would help me most is to know what I should consider to be an open sore or an open wound that would provide access to my bloodstream. If splits in my skin that aren't bleeding aren't a point of possible infection that is reassuring for me. For something to have access to my bloodstream would I have to have a really deep cut...something that would require stitches? Then I have the same concern inside my mouth. Are these blisters from spicy and crunchy food an entry point for viruses or would I have to be seriously bleeding to the extent that I obviously know that I'm bleeding? My fear is that if I have an entry point for a virus in my mouth I may unknowingly eat food contaminated with HepC infected blood or that if the cracks in my skin are an entry point for infection I may touch something that has some microscopic amount of blood on it.

If I continue to worry about cracks in my skin and blisters in my mouth I will never make the connections I need to make to overcome my health phobia.

Thank you for your time. I realize this is a lot of information. I'm trying to communicate this as clearly as possible so that someone may understand and offer me the information I need in order to move on with my life.
doctor
Answered by Dr. Alexander H. Sheppe (1 hour later)
Brief Answer:
Consultation

Detailed Answer:
Hello, and thanks for your question.

The problem with your reasoning is that you are afraid of things out of proportion to their likelihood. For example, the likelihood that you would contract Hepatitis C without exposure to bodily fluids is essentially zero. There are some nearly impossible scenarios where this might occur, but the likelihood is far less than things you would likely see as ridiculous -- for example, getting struck by lightning. You certainly have a "theoretical" risk of getting struck by lightning, but you aren't worrying about it. You have a far greater risk of getting struck by lightning than contracting Hepatitis C without exposure to bodily fluids. Through therapy, you can train your brain to evaluate risk more accurately.

Please rate and close your answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Alexander H. Sheppe (29 minutes later)
Hi Dr. Sheppe,

I'll be happy to contact you through your page to continue discussing my phobia. I do realize that a phobia is irrational thought. I feel like since I am aware of this I do have some hope in reasoning with rational reasons I should not be worried. I feel this part of my question went unanswered:

"What I think would help me most is to know what I should consider to be an open sore or an open wound that would provide access to my bloodstream. If splits in my skin that aren't bleeding aren't a point of possible infection that is reassuring for me. For something to have access to my bloodstream would I have to have a really deep cut...something that would require stitches? Then I have the same concern inside my mouth. Are these blisters from spicy and crunchy food an entry point for viruses or would I have to be seriously bleeding to the extent that I obviously know that I'm bleeding? My fear is that if I have an entry point for a virus in my mouth I may unknowingly eat food contaminated with HepC infected blood or that if the cracks in my skin are an entry point for infection I may touch something that has some microscopic amount of blood on it."


I am aware that I need help beyond this to treat my phobia. I'd like to leave this question "open" for the moment but would be happy to talk more on your page.

Thanks you!
XXXXXXX
doctor
Answered by Dr. Alexander H. Sheppe (14 minutes later)
Brief Answer:
Followup

Detailed Answer:
I do not think that answering this question will help you, as your phobia is not based in reality, but I will go ahead and say that cracks in the skin or mouth that is not bleeding makes it very unlikely you would contract a bloodborne illness.


Please rate and close your answer when you are finished and satisfied.

In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers

Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
Answered by
Dr.
Dr. Alexander H. Sheppe

Psychiatrist

Practicing since :2014

Answered : 2240 Questions

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What Causes Health Phobias?

Brief Answer: Consultation Detailed Answer: Hello, and thanks for your question. The problem with your reasoning is that you are afraid of things out of proportion to their likelihood. For example, the likelihood that you would contract Hepatitis C without exposure to bodily fluids is essentially zero. There are some nearly impossible scenarios where this might occur, but the likelihood is far less than things you would likely see as ridiculous -- for example, getting struck by lightning. You certainly have a "theoretical" risk of getting struck by lightning, but you aren't worrying about it. You have a far greater risk of getting struck by lightning than contracting Hepatitis C without exposure to bodily fluids. Through therapy, you can train your brain to evaluate risk more accurately. Please rate and close your answer when you are finished and satisfied. In the future, for continuity of care, I encourage you to contact me directly at my private web address below. After you ask a direct question, it would be my pleasure to be your dedicated personal physician on this website. My name is Dr. Sheppe, and I am an XXXXXXX doctor working in New York City at NewYork-Presbyterian Hospital, ranked #1 for Psychiatry in the United States (tinyurl.com/psyrank). For a personalized comprehensive evaluation, treatment recommendations, and individual therapy, ask me at HealthCareMagic at this private web address: tinyurl.com/DrSheppeAnswers