Adult Asperger’s Video 12. Living in a Bubble – Living with Asperger’s Fear of Doctors and Dentists
Living with Asperger’s Fear of Doctors and Dentists
Many people with ASD find going to the dentist or doctors very stressful. Fear of the unknown is part of that. The “idea” of going is often, like many things, worse than the act itself. Many times, the medical practitioners and their staff are not trained to deal with individuals with ASD or might not fully understand. This will compound the problem. Another issue is that an unexpected (or even anticipated) appointment will often be a departure from the usual day to day routine hence a cause of anxiety. This is because the usual safety net of familiarity and routine, which can be a calming framework, or the usual learned coping mechanisms, will be suspended to visit the doctors or dentists. In a way, it’s an obvious “double trouble” situation because of the removal of familiarity and the insertion into this alien environment with people that are often not aware and can amplify the problem (which is quite ironic if you think about, because this is a visit to locations where you’d expect a full understanding of ASD!). Once with the doctor or dentist, let’s not forget that the patient with ASD must be examined, which can throw up another set of challenges because often the patient does not wish to be examined and is uncomfortable with people in their personal space, often uncomfortable being touched or even being asked to remove clothes that are special to them and help calm the patient. When I think about visiting the doctors or dentists it’s also the waiting that makes me the incredibly anxious. Then the fact that doctor’s surgeries have “annoying” beeps, buzzers and sounds and an intercom system. There might be music playing and strange people doing strange things. Tapping and banging, coughing and babies crying. There are a lot of different factors involved and these are things which need to be interpreted, dealt with, and coped with in a public place. This can be very tough for some on the spectrum. Other sensory challenges when actually with the doctor or dentists can be the certain type of fluorescent lighting and the equipment buzzing, including drills and other equipment. Even the small torchlight that they use and point in your mouth and eyes – if you have a particular sensitivity to light – can be a challenge. If you are distracted by these things it can make the whole experience harder for both yourself and the medical practitioner. If somebody on the spectrum has communication challenges then this could also be an issue, such as expressing pain when a dentist does something, or being extra sensitive to the slightest touch, which, ordinarily, they might not be, which, again, causes a wrong impression and can cause problems in identifying what the actual underlying problem might be. It’s my understanding that education in the medical community is improving. I read an information pack given to doctors which was brilliant. However, it’s also important to remember that often doctors and dentists are overworked and stressed out themselves and might be more inclined to be accommodating to somebody extreme on the spectrum but not high functioning. I feel this is a fair point because if a doctor or dentist is meeting you for the first time, a large part of the dynamic will be first impressions. Communication in a very short limited amount of time and sometimes if you look good and communicate well then you might not get the same accommodations as somebody who doesn’t communicate quite like yourself. On the surface you are calm and might look wonderful but under the water, the feet are treading water overtime!
Tips and Advice
1) Rehearse
Rehearse the visit in advance! Don’t be afraid to visit the surgery and take a look around before you visit. Sit down in the waiting room for a few moments. Familiarise yourself with the staff and feel free to explain what you are doing if they ask. It’s also a good idea to have a walk around the local area or have a drink nearby too. If it is far away then read about the location online and use Google Maps and street view. If you are a young person or a carer for somebody on the spectrum it might even be an option to rehearse with chairs and play out a proper role play. Do whatever you need to do to make life comfortable and the experience as easy as it can be.
2) Plan
It’s very important that once your visit is confirmed that you plan the logistics carefully. Think of it like you are a VIP or the President of the United States is arriving – protocol and planning is key, except this time YOU are the VIP! If possible contact the clinic and find out when the quietest time will be and visit when the likelihood is that there won’t be a lot of people in the waiting room or nearby. You might even be able to book an appointment at the end of the day when everybody else has left, or the earliest appointment before people arrive. Timing is key and they might even appreciate it if you come in when it is quiet as it’s more convenient for them. You do not want to be queueing or spending unnecessary time in an uncomfortable unfamiliar waiting room environment, so do all that you can to avoid this by communicating with the practice in advance.
3) Communicate
When you’re planning your visit make sure that you tell the practice about any concerns and fears that you have in advance. Most of the time they will be happy to accommodate you and help allay them. Remember that, although they might not be perfect, they are trained professionals and have seen every embarrassing serious illness and problem under the sun. Tell them your problems! As long as you are polite, friendly and genuine they will be happy to help you and go ‘the extra mile’. When you realise that they are on your side and accommodating then that fact alone will help you relax. Communication is important and communication in advance is even better because you’ll be more likely to be in a better state of mind. Don’t leave it until you arrive to address potential issues.
4) Rationalise
Understand that in life, at times, we must all go to the dentist and the doctor. Educate yourself and understand the reasons and the benefits of going. This will help the process significantly. Know that this does not have to be a regular thing and that it might be once or twice a year. Convince yourself with facts and acknowledge the benefits of going even though you don’t like it. You will realise that you spend a lot of time doing things that you don’t like and that sometimes just getting them done quickly and efficiently is the best way. Complete the task and move on to what you do enjoy!
5) Involve
Have a friend or family member help you with the planning and logistics. My friend is not very good at talking on the phone to often seemingly insensitive call centres and receptionists and arranging these things and I have called on his behalf many times. It can save a lot emotional stress and energy that you can use for dealing with the actual visit. Feel free to enlist help! Many times people will be happy to help you. You don’t have to do this on your own necessarily!
6) State of mind
On the day of the visit make sure that you are in a good state of mind, as best as you can. Everything that is in your control make sure is as you like it. Eat well, sleep well, relax, recuperate, exercise, listen to music – do whatever it is that you need to do to be happy and strong! These things aren’t nice at the best of times for people that aren’t on the spectrum so you are not alone and it’s a big achievement to go through this with our challenges. Arrange in advance a really nice reward after the appointment or later on in the day too! This will give you some motivation and make things flow a little nicer.
7) Music
If you like listening to music then ask permission and take along your personal stereo. Make sure that you tell the practitioner or receptionist, so that you can hear when you are called. The doctor or dentist may even let you listen to music whilst in a procedure, you never know! Take whatever you need to be comfortable. If that is a cushion, take your special cushion. If that means you want to take a friend, take a friend! I’d suggest that you keep the medical practitioner aware though and if you are too shy or embarrassed to tell them, have someone else do it for you. People want to be included and they will often be privileged that you are letting them into your world!
8) Compatibility
If for any reason you feel that you can’t interact with a certain medical practitioner then you should make contact with their receptionist and communicate your doubts and fears. If you have been upset and feel that you can’t get over it, you should find a new medical practitioner and make any necessary official complaints. Not everybody is compatible, so if you need to move on and find someone more suitable for you, then that is sometimes a valid option. I would suggest that you make this decision in collaboration with others, including friends and family or peers.