Dear Therapist:

My spouse has the interesting issue where he just refuses to go to the doctor for a well checkup. He is pushing 45 and probably hasn't been by a doctor in 15 years. When he is sick etc. he will go to an urgent care or a PA and take care of it, but that is pretty much it. He claims he is healthy and doctors just find issues. He seems ok but at this point I wonder if he is just nervous and so he is avoiding it. Do you have any suggestions on how to deal with this? Thank you. 

Response:

What you describe is in no way unusual. Many people—and stereotypically men—have no use for the medical profession unless absolutely necessary. Reasons for this vary. Some people simply don’t want to deal with a hassle that they deem unnecessary. Others have the sense that they would know if something was wrong with their bodies. Yet others don’t want to acknowledge that they are getting older. There are other possible reasons for people to neglect or avoid doctor visits. For most, as with many decisions, there are a combination of factors that lead to this one.

You wonder whether your husband avoids doctors because he is nervous. Do you have a reason to believe that doctors or health issues make him nervous? Or are you simply hypothesizing since nothing else seems to make sense? If the latter, you are likely projecting your logic and emotion onto your husband.

We all project our thoughts and feelings onto others. When someone does something, we automatically (and unconsciously) assume that they are doing it for reasons that would cause us to do the same thing. For instance, if I see someone helping another person, I might assume that they feel bad, and recognize that they would want others to help them. I might assume that they want to feel like a good person. I would be making these assumptions because of the projection of my thoughts, feelings, and needs onto the other person.

If you were to refuse to see a doctor, this would be for your own very specific reasons. Perhaps the strongest reason of which you can conceive is a fear of finding something wrong. Although you may visit doctors religiously, your conception of what could possibly cause you to avoid them might relate to fear. Perhaps you tend toward avoidance of feared scenarios (or perhaps you have taught yourself to face these fears).

You wonder how you can deal with your husband’s refusal to obtain a well checkup. I wonder whether this is truly a refusal (something about which he is adamant) or simply a matter of disinterest. If he has no strong need not to see a doctor, he might be amenable to the idea if you showed him how important it is to you. Rather than appealing to his logical side (“It makes sense;” “You’re older now.”) you might focus on the fact that you are afraid of losing him and that a doctor’s visit would make you feel more secure.

If your husband does, however, have an aversion to doctors due to a fear of finding something wrong, this is something that he will need to deal with. Whether you can help him to acknowledge this fear (the first, necessary step) is questionable. If he can recognize his fear, he would be more likely to challenge them. Once unconscious fears are introduced to the realm of the conscious mind, we are able to apply our intellect to them—something that is much less likely when confined to our unconscious minds.

Whatever the reason for your husband’s choice not to see a doctor, you should have an open mind in terms of your understanding of his decision. Naturally, your approach will depend on factors like his general temperament, your relationship, his reaction, and other factors specific to your situation. If you are able to acknowledge your own assumptions, fears and needs, this will make it easier for you to understand your husband’s, leading to a more effective approach.

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

  Woodmere, NY

  adjunct professor at Touro College

  Graduate School of Social Work

  author of Self-Esteem: A Primer

  www.ylcsw.com / 516-218-4200

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