You wake up with a new, never-before-experienced ache. Try to play it cool, convinced that it will soon pass. But the soreness persists, it doesn’t go away, it continues to bother you. Now you know very well what you should do: you should get it checked out, investigate, seek advice from your doctor. Yet you fail because, underneath, you are afraid to find out that there is some serious problem behind that ache. A disease, perhaps incurable. If you recognized yourself in this little example, it is likely that you are also part of the group of people who suffer from FOFO, an acronym that stands for“fear of finding out.” This is a rather widespread fear, and in truth it is not just about health: a study conducted by Barclays, for example, revealed that more than one-third of millennialsare so worried about their economic status that they cannot check their bank account. For fear, precisely, of “finding out” that they are poor.
Fear of fears
FOFO in the medical field began to be discussed extensively in 2018, following the publication of an editorialin the British Medical Journal Opinion by Muir Gray, visiting professor at the Nuffield Department of Primary Care Health Science in Oxford, UK. “There is a lot of talk about the problem of excessive pressure on GPs,” Gray explains, “and the overuse of primary care by people who would not really need it, and who benefit little from it. Much less is said, however, about the flip side of the coin, which is the underreporting of the use of physicians and primary care by those who would actually need it.” A 2017 report conducted by 2020 health showed that about one-third of the reasons why people resist visiting their doctor have nothing to do with practical problems, but are related to psychological issues: FOFO, in fact. FOFO is defined in the report as “a multifactorial construct related to the clinical environment, and/or clinical investigation, and/or diagnosis. Fears within any of these domains may interact with other psychological, environmental, logistical, and experiential barriers to self-help.” FOFO, then, would also be linked to the fear of being physically examined, of dealing with thehospital environment, having to undergo treatment, experiencing some form of stigma or discrimination, feeling pressured, having to change lifestyle, appearing weak, or no longer being able to keep control of their lives.
Studying the phenomenon
FOFO needs to be recognized and kept under control, as this block can have a negative impact on daily life and even on one’s health status. Postponing -or even avoiding- medical checkups just out of fear of knowing can lead to a delay in treatment and worsening of the condition, which can in turn trigger a vicious cycle from which it becomes difficult to escape. Experts know this well, and recognize that the problem, even before it is psychological, is social: “In the last fifty years,” Gray continues, “medicine has made great strides, but there are still major gaps, for example, in the inclusion of all social groups. Now is the time to act not only to answer patients’ questions, but to make sure we identify and include people who do not contact health services despite potentially needing them. It means that we first need to understand who the people suffering from FOFO are and then how to deal with them. To do that we need education and predictive analysis.”
How to overcome FOFO
So, what can patients do? First -this is step zero- identify the problem and acknowledge your fears. And then seek expert advice: overcoming FOFO alone can be very difficult, but psychotherapy can be a good and effective help. There are cognitive-behavioral techniques, for example, based on conscious exposure to a certain type of stimulus, that which is feared, to learn how to frame and cope with it. In this way, experts say, one can overcome an anxious blockage by “training” oneself to tolerate that type of anxiety.
