Don't delay ILLUSTRATION: Tim Furey

Don't delay

Procrastinating on health issues could have catastrophic consequences

By Patti Carmalt-Vener 01/19/2012

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Dear Patti.
I’m a survivor of pediatric Hodgkin’s disease. Radiation was the exclusive treatment years ago, the dose was extremely high and I’m told I now have a much greater chance for breast cancer. I’m due for preventative checkups but keep postponing it; the thought of sitting and waiting for results like I did so many times in the past is very hard to face.  — Dana

Dear Dana,
I’m very sorry for everything you’ve had to endure. Let’s help you move forward so that your past medical trauma doesn’t interfere with protecting your life today. The more you acknowledge and experience your feelings and terrifying childhood memories, the less power those historic feelings will exert on how you handle the present. 
When someone has severely traumatic experiences, the defense of avoidance — coupled with procrastination — is sometimes used. Avoidance is a coping mechanism to evade issues and events that cause conflict or distress. You know better than anyone how crucial it is to schedule necessary tests and screenings. If you continue to procrastinate, I’d strongly recommend professional counseling. A therapist whom you trust can help you heal painful memories, thus reducing the need for avoidance. Take care of yourself and work this problem through, sooner than later.

Dear Patti,
My husband is a clean, healthy guy, except for his teeth. They need a lot of work, but he’s totally phobic about going to the dentist. I found a doctor who would put my husband completely under, but he even canceled out of that. Any suggestions? — Tina

Dear Tina,
Dental phobia — an unreasonable fear of dentists — can become a serious problem. By putting off routine care for years, people put themselves at risk of gum infections, pain and broken or unsightly teeth. They may also suffer from poorer health in general, including a lower life expectancy, because bad oral health has been found to be related to life-threatening conditions, such as heart disease and lung infections. Diminished self-esteem can be another side effect, as studies reveal that society often perceives people with broken or badly stained teeth as having 15 fewer IQ points. Symptoms include helplessness and loss of control, memories of negative experiences during previous dental work and intense anxiety and panic before and during procedures. 
Dentists address dental phobias with positive reinforcement, relaxation techniques, systematic desensitization involving gradual exposure to the particular feared procedure and pharmacological techniques ranging from mild sedation to general anesthesia. If none of this is helpful, your husband may need to be referred to a mental health professional.

Dear Patti,
My two sisters and I are all in our 40s and lost our mother to breast cancer when we were young. Darcy and I get regular checkups, but we’re beside ourselves that Christine, who was very close to our mother, keeps postponing her mammograms. She seems to think that, because she eats healthy and exercises, she’ll be fine. Many women think it can never happen to them, but it’s just not true. Darcy and I feel we’ve lost enough already and don’t want to lose our sister, too. How can we get through to her? — Ginny

Dear Ginny,
I’m deeply sorry for the painful loss you three sisters have had. The death of a mother is an impossible grief and a horrific tragedy, especially when her offspring are young. When people experience emotionally traumatic events, they can create various defenses as a way to cope with distress. In the case of Christine, it could be that one of her defenses is denial. Denial gives a false sense of safety, being in control and insulating oneself from future devastation. 
No matter how skilled or kind the radiology technician is, many women suffer from “mammogram fear,” because they know this unpleasant procedure is a screening for cancer. Although no woman wants to be screened, early detection is a key to long-term survival. 
Your sister’s fears run very deep. Not only does she have to face the possibility of her own death, but she’ll likely have to face old pain, sorrow and even anger concerning your mother’s death. While extremely difficult, it’s mentally healthy to heal old trauma. I’d recommend that Christine see a psychotherapist who can help her address her pent-up feelings of longing, loneliness, fear, rage and grief and guide her to become more protective of her future well-being.

Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email Visit her Web site:


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