Your MRI: Facing Fears and Conquering Claustrophobia
Back in the days of the caveman, a fear of being trapped was helpful. It might have kept you alive. It could have prevented you from becoming something else’s dinner. Even today, Dr. Todd Farchione of Boston University’s Center for Anxiety and Related Disorders says the fear of getting cornered can be useful. “It’s not good for a boxer to get in the corner because they don’t have many options to get out of the situation, so that’s a very dangerous place to be.” But Dr. Farchione draws a fine line between dangerous situations and those that induce the same reaction but aren’t really dangerous. One modern-day example is the MRI.
There are countless diagnostic uses for an MRI. But for a lot of patients, the thought of the exam is enough to induce panic. Forget how it helps them diagnose and treat health challenges. That machine is huge and loud and you have to go inside! Many people describe their feelings about the exam as claustrophobia, though Dr. Farchione points back to evolution. An MRI can make people feel vulnerable and tap into that age-old caveman instinct, paralyzing some with fear.
Conquering Claustrophobia with Real Relaxation
What do you do in a stressful situation? Chances are, you tell yourself to relax. You might even try some relaxation techniques like square breathing or hypnosis (for more, click here). But going into an MRI armed only with the idea that you need to relax is a “mixed bag” according to Dr. Farchione:
“Sometimes it backfires because, as the person is trying to apply it. They may notice like, wow, it’s not working the way I wanted it to work. It’s not going to work. Oh my god, it’s not working! It’s not working! I’m out of here!”
He suggests being aware of your breathing, but focusing more on changing your physical response. If your shoulders are tensed up to your ears, push them back down. If your hands are clenched into fists, release your fingers. If you have a look of fear on your face, try smiling. “Doing the opposite often helps the emotion diminish faster,” says Dr. Farchione. “It sort of cuts off the emotional response very quickly.” For more on how to do this, watch this video:
Managing Fear with Medication
Deborah Forman says the idea of an MRI makes her heart start beating faster. To get the scans her doctor needs to treat a herniated disc in her lower back, she has to make it through the exam without crawling out the end of the machine. “Some people need medication,” Deborah explains. “Just a little bit of anti-anxiety medication will really do the trick if you feel like that’s going to happen to you.”
While a dose of anti-anxiety medication may help you conquer your fears, Dr. Farchione says it is a one-time victory. The prescription that helps patients get through their exam can also make them feel dependent. Not that you need the medicine on a daily basis, but you might think you can only get an MRI with the help of a dose. Instead, Dr. Farchione suggests finding other tools:
“In the same way, I don’t encourage people to bring in lucky charms, no lucky socks, don’t have your teddy bear nearby. It’s not necessary. You did it because you were able to experience an emotion and respond to it in an appropriate manner.”
Finding a Scanner That’s Not so Scary
If you experience panic when a doctor says, “You need an MRI,” you can also seek an alternative scanner. Some people describe a traditional MRI scanner as a tube or a tunnel, which can elevate your fear of being trapped. Another scanning option is the High-field Open MRI. CDI radiologist Dr. Joel Newman says the Open MRI looks like the buns of a hamburger without the hamburger in between:
“It makes a huge difference if you are claustrophobic and a lot of people are. I am myself and I would say if you have a patient who is claustrophobic they will feel much more at ease knowing they could reach their arms out and they’re not stuck in a tunnel.”
Patients can actually hold the hand of a family member or friend through the exam. That comforting touch is enough to help some patients push aside fears. The High-field Open MRI gives doctors high quality images that are comparable to the pictures from a traditional MRI machine. Click here to see what it’s like to get a High-field Open MRI.
Focusing on the Finish Line
After two MRIs, Michael Fauci says he has no issues with the exam whatsoever. A self-proclaimed claustrophobic, he says the music in the headphones he wore during the exam helped distract him. Despite all his fears, he says, “It was actually easy.” As an athlete, Michael is accustomed to focusing on a finish line. That can really help when you’re feeling that primal fear of being trapped explains Dr. Farchione. Reminding yourself that there is a medical reason you’re getting the exam and the MRI will help get you the answers you need.
Finally, you may just need to buy yourself enough time to see that there is no threat. Try convincing yourself you can get through just one or two minutes. Technologist Derek Cicchetti of CDI’s Dedham, MA center does dozens of scans on patients each week. He estimates that 90% of his patients who make it through the first 90 seconds will make it all the way to the end. With or without relaxation techniques, most people start to realize that there is no danger as the seconds tick by. Dr. Farchione says it works, no matter what your fight or flight response is telling you:
"The emotional system adjusts. People just don’t give it enough time to adjust because of that fear that it’s not going to adjust.”
Once you realize you CAN handle it, you’ve won. It doesn’t mean getting an MRI would be your chosen pastime. It does mean you’ve successfully changed your natural response. After all, you don’t dress like a caveman, so why think like one?
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