Q: Over the past year or so, our five-year-old has developed an extreme fear of going to the doctor or dentist. This came on suddenly, without a precipitating incident. The crying begins when we arrive at the appointment. When the doctor or nurse tries to examine him, he goes bonkers—screaming, hitting, kicking. He has to be held down for something as simple as looking in his ears. Otherwise, he’s a normal little boy—occasionally disobedient but nothing at all serious. This last time I decided to punish him by not giving him what I’d promised if he was good and sending him to his room when we got back home. Is this something I should treat as any other behavior problem? I’m really confused.
A: Whether the behavior in question reflects a true fear or not is open to question. With children (and even adults at times) one cannot accurately judge the book of behavior by the cover. Sometimes, what looks like a fear can be a form of rebellion.. One thing is certain: your son is trying to exercise control over his health-care appointments. Given that (a) there was no obvious precipitating incident, (b) he is not generally fearful or disobedient, and (c) his “fearful” behavior is not part of a larger pattern, I’d approach this as a behavior problem.
However, I’ll mention two things before describing a tactic that has proven to be successful in other situations of this sort involving children around your son’s age.
First, offering a bribe for good behavior is not going to work (as you have already discovered) and in fact is likely, in the long run, to be counterproductive. You do not want your son to begin demanding “goodies” in return for obedience. Demands of that sort escalate over time. What begins as “I want ice cream” is likely to turn into “I want a trip to Disney World” in short order.
Second, your confusion is preventing you from acting authoritatively. You are trying to persuade and nudge him into being a good patient. Getting over this hump is going to require force. I am not referring to anything physical, mind you. Rather, I am talking about using a form of what I call the Godfather Principle: making your son an offer he can’t refuse. (For the benefit of some younger readers, I am referring to a famous line from the film The Godfather.)
The godfather offer in question: Tell your son that until he fully cooperates with a doctor or dentist appointment, he will enjoy absolutely no privileges; he will be confined to his room after supper; and he will go to bed one hour early. “Privileges” include any and all after-school activities, birthday parties, sleepovers, playdates, toys, television, and any purchases above what is absolutely necessary.
To restore his privileges, he must tell you he is ready to be a cooperative patient. At that point, you make an appointment with the doctor. If he displays any form of resistance on the way to or at the appointment, take him home immediately, reinstate his Spartan standard of living, and just wait. This may take a week or it may take a month, so be prepared to hang in there with an attitude of nonchalance.
Family psychologist John Rosemond is the director of the Center for Affirmative Parenting in Gastonia, North Carolina. For information about his talks and workshops, contact Tracy Owens-Jahn at firstname.lastname@example.org or (817) 295-1751.