Q: Over the past year or so, our 5-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 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 healthcare 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.
Before describing a tactic that has proven to be successful in other situations of this sort, involving children around your son's age, two things:
First, offering a bribe for good behavior isn't going to work, as you've already discovered, and is likely, in the long run, to be counterproductive. You don't 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're trying to persuade and nudge him into being a good patient. Getting over this hump is going to require force. I'm not referring to anything physical, mind you. Rather, I'm 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'm 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 privilege, be confined to his room after supper and go to bed one hour early. Privilege includes any and all after-school activities, birthday parties, sleep-overs, play dates, toys, television and any purchases above what is absolutely necessary.
To restore his privileges, he must tell you that 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.
Make this your son's problem and he will solve it.
Family psychologist John Rosemond answers parents' questions on his websites, johnrosemond.com and parentguru.com.