Yet Another Entry for DSM-V: Nomophobia?

From The Indian Journal of Community Medicine, a study by Dixit, Shukla, et. al.


Nomophobia(1) literally means no mobile phobia that is the fear of being out of mobile phone contact. If a person is in an area of no network, has run out of balance or even worse run out of battery, the persons gets anxious, which adversely affects the concentration level of the person. In recent times there seems to have been a transformation of the cell phone from a status symbol to a necessity because of the countless perks that a mobile phone provides like personal diary, email dispatcher, calculator, video game player, camera and music player.(2) Indian market has emerged as the second-largest market after China for mobile phone handsets. Our study was undertaken to find out the prevalence of nomophobia in the Indian scenario considering the tremendous increase in the number of mobile phone users in the past decade. We decided to conduct the study in our college since the younger generation is the latest consumer of the mobile phones, and the under 25 year age group in professional colleges like medical colleges use mobile phones quite frequently since most of them reside in hostels. Day scholar students too want to be in constant touch with their family members and friends since they are out of their homes for the whole day and at nights while studying in colleges and working in hospitals.

The study goes on to say:


A study from United Kingdom on 2163 people revealed that 53% of the subjects tend to be anxious when they lose their mobile phone, run out of battery or credit or have no network coverage. The study found that about 58% of men and 48% of women suffer from the phobia, and an additional 9% feel stressed when their mobile phones are off. About 55% of those surveyed cited keeping in touch with friends or family as the main reason that they got anxious when they could not use their mobile phones.(1) A study conducted by Market Analysis and Consumer Research Organization (MACRO) in Mumbai to study the various patterns and association of mobile phone usage reported that 58% of the respondents could not manage without a mobile phone even for a day.(2)

I'll Take That Call Now.

Jill of All Trades, MD is a family physician blogger who has a post on KevinMD titled Why answering a cell phone during an office visit is a problem. She writes from the perspective of a primary care doc, and talks about the awkwardness of patients talking on the phone during their office visits. She talks about it with a detective/spy metaphor:

Me: “Your recent lab test shows that your diabetes is currently not sufficiently controlled with the current regimen. Your hemoglobin A1C, which is a lab test that tells me what your sugar level has been at home for the past three months, is 8.1. We need to add a medication at this point because…”

“Riiinnnggg!!,” a quite startling sound lifts me off my seat, as if signaling a new secret-agent assignment.

Patient: “Oh, Doctor, hold on one minute please.”

Is this a conspiracy? Before I can even respond, she picks up the cell phone and starts talking to this rather shady intruder.

Patient: “Hi, honey. I’m at the doctor’s office. What do you need? …”

I wait about thirty seconds, with what seems like an eternity in the secret agent world, and she is still on the phone with this suspicious invader. At this point, I decide to exit the premises.
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For some people, answering the phone immediately seems to be a bit of a compulsion. And for someone who's waited a long time to see an over-booked doctor, I can see why they might want to take a call. Maybe it's a call that was prearranged for a time long after the patient thought they'd be free...but the patient was surprised to find the doctor was running late, and so why should they put someone on hold for a doctor who's kept them waiting? Why is it a one-way street? Oh, because it is.

In psychotherapy it's a different story: people pay for time by the chunk and there aren't patients backed up waiting to fit into the same time slot. I feel like it's the patient's time, and I don't feel like I should say to an anxious mother, "Don't take that call." Still, I'm always a bit surprised when people feel the need to take non-urgent calls during an appointment, and to talk for a bit. I feel a little uncomfortable listening. And even for those who quickly say, "I'm with the doctor, I'll call you back," I'm not sure what that gains over having the phone off.

Does my phone ring during sessions? Yes, because sometimes I forget to turn it off--and if it rings, I reach over and silence it . Do I answer it during a session? Never. Whatever it is waits until the session is over. The only exception I make is if I'm trying to get in touch with another physician regarding the care of the patient I'm seeing during that block of time.

I let people talk on the phone or text or deal with their families or clients. No one has done it repeatedly or in a way that notably distracts from therapy. I'm a bit surprised when anyone wants to pay my fee to talk on the phone, or even when anyone runs late, but hey. If I weren't "rented out" in blocks of time, so to speak, I'd be exiting with Dr. Jill-of-all-trades whenever the phone rang.
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And on a completely different note, I noticed that Jill of All Trades has a link on her sidebar to "Shrink Rapping"....I clicked on it thinking it would be us. But, no....There's another Shrink Rapping doc out there-- Dr. Gregory Smith from Georgia and he's been at it a while. How'd we miss that?