Some thoughts on Hemaphobia

After hearing Ruth tell Martin that his hemaphobia could be related to his experiences as a child, I started thinking about the way his hemaphobia is handled in this show. As Ruth says, M’s hemaphobia is a psychosomatic condition that arose while he was doing surgery, something he loved. As a result, he quit surgery and moved to Portwenn to be a GP. Obviously, his fear of blood is not conquered by the move because we see him throw up numerous times and faint once after he is exposed to blood. As far as I can tell, these two reactions are pretty common among hemaphobics. Of course the comedic value is great because a doctor who has trouble with the sight of blood is so incongruous. More than that, though, Ruth has now brought up the likelihood that his parents and something in his childhood may be at the root of this disorder.

Many viewers, including me, have thought that series 6 was much darker than we were used to. After E1 & 2 the series takes a turn mostly because Martin’s hemaphobia returns in E3. He had thought that he had overcome it, and when he operates on the caravan owner in E1, there is no sign of it despite a tremendous amount of blood. It’s not surprising that when he takes blood from Robert Campbell and feels a surge of nausea, he’s disturbed that he has fallen back into that condition. Thereafter Martin has many scenes where he’s sitting in the dark looking forlorn and somewhat lost. He has trouble sleeping too. In short, he seems rather depressed, a condition that often occurs concomitantly with hemaphobia.

Instead of blaming Louisa and their relationship difficulties, it may make more sense to look to his parents and some childhood trauma, possibly between the ages of 4 and 6, since that’s when Ruth noticed Martin became a more withdrawn boy. He’s now had a son of his own and that in itself could have brought up subconscious memories/repressed memories from his own past. Then his mother returns and he’s horrified to have her there and around his son. We see him appear pretty unhappy when he looks down onto the beach and sees Margaret with Mike and James. I could definitely imagine some flashbacks of something that happened in his childhood appearing in series 7.

Both Ruth and Louisa want Martin to seek help from a psychiatrist to overcome the recurrence and hopefully put the matter to rest. He isn’t comfortable talking to anyone in his close circle, and he’s had difficulty confiding in the psychologist he went to before. He tried to desensitize himself without success. Really there are not many other options other than trying psychiatry or hypnotherapy. I’d love to see them try hypnosis on him, but it’s hard to believe it would work with him. Who knows, we might be surprised! Now that he’s banished his mother from his life, perhaps he can have a breakthrough with Louisa’s support. To me, she’s been trying everything she can think of and would be thrilled to be included in any effort he makes to change in any way.

Originally posted 2013-12-07 19:26:25.

21 thoughts on “Some thoughts on Hemaphobia

  1. Santa Traugott

    Traumas are not always, or even mostly, at the root of phobias. Sometimes their etiology is this: something happens that is disturbing. A relatively anxious person begins to avoid that situation. Soon enough, avoidant behavior becomes established, and there is a distinct “flight or fight” physiological reaction whenever the stimulus is presented. But it isn’t (usually) like.e.g, seeing a bloody scene of some kind, and then developing a phobia about blood.

    It does seem to me that Martin’s issues are rooted in his childhood. But perhaps they are about learning to be very wary of intimate relationships and families — that every time he expected consolation or affection, he was met by remoteness or worse, outright rejection. I think that would cause him to learn to wall himself off from these “softer” feelings that left him vulnerable, and when they suddenly arise, they produce intense anxiety in him =— which, rather than face and deal with — anxiety provoking in itself — become bound up in a specific phobia. And that conforms with what we were told in S1 — that the phobia first appeared after he had witnessed a loving scene between family members. I think his early childhood was probably one long, repetitive series of cumulative insults that led to the construction of his defensive armor, which now, he has great difficulty shedding, even when he wants to.

    As for why the phobia returned: Part of the answer may lie in his experience of parenting a young child, and watching Louisa be the mother to that child that he never had. I expect there is a lot of grief, not far under the surface, about the way he was treated as a child, which now he is forced to recognize, even if for the moment unconsciously, as inhumane and cruel. But, these feelings are in themselves anxiety provoking, and his template of dealing with anxiety, when being a control freak doesn’t suffice, is the phobia. It’s a marker of distress that has not been dealt with.

    Also, as a man who has great difficulty with intimacy, and who needs to exercise a lot of control over his environment to keep his anxieties in check, he is now living in a too-small house, with a family whose behavior he can’t control, and it must now be sinking in that this is what he has let himself in for.

    However, I really don’t know how they will show him dealing with the new insight that he gained from talking with Aunt Ruth — how he will build on it. I don’t think they will go the route of having him explore a single trauma. In fact, I wonder if they will even show him receiving any professional help at all, although it may be something that Louisa insists on as a condition of their reconciliation.

    I would like to see them do couples therapy.

    But to answer your other question, there is a treatment called EMDR developed specifically for dealing with trauma, and some practitioners swear by it. It always seemed somewhat “magical” to me — b/c no one, at the time I was practicing, really could explain how it worked. But it seems to work, in many cases.

  2. kjacobson@mindspring.com Post author

    Thanks for the insight Santa. I understand and agree that there doesn’t have to be a bloody scene in his childhood to have caused his blood phobia later in life. We’ve certainly seen how domineering and unloving his father was during his childhood with just that one butterfly scene. His father is also quick to ridicule M as a doctor too. And there’s no doubt that his mother has always been remote, cold, and unaffectionate. Then she demonstrates her inclination to be devious and demeaning as well when she returns in S6.

    Your explanation of why his phobia returned sounds really plausible. I know the house seems small, but in S5 they seemed ok in it. I’ve always been so impressed with how much they show M participating in JH’s care, even taking him for a ride in the car while still in his PJs just to get him to sleep. But I suppose with everything else building, the house may have started to close in on him like never before.

    Couples therapy would always be good, and it could be something L insists on too. I guess we’ll see what route they opt to take. Thanks for telling me about EMDR. I had never heard of it before and it sounds unique to say the least. It’s so nice to hear from you and learn something new!

  3. KR

    Santa, I think you’re on to something about the Control issues Martin has….and how a lack of love and proper parenting during his youth are likely an underlying cause of these issues.

    When Martin gets to Port Wenn he’s certainly not in control — he has to deal with the loose canon of Elaine and the repercussions of firing her. And then the uncertainty of how Roger will fare. He never really does get a firm control of life in Port Wenn, which is always somewhat chaotic — not a good scene for someone who needs to control the environment he’s in. In comparison, surgery must be a very controlled environment — or at least Martin was the definite controller of what happens and when, as far as processes go. He could also mentally prepare himself for any contingency, as a skilled surgeon.

    The behavior of Martin’s parents towards him as a child contribute to his need for control. I think it’s implied that he tries to control his emotions and behavior as a child so that his parents would not criticize or punish him — and later in boarding school, he would surely have to have a strong front to stand up to bullying etc.. I think Martin looked to Louisa to fill an intimacy gap in his life — but his defenses/wall are already thick, and he finds he cannot assert control over intimate relationships either. First, he loses control and gets Louisa pregnant. Then, in S5 he tries to control too many aspects of their life together, without consulting her — pushing Louisa to become so frustrated she leaves for her own cottage.

    Interestingly, the first psychologist helped Martin gain a sense of control — and he was then able to become mostly desensitized to the blood. But, all of this vanishes by S6, and he realizes that family life and the permanency of marriage is anything but controllable. So, when Louisa asked if the blood thing was related to her, or the “house” — she was onto something (even though Martin may not even realize this).

    Martin needs to find a way to balance the control he feels he needs to assert, with the intimacy he craves. Not easy!

    I too am not sure how BP will deal with the underlying issues of Martin’s character — or even if they originally planned for things to get so deep. If they continue the exploration, we’re on to a totally new sort of Doc Martin show. Martin Clunes hinted in one interview that he didn’t know if Louisa and Doc would ultimately stay together . Sadly, BP may decide to let the two separate — so that they won’t have to deal w/ Docs childhood, and can get on with the humorous medical side of things. And also bring some humor back into life with juggling care for James. I, for one, hope it doesn’t go this way…. I think many fans would be disappointed in this route. I vote for couples therapy along with some extra therapy for both Martin and Louisa individually. They both need to recognize how events of their youth play a role in who they are today.

    (PS: Wow, sometimes I wonder if I’m a bit bodmin — after all, this is just a TV show. But, on the other hand, I just love all of this analysis on this blog. That’s the mark of a quality show — it really makes you think. Sorry this is so long — I think I have too much time on my hands. Cheers, KR.

  4. kjacobson@mindspring.com Post author

    First off, Karen, I want to say that we have all spent a ridiculous amount of time analyzing this show, so you should not feel any crazier than the rest of us!! For me the show has been a great way to get myself back in the habit of literary analysis that I’ve spent so much of my life doing. Some people could say that that exercise is a bit nutty too. One of my colleagues used to tell a story about her father being surprised that she could actually earn a living reading books, analyzing them, and writing and teaching about that. But she certainly did and became world renowned for her analysis. I’ll never reach her level, but I have taught literature, published a bit, and get lots of enjoyment out of close reading and thinking about good writing and what makes a novel or, in this case a series, so effective and stimulating.

    I really like your comments about Martin not being able to control much that happens in Port Wenn, including his own emotions. Along with him being a so-called “fish out of water” in that town, his constant intersection with the people in the town is what makes the show funny AND there’s no doctor who can control his life when he’s the only doc in the area. People call him at all hours of the day and night, pop into the clinic without appointments, etc. Surgery is definitely much more under the surgeon’s control and schedule, with the exception of emergencies of course.

    I still have a couple of more ideas for posts and hope to write them in the next week. Thanks for the comments, as always!

  5. Santa Traugott

    For my part, trying to understand (and maybe “control”) my deep fascination with all aspects of this show has led me to dip a little into the psychology of getting involved with narratives. There’s a fair amount of work done on something called “narrative transportation” — which talks about getting caught up in a narrative. It’s quite interesting, and I do think a mark of a very special production that it can bring about this phenomenon. Or it may just be Martin Clunes, I’m not entirely sure!

  6. kjacobson@mindspring.com Post author

    That you bring up narrative transportation is very interesting. My minimal understanding of it is that the person who is transported really becomes so immersed in the narrative that he/she loses awareness of the physical world and isn’t aware of what’s happening around them. The person may also confuse what’s going on in the narrative with reality. That’s pretty extreme and I doubt you’ve gotten so immersed in this show that you are losing contact with reality. I would have been diagnosed with narrative transportation over and over by now if my literary studies were viewed as some sort of disorder. Whenever I’ve written about or taught a book, I can’t stop thinking about what parts of the story could contribute to the argument I’m making. I come up with ideas when I’m exercising, when I’m going to sleep at night, when I’m driving, etc. I think what you and I have been doing is applying our knowledge and training to these fictional characters because the writers, et. al. have done an excellent job of character development and story writing. If relating to a story on an emotional level were a disorder writers would be out of business. All writers want to draw their readers/viewers into the story and captivate them, right? Maybe there’s a reason we find ourselves getting caught up in a story at certain times in our lives more than at others because we need the escape or whatever. I don’t think that’s so bad. I also know that most celebrities have somewhat obsessed fans. I know of a woman who goes wherever Hugh Jackman is even if it means flying across the country. He actually knows who she is at this point and is pretty nice about it. I’m enjoying thinking about all the topics the show touches on and the conversation with you and others and I hope you won’t be too hard on yourself. Let’s just have fun with this!

  7. Santa Traugott

    Oh, I didn’t understand narrative transportation in such a drastic way. I do actually agree with you that it’s largely a positive experience to be so captivated by a show/movie/book, that you think about the characters and how the story line might work out and so on. It’s a tribute to the producers that this can be done, and maybe even to the capacity of the captivated viewer to become engaged with stories and their characters. Really, it says a lot about the ability to put yourself in another character’s place, and try to experience and understand things from their point of view.

  8. kjacobson@mindspring.com Post author

    I am relieved to see that you can just enjoy the experience, and your insights have given me a different perspective on the topics I’ve written about. Thanks for the info and the comments!

  9. Jane Martinez

    I would like to respond to the ending thought in the first comment:
    “… perhaps he can have a breakthrough with Louisa’s support. To me, she’s been trying everything she can think of and would be thrilled to be included in any effort he makes to change in any way.” I cannot see that she is portrayed as thinking of many ways to assist him. She puts him is situations where she has expectations without giving him any preparation.

    I think the writers should look more carefully at the character they have created in Louisa. She doesn’t seem to have grown the way Martin has. She still expects him to be a different person than he is and to know how to talk to others the way she does. And she does not give him ways to learn. She seldom physically touches him, his arm, his cheek, his hand. He touches her in a loving way — not often — but occasionally. He appears repressed in his emotions, not lacking. It must be difficult for him to express physical emotions, but it should not be so for Louisa.

    Louisa seems to be lacking in the teaching skills that would help him in developing their relationship as husband and wife. (There is a medical specialist that directs the procedures and diagnoses of Martin as a doctor. The program could use an expert teacher to guide Louisa’s character in simple role playing, questioning techniques, active participation, etc. And also keep her character from so regularly ordering students around.) She knew what kind of a character Martin was in the beginning. We as watchers now know that he is kind underneath the gruff, but that he is completely factual. I am sorry that he feels the need to call people names, “idiot” being a common one. We accept that because we now know that he is really concerned with the health of the individuals, and we are able to excuse and to laugh at the name-calling because we now “understand” him. The other town characters clearly also excuse, admire, and love him. They understand that he is nearly perfect in one way and imperfect in many other ways.

    I am resigned that we must have controversy in order to go on with the program. It was very hard to watch Series 6 and see how mean-spirited his mother was, how life in the little house became so cramped. I wish the writers and producers well in their future productions and look forward to many more episodes of Doc Martin.

    I had never heard of Doc Martin until I went on a trek on the South West Path and met Port Isaac for the first time. I came home, looked online, watched one series after another, and then purchased Series 6. Great job.

  10. kjacobson@mindspring.com Post author

    Welcome to our discussion!! I think we all find a lot to admire in this show. It’s also good that we can have differences of opinion about a variety of things since we all have our own perspectives and can provide each other with new ways of looking at the characters and the themes.

    Although I agree that Louisa has her own issues to deal with and may not always handle Martin as well as possible, I still think the writers have made her a fully realized character that does no deserve to be blamed for how he acts or reacts. I can come up with many occasions when she has been the one who initiates physical contact, sometimes to her own chagrin. Here are some: she kisses him first in the car and after the concert, she kisses him on the cheek while riding her bicycle after he gives her something to end her nausea, she holds his hand at Joan’s funeral and when his mother tells him his father died, she kisses him goodbye when she’s leaving for work and tells him she’ll miss him, she kisses him goodnight in bed. I could go on. Louisa certainly knows Martin is kind and caring, and she admires him in many ways or she wouldn’t have married him. The townspeople are more inclined to call him “tosser” than anything else, although they do think he’s a good diagnostician and dedicated to their welfare. Much of the conflict in the first 5 series had a lot of humor. They decided to go with more serious plotlines for Martin and Louisa in series 6, although there’s certainly some humor too. I can see how Louisa’s teaching experience could be of more help to her than it sometimes appears to be in dealing with Martin, but I think she displays a great deal of warmth towards the students at the school. She certainly cares deeply for Peter Cronk and tousles his hair. She does other playful things along the way with various students. She also always knows their names and defends them and their behavior when necessary. She even ends up giving Becky the right to speak her mind in the school newspaper despite being angry at her for printing the paper without getting permission. I guess I feel that Louisa has been written as a strong woman with as much dedication to her job as Martin has to his and she should be seen as a female leader in the community who has the same difficulties as many females in jobs with authority: she must invoke authority as well as remain sensitive. Her mother’s comments in series 5, episode 8 emphasize the mixed up perception of her that she has to fight — her mother tells her she is surprised at how she looks like a “real teacher” when Louisa takes her into her office as headmistress. She’s in charge of the school and has been for a while, but even her mother has trouble appreciating that. The way women’s issues are depicted in this series is one of the reasons I like it so much.

    I’ve never been to Cornwall and would like to go. I, too, look forward to at least one more series. I hope to hear more from you in the future and hope my defense of Louisa’s character doesn’t strike you as too strong.

  11. Carol

    Karen, This is late but wanted to tell you about it. I had one of my fanfiction readers, who is a therapist, tell me that she would use EMDR with a patient like Martin. I had already read these posts and I have looked it up and written about it now. It is very interesting and has such good success. I don’t think I would have ever thought about Martin needing some special “trauma” therapy but I think this is a very good point to remember about him. He has been traumatized, yet one more level of abuse, and so no wonder he acts the way he does.

  12. kjacobson@mindspring.com Post author

    Carol, it’s never too late for a comment on anything. I wonder if the person who mentioned EMDR therapy to you is the same person who wrote a comment about it on this blog in early Dec., Santa Traugott. I had never heard of it then and have looked it up since. As Santa said when she mentioned it then, there is a “magical” quality about this therapy that makes me wonder if someone like ME would be willing to try it. He is so evidence based that it would take a lot of convincing in my mind. But he was willing to try cognitive behavioral therapy on his own and might try any number of therapies now that he’s committed to changing in order to save his marriage. Any therapy would be good to see being used and could be used as a combination of demonstrating an effort to change while also bringing in some humor. I’m looking forward to seeing if they go in that direction.

    In case you are wondering (which you may not be), I have another post I’ve been working on that may be fairly long again. I’ve been out of town with family and will be back home again today where I can work on it some more and hopefully publish it soon. I have read some of your fiction and want to write you about it soon too. Thank you for continuing to follow this blog. I really appreciate it and enjoy the exchange of ideas we all have.

  13. Carol

    Karen, It COULD be the same person going by a different id but I don’t think so. The lady who contacted me is a licensed therapist and is actually trained in doing EMDR. I can’t quite see her talking of it as having a “magical” quality – just doesn’t sound like vocabulary she would use – although from my reading about it, it sure sounds very miraculous. So much progress for so many in such a small amount of time.

    But my understanding is that to get training in this particular therapy is not so easy – the person who developed it only trained a small group of people to train others – and she evidently hasn’t developed any more trainers as of this time. Evidently it requires a lot of work on the part of the therapist being trained and then the patient when the therapy is used. I would love to talk to someone who has been through it about what the experience is like.

    Just another thing to like about this TV show – all of the intelligent, creative people who watch it and are willing to get on the internet and discuss it.

    I am thrilled to know that you have read some of the stories and would love to hear your “take” on them. You can use the private message feature on the site to contact me if you wish.

    Look forward to your next post.

  14. Santa Traugott

    No, it is not me that has been communicating with Carol. I was a therapist, but never trained in EMDR. I worked with colleagues who used it with what they said was a lot of success. I believe they can now tell a plausible story about why it works, but I have not followed the research.

  15. Linda

    What IS EMDR? I can’t see any explanation and I’ve certain l’ve never heard about it. Can someone enlighten me?

  16. Maria

    I’m sure others here have a much better understanding of this than I do, but in brief, EMDR is a psychotherapy called Eye Movement Desensitization and Reprocessing, originally developed about 20 years ago to treat trauma, particularly PTSD. It incorporates elements of more traditional therapies, like CBT, but focuses specifically on associating stimuli, particularly eye movements, with the traumatic memories. The patient is thus attending to two things simultaneously – visual images of the memory and a visual stimulus; for instance, the patient is instructed to follow the therapist’s fingers while thinking of the traumatic image or event. (Aside: this is also done as part of a neurological exam, as we have seen ME do many times, but he is not asking the person to simultaneously focus on a traumatic memory). The goal is to gradually replace negative ideas and feelings about oneself with positive ones, leading to stress reduction, cognitive insight, and associated improved coping skills. Many people believe strongly in EMDR’s effectiveness. Others claim that the theory is not sufficiently scientific (and thus not verifiable or refutable), that the therapy is not as effective as it claims, or or that if it is effective, that is not due to not to the eye movements. My explanation here is very elementary and does not do the underlying theory or the process justice. If you google the whole name, not just the abbreviation, I’m sure you will find much more extensive information!

  17. DM

    Well, then this note would be really, really late… EMDR does show some therapeutic efficacy that some early research supports the theory that its usefulness stems from a similar brain mechanism to REM sleep (which it emulates in practice). In a very broad sense its usage is in the vein of “embodied cognition”, a very popular topic these days in the field of neuroscience.

  18. Bill

    Do you have any thoughts on how the story of the frog given to Martin at age 5, and it’s subsequent dissection, might play into his phobia and Louisa issues? Could it be Martin really didn’t want to dissect the frog but suppressed his emotions and just got on with it?

  19. kjacobson@mindspring.com Post author

    Welcome to the blog Bill. I have to say that the question you have posed is somewhat out of my league. It also requires a lot of conjecture, which is something I hesitate to engage in.

    I’m pretty sure there is no blood when a frog is dissected. (I remember doing that in biology class in high school many years ago.) You can find a frog dissection on You Tube if you want to see how it’s done. Of course some 5 yo boys would be squeamish about cutting up a dead frog and others would be fascinated. Martin might have been fascinated, especially if his grandfather went through the dissection with him. My personal point of view is that when Martin tells Louisa about the gift of a frog it was both another odd thing to say and have as a memory that was distinctive to him, and he was likely to have considered it a special event in his childhood. How it might be connected to his blood phobia or his issues with Louisa escapes me. From what we know about him, he enjoys watching medical interventions on videos and doesn’t appear to be bothered by them when they don’t include blood, e.g. the brain abscess removal he watches on his laptop in the kitchen. His explanation about when his phobia first appeared had more to do with realizing that the person he was about to operate on was a member of a family who was concerned about her. To him the phobia was related to attaching importance to the person on the surgical table and not to the actual carrying through of the surgery in itself. Obviously he was unable to cut into the person on that occasion and then became averse to seeing blood. It’s a little curious that he was a vascular surgeon, which particularly focuses on the parts of the body that carry blood: arteries and veins. Being unable to look at blood without becoming nauseated would certainly make it impossible for him to operate.

    Maybe others would like to offer some thoughts.

  20. kjacobson@mindspring.com Post author

    Another thing that came to mind is that so much time elapsed between being a 5 yo dissecting a frog and becoming a surgeon. The space between these two events would make it unlikely that the early childhood event would have had much of an impact later on. ME also says surgery was the only thing he was ever good at. I could see how dissecting the frog with a grandfather who was an accomplished surgeon might have led to him choosing surgery rather than giving him a phobia.

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