Needle fear is often thought of as a children’s problem. It is not. A large number of adults dread injections and blood tests, and a good many avoid them altogether: no vaccinations, no blood tests, no dentist, sometimes for decades.
It is nothing to be ashamed of, and it responds well to treatment. Hypnosis can help, but the first thing to work out is which kind of needle fear you have, because one type needs handling differently.
Two kinds
The anxious type. Your heart races, you sweat, you feel panicky and want to escape. This is the ordinary fear response.
The fainting type. Your heart rate and blood pressure rise briefly and then drop sharply. You go pale, clammy and light-headed, your vision narrows, and you may pass out. This is called a vasovagal response. It is common with needles, blood and injuries, and tends to run in families.
Many people have a mixture, and people who have fainted once often become afraid of fainting again.
Why it matters: deep relaxation, which is the usual advice for anxiety and the usual feel of hypnosis, lowers blood pressure further. If you are a fainter, relaxing during the needle can make fainting more likely.
If you faint: applied tension
The standard technique for fainters is applied tension, developed by the Swedish psychologist Lars-Göran Öst. It raises blood pressure for long enough to prevent a faint.
- Sit comfortably.
- Tense the muscles of your arms, legs and trunk, and hold for ten to fifteen seconds, until you feel warmth rising in your face.
- Release, back to normal. Do not go floppy.
- Wait twenty to thirty seconds.
- Repeat five times.
Practise three times a day for a week. Then use it before and during the procedure, keeping the arm being used relaxed while tensing the rest of your body. Start again at the first sign of light-headedness.
Also:
- Tell the person doing it that you tend to faint
- Ask to lie down
- Eat and drink beforehand
- Do not jump up afterwards. Sit for ten minutes.
If you have a heart condition or high blood pressure, check with your doctor before using applied tension.
Where hypnosis fits
For the anxious type, hypnosis is well suited. For fainters, use it for the dread beforehand and for mental rehearsal, with an alert, focused state at the time and applied tension when the needle is near.
Hypnosis helps with:
- Anticipation, which is often worse than the event
- Changing the mental film you run beforehand
- Shifting attention during the procedure
- Altering sensation in the arm
- Rehearsing the whole thing going well
The evidence for hypnosis in adult needle phobia specifically is limited. The best-supported treatment is gradual exposure, which hypnosis can make easier.
A step-by-step plan
Step 1: Build a ladder.
List situations from easiest to hardest. For example:
- Reading the word “injection”
- Looking at a picture of a syringe
- Watching a short video of a blood test
- Holding a capped syringe
- Sitting in a clinic waiting room
- Having a tourniquet put on
- Having the skin cleaned
- The needle itself
Step 2: Learn your calm, or your tension.
Anxious type: practise a short self-hypnosis routine daily. Slow breath out, soften your body, go to a place you like.
Fainting type: practise applied tension daily.
Step 3: Climb the ladder in imagination.
In self-hypnosis, picture the first step while staying steady. When it is dull, move up one. Stay with each until your discomfort has clearly fallen.
Step 4: Climb it in real life.
Do the same with the real thing. Stay at each step long enough for the fear to drop. Leaving at the peak teaches your body that escape was necessary.
Step 5: Rehearse the whole appointment.
Run it through from arriving to walking out, seeing yourself cope. Include a wobble and recovering from it.
Step 6: Book it.
Choose a quiet time. Tell them when you book that you are afraid of needles.
On the day
- Say so. “I’m very nervous about needles.” Staff see it daily and will adapt.
- Ask for what helps: lying down, not being shown the needle, a countdown or no warning, as you prefer.
- Ask about numbing cream or cold spray.
- Look away, at a fixed point or at your phone.
- Breathe out slowly as the needle goes in. Do not hold your breath.
- Give your attention a task: count backward in sevens, name countries, press your toes into the floor.
- Try the numb arm: imagine the arm in a thick glove, or packed in cold snow, and let it belong to someone else for a minute.
- Fainters: tense, release, tense.
- Afterwards, sit quietly, have a drink, and take a moment to notice that you did it.
Things that make it worse
- Avoidance. Each appointment dodged strengthens the fear.
- Arriving early and waiting a long time.
- Caffeine beforehand.
- An empty stomach.
- Watching the needle if that sets you off.
- Being told to pull yourself together.
- Being held or rushed.
When to get help
See your GP if fear is stopping you having tests, vaccinations or treatment you need, or if you are pregnant or have a condition such as diabetes that involves regular needles. In England you can refer yourself to NHS Talking Therapies. Treatment for specific phobias is brief and usually works well, sometimes in a single long session.
A hypnotherapist can help with the imaginal steps, but should work within a graded exposure plan and should ask whether you faint.
The bottom line
Needle fear in adults is common and very treatable. Find out whether you panic or faint. If you faint, learn applied tension and stay alert. If you panic, use self-hypnosis to settle the dread and rehearse. Then take it one step at a time, and tell the person holding the needle.
Next in the series: Twelve Common Self-Hypnosis Mistakes, and How to Fix Them
This article is for general information and is not medical advice.