| Disclaimer: The “Spooky Season” blogs are for educational purposes only and are not intended to serve as a substitute for professional mental health care, diagnosis, or treatment. Some of the blogs in this series include topics that are distressing or triggering for people who experience related fears or phobias. Please use your discretion when reading. |
| Needle Phobia: When Fear Gets in the Way of Getting Care |
| Pumpkin picking, corn mazes, ghost stories around a campfire, haunted houses with creepy medical rooms. These are all things that I can think about when considering activities to participate in during the fall. Some people may prefer to skip out on the last two (myself included!) because they know they’re easily susceptible to these types of scares, but they are also aware that these fears are not really real–they’re driven by the imagination that the story or surroundings create. But let’s pivot to a second to a very real fear for some people–that of needles. Most people don’t particularly enjoy getting poked and prodded, so when does that fear become a phobia? While choosing to avoid the haunted house is not going to dramatically interfere with much more than your social life, avoiding needles because of a clinically significant fear may mean lack of access to medical care that you need. Trypanophobia is an intense irrational fear of medical procedures that involve injections or hypodermic needles. Trypanophobia is way more than the “I don’t want to” or “I’d really rather not” thoughts that plague most of us when heading in for routine bloodwork. Those with a needle phobia avoid might: avoid appointments, delay bloodwork, feel faint, experience panic or nausea, and have high levels of distress just thinking about accessing medical care, let alone anticipating an injection! Why are needles such a powerful trigger? Well, there is the pain and injury associated with them. There’s a distinct loss of control–someone else is usually administering the needle (and in the case of an EpiPen needing to be used, its use is because things ARE already dangerous for you!). The visual of a needle being held in a nurse’s or tech’s hand can be hard to tolerate, especially if we add in the times they have to squirt a little out of the needle before injecting it into you(yuck, even typing this makes my stomach roll!). It could also be the anticipation of what the actual shot may feel like, or for some, how long they will feel sore AFTER the shot. Blood-injection-injury responses and fainting can also be relevant past experiences that influence current perceptions and fears. This is why so many people with a needle phobia avoid needles! Avoiding the needle produces immediate relief–but it also teaches the brain that avoidance is keeping you safe. This makes the next appointment even harder to get to, creating what often becomes a cascade of missed appointments. This may mean a lot of missed vaccines in younger kids, or in adults, a lot of missed rounds of bloodwork—both of which can lead to actual medical issues–all because of a negative reinforcement cycle. Negative reinforcement cycles are what were just described—a repeating loop where a behavior (avoidance) increases because it removes or stops an unpleasant feeling or situation (anything with a needle). So, how do you learn to manage that fear response and negative reinforcement loop that kicks up every time there is a doctor’s appointment on the schedule? Exposure based treatment. No, this does not mean going to the doctor and catching up on all of those missed shots in one visit! It does mean building a gradual hierarchy so that you can learn how to stay in the situation that produces the fear rather than escape. It’s also important to address the cognitive distortions that are often present–the catastrophe you are worried about is a prediction, not a fact! Finally, if your response includes a lot of somatic responses, using [panic treatment models can help as well. So, when do you actually need to do all that? When your fear is preventing routine medical care; when your anxiety about routine medical care is beginning weeks before your appointment; when your avoidance is affecting your health decisions; when your panic or fainting responses make medical procedures you know you need difficult for your providers to complete. The goal of treatment won’t be to make you love a trip to the doctor, an injection, a blood draw or a vaccination. The goal is to build the ability to tolerate the discomfort and fear that these situations can produce without letting fear and avoidance make the choice for you and your medical needs. |