Standing up to anxiety and needle fears and phobias

Needle fear or phobia is extremely common. It can be something that has been brought on by an experience of feeling faint, unwell, pain or bad bruising during/after a blood test, or it could just be the idea of needles which for whatever reason has always been there or developed over time.

It is common for patients who undergo repeated tests in treatments for IVF, pregnancy or oncology for example to sometimes develop needle phobia which causes distress and fear of injections, blood tests, cannulas or vaccines.  

Common experiences include:

• a racing or pounding heart rate
• high blood pressure
• feeling dizzy or faint
• fear of the clinical setting and anticipating an injection or blood test 
• fear of seeing the needle
• sweating or feeling nauseous
• a feeling of holding one’s breath, shallow or rapid breathing

You may have tried things to help such as telling the health professional and seeking reassurance-this is always a good thing to do as they will be more aware and will have encountered this many, many times before. It is very common.  

You could also try:

• Lying down, as having your feet level with your heart may reduce the feeling of light-headedness and is safer if you do feel faint.
• Looking away or closing your eyes. 
• You may like them not to say when they are about to proceed, or use a different phrase or word or your choice to warn you-something simple like "well done" rather than "sharp scratch".
• Using music or meditation recordings beforehand to help you feel calm.
• Taking someone with you to appointments.
• Deep breathing during the procedure.
• If it is an arm injection, having someone stand on the opposite side and hold your hand or rub the opposite upper arm can be distracting and helpful.

If it is a blood test, and your treatment allows, it is a good idea to go to the test well hydrated as this can make accessing the vein easier for the phlebotomist.  Thinking about it, when we’re worried drinking enough water can be the last thing we think of or feel like doing but it can help. This can be particularly helpful for oncology patients for example, who may have more difficult access due to previous chemotherapy.

Emla cream (a local numbing cream which works on the skin) may also help and may be available to you at your treatment centre for cannulas or bloods –sometimes keeping the arm warm or even applying a hot pack can encourage difficult veins to be more cooperative.

Whilst these can be beneficial, they may not work well enough for everyone or in long term, and you may benefit from a little more help and support. 

How can hypnotherapy help?

Hypnotherapy can certainly help with dealing with phobias, including needle phobia. There are many different strategies and approaches which can be employed to help someone, but I always find a personalised approach works best.  

Everyone is different, every background story is unique, and every personality will be more drawn to their own preference of techniques: for example, some may favour a more cognitive, thought-led approach whilst others will respond to more creative or experiential solutions such as those who have strong kinaesthetic tendencies. Whilst a session in isolation can be helpful, it usually takes a course of sessions to see a change and improvement in dealing with needle phobia. 

Relaxation and the stress response

Hypnotherapy can be extremely effective and an enjoyable way of inducing relaxation. If you’ve had a bad experience with needles, it may be that the next encounter triggers those memories or feelings or may make you more aware of sensations or pain. Difficult memories can induce an unhelpful stress response in the body when there are reminders or triggers – you can read a bit more about the stress response in my article about health anxiety.  

Hypnotherapy can calm the stress response and soothe the nervous system so that you feel more relaxed and in control of your mind and body, but it doesn’t stop there. Deep relaxation allows us to access a more creative, innovative part of the brain which is very good for problems solving including overcoming fears and phobias.  

Hypnotherapy can use techniques such as breathing techniques and muscle relaxation or sensory suggestions to feel calm and induce this more innovative way of thinking. I can teach the client to replicate this calm in self-hypnosis to use outside sessions which is a great skill to have in general but also wonderful in preparation for situations where needle fear may be an issue.

CBT

Using CBT exercises prior to hypnosis can help identify any unhelpful thoughts that may be associated with needle fear. Together we can start to unpack the cycle that may happen based on those thoughts such as catastrophic fear of pain or harm from the needle and how this affects feelings and behaviours – a vicious cycle.  

We can identify the desired or more helpful thought that could be substituted and explore what results this would have for your thoughts and feelings – a virtuous cycle. I can also use your personalised choices during hypnosis to underpin these desirable and helpful thoughts and suggest that they are easy to recall and use when needed. 

The fear ladder 

It may be that there are different degrees of fear about the process of encountering needles, and we can work together to identify these. By understanding and scaling or scoring the degrees of fear we can chip away at the scores.

For example, starting with something that is mild such as booking an appointment involved with needles, you can experience how it feels to desensitise that fear by talking about making the booking and the benefits, whilst feeling very relaxed or rehearsing a new pleasant feeling paired with making the booking in hypnosis. This allows you to experience making the decision for yourself to let go of those old unhelpful reactions and the substituted positive feelings of calm and control.  

We may also use anchors for example, which are simple physical gestures paired with a positive emotion which serve to restore a sense of control both in session and when using them again outside sessions. 

A safe place 

The mind is so powerful and always needs something to think about. Without an agenda, the mind will easily focus on what it might perceive as a threat (or what has been threatening in the past) and amplify this fear in order to keep us on alert, and safe. However, it has the opposite effect if we are feeling overly alert and anxious about something which is a straightforward intervention that we want to have for our health.  

If we intentionally create and repeat the experience of going to a safe place this can be used to control needle phobia in dentistry appointments, claustrophobia or during anxiety-inducing scans as well as routine blood tests. I have had clients who were previously extremely anxious about scans, able to use hypnotherapy techniques to actually induce the feeling of being safe and calm in the place of their choice such as a beach or garden for example. The confidence of experiencing this builds as the person realises they have control over their mind and emotions using such techniques.

Imagery and altered sensation

Once you are deeply relaxed, I may use imagery such as a magic glove giving a feeling of altered sensation to the hand. You are completely in control of this and, should you wish to use the technique can dial up or down the sensitivity of the hand to allow it to feel similar to being numb, like having had ice on the skin for a short period, or comfortably warm, or a comforting colour for example.  

This sensation can then be moved to the cubital fossa (the area in the fold of the inner arm) or another site so that you can be prepared and more in control meaning you’re able to calm yourself, but also let the healthcare professional know when you’re in that calm state and ready for them to proceed which is a much more active and empowered position.

There are many ways we can work together to overcome this very common phobia. The important thing is that you take steps to gain support. A GP is always a good place to start to ensure it isn’t something that is part of a more complex issue.  

Hypnotherapy has helped many people overcome needle fear, and the benefits mean that you can let go of the anxiety and are able to attend appointments and treatments to take care of your health and well-being. It's also a great feeling to stand up to anxiety, overpower it and know that you have the inner resources to cope – as many clients have said to me, they only wish they had tried hypnotherapy sooner. 

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