Flexing muscles can beat your fear of needles
A Covid vaccine jab will be a trial for those with trypanophobia, but there is hope...
From trips to the dentist to vaccinations, injections are a mainstay of modern medicine. And, while it’s fair to say few of us really like them, the mere thought of a needle is enough to make some pass out.
Up to 10 per cent of the UK population has a needle phobia and, with the biggest vaccination programme in Britain’s history under way — in which at least 30 million adults are due to be offered two shots of the coronavirus vaccine — millions of trypanophobics, as needle phobia is known, could be struggling with fear over the next few months.
‘If someone does have an extreme needle phobia it could stop them going for their coronavirus vaccine,’ says rose Aghdami, a chartered psychologist i n London who specialises i n treating anxiety and phobias.
Even if they ‘really want the vaccination’, this phobia will stop some people from having it, says Elisabeth Huis in ’t Veld, a neuroscientist researching the phobia at Tilburg University in the Netherlands.
‘They will say “I’m just too scared — I can’t.” ’
As well as passing out, other symptoms of needle phobia include dizziness, a dry mouth, palpitations, sweating, trembling, shortness of breath and nausea.
The symptoms occur as the brain triggers the ‘fight or flight’ response, sending chemical messengers around the body to prepare it for action, including the heart (speeding it up), and shutting down the digestive system ( to preserve energy). Trypanophobia can lead to people delaying or avoiding all kinds of medical treatment from dental fillings to IVF ( which typically involves multiple injections), says Dr Huis in ’t Veld.
‘ my research shows that around 40 per cent of people with a needle phobia refuse some sort of medical treatment due to their fear,’ she adds. ‘And 29 per cent of those with needle phobia say it means they are in worse health than they would otherwise be.
‘It’s very sad. This phobia just doesn’t get t he attention it deserves.’
Indeed, when Dr Huis in ’t Veld surveyed around 200 people with needle phobias last year one in five told her they avoid vaccinations. (Although a nasal spray is used to immunise children against flu, most vaccines are given as injections.)
She believes that we are hardwired to be wary of needles — it’s been suggested that a fear of sharp objects would have helped protect our ancestors from potentially fatal wounds from, for example, thorns, jagged rocks and animal claws.
EVIDENCE for hardwiring includes a study in which she measured stress in more than 370 men and women as they donated blood. Almost every participant, including those who didn’t think of themselves as afraid of needles, experienced a surge in bl ood pressure or ot her physiological changes associated with stress, the transfusion medicine journal Vox Sanguinis reported in 2018.
What triggers an inbuilt but non-problematic wariness of needles into a full-blown phobia varies, but it is thought to include an upsetting experience with needles when young, such as a painful vaccination, says Dr Huis in ’t Veld. It is also believed we can ‘learn’ the phobia from others, and studies show up to 80 per cent of adults with a needle phobia had a first-degree relative (such as a parent or sibling) with the same fear.
‘People may well pick up from others in the family that injections are a nasty thing to have,’ says Dr Aghdami. ‘Similarly, with other phobias, if you have a parent who is very afraid of spiders and children notice this, they may learn this is the way to behave around spiders.’
The good news is that needle phobia can be treated, especially if the patient is motivated to overcome it, she adds.
The charity Anxiety UK recommends exposure therapy, hypnotherapy and cognitive behavioural therapy (cBT), a ‘talking therapy’ that helps people manage problems by recognising how their thoughts affect their feelings and behaviour, as treatments for needle phobia.
Exposure therapy is also used to treat other phobias such as f ear of spiders. It i nvolves gradually exposing a person to the stimulus they fear, to make it less daunting.
Anxiety UK has detailed information about how to do it alone on its website. Your GP can refer you for cBT, or you can self- refer, through the NHS website (going private costs £40 to £100 per session).
Those who are afraid of needles but would like to be vaccinated against coronavirus might want to start by simply driving past the vaccination centre, says Dave Smithson, Anxiety UK’s operations director.
once they are comfortable with this, they could go inside and talk to the receptionist. The next step would be to chat to a nurse who gives the jabs there, followed by having the vaccine.
‘most GPs are aware of needle phobias and how debilitating it can be,’ says mr Smithson, ‘and they would be happy to arrange for patients to gradually get to know a vaccination centre ahead of having their jab.’
Guy’s and St Thomas’ Hospital i n London s uggests t hat patients whose fear makes them prone to fainting practise a t e c hnique c al l e d applied t ension ahead of starting exposure therapy.
THISinvolves tensing the muscles in your arms, upper body and legs for ten to 15 seconds or until you start to f eel a warm sensation in your face. You then release the tension for 30 seconds, before repeating the tense-release sequence four or five times.
Three such sets of the exercise should be done each day for around a week, before moving on to exposure therapy.
It is designed to bring blood pressure levels back to normal — fear can make blood pressure rise then rapidly fall, leading to f ainting. The technique is designed to raise blood pressure, making fainting less likely.
other fear-busters range from a smartphone game to simply s mili ng. The Ainar a pp, which was developed by Dr Huis in ’t Veld, consists of a game in which coloured blocks turn blue or red when the user touches a phone’s screen.
The aim is to keep the blocks blue (or change them back to blue if they turn red), but the only way of doing this is for the player to keep their anxiety levels low (or to make them fall if they start high). This is calculated using the phone camera, which scans their face before the app feeds the images into an algorithm which uses signs of fear in their expression to calculate how worried they are.
The user isn’t given instructions on how to lower anxiety levels; rather, the idea is they will find a method that works for them, whether it is breathing exercises or thinking of a time when they were relaxed.
It is too early to say how well the app works, but it draws on the principles of biofeedback, a therapy used to treat conditions from urinary incontinence to tinnitus (ringing in the ears).
meanwhile, a study published in the journal Emotion this month found that participants who smiled broadly as they were given an i njection found it roughly half as painful as those who kept a neutral expression.
The University of california researchers say smiling may trick the brain into perceiving less pai n because it is something it usually associates with happiness.
Whatever the nature of the phobia, experts say it’s important to recognise they are ‘very real’ to the person experiencing them, says Dr Aghdami. ‘Needle phobia does need to be taken seriously — it’s not somebody just making a fuss.’
To find out more about the Ainar app, go to ainar.io