As we put a difficult year behind us and emerge blinking into the light of a new and better year, measures to immunise the population against the ravages of Coronavirus are under way. Given the heroic efforts of the scientific community to produce vaccines in a matter of months which would normally take years to develop, you’d think we’d all be rushing to join the queue.
But more than ten percent of us are likely to be quaking in our boots at the prospect. Needle phobia, or ‘trypanophobia’, is one the most common fears I have helped people to overcome and never more so than now.
And yet the use of vaccines has saved us from many of the most dangerous diseases known to mankind which damned our forebears to short and unpleasant lives and often painful, lingering deaths. So having a vaccination against a deadly virus is a no brainer, right? Wrong. If you have a needle phobia, that is.
PHOBIAS MAKE NO SENSE
The definition of a phobia is an exaggerated or unrealistic sense of danger which creates an overwhelming and debilitating fear. It’s the lack of logic and reason that confounds most phobia sufferers. Being terrified of the momentary discomfort of an injection makes no sense. Anyone who has been reduced to a gibbering wreck at the prospect of this simple, perfectly safe, commonplace medical procedure will be embarrassed and humiliated by their fear.
And I should know. I went to the doctor with a nasty bout of tonsillitis while on holiday in France some years ago expecting to be prescribed oral antibiotics. When he got out a horse needle (it must have been at least a foot long), I instinctively backed away clutching at my arm. With an evil glint in his eye, he pointed at my bum. That is how I ended up whimpering in a corner with my jeans around my knees thinking I’d rather die than let that doctor anywhere near me.
I got over the tonsillitis but the trauma of that experience is etched in my memory. My reaction to being stabbed by a needle was purely instinctive. Luckily, because of some simple hypnotherapy techniques, injections are no longer a problem.
SURVIVAL INSTINCT
Our basic need for survival is neurologically hardwired to protect us against any perceived threat. The trouble is, the evolution of the human brain’s defence systems hasn’t caught up with the evolution of science and technology and we’re still programmed to react as if living in primeval conditions. This can cause a few complications.
For example, the flight or fight response overrules logic or reason to enable us to react instantly, without pausing for thought, to a predatory attack. This accelerates our bodily functions and increases the production of inflammatory hormones. Not useful when you’re sitting in a doctor’s surgery with no man-eating bears in the vicinity.
This turbocharging of our senses and physical ability gives us the strength and energy to run or defend ourselves. Like a vehicle being driven at top speed, we overheat and our parts wear out more quickly. Luckily, our nervous system can counteract this tendency but not without some equally uncomfortable side effects.
A nerve called the vagus connects our brain and body, affecting the functioning of our senses, vocal cords, heart, lungs, blood vessels and abdominal organs. As the vagus nerve calms down the flight or fight response, it causes our heart rate to slow right down, blood pressure to drop, waves of nausea and the possibility of fainting.
When the fight or flight response is activated in the waiting room and then the vagus nerve kicks in to slow things down, lots of needle phobics will faint as their blood pressure crashes from high to low. There are many different triggers for this see-sawing between what are described as the sympathetic (fight or flight) and parasympathetic (rest and digest) parts of the autonomic nervous system.
A typical example of the needle phobic’s anticipatory anxiety about a vaccination goes something like this: from the moment an appointment is made is a roller coaster ride of panic symptoms, including heart palpitations and clammy hot and cold sweats. There will be restless nights, bouts of loose bowels and nausea and a sense of dread which disturbs sleep and fills every waking moment. These will increase in intensity as the day approaches.
THE FEAR FACTOR
There are no fewer than 10 routine vaccinations provided by the NHS between birth and age 14, plus occasional boosters or travel vaccinations and a covid vaccination which may be necessary every year like the flu jab. Many of those are administered during the first two years of life. During that period of rapid brain development, we are neurologically accumulating nice and nasty experiences which are filed away in our subconscious for future reference.
Every mother will recall a baby’s howls when a needle is jabbed into their unsuspecting arm. Who knows if this sets us all up as we get older to recoil at the sight of a needle? As we get older and more aware of what’s ahead, we’re programmed to avoid or move away from anticipatory pain. This desire to protect ourselves is so powerful, I’ve seen otherwise docile people who get wound up to such a pitch that they become violent, lashing out at anyone who gets in the way of them getting away from a syringe brandishing clinician.
As far as our primitive survival instinct is concerned, any pain is bad or dangerous. It doesn’t compute that medical science has given us the means to live longer and be healthier and that some of the ways it does that will hurt. It is this neurology that also objects to the drawing of blood, which can be a very specific form of needle phobia based on the fundamental fear that, if we’re bleeding, we might die.
TRUST ME, I’M A DOCTOR
Medics are trained to heal and managing the pain caused by treatment is a secondary priority. Also, they often use medical jargon and language which doesn’t take into account the emotional impact on their patients. There is little training in what’s euphemistically described as ‘bedside manner’ and busy doctors and nurses may not always have time to show empathy and understanding of a needle phobic’s terror.
Interestingly, these days dentists are somewhat better in that regard because their effective management of anxiety and pain makes it much easier and quicker for them to treat worried patients. Most dental phobics I see are older and have experienced more brutal dentistry in childhood.
There is much that could be done through training in use of language and how to communicate with patients which would improve the experience of painful medical treatment. When someone wearing a white coat tells us something will hurt, we believe them. If they say ‘this won’t hurt much’, we don’t believe them because they’ve just told us something will hurt and our unconscious mind fixates on that without caring how much!
Clinicians will often describe an injection as a ‘sharp scratch’. That description would make anyone wince and tense their muscles which then causes more resistance and discomfort as the needle goes in. This is described as the ‘fear, tension, pain cycle’ and is one of the reactions that increases pain in childbirth, for example.
In any event, injections of any kind are rarely that painful and needle phobics will report that pain is not the problem. Like any phobia, their fear is irrational, illogical and defies any reason. It may be triggered by memories of circumstances or environments which are associated with the fear. This can lead to a fear of the fear and its symptoms as the sufferer recalls feelings of panic and lack of control.
TAKE CONTROL OF FEAR
There are some simple techniques to deconstruct those triggers, dissociate from the situation and desensitise the emotions to make the experience of having a vaccination tolerable (bear in mind, having a vaccination is never going to be a fun way to spend the afternoon).
- Think of a time or place when you were having an amazing time and vividly recall how that felt, focusing on memorable details of that positive experience. This can then be a ‘happy place’ to take yourself to while being vaccinated.
- Play a few bars of a piece of music you find empowering or sing the lyrics of something inspirational in your head. If it makes you smile like Miranda singing ‘Search for the Hero’ all the better. This is described as an ‘ear worm’ and is a powerful way to tap into confident emotions.
- When you feel panicky, take three long, slow, deep breaths and repeat the words ‘calm, confident and in control’ (or words to that effect) with each breath.
- Swipe any tendency to overthink out of your mind just like you’d swipe something off the screen of your phone (or swipe left on a dating app).
- If the vaccination is in your left arm, focus your attention on your right arm (or your big toe or any other part of your body which isn’t having a needle stuck in it).
There are various other hypnotic techniques which, with a bit of practice can rid a needle phobic of their fear so they can have life-saving treatment and protect others from contagion. The survival of millions depends on all of us being vaccinated at the earliest opportunity. This is the fastest and most effective way of stopping the covid pandemic in its tracks. With such high stakes, it’s in all our interests to suffer the momentary discomfort of a little prick.