Overcoming your fear of needles

Many people have this fear, but it can be overcome with simple exercises and practice. Especially with the importance of the Covid-19 vaccine, it is something that can be worked on.

Watch this short video in which Glory, an Assistant Psychologist at Keeping Well, explains needle phobia and treatment.

For some people, it is linked to fainting, or feeling faint. When their fear is triggered (for example, by seeing blood or thinking about an injection), their heart rate and blood pressure increase (as with other kinds of fears), but then rapidly drop. It is this fall in blood pressure that can cause fainting. Many people do not confront their fear because they are worried they may embarrass or hurt themselves through fainting.

Other people do not feel faint or actually faint, but do feel panicky when their fear is triggered.

What can I do to overcome my fears?

First of all, do tell the person who is co-ordinating your care, or the person who is giving you your injection or blood test, about your worries. They may be able to answer any specific questions you have. They may also be able to help you cope with the procedure, for example, by chatting to distract you.

Also, think about whether there been has anything which has helped you to cope with needles in the past. Can you use something like this to help you again?

If your fear is linked to fainting (or feeling very faint), the next step is to teach yourself applied tension.

If you feel panicky (for example, your heart races, your chest feels tight and your stomach churns), but do not feel faint, the next step is to learn breathing for relaxation.

These exercises are safe in pregnancy, and with most medical conditions.

Applied tension

Applied tension is a simple technique to increase blood pressure back to normal levels, so that you do not faint.

This how you do it:

  1. Sit down somewhere you are comfortable
  2. Tense the muscles in your arms, upper body and legs and hold this tension for about 10-15 seconds, or until you start to feel the warmth rising in your face.
  3. Release the tension and go back to your normal sitting position
  4. After about 20-30 seconds go through the tension procedure, again until you feel the warmth in your face.
  5. Repeat this procedure so that you have practised the tension 5 times.

If you can, practise this procedure three times every day for about a week, before moving on to the next step. This will help you to build your confidence in using the procedure and increasing your blood pressure. It will take about five minutes on each occasion. It may be helpful to think ahead and plan for when you are likely to have a few spare minutes to do it.

If you get headaches after doing this exercise, take care not to tense the muscles in your face and head. Also, go gently when tensing any part of your body where you have any health problems.

Breathing for relaxation

Sit in a comfortable position, with your back upright but not stiff. Let your shoulders and jaw relax. Put one hand low down on your belly. Take a long, slow, deep, gentle breath, in through your nose and out through your mouth. Try to breathe right down into your belly, but don’t force it. Just let your body breathe as deeply as is comfortable for you. Do this for five breaths.

If possible, practise this exercise three times every day for a week, before moving on to the next step. This will help you to build your confidence in doing the exercise and using it to relax. It will take less than five minutes on each occasion. It may be helpful to think ahead and plan for when you are likely to have a few spare minutes to do it.

Using a hierarchy

Once you have mastered applied tension or breathing for relaxation, the next step is to develop a “hierarchy”; a list of all of the situations related to needles which you fear, arranged in order of difficulty. This might include thinking about procedures, seeing pictures of them, watching them on video and in real life, and actually having them done.

Rate each situation on a 0-10 scale, where 10 is the most difficult and 0 is not difficult at all.

Write down your own hierarchy

Try to include some situations which are not too difficult. These are the ones you will start with. Think about what makes a difference to how difficult a situation is. For example, you might find it easier to look at a picture of a small needle than of a large one. Then:

  1. Start with the least difficult item on the hierarchy (e.g. thinking about having an injection, in the example above).
  2. Plan enough time so that you can stay with the anxiety long enough to watch it peak, stay on a level for a while, then gradually reduce. Staying with it allows you to see that this is what anxiety does.
  3. Begin to use applied tension or breathing for relaxation, as you have been practising.
  4. Go into the situation, and stay with it until your anxiety has started to drop.
  5. Take some time to relax, perhaps using the breathing for relaxation exercise.
  6. When you feel confident with one situation, move on to the next one up the hierarchy. You may need to practice with one situation on several occasions before you are ready to move on to the next one.
Hiararchy example
Situations Distress rating
Having an injection in my arm 10
Holding a needle 9
Touching a neddle 8
Watching someone else having an injection in real life 8
Watching a video of someone having an injection on Youtube 7
Looking at photos of injections 6
Listening to someone talking about having an injection 6
Thinking about having an injection 5

Overcoming your fear will take some time and practice, but in the long run, it will make your life less stressful and freer from anxiety.

Reference: Dr Jane Hutton, Clinical Psychologist, King’s College Hospital.

Updated on: 09/05/2022