Ask the Experts: Medical Phobias

A: Fear of any medical situation, such as visiting medical settings, getting injections, seeing blood, or watching procedures. It’s common to be uncomfortable with these situations; it becomes a phobia when fear interferes with a person’s life. 

 

A: A person may have a negative experience— for instance, a painful medical procedure that triggers the fear. Or perhaps a person’s parents were afraid, and the child learned from them. What keeps fear going, however, is avoidance of the situation—so it’s best not to do that.

 

A: People who are highly sensitive and easily anxious may be more likely to develop phobias following a negative event. Men and women suffer equally from medical phobias.

 

A: That depends on the phobia. For someone who is afraid of the dentist, for instance, it’s a

panic response: dizziness, increased heart rate, breathlessness, muscle tension, anxiety, and worry in advance of the situation.

With most fears, like fear of public speaking, you get an increase in blood pressure and heart rate. But with blood and needle phobias, it’s the opposite. In fact, 70% of people with blood phobias and 50% of those with needle phobias actually faint. A drop in blood pressure causes fainting; it’s the body’s way of preventing blood loss. 

 

A: If patients can’t “unlearn” the fainting response by being exposed to the situation enough times to overcome it, they can try a technique called applied muscle tension, which increases blood pressure. Before having an injection or blood test, sit as comfortably as possible and contract—or “tense”—the muscles in your legs, arms, and torso. Hold the contraction until you experience a warm feeling—or “rush”—in your head. This usually takes 10 or 15 seconds. Then relax for 30 seconds. Repeat this procedure four more times.

 

A: The most helpful treatment is repeated exposure to the situation—especially for blood and needle phobias. For dental phobias, cognitive behavior therapy (CBT) can help. CBT helps people identify patterns of negative thinking and replace them with more realistic ones. Relaxation techniques—such as deep, slow breathing, and tensing and relaxing different muscle groups—may also be useful.

 

A: Force yourself to confront the situation in a prolonged manner. If a person were afraid of hospitals, I’d want him or her to spend an hour in that setting several times a week. Start with small fears and work up to the worst ones. Remember that behavioral and pharmacologic treatments are available. People don’t need long-term psychological treatment to overcome phobias.