Health

Tensing muscles could help those with a fear of needles

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.

Up to 10 per cent of the UK population has the needle phobia trypanophobia. (Stock image)

‘If someone does have an extreme needle phobia it could stop them going for their coronavirus vaccine,’ says Rose Aghdami, a chartered psychologist in London who specialises in 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 the 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 hard-wiring 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 blood pressure or other 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.

Under the microscope: Actor Simon Williams, 74, answers our health quiz

Simon Williams, 74, plays Justin Elliott in Radio 4's The Archers

Simon Williams, 74, plays Justin Elliott in Radio 4’s The Archers

Can you run up the stairs?

Yes. I walk around five miles a day with our cockapoo, Gus. My wife Lucy, 73, and I also go for bike rides. We take sandwiches and cycle for two or three hours.

Get your five a day?

Certainly. I start with muesli and fruit, then have a salad for lunch.

Ever dieted?

Not seriously. I am 6 ft 3 in and 14 st (89kg). Now and then I cut down on chocolate biscuits. I’ve a sweet tooth. There is no point in having just one Jaffa Cake.

Pop any pills?

I take amlodipine for high blood pressure and health supplements such as turmeric (a natural anti-inflammatory), vitamin C for the immune system and, in winter, I take extra vitamin D.

Any family ailments?

My mother had emphysema. She had smoked, but stopped for the last 20 years of her life. 

She died in 1993, aged 78. My father died of peritonitis at 65, in 1969 — which felt old in those days.

Had anything removed?

I had bowel cancer, and some of my colon was successfully removed about five years ago. 

I encourage anyone who gets the testing kit in the post to do it; I had no symptoms, but that was how I found out. I also had my right hip replaced four years ago, and I broke my left leg last year.

Alternative remedies?

I am a big fan of CBD oil, which I find good for sleep.

Ever been depressed?

No. I think the world can be divided into people who lean towards happiness and those who can’t. I am lucky that my default position is to be happy.

Ever have plastic surgery?

I have a horror of the knife. I leave the surgery for essentials.

Hangover cure?

I haven’t had a drink for ten years — no big reason, I just feel better without it — and have as much fun when stone-cold sober.

What keeps you awake?

I’m writing an adaptation of an Andre Gide novel and the occasional column for The Oldie magazine, so I lie there listening to the owls hooting and thinking about things to write.

Any phobias?

Vertigo! At 6 ft 3 in I’m already high enough for my liking.

Like to live for ever?

I’d like to live somewhere between tomorrow and for ever.

Simon plays Justin Elliott in Radio 4’s The Archers.

‘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 fear of spiders. It involves 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 in London suggests that patients whose fear makes them prone to fainting practise a technique called applied tension ahead of starting exposure therapy.

This involves tensing the muscles in your arms, upper body and legs for ten to 15 seconds or until you start to feel 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 fainting. 

The technique is designed to raise blood pressure, making fainting less likely.

Other fear-busters range from a smartphone game to simply smiling. 

The Ainar app, 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 injection 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 pain 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


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