You Ask , They Answer
Q
: What is trypanophobia ?
A
: Trypanophobia is needle phobia , which is very common and associated with the fear of needles , of injections themselves , the thought of skin being pierced , or the fear of seeing your own blood .
What differentiates a fear from a phobia is the degree of impairment . I might fear needles , but if I need to get a vaccination , for example , I could book in and get it done despite my fear . Someone with a phobia might delay that appointment or not even have a vaccination because they ’ re afraid of the needle . We often also see fainting , which is quite common , and people might struggle to stay conscious at the sight of a needle .
Q
: What is known about the causes ?
A
: Needle phobia is not just a fear response ; the idea of receiving a needle often elicits a repulsive disgust response in a person . The underlying causes of fear and disgust response are thought to be similar , and the way they ’ re treated is similar .
We know that humans are born with certain stimuli that can elicit fear . We don ’ t know why ; we think it may have some evolutionary significance .
There ’ s also an element of genetics , but we don ’ t know a lot about specific genes leading to specific phobias , and there ’ s a degree of heritability . If your parents have anxiety , you are more likely to develop a phobia .
Many people have a fear of certain things , but it ’ s often what we learn to do about it that determines whether we develop a phobia or not . Often the reaction of our parents , our peers , and the people around us will guide whether we choose to face our fears or whether we choose to escape and not face them . In children , studies show that even little things parents do which result in avoidance or exaggerating a threat might result in an increase in the anxiety of the child .
Finally , we develop our own skills to regulate emotion , and we can learn for ourselves that we have control and influence when we fear , or we can lose control and be passive in our response to fear .
Q
: How is it treated ?
A
: It ’ s principally treated through behaviour and cognitive therapy . Behaviour therapy programmes will gradually help people get more confident with their fear by having them look at pictures of needles , see blood , and then gradually step up to a place where they might be close to real needles and perhaps be given an injection . It ’ s that sort of graded exposure that ’ s incredibly effective in producing positive outcomes .
There ’ s also cognitive training . Fears are often driven by exaggeration of threat and a belief that something bad is going to happen . So cognitive therapy is about trying to help people make realistic predictions . By using a combination of behaviour and cognitive therapy , phobias can be treated very successfully , often in a very short space of time .
Q
: How should needle phobes prepare for injection ?
A
: It ’ s important for patients to be open about their fears and have support in place so they can get needed healthcare . One of the things patients could do before an injection is look at images of needles and blood at home . They could hold the needle once they meet the doctor to get some exposure . Often the fear of fainting while receiving the needle is an issue ; if that ’ s the case , they could do breathing strategies and tense and relax their muscles to reduce the risk of passing out . Finally , there are strategies for the administration of the injection . Skin numbing cream can be used to reduce the feeling of the injection , which could be done in a graduated and slow way so the patient feels like they ’ re in control .
Professor Adam Guastella
Professor Adam Guastella is a clinical psychologist and Michael Crouch Chair in Child and Youth Mental Health at Westmead Clinical School at the University of Sydney .
14 AUGUST 2021 GlobalHealthAsiaPacific . com