How to Treat Fear of Needles

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Many people are frightened of needles because they have learned to associate discomfort with immunizations or blood draws. In fact, fear of needles affects the majority of children under 11, 20 to 50 percent of adolescents, and 20 to 30 percent of young adults (Anbar et al., 2023).

Fear of needles can cause children and adults to avoid seeking health care, or to refuse to receive immunizations or undergo medical tests. In fact, my own fear of needles almost prevented me from applying to medical school! Ultimately, I figured out that when other people undergo medical procedures, it is not the same as when I am the patient.

It was only after I learned to apply self-hypnosis techniques that I realized that the pain associated with needles is related more to my fears than the physical sensation. I also learned that the term “shots” contributed to my fears. Who wants to be shot? Far better to receive an immunization, vaccine, inoculation, or a jab.

It is easy to assume that children don’t like needles because their insertion causes pain. While that is the most common reason, I have encountered many patients who don't care for needles for other reasons, including dislike of a foreign object being inserted or injected into the body, the sight of blood, fear that the body will be drained of blood, dislike of being held down with the associated loss of control, and memories of traumatic events associated with needle insertion, such as after being involved in a motor vehicle accident, or sustaining major burns.

Fears of Pain

In treating the fear of needles, it is important to identify and address the underlying cause. This can dictate the appropriate therapy. For example, people who are afraid of pain associated with needle insertion might be treated with:

• A topical anesthetic cream, applied 30-60 minutes prior to needle insertion in an extremity.
• A distraction device, such as a vibrating device that is applied to the site of a vaccine administration. The pain signal to the brain is altered by the vibration, and therefore the child is less likely to focus on any injection-associated discomfort.
• Hypnosis can be used to achieve pain relief, including through imagining a dial that, when turned, can decrease or eliminate the sensation of pain at the site of needle insertion.

Anxiety About the Unknown

In cases in which the main fear of needles arises from anxiety regarding what could go wrong, cognitive behavioral techniques can be used to help reduce discomfort.

For example, patients can learn that the amount of blood removed during phlebotomy is minuscule compared to the blood that remains in the body, or that the substances being injected into the body have the important function of helping prevent future infections, without any danger of causing an infection.

Memory-Based Fears

Memory-based fears can be addressed with cognitive behavioral techniques, such as a discussion that what occurred in the past may no longer be true in the present. Alternatively, techniques that involve memory restructuring can also be very helpful, such as revisiting and rewriting a memory through age regression in hypnosis (Anbar et al., 2023).

Age regression can be accomplished by asking a patient in a hypnotic state to think back to a traumatic time and imagine how their reaction might have been different had they known they would survive the difficult situation or had been able to apply self-calming tools during the difficult event. Following such hypnotic interventions, patients often report an improvement or resolution of their fears.

Maintaining a Flexible Approach

It is important to maintain a flexible therapeutic approach when treating patients. For instance, in a recent case (Anbar et al., 2023), a 29-year-old expressed that he thought the origin of his fear of needles related to undergoing medical procedures at a young age.

However, his fear did not improve when I treated him with hypnotic age regression and taught him to imagine that he could have remained calm during the medical procedures.

At that point, I asked the patient if his subconscious had anything to contribute regarding why his fear remained. He said all he heard was the word “mother.” (Later, he told me he actually heard the word “mommy” but did not want to say that because it seemed childish.)

In thinking about this curious input, I was struck that perhaps his fear related to separation from his mother while he had undergone the medical procedures.

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I pulled the book The Invisible String by Patricia Karst (2018) off my shelf and read the story to him. I told him this was a story for the young child in his memory and he could just listen in.

The story tells of an invisible string of love that connects all people who love each other, including children and their mothers. The story concludes by stating, “No one is ever alone.”

The patient then told me that he felt strangely emotional during the reading. Subsequently, he reported he was no longer afraid of needles. After checking with his mother, he verified that, indeed, she was not present during the time he had undergone his medical procedures. Thus, this patient’s fear of needles appears to have been the result of separation anxiety!

Takeaway

Helping patients with a fear of needles should start with identifying the cause of the fear. Therapy directed at the source of the fear is often helpful, including through the use of hypnosis and interactions with the subconscious.

To find a therapist near you, visit the Psychology Today Therapy Directory.