Overview

Needle phobia is a fear of medical procedures that involve needles or injections. It is very common and affects at least 1 in 10 people.

There is no need to feel ashamed if you have needle phobia. Simple exercises and practice can help to overcome it.

Many people with needle phobia may have had a lot of blood tests or procedures as a child. A fear of needles and injections often, but not always, results from bad memories of needles earlier in life.

Signs and symptoms

For many people, fear of needles is linked to fainting or feeling faint. When something triggers their fear (for example, seeing blood or thinking about an injection), their heart rate and blood pressure increase. They then rapidly drop. This fall in blood pressure can cause fainting.

Many people do not confront their fear because they are embarrassed. Other people do not feel faint or actually faint, but feel panicky when something triggers their fear. 

How to overcome your fear of needles

There are things you can do to help overcome your fear of needles.

• Tell the person who is coordinating your care, giving you an injection or doing a blood test about your worries. They can answer any specific questions you have and help you to cope with the procedure. For example, they could chat with you during the procedure to distract you.
• Try not to worry about other people's reaction. Staff looking after you will not be annoyed or think that you are weak or cowardly when you tell them about your fear of needles. It is useful for them to know about this because they can make things easier for you.
• Think about if anything has helped you to cope with needles in the past. Can something like this help you again?
• If your fear is linked to fainting or feeling faint, you can learn an applied tension technique.
• If you feel panicky (for example, your heart races, your chest feels tight and your stomach churns) but you do not feel faint, you can learn a breathing for relaxation exercise. These exercises are safe in pregnancy and with most medical conditions.

Remember, the needle is not unbearably painful. It might hurt a little, but there are things you can do to help you cope with the anxiety. Examples are distracting your thoughts and using relaxation techniques. 

Applied tension

This is a simple technique to increase your blood pressure to a normal level again and avoid fainting.

1. Sit down somewhere comfortable. 
2. Tense the muscles in your arms, upper body and legs. Hold this tension for 10 to 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 20 to 30 seconds, go through the tension procedure again until you feel the warmth in your face.
5. Repeat this sequence until you have practised the tension 5 times.

If you can, practise this sequence 3 times every day for about a week. You can then try to face your fear.

If you get headaches after doing this exercise, avoid tensing the muscles in your face and head. Also, be careful when tensing any part of your body where you have health problems.

Breathing for relaxation

1. Sit in a comfortable position, with your back upright but not stiff. Let your shoulders and jaw relax.
2. Put one hand low 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 do not force the breath. Just let your body breathe as deeply as is comfortable for you.
3. Do this for 5 breaths.

If possible, practise this exercise 3 times every day for a week. You can then try to face your fear.

Final steps: facing your fear

When you have practised these exercises, the next step is to face your fear of needles. It is important to take one small step at a time.

You can create a ‘fear ladder’. This is a list of all the situations involving needles that you fear, arranged in order of difficulty. They might include:

• thinking about procedures that involve needles
• seeing pictures of the procedures
• watching the procedures on TV and in real life
• actually having the procedures

Rate each situation on a scale of 0 to 10, where 10 is the most difficult and 0 is the easiest. Put the easiest situation at the bottom, like the first rung of the ladder.

Creating your fear ladder

To climb your fear ladder, you need to think about, or act out, each step. So, try to include some situations that are not too difficult. You can start with these.

Think about what could make a situation easier. For example, you might find it easier to look at a picture of a small needle than a large one.

Here's an example of a fear ladder:

Climbing your fear ladder

1. Start with the least difficult situation (in the table above, this is thinking about having an injection).
2. Plan enough time for the exercise. You need to stay with the fear long enough to understand how anxiety works. Your anxiety peaks, stays at that level for a while, and then will likely gradually reduce on its own over time. Even if your anxiety does not reduce, it is important to stay in the situation long enough to prove your fear wrong (for example, thinking that you will faint). Over time, you may also be able to reduce the things you do more, or less of, to feel safe, such as avoiding or distraction. 
3. Start to use the applied tension or breathing exercise.
4. Go into the feared situation and stay with it until your anxiety starts to reduce.
5. Take some time to relax, perhaps using the breathing exercise.
6. When you feel confident with 1 situation, move up to the next step of the ladder. You may need to practise 1 situation a few times before you are ready to move to the next.

Overcoming your fear takes time and practice, but acknowledge and give yourself credit for the progress you have made.You may still feel anxious, but in time you will feel better able to manage procedures with needles, and the more you do this, the more confident you will feel. 

Getting support

Sometimes, it can be helpful to get professional support to overcome your fear of needles. You can speak to your healthcare team to find out if specialist psychological therapy is available.

Alternatively, you can self-refer to your local NHS talking therapies service, where qualified practitioners provide treatment for a range of difficulties, including needle phobia. You can refer yourself directly, or a GP can refer you. All therapy is free on the NHS. 

There are a range of talking therapies available, but cognitive behavioural therapy (CBT) is usually recommended for needle phobia.

CBT helps to change the way you: 

• think, for example what you predict might happen
• behave, for example avoiding and using unhelpful coping mechanisms

It does this through breaking down negative cycles of thoughts, actions, and feelings that can lead you to feel trapped. This way you can find a more balanced view, and improve the way you feel.

You can search for your local talking therapies service on the NHS website. 

Key points

• Do not be ashamed if you are scared of injections. You are not alone.
• Tell health professionals about your worries.
• Think about what helps.
• Learn the applied tension technique if you faint or feel faint, or the breathing for relaxation exercise if you feel panicky.
• Overcome your fear one step at a time.
• Know that NHS talking therapy is available if you need it.