Blood phobia and syringes

There blood phobia It is a fear characterized by the intense fear of coming into contact, even only visual, with this substance (Lillecreutz et al., 2010). The boundaries of this phobia, however, also extend frequently to needles, injections, injuries and invasive medical procedures. So much so that, in the Anglo -Saxon world, it is defined Blood-Injection-Injury Phobia (blood phobia-injects-fenice).

The people with the phobia of blood and syringes They tend to avoid situations in which the majority of individuals feel comfortable. For example, violent TV programs, blood donations, medical or dental visits. According to epidemiological studies, this phobia is present in 3-4% of the general population (Bienvenu & Eaton, 1998), placing it among the most frequent fears.

The role of sensitivity to disgust in fear of blood

Recent literature (Connolly et al. 2006; Olatunji et al. 2006) highlighted the role of emotions in this phobia. In addition to the emotion of fear, common to all phobias, another typical component of the Blood phobia and syringes There is that of disgust. People with excessive fear of the blood would seem to have a threshold of sensitivity to the lower disgust compared to the general population against wounds, injections and blood (De Jong & Merckelbach, 1998). This is true at such an extent that the emotion of disgust can reach levels well higher than fear itself.

The vasovagal reaction

At the physiological level, the blood phobia It seems to differentiate from other fears for a particular and characteristic response. In front of the blood, the person tries sensations such as turning head, cloud, light head and, sometimes, fainting (Ost & Stern, 1987; Marks, 1988). These symptoms seem absent in all the other known phobias.

Typically when the person suffering from a phobia comes into contact with the feared stimulus he experiences an increase in the activation of the sympathetic nervous system that produces, for example, tachycardia. People with blood phobia initially experience this response with an increase in heartbeat and blood pressure. However, this is followed by a sudden reaction of the parasimpatic nervous system that involves a fall of these two parameters (Mednick & Clarar, 2012). This second phase is called Vasovagal syncope And he is responsible for the typical fainting of those suffering from this phobia.

It is not surprising, therefore, that more than 50% of people with this phobia of the blood report a history of fainting the course of life (Ost, 1992). The fainting resulting from the sight of blood, injections or wounds is configured as a loss of consciousness lasting a few seconds. A recovery phase is followed by exhaustion that can last even a few hours.

Why the fainting in front of the blood or syringes?

On the evolutionary level (Bracha, 2004) the reasons proposed for this response pattern are substantially three:

1. The rapid physiological activation/deactivation cycle may have favored the survival of some ancestors in prehistoric times since many animals do not attack deceased or unconscious victims. The fainting, mimicking the death, can reduce the probability of an attack.
2. In terms of learning, since the fainting is an unpleasant response to the sight of the blood and wounds, it promotes fear for such stimuli. That is, the person, providing for the fainting, will have greater fear of getting in touch with the blood And this will lead her to avoid more dangerous situations, thus increasing her chances of survival.
3. In case of injury, the sudden reduction in blood pressure involves less blood supply in the limbs. The body thus prevents excessive blood loss and potentially death.

Despite the possible adaptive functions, it is clear how these consequences involve numerous limitations in daily life. For example, the blood phobia It can limit the freedom of the person. This is in terms of work choices, not allowing you to embark on a medical career, and in terms of physical health care if it involves the avoidance of diagnostic tests. The person thus lives in the constant fear of being able to hurt themselves or that others are injured, reducing their freedom and psychological well -being.

Treatment of blood phobia and syringes

The treatment of election for blood phobia is cognitive-behavioral therapy based on the technique of graduated exposure to phobic stimuli (Wolitzky-Taylor et al., 2008).

The treatment is structured in four phases:

First phase

A first phase In which, together with the therapist, the person learns active techniques to counter the vasovagal reflection. An example of these techniques is the voluntary muscle tension that provides for the contraction of multiple muscle groups simultaneously in order to maintain blood pressure at normality levels in the face of the phobic stimulus (Chapman & Delapp, 2013; Mednick & Claris, 2012).

Second phase

There second phasecommon to the treatment of many phobias, is to identify specific situations that evoke emotions of fear or disgust. This is a fundamental step since by ordering these situations based on their ability to evoke fear it will be possible to create a hierarchy from the least feared to the most feared.

Typically the situations avoided are:

• MEDICAL THEME TV PROGRAMS or violent films
• images of injured people
• Blood donations or analysis
• medical visits and hospitals
• Other people (including children) with cuts
• High physical contact sports sports
• surgery (including simple operations by the dentist)
• handle knives or other pointed objects

Third phase

Subsequently, in the third phaseIn collaboration with the therapist, the thoughts evoked by these situations are identified. It is important that the person becomes aware of them, since often, coexisting for a long time with the phobia of the blood, it is considered automatic and uncontrollable. In reality, understanding the role that the person can play in contrasting the reaction is of fundamental importance to overcome the problem.

In particular, two classes of thoughts typical of blood phobia have been identified:

1. Negative thoughts about the situation
2. Negative thoughts regarding one’s reaction in the face of the situation

In the first case, the theme concerns which person imagines the consequences of the situation. For example, “I will suffer”, “the needle will break”, “the doctor might make mistakes”. In the second case, expectations regarding yourself are central: “I will change”, “I tremble”, “I will lose control”, “will be embarrassing”.

A fundamental step in the overcoming the phobia of blood and syringes It is to change the behavioral patterns that support it. Avoiding feared situations strengthens the beliefs seen above and, if on the one hand it allows to reduce short -term fear, supports the convictions of uncontrollability with respect to the phobic reaction.

In other words, avoidance prevents you from learning new information. For example, that what feared regarding the injections rarely occurs, but above all prevents you from developing more useful strategies to manage these situations.

Fourth phase

Therefore, the fourth phase treatment is dedicated to gradual exposure to feared situations. With the guide and support of the therapist, the person he has Fear of blood and syringes It exposes itself to phobic stimuli starting from the less activating situations and putting into practice the techniques learned at the beginning of the route. For what initially the exhibition can generate discomfort, within some sessions, unpleasant sensations will begin to decrease by favoring the continuation of the treatment.

Parallel, the catastrophic thoughts will be discussed with the therapist, their validity verified through exhibitions and generated new cognitive strategies to cope with it.

Concluding, the blood phobia And, more generally, wounds are a highly disabling fear that can affect the life of the person in a consistent way. Fortunately, there are structured treatments that may significantly reduce it, if not eliminate it, allowing a recovery of psychological well -being and personal freedom.

Bibliography

• Bienvenu, O. and Eaton, W. (1998). The Epidemiology of Blood-Injejection-Injury Phobia. Psychological Medicine28 (5), pp.1129-1136.
• Blood-Injury Phobia: A review. (1988). American Journal of Psychiatry145 (10), pp.1207-1213.
• Bracha, H. (2004). Freeze, Flight, Fight, Frigt, Faint: Adaptationist Perspectives on the acute stress response spectrum.CNS Spectrums9 (09), pp. 679-685.
• Chapman, L. and Delapp, R. (2013). Nine Session Treatment of a Blood -Injection -Injury Phobia with manualized cognitive Behavoral Therapy. Clinical Case Studies13 (4), pp.299-312.
• Connolly, K., Katherine O’Neill, H., Flexner, C. and Olatunji, B. (2006). Fear, Disgust, and Fainting in Blood-Injection-Injury Fears: A Multi-Method Approach. Anxiety, stress & coping19 (4), pp.409-420.
• De Jong, P. and Merckelbach, H. (1998). Blood-injection-injury Phobia and Fear of Spiders: Domain Specific Individual Differen Differes in Disgust Sensitità. Personality and Individual Differences24 (2), pp. 153-158.
• Mednick, L. and Clarar, R. (2012). Treatment of Severe Blood-Injection-Injury Phobia with the Applied-Tension Method. Clinical Case Studies11 (1), pp.24-34.
• Olaunji, B., Williams, N., Sawchuk, C. and Lohr, J. (2006). Disgust, Anxiety and Fainting Sympoms Associated With Blood-Injection-Injury Fears: A Structural Model. Journal of Anxiety Disorders20 (1), pp.23-41.
• Öst, L. (1992). Blood and Injection Phobia: Background and Cognitive, Physiological, and Behavoral Variables. Journal of Abnormal Psychology101 (1), pp. 68-74.
• Öst, L. and Stern, U. (1987). A Specific Behavoral Method for Treatment of Blood Phobia. Behaviour Research and Therapy25 (1), pp.25-29.
• Pitkin, M. and Malouff, J. (2014). Self-Aroranged Exposure for overcoming Blood-Injection-Injury Phobia: A Case Study. Health Psychology and Behavoral Medicine2 (1), pp. 665-669.
• Sarlo, M., Palomba, D., Angrilli, A. and Stegagno, L. (2002). Blood Phobia And Spider Phobia: Two Specific Phobias with different autonomic cardiac modulation. Biological Psychology60 (2-3), pp. 91-108.
• Wolitzky-Taylor, K., Horowitz, J., Powers, M. and Telch, M. (2008). Psychological approaches in the Treatment of Specific Phobias: A Meta-Aalysis. Clinical Psychology Review28 (6), pp. 1021-1037.