Case Study: Resolving a Complex Needle & Medical Phobia
Overcoming a profound and complicated needle phobia
Published in the Association for Solution Focused Hypnotherapists Journal, May 2022. Updated March 2024.
with Solution Focused Hypnotherapy, Rewind Phobia Therapy and Reframing
Needle Phobias are usually more straight forward to resolve. See Sense-Ability article How so I Overcome Needle Phobias? to find out more.
For over 20 years, Ash had a profound phobia of needles, complicated by medical phobias and the vasovagal or fainting response.
Ash’s phobia had become deeply embedded and extreme. In addition, Ash was highly analytical and process driven. The loss of control linked to his vasovagal fainting response had had a significant effect on him. He just wanted to be able to take back control and get the vaccinations he needed but however hard he had tried, he just hadn’t been able to overcome his fear of fainting.
Yet in October 2021, after just 5 sessions with Jane Pendry at Sense-Ability Hypnotherapy & Coaching, Ash finally had his first Covid Vaccination.
How did he do it?
What is a vasovagal response involving needles?
When pierced by a sharp object, a dramatic drop in blood pressure can cause fainting. It’s not psychological. This is the vasovagal response - an autonomic response that can’t be helped by hypnosis. It is thought to be evolutionary: anyone with this response, when pierced in battle, lives to fight another day!
Although hypnosis cannot alter the physiological basis of the vasovagal response, Solution Focused Hypnotherapy and the Rewind Trauma Technique was able to help Ash overcome associated trauma, then reframe and embed a process to help him tackle future vaccinations.
This is Ash’s story.
Ash’s specific traumas
As a child, Ash had fainted after a vaccination, hit his head on a radiator and was knocked out. A trauma that haunted him ever since.
As a young adult, while on holiday overseas, Ash unexpectedly felt light-headed and passed out, waking up in a pool of blood from his bleeding nose. Feeling really tired, he just wanted to go to bed. However, his concerned family had called an ambulance. He was taken to hospital where a canula was inserted to rehydrate him. Ash explained, “I completely lost all personal agency.”
His fear of needles had become a deep-rooted complex medical phobia.
Seeking a Solution for Needle Phobia
Ash was aware this was no ordinary phobia: “Just by seeking treatment with Jane, I had begun to chip away at the problem. I knew I was going to have to throw everything at overcoming it.”
What had Ash done to fix his needle phobia?
Ash explained, “I had done nothing to fix it. I avoided it completely. When Covid came, I needed to fix my phobia. I needed the vaccine for work and travel. There was some social pressure too. Now I had a strong enough motivation to finally overcome my fear.”
Initial progress
During our third session, Ash identified through our Solution Focused conversation, “Having personal agency is key. I realised being restrained and losing control were core issues. I was now clear about what I needed to resolve.”
Ash had learnt how to control his vasovagal response by following medical guidance, and was now able to reframe that aspect of his fear. Our Solution Focused conversations then uncovered Ash’s need to tackle his remaining fears head on.
“I had done nothing to fix it. I avoided it completely. When Covid came, I needed to fix my phobia. I needed the vaccine for work and travel. There was some social pressure too. Now I had a strong enough motivation to finally overcome my fear.”
Ash’s unique solutions to tackling his fears
Ash’s unique solution was to visualise, imagine and rehearse having his vaccination while staying fully alert and in control.
Ash identified that a ‘preparation ritual’ to calm his mind would help him build his strengths and resources; a helpful reframe we likened to ‘military training’.
“It was like peeling layers of an onion.” Ash said, “Once I understood what I needed to address, I imagined each stage of the vaccination process, both consciously (reframing) and during hypnotherapy, until I became comfortable with each part of the process.”
What did our SF hypnotherapy sessions involve?
Supporting Ash reinforced how important it is to allow your client to find their own solutions. The process involved.
Rewind Phobia to resolve past traumas
Reframing the vasovagal response
Reframing and rehearsing the vaccine process – from unsafe to safe
Creating a pre-vaccination ritual to build a sense of agency and control which included actions as advised by medical staff to counter the vasovagal fainting response
Affirmations, breathing and mindfulness exercises to help ‘surf’ through difficult emotions
I used standards Solution Focused Hypnotherapy scripts, adding in Ash’s own reframes and affirmations as appropriate.
First Attempt – the Dress Rehearsal
Ash’s first attempted Covid vaccination didn’t succeed. However, Ash explained that being able to walk away without consequence or judgement restored his feelings of agency. Sensory feedback from the experience helped him anticipate feelings at his next attempt.
Ash explained the unique solution that suited his analytical mind: “I can’t over-emphasise the importance of rehearsing reframes with my partner, Davina. I practised and visualised painful mock injections with a sharp tool ad nauseam, allowing me to experience a momentary loss of agency and a set of sensations that I knew were much more uncomfortable than the reality. It felt like exam revision. I felt ownership and progress.”
If you have a needle phobia, always ask for staff trained in dealing with nervous patients
Final vaccination
Having already attempted a vaccination, Ash now knew the vaccination venue, the process and staff, including Jack who specialised in vaccinating people with needle phobias.
On the day of the vaccination, Ash hadn’t received a call to say Jack was available. He feared things might go awry. Encouraged by his partner Davina, however, Ash went ahead!
Morning ritual
Waking up early, Ash began his pre-vaccination ritual: eating a chocolate bar and drinking a glucose drink to keep blood sugar high to help mitigate any vasovagal response. He put on his ‘horrible shirt’ with no sleeves which made access to the vaccination site easy. He applied his numbing cream.
Before 8.00am, Ash and Davina were ushered inside the pharmacy as pre-arranged. Ash said, “The pharmacy was just preparing for opening. I could smell coffee. Staff were turning on tills and computers. Drugs were being prepared for dispensing. The shutters remained half raised.”
Staying calm and focused
A long time passed. Ash said, “I could hear Jack’s voice. Everything was going to plan and my nerves remained under control.”
Using his grounding exercises - box breathing and mindfulness exercises – Ash managed to stay calm and focused: “Some shelves were stacked floor-to-ceiling with products – shampoo, shower gel, toothpaste – with unknown brands and unconventional scents or flavours. Davina and I competed to find the most unappealing products on sale to occupy us until Jack finally appeared.”
Jack always wore a mask; Ash recognised him by his hair and gait. “I'd met Jack twice before and shared so much of my deeply personal and challenging journey. Yet I wouldn't recognise him on the street. As Jack strode out from behind the dispensary desk, a bubble of calm, excitement and fear arose.
Curveballs!
Jack sounded harassed and tense. "Hi guys. We have 400 boosters scheduled. I’m really sorry. I don't have time today but there’s a clinic at the Royal Free (hospital) who specialise in needle-phobic patients. I can get you a referral. It'll take a few weeks, maybe a month or so. How does that sound?"
Ash felt crushed. His rock-solid, rehearsed plan had taken a wrong turn. “Jack had grabbed the steering wheel and driven us off a cliff. The visualisations and hypnosis suddenly felt worthless. My laser-like focus was now clouded. Jack suddenly withdrew all support.”
Ash realised Jack didn’t have 20 minutes to spare (the time taken at the earlier failed attempt). If the injection didn’t happen within 2 to 3 minutes of sitting on the crash couch, Ash knew it wouldn’t happen at all.
Pharmacies and medical centres have specialised staff who can deal with the vasovagal response and needle phobias
The final vaccination
Then Davina made a suggestion. Why not just ask for just 5 minutes of Jack’s time? After that, Ash could abandon the attempt and attend the hospital clinic later. Ash said, “Jack's mood - even from behind his mask - visibly changed. I sensed he wanted to get me through this and he seemed extremely agreeable.”
Ash and Davina finally went into the vaccination room: “Suddenly, I felt strangely comfortable.” Jack stood in Ash’s peripheral vision; Ash grabbed Davina’s thumb, as rehearsed. Jack wiped numbing cream off Ash’s left arm and gave it a gentle poke.
Ash used his breathing exercises to stay present and calm, while simultaneously staying alert and focused, and in control. Bracing himself, Ash said clearly and firmly:
“Do it Jack.” He paused and added, “Tell me when it’s done,”.
Jack replied, “Yes, it’s done.”
Ash had felt nothing. Immediately afterwards, he felt a “sense of elation”.
“It was like peeling layers of an onion.” Ash said, “Once I understood what I needed to address, I imagined each stage of the vaccination process, both consciously (reframing) and during hypnotherapy, until I became comfortable with each part of the process.”
Reflecting on the Experience of Recovery from Needle Phobia
Ash explained why his second attempt succeeded, “On the day, I was able to relax. I did everything as rehearsed. I surrendered my left arm only. For the first time in a medical situation, I took back control and I saw it through.”
To counter the vasovagal response, Ash lay on the couch. Davina held his legs up to help blood move back up to his brain. He tensed his muscles and waited. Once assured there was no fainting response, Jack asked Ash to slowly stand up. He locked arms to help Ash walk, but he said, “It’s okay Jack. I’m fine.”
After a few minutes in the pharmacy, Ash still felt fine.
Although he had taken the morning off, he happily went back to work later that morning.
Ash reflected. “It was important Davina was there to support me. When I felt pressured, she kept me moving forward. Immediately after the vaccination I was back in a zone of comfort. There was so little fluid involved, I thought ‘the body won’t notice’ … and it didn’t! The whole experience seemed uneventful.”
Triumph
The hypnotherapy sessions, breathing, reframes, mental training and preparation had paid off. “Being unvaccinated was a huge inconvenience.” Ash explained, “Now, I could breathe again. I had invested a lot in therapy, and Ubers, but it was all worth it. I appreciated all the support and help Jane had given me. And above all, I felt proud of myself.”
Ash has been able to overcome his debilitating fear and get his life back on track. After being fully vaccinated, Ash and Davina flew to New York together early in 2022.
“Jack had grabbed the steering wheel and driven us off a cliff. The visualisations and hypnosis suddenly felt worthless. My laser-like focus was now clouded. Jack suddenly withdrew all support.”
My Reflections on Treating a Complex Needle Phobia
Having worked with a number of complex phobias over a few years, I have discovered that a loss of agency or control can be at the root of many complex phobias. That’s why complex phobias such as agoraphobia, claustrophobia, medical phobias, social phobia and emetophobia or fear of vomiting, take much longer to resolve. Simple phobias, such as spiders, dogs or birds for example, usually take just one or two sessions to resolve.
Most people just avoid the thing they fear as they can adjust their life to do so. However, complex phobias that involve a loss of personal agency and deep rooted behaviours that pervade all aspects of a person’s life, require a more tailored approach over a number of sessions.
Solution Focused conversations do really empower the client to find their own unique solutions.
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Jane Pendry specialises in emetophobia, complex phobias and trauma resolution while continuing to work with most anxiety related conditions.
Jane Pendry
Sense-Ability Hypnotherapy & Coaching
Wheatley, Oxford, OX33 1XJ
+44 (0)7843 813 883