Trypanophobia: Overcoming the Fear of Needles and Blood

By: Suzanne Feinstein, PhD

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Trypanophobia is a specific phobia characterized by an intense fear of needles, injections, and medical procedures involving needles. It affects approximately 10-20% of adults. This fear can lead to avoidance behavior, delaying necessary medical care and causing significant distress.

Causes and Symptoms


  • Innate Response: Humans are preprogrammed to perceive sharp objects that pierce the skin as threatening. This response is like an alarm system, warning us of potential danger.
  • Context Mismatch: Unfortunately, this fear response occurs even when there is no real danger during routine medical procedures like blood draws or vaccinations.


  • Nausea: Feeling queasy or lightheaded.
  • Fainting: Some individuals experience a vasovagal response, causing blood pressure to drop and leading to fainting.
  • Increased Heart Rate: Anxiety triggers a rapid heartbeat.
  • Panic Attacks: Intense fear can lead to panic symptoms.

About Vasovagal Syncope and Applied Tension Technique

Vasovagal Syncope

Vasovagal syncope is a condition characterized by fainting or passing out due to a temporary drop in blood pressure. It often occurs in response to triggers such as pain, emotional distress, or specific situations like seeing blood or needles. When someone experiences vasovagal syncope, their heart rate and blood pressure decrease suddenly, leading to fainting.

Applied Tension Technique

The Applied Tension Technique is a behavioral treatment primarily used for managing blood-injection-injury (BII) phobias and vasovagal syncope. Here’s how it works:

Purpose: The goal of this technique is to prevent fainting or dizziness by counteracting the sudden drop in blood pressure and heart rate associated with vasovagal syncope.

Mechanism: The technique involves tensing specific muscle groups in the body. By doing so, blood pressure increases temporarily, making fainting less likely.


  • Sit in a comfortable chair.
  • Tense the muscles in your arms, legs, and trunk for about 10 to 15 seconds.
  • Hold the tension until you start feeling a warm sensation in your head.
  • Relax your body for 20 to 30 seconds.
  • Repeat this process five times.
  • Note: When relaxing your muscles after tensing them, the goal is not complete relaxation but rather returning your body to a normal state (not overly tense or completely relaxed).

Practice: It’s essential to practice this technique several times a day for at least a week.

Using It with Exposure Exercises: After practicing for a week, you can apply this strategy during exposure exercises related to blood and needles.

Remember that while fainting from vasovagal syncope is generally harmless, it’s crucial to discuss your fainting episodes with a doctor before using this technique or exposing yourself to situations that could trigger fainting. If you do faint, lying down and elevating your feet can help speed up recovery.

In summary, the Applied Tension Technique provides a practical approach to manage vasovagal syncope and prevent fainting. If you experience this issue, consider discussing it with a healthcare professional and incorporating this technique into your coping strategies.

Treatment, Coping Strategies, and Overcoming Trypanophobia:


  • Staying hydrated is crucial. Drink plenty of water the day before and on the day of your appointment.
  • Proper hydration helps maintain blood pressure and reduces the risk of fainting.

Mindfulness and Breathing:

  • Focus on slow, deep breaths during the procedure.
  • Remind yourself that you are safe and that the needle is necessary for your health.

Distraction Techniques:

  • Bring a book, listen to music, or engage in conversation to divert your attention.
  • Some clinics offer virtual reality headsets to immerse patients in calming environments during procedures.


  • Gradual exposure to needles can reduce fear over time.
  • Start with small steps, such as looking at pictures of needles or holding a syringe.


  • Cognitive-Behavioral Therapy (CBT): Helps challenge irrational thoughts and change negative beliefs about needles.
  • Systematic Desensitization: A type of CBT that gradually exposes you to needles in a controlled environment.
  • Applied Tension Technique: Tensing specific muscle groups to help prevent a drop in blood pressure and subsequent fainting


  • Anti-Anxiety Medications: Short-term use can help manage anxiety during medical procedures.
  • Consult a healthcare professional before using any medication.

Examples of individuals overcoming this fear:

Tattoo Experience:
A client who had a strong fear of needles managed to overcome it. After successful hypnotherapy sessions, she felt confident enough to get a tattoo on her arm. This transformation allowed her to face her fear head-on and experience a stress-free tattooing process.

Self-Administered Insulin Shots:
A middle aged woman, who had been terrified of needles, faced a pivotal moment. Her grandfather offered her money to give herself an insulin shot. Despite her fear, she accepted the challenge. She overcame her trypanophobia and took control of her blood testing and insulin injections from that day forward.

Stress-Free Hospital Visit:
Another client recently messaged me about her hospital experience. She underwent various tests, including blood tests, and found the entire process stress-free. Overcoming her fear of needles allowed her to receive necessary medical care without anxiety.


Remember that you’re not alone in your fear of needles. Many people share this phobia, and there are effective strategies to cope with it.

Systematic Desensitization and other CBT techniques involve gradual exposure to needles, allowing individuals to become desensitized to the anxiety associated with injections. With repetition and practice, the fear diminishes, making medical procedures less anxiety-inducing.

Remember, trypanophobia is common, but seeking professional help and gradually facing the fear head-on can lead to positive outcomes during medical procedures. So take a deep breath, stay hydrated, and know that you’re taking proper steps to benefit your physical and mental health. If you or someone you know struggles with needle phobia, consider seeking professional help to overcome it and ensure timely medical care when needed.

Learn more about the supportive treatment we offer. Contact us today at Advanced Behavioral Health to schedule an initial consultation. Dr. Suzanne Feinstein is an Instructor in Medical Psychology at the Columbia University Department of Psychiatry/ NYSPI.

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