Key takeaways
- A fear of needles is very common, and can be exacerbated by cancer treatment.
- Simple strategies like informing the healthcare professional, and taking someone with you to the appointment, can be helpful. But you may feel you need more specialist support.
- With meditation and mindfulness, you can learn to accept your fear without judgement, as well as helpful breathing and grounding techniques to use during appointments.
- A trained hypnotherapist can select the supportive techniques that work best for you, including deep relaxation and CBT, and teach you self-hypnosis to use during appointments
At least one in ten adults are thought to have strong fears around needles. It might be that you have feared needles since childhood, which is very common, or that the prevalence of needles during cancer treatment has triggered the fear. If chemotherapy was part of your treatment, it can affect vein quality, meaning that, as treatment progresses, needle insertion becomes more challenging, and fears and anxieties around procedures can increase. With specialist support, it is possible to develop the skills and mindset you need to approach appointments involving needles calmly and with confidence. We asked Perci Health hypnotherapist Beverly Longhurst, and mindfulness and meditation professional, Laura Ashurst, about their individual approaches.
What does fear of needles feel like?
A fear of needles often manifests long before the moment of the procedure itself. Many people experience anxiety in anticipation of the appointment, or develop a fear of being in a clinical setting. As Laura explains, ‘Someone with a needle phobia will often ruminate on how difficult the procedure was last time, then get into catastrophic thinking about how difficult it’s going to be this time. This thought cycle triggers a stress response in the body, which manifests as very real physical symptoms’. These symptoms can include:
- A racing or pounding heart
- Shallow or rapid breathing
- A feeling of holding one’s breath
- High blood pressure
- Feeling dizzy or faint
- Sweating or feeling nauseous
Someone with a needle phobia will often ruminate on how difficult the procedure was last time, then get into catastrophic thinking about how difficult it’s going to be this time
Laura Ashurst, meditation and mindfulness professional
The importance of preparation
Both Beverly and Laura agree that it’s important to tell the health professionals involved how you are feeling. Laura points out that, ‘Trying to mask the fear is very anxiety inducing. If you are transparent, the professional can be mindful as well’.
Beverly also recommends arriving hydrated, to make accessing a vein easier: ‘When we’re worried, drinking enough water can be the last thing we think of or feel like doing but it can help. This can be particularly helpful for those undergoing cancer treatment, who may have more difficult vein access due to previous chemotherapy.’
You may want to ask whether your treatment centre provides a local anaesthetic cream like Emla, that can be applied in advance to numb the area. Sometimes keeping the area warm or even applying a hot pack can encourage difficult veins to be more cooperative.
What to do during the appointment
If you have a fear of needles, Beverly recommends taking someone with you to appointments for reassurance and to support you during the procedure itself: ‘If it is an arm injection, having someone stand on the opposite side and hold your hand or rub the opposite upper arm can be distracting and helpful.’ Another tip is to tell the health professional carrying out the procedure what you would like them to say or not to say. ‘You may not want to know when they are about to start, or ask them to use certain wording to warn you – something like “well done” rather than “sharp scratch”.’
Lying down during the procedure, so your feet are level with your heart, may reduce the feeling of light-headedness and is safer if you feel faint. Many people find looking away or closing their eyes to be helpful, as well as breathing deeply. These simple strategies can go a long way towards mitigating fear around the appointment and during the procedure itself, however, they may not work or be enough for everyone. For those who feel they need an extra layer or support, the practices of mindfulness and meditation, and hypnotherapy, can be really beneficial.
Overcoming needle phobia with mindfulness
Perci meditation and mindfulness professional, Laura Ashurst
‘The definition of mindfulness I use is by Jon Kabat-Zinn: “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgmentally.” Anyone can practise mindfulness, and it can be very helpful for people acknowledging fears around a certain issue, like needles. Mindfulness is about acknowledging and noticing what is. When we try to block and suppress our feelings, they speak louder to be heard. Through mindfulness, you can develop the skills to live well and presently through, during, and beyond your cancer treatment.’
How can mindfulness support someone with needle phobia?
‘The rumination and catastrophic thinking that accompanies needle phobia triggers a stress response in the body. With mindfulness, we acknowledge this. We pause, we use the breath as an anchor and notice where our thoughts have taken us to. We remind ourselves that this is a moment of unpleasantness; that it’s real. This allows us to name and gently embrace with kindness, the cause of our suffering – in this case, needles. The idea is to come to a point of acceptance about your experience, without berating yourself.’
We remind ourselves that this is a moment of unpleasantness; that it’s real. This allows us to name and gently embrace with kindness, the cause of our suffering.
Laura Ashurst, meditation and mindfulness professional
What to expect in mindfulness sessions
‘Just like any other skill, we need to practise mindfulness and meditation to become proficient. Someone who has needle phobia will need a course of sessions to develop that skill set; to develop the practical, invisible toolkit that they walk into their appointments with.
‘I offer techniques to help you focus your awareness by paying attention to the breath. We do this through basic meditation techniques. I would be guiding you slowly, over a number of sessions, to develop an awareness of where your thoughts are taking you. Then we gently begin to be curious about where in your body you can feel this emotional response. During our sessions, we can explore different practices, to find what works for you. Some people, for example, find that focusing on breathing can accelerate anxiety. So in this situation, I use grounding techniques.
‘Throughout our sessions, I’ll pick up on subtle messages from your body language and the things you say. This allows me to gently guide you to release tension wherever you carry it in the body, and to tease out certain feelings. So it’s a very different experience to, say, practising mindfulness with an app. What’s important is that these techniques are manageable when you are on your own.’
How to approach appointments with mindfulness
‘During the appointment, you need nothing other than your senses, your breath, and your focused attention, which you have been practising. Once the needle has been inserted, the focus is on turning towards yourself with kindness. We acknowledge the discomfort, but soften the attitude towards the level of discomfort. I also teach a self-soothing hug. You take your spare hand and bring it across your chest to rest on top of your arm, or gently pat yourself. If, during the appointment, connecting to the breath feels out of reach, you would focus on what you can see, hear, touch, taste and smell. The use of the senses is integral to being a human being who practises mindfulness.’
Overcoming needle phobia with hypnotherapy
Perci hypnotherapist, Beverly Longhurst
‘Hypnotherapy is a talking therapy which utilises a focused state of attention in a safe and controlled way. Hypnotherapy has helped many people overcome needle fear, and the benefits mean that you can let go of anxiety around attending appointments and treatments that are essential to your health. There are many different strategies and approaches that can be employed to help someone with a needle phobia. Some people may favour a thought-led approach, while others will respond to more creative or embodied solutions. Examples of both are outlined below.’
Relaxation and the stress response
‘Hypnotherapy can use techniques such as breathing, muscle relaxation or sensory suggestions, to calm the stress response and soothe the nervous system, so you feel more relaxed and in control of your mind and body. Deep relaxation also allows us to access the creative part of the brain that is good for problem solving, including overcoming fears and phobias. I teach my clients to replicate this calm by using self-hypnosis outside of sessions, which is wonderful for situations where needle fear may be an issue.’
Hypnotherapy can use techniques such as breathing, muscle relaxation or sensory suggestions, to calm the stress response and soothe the nervous system, so you feel more relaxed and in control of your mind and body.
Beverly Longhurst, hypnotherapist
Cognitive behavioural therapy (CBT)
‘Using CBT exercises prior to hypnosis can help identify any unhelpful thoughts that may be associated with needle fear. Together we can start to unpack the cycle that may happen based on those thoughts, such as catastrophic fear of pain or harm from the needle, and how this affects feelings and behaviours – a vicious cycle. We can identify the desired or more helpful thought that could be substituted and explore what results this would have for your thoughts and feelings – a virtuous cycle. I can also use your personalised choices during hypnosis to underpin these helpful thoughts and suggest that they are easy to recall and use when needed.’
The fear ladder
‘It may be that there are different degrees of fear around encountering needles (called the ‘fear ladder’), and we can work together to identify these. By understanding and scaling or scoring the degrees of fear, we can chip away at the scores. For example, you can desensitise the fear of booking an appointment involving needles by talking about making the booking and the benefits, while feeling very relaxed or rehearsing a new pleasant feeling in hypnosis. We may also use anchors, which are simple physical gestures paired with a positive emotion, which serve to restore a sense of control both in session and when using them outside sessions.’
A safe place
‘Without an agenda, the mind will easily focus on what it might perceive as a threat (or what has been threatening in the past) and amplify this fear in order to keep us alert and safe. However, when it comes to a straightforward intervention that we need for our health, such as a procedure involving needles, it can result in feeling overly alert and anxious. Intentionally creating and repeating the experience of going to a safe place can be used to control this reaction during treatment.’
Imagery and altered sensation
Once you are deeply relaxed, I may use imagery such as a magic glove to help you change the feeling in your hand, allowing it to feel similar to being numb or comfortably warm, or a comforting colour, for example. You are completely in control of this and, should you wish to use the technique, can dial up or down the sensitivity. This sensation can then be moved to the cubital fossa (the area in the fold of the inner arm) or another site where the needle will enter. This technique allows you to be prepared and in control.
Find out more about mindfulness and meditation professional Laura Ashurst, and hypnotherapist Beverly Longhurst, including their availability.
While we have ensured that every article is medically reviewed and approved, information presented here is not intended to be a substitute for professional medical advice, diagnosis, or treatment. If you have any questions or concerns, please talk to one of our healthcare professionals or your primary healthcare team.