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Joe’s story

Background

I’ve been needle phobic since a small child. The last vaccination I had was as a child – before the age of ten. I remember being so panicked about the BCG vaccination as a teenager, and refusing to have this. 

As an adult, I avoided doctors as much as possible. I deregistered from the NHS around ten years ago, and used a private GP, who had a non-clinical looking consulting room. He was able to offer urine or saliva tests for most of my medical complaints.

Over the last 15 years, I’ve attempted hypnotism, hypnotherapy and NLP based approaches to needle phobia, but none of these worked for me. 

About 7 years ago, I had a head injury that resulted in some vision problems (posterior vitreous detachment) in my left eye. When the optician told me I’d need to urgently visit the eye hospital and that surgery may be needed, I fainted in the opticians consulting room. My fear wasn’t possible surgery, but the needle.

Entering my 30’s, I got more and more worried about not being able to take blood tests. I was convinced that something may be wrong with me, perhaps something latent from younger years. A programme on TV convinced me that an HIV test was something I ought to do, so the NHS sent me a free HIV test to take at home – this requires a blood sample from a finger prick. I couldn’t even bring myself to use the auto-lancet, and ended up taking this apart. After a few hours of getting quite upset about my inability to take the sample (and being scared by the TV programme about dormant HIV turning into Aids), I eventually cut myself with a knife. Only a severe needlephobe would consider a Stanley-knife less intimidating than a tiny needle prick! I got my sample, and shortly after, a negative test result.

About the same time as the HIV programme aired on TV, the Covid vaccination was being rolled out in Scotland – before long, my age group would be eligible for vaccination, and I was terrified. The drama with taking a small blood sample convinced me that I’d end up dying of Covid rather than get vaccinated.

I met with another hypnotist, but that still didn’t work. I downloaded self hypnotism MP3s, and they didn’t work either. I chose instead, to stay away from people, to work from home, to not go to cinema or theatre, and to only visit restaurants with good social distancing or outside dining.

In September 2021 I decided to use Exposure Therapy with help from a psychologist, and on 4th December, I had my first Covid vaccination, and my first injection in nearly three decades. 

The weight off my shoulders has been greater than expected, and while I’m not ready to embrace blood tests, I feel like the burden of the last few years has been lifted forever.

My solution

Short version – more detail further down this page:

  1. Exposure therapy, with a Clinical Psychologist.
  2. Exposure therapy at home, between sessions.
  3. Advocate for yourself.
  4. Make a plan – what triggers need removing for you to get vaccinated?
  5. Make contact with the vaccination clinic, and get a named nurse to help you with your plan.

Solution - with more detail

I heard about exposure therapy from a needle phobia support group on Facebook. Many people had reported success, so I decided to try.

There are two types – my experience was with graded exposure. There is another type called “flooding” – which sounds far too intense for me. Very few practitioners offer flooding.

The thought of a face to face psychologist did not appeal, because I worried that they’d progress the therapy faster than I was able to. So I used an online service that offers a combination of text resources between sessions, and 1-to-1 video chat sessions lasting 25 minutes.

I only had 4 sessions before I chose to use a face to face clinical psychologist instead. However, the remote sessions were useful to me, because I was taught to construct a “ladder” –  a ranking of things that worried me about needles. It also reassured me that a psychologist will not belittle my phobia.

The face to face clinical psychologist undertook the same “phobia ladder” exercise. Here’s how it works:

  1. Think of every single needle related trigger.
  2. Rank them by least anxiety to most stressful.
  3. That’s it!

I used Trello to create a card list, so I could quickly reorder cards to make sure my order was correct. At the very bottom of my list (the easiest) was “photo of a needle” and at the very top was “cannula – back of hand”. In between that, I had various items such as “video of a blood test”, “receive Covid vaccination injection” and about 20 other things.

The way the therapy works, is that I took the least triggering item on the ladder, and exposure self to that trigger, while practicing other techniques that the psychologist will teach you. 

In my case, the most valuable technique in exposure therapy was diaphragmatic breathing. This involves learning a special breathing technique, and using this immediately before and during exposing the anxiety trigger.

You will try this exposure again and again, practicing the breathing, talking through your anxiety, until you experience a dip in the anxiety.

Only then can you proceed to the next step on the ladder. Do not be afraid to reorder this ladder if your anxiety responses are not as you imagined. 

So, over the weeks, I got several steps up my ladder, but as it became clearer that I was heading closer to “allow psychologist to hold a needle against my skin”, I started to panic outside the sessions. I came very close to not having another session.

Anyway. I purchased some needles from a medical supplier online (I’ve no idea what I’ll do with the other 100 24G needles!) and managed to press some against my own skin. A few sessions later I was able to bring one to the session, and eventually the psychologist was able to hold one against my skin. The first time she did this, I noticeably stopped breathing for a few seconds. My anxiety was pretty high. So we practiced diaphragm breathing again, and repeated the skin-needle contact. As simple as it sounds, each time we repeated the contact, my anxiety reduced. By the end of the session, my anxiety was minimal. However, I was convinced that my anxiety had only lowered, because I knew she would not pierce my skin – I trusted her, and was confident that she would not do anything I hadn’t agreed to. 

As these sessions progressed, I felt confident that I would ultimately be able to get my Covid vaccination, so I started work on finding a nurse to help me with the actual injection. I was fairly sure of a ‘fight or flight’ response, and I knew anxiety responses would be heightened by:

  • Vaccination hall – photos and videos of Scottish vaccination clinics all showed large rooms, with queues of people, and little privacy – that someone waiting could see other people receiving a vaccination.
  • Needle paraphernalia – sharps boxes, needles, syringes. All these things raise anxiety.
  • Not being in control.

Thankfully, I found a nurse who was able to help with all these! Without her, I don’t know if I’d have had the vaccination.

We spoke on the phone, and here’s what we arranged:

  • To meet at the hospital that housed the vaccination clinic.
  • Go to main reception, not the Covid clinic, and ask for the nurse by name.
  • I was directed to a non-clinical room outside the clinic, where the nurse and another nurse met me.
  • The primary nurse calmed me down, while her colleague prepared the vaccination outside the room, and stayed outside until I’d calmed down.
  • When ready, the other nurse came in, and sat beside me and told me that he’d not do anything other than sit there, until I was ready.
  • Primary nurse talked me through my breathing exercises again.
  • When I was ready, I gave the go ahead, and before I knew it, I was injected. For the first time in decades.

I started to feel dizzy, and immediately squeezed every muscle as hard as I could – as per the Applied Tension technique taught by the psychologist. My dizziness didn’t turn into fainting!

At no point did I see a needle. I was in control.

My 2nd vaccination isn’t due yet, but next time, I feel happier about going to the main clinic – and I plan to simply ask not to see the needle. If anxiety does get the better of me, I’ll just reschedule and perform the steps described above.

I’m two-thirds up my anxiety ladder. Blood tests aren’t going to happen just yet, but I plan to start some self-guided exposure therapy to see if I can bring myself up the ladder. If not, I’ll return to my trusted psychologist.

Snags along the way

The nurses described above were key to getting this done so smoothly, but finding such helpful people wasn’t easy. 

Like some needlephobic patients, I did not engage with medical services. I was not registered with an NHS GP. So I called the Covid helpline and explained my phobia. They did not know how to help at all. I tried a few times, and while the call handlers scoured their systems, they had no advice for needle phobes.

The NHS website had very little, beyond “tell the receptionist at the clinic”. Only someone with needle phobia can imagine the anxiety build up from waiting in a line outside a vaccination centre, and then in a queue surrounded by others, explaining the phobia. Given that most people don’t know the difference between a dislike of needles, and a phobia, it’s not a conversation a needlephobic patient wants to have with a member of non-medical staff.

So, I didn’t do that.

I tried to reach out on social media, but nobody knew how to handle my query. I was eventually given an email address, but nobody got back.

I managed to register with my GP, and made an appointment with the nurse. He completely understood my phobia, and asked for a week to research and get back to me. Unfortunately, he had the same advice described above. This was surprising, as he didn’t see why this couldn’t be done at the medical practice, given the circumstances. He was lovely and understanding, and although he couldn’t resolve my problem, gave me a positive experience that made me more confident in other nursing staff. At this point, I’d moved to “front line staff are good, but the system is crap”.

One day, I noticed the children’s vaccination service posting on Twitter, and they had an email address in their profile. So I emailed them – and they forwarded my email to a nurse who runs some clinics who could help.

We came up with a solution as described further up this page. However, she was on leave for a week, and while discussing my situation with a friend, I was put in contact with another nurse, who was able to help the very next day. We used the same plan.

I need to stress how impressed I am with the staff actually running and working in the clinics, but how disappointed I am with the helpline and online content that makes it so hard for phobic patients to access treatment.