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Calgary Health Region / Dr. Gene Flessati / Breakfast Televion Interviews

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PSYCHOLOGY DEPARTMENT (Adult)

 

Dr. Gene Flessati

Dr. Gene Flessati is a Clinical Psychologist who works in an outpatient mentalhealth clinic in the Calgary Health Region. His clinical interests include anxiety and mood disorders, health psychology, relationship issues, psychological resilience, and the promotion of psychological health and well-being.

At Issue: Blood-Injection-Injury Phobia

 

Q: Many individuals say they are afraid of blood. Is fear of blood a phobia?

A: Many individuals are fearful of, or become squeamish, at the sight of blood. If the individual’s reaction affects his ability to function, it is classified as a phobia. Because individuals who react to the sight of blood have concerns about a number of related situations, the technical term for this phobia is blood-injection-injury phobia.

A number of health consequences are associated with having a blood-related phobia. Individuals with blood phobia may avoid seeing their dentist or doctor, and may avoid necessary medical procedures, including medical procedures for potentially life-threatening conditions. For example, an individual with cancer who has a phobia about needles and injections may refuse chemotherapy, even though she knows that chemotherapy may save her life.

Blood phobia shares a number of characteristics of other specific phobias. However, blood phobia is unique in several important ways.

Q: What makes blood phobia unique?

A: Typically, the primary emotion that underlies phobias is fear. For example, an individual with a phobia of heights will describe being scared of heights. In contrast, although individuals with blood-related phobias describe being afraid of blood-related stimuli, when we explore their reaction more closely, we discover that the main emotion that individuals with blood-related phobias experience is disgust. Put simply, individuals with blood-related phobias are grossed out by, rather than scared of, the sight of blood.

When placed in a situation that triggers their phobic reaction, individuals with specific phobias usually react by becoming afraid and perhaps having a panic attack. They may experience physical symptoms such as increased blood pressure and heart rate, increased muscle tension, and they have a strong urge to flee. We term this reaction the fight or flight response. In contrast, individuals with blood phobia initially show the same panic response as individuals with other phobias. However, after a minute or so they may then experience a sudden and dramatic decrease in physical arousal. For example, the person’s blood pressure will initially rise and then may fall suddenly and dramatically. This decrease may be so dramatic that the person faints. In fact, approximately 70 percent of individuals with blood-related phobias report that they have fainted in response to seeing blood.

At first, it may seem odd that a person would faint in response to seeing blood. However, as with most anxiety problems, blood phobia results from a physiological mechanism that has potential benefit for the individual. Experts agree that although fainting at the sight of a needle or of blood is problematic, a drop in blood pressure (which is what causes the person to faint) that occurs from bleeding profusely is very adaptive as it could save an individual’s life if it slows down bleeding, which may prevent the individual from bleeding to death.

Q: Are there effective treatments for blood phobia?

A: Absolutely! The most effective treatment for blood phobia is a type of behavior therapy called exposure therapy. A number of studies have reported that exposure therapy effectively reduces fear and disgust, as well as fainting. This treatment is usually effective within five to ten sessions.

Exposure therapy involves the phobic individual confronting various situations that trigger his phobia. Initially, the individual confronts situations that are moderately frightening to him (e.g., pictures of needles or of blood). As the individual becomes less fearful in this situation, he then confronts more intense situations (e.g., observing the therapist handle a needle).

The exposure component of therapy is identical in principle to exposure therapy for other phobias such as animals and heights. However, the treatment is modified to ensure that the individual does not faint during exposure. Fortunately, because the fainting response is due to the drop in blood pressure that occurs when the individual is exposed to blood, there is a simple, but highly effective, strategy to prevent fainting. This strategy involves the individual systematically tensing and relaxing the major muscles in his body – the legs, chest, and arms. The individual holds the tension for a period of ten to twenty seconds, releases the tension slightly, increases it again, and continues this process. Once the individual is able to maintain the tension in this manner, the therapist then assists him to confront feared situations. During the exposure practice, the individual uses the tensing strategy whenever he starts to feel the very beginnings of a fainting response. This very simple strategy is effective in preventing blood pressure from dropping, and it ensures that the person will not faint during exposure.

In order to reduce blood-related fears and phobias, it is very important to follow the principles of effective exposure therapy. These principles include having a systematic exposure plan, planning frequent exposure sessions, continuing each exposure to the blood-related stimulus until you experience a significant decrease in fear, and developing coping statements to counter the thoughts that drive your fear. Refer to Treating Specific Phobias for more information.

A detailed self-directed treatment plan is described in Overcoming Medical Phobias: How to Conquer Fear of Blood, Needles, Doctors & Dentists, written by Dr. Martin Antony and Dr. Mark A. Watling.

Prepared by: Department of Psychology, Rehabilitation & Specialized Clinical Services, Southeast Community Portfolio, Calgary Health Region
 

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