I know a woman who bravely withstood surgery and radiation for breast cancer, who is fearless in the face of life’s many challenges… but she was horrified when I suggested acupuncture to her. “Needles… no way!” Fear of needles is not unique to childhood — it’s estimated that 21% of Americans are, like my friend, terrified of them. For many people, needle fear leads to health problems as they avoid routine blood tests and vaccinations, and for those with diabetes or another chronic condition requiring regular injections, needle anxiety can turn into a nightmare. I don’t know why this problem isn’t more widely discussed in health-care settings, because there are some remarkably simple strategies that can stop or reduce almost anyone’s fear of needles… so let’s explore them now.

The Worst Three Things You Can Say

Lindsay Uman, PhD, is a clinical psychologist at the IWK Health Centre in Halifax, Nova Scotia, which is an international leader in research concerning needle fear and distress. Although the Centre focuses on children, Dr. Uman says techniques to ease needle fear are similar to those for adults. Here’s the funny thing: The studies Dr. Uman reviewed show that most well-meaning nurses, doctors and phlebotomists actually have a habit of saying just the wrong thing to nervous patients. Their intentions are the best, but the results are not.

  • Their first mistake? The very human impulse to be reassuring. “If someone keeps saying there is nothing to worry about, the message generally received is that there is something you really do need to worry about,” said Dr. Uman.
  • The second worst mistake? Criticizing patients’ fear by telling them to “Get a grip,” “Get over it” or “Don’t be a baby” — belittling messages that would make anyone feel worse.
  • The third kind of phrase often heard but best not uttered? A “pre-apology,” such as saying “Sorry about this,” as the elastic strap is wound tightly around the arm. This, Dr. Uman said, only brings more fear and distress.

What Does Help

If you have ever felt weak or silly because you couldn’t talk yourself out of the fear of needles, give yourself a break — as with most fears, this one isn’t rational, so you can’t expect rational talk (from yourself or anyone else) to help. Instead, you can try the following…

Distraction. This is number one in effectiveness and can include anything from blowing bubbles for young children to putting on headphones and playing music for adults. Watching TV, reading, chatting about the weather or the latest news… even making up stories about people around you and saying them aloud if you enjoy being creative… talking about anything but the needle will be helpful. I had a doctor who always pointed to something fascinating outside the window — a cardinal on the branch… tiger lilies starting to bloom. By the time I’d focused my eyes out the window, the shot was over.

Relaxation techniques. These can help, especially when practiced shortly before the procedure — calm breathing, positive imagery, a few minutes of meditation, whatever relaxes a nervous patient is the way to go. Not only do techniques for relaxing the mind ease fear — they also reduce muscle tension that could otherwise make shots more painful.

Skin-numbing creams. A product called EMLA, available by prescription, combines the anesthetics lidocaine and prilocaine and will numb the area, but for best results, you need to apply the cream 30 to 60 minutes in advance. Dr. Uman said that for some people, using the cream provides a calming psychological effect that comes just from knowing that the physical pain will be reduced.

If your fear of needles continues to be a problem, consider talking with a cognitive behavioral therapist or any psychologist trained in anxiety-reducing techniques — these professionals likely can help you. Ask your doctor or local hospital for a referral. For some people, Dr. Uman said, it takes only a few sessions for a patient to put needle fear into the past.

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