Hypnosis and the Fear of Blood Draws and Needles
The letter arrives with the prescription, and it starts right there. Not on the day: three weeks before.
You put it off. You book an appointment, you cancel it. You end up going on an empty stomach, after a bad night, looking for a chair as soon as you walk in, because you know what can happen.
And there is what other people do not understand: it is not the pain. You know perfectly well that it barely hurts. It changes nothing at all.
A phobia unlike the others
The fear of blood, needles and medical procedures often brings together haemophobia, the fear of blood, and belonephobia, the fear of needles.
It differs from every other phobia on one essential point, and that changes everything about how to approach it.
In an ordinary phobia — flying, spiders, crowds — the body revs up: the heart speeds up, blood pressure rises, and it stays that way.
Here, the reaction comes in two stages. The body revs up first, as elsewhere. Then, abruptly, heart rate and blood pressure drop. That is the vasovagal response, and it is why this is the one phobia where people faint regularly. A substantial share of those affected report at least one such episode.
And there is a loop: having lost consciousness once installs the fear of it happening again, which increases anticipation, which makes the next episode more likely.
The practical consequence, and it is the most important point on this page. Relaxing deeply is not the right instruction for this phobia. For all the others, bringing arousal down is exactly what is needed. Here, blood pressure is already dropping on its own, and going along with it can encourage fainting rather than prevent it. The reference approach is called applied tension, formalised by the Swedish psychologist Lars-Göran Öst in the late 1980s. The principle: deliberately tensing the large muscle groups to bring blood pressure back up at the first signs of faintness. In practice, as the protocols describe it: tense the muscles of the arms, chest and legs for 15 to 20 seconds, until you feel a slight warmth rising in your face, then release for 20 to 30 seconds without seeking relaxation, and repeat the cycle about five times. You practise it before the appointment, then during the procedure. It is simple, it is quickly learned, and it is the opposite of what you read everywhere else. Ask your doctor or your practitioner about it. It combines very well with work on anticipation.
What it really costs
And it is not just a bad quarter of an hour. Tests put off are the real issue. A check-up delayed six months, irregular diabetes monitoring, a screening never done. The phobia ends up costing you in health. Vaccinations avoided. Pregnancy, with its repeated blood tests, sometimes an epidural dreaded months in advance. Blood donation, which many would gladly do otherwise.
Everyday care: the dentist, a local anaesthetic, having a drip put in, an MRI with contrast. And for people followed for a chronic illness, the monitoring blood tests, for instance in IBD follow-up.
And the shame. Many adults never mention it, because they find it ridiculous at their age. The people who take the sample see it every day.
What exists, and what you can ask for
A good part of it rests with the person taking the sample, and often it is enough to say so.
- Applied tension, described above.
- Lying down during the procedure. It is the simplest and most effective measure against fainting, and it is almost never refused.
- Telling the person taking the sample, as soon as you arrive. It is neither awkward nor unusual, and it genuinely changes how the procedure is done.
- A numbing cream, applied before the appointment, particularly useful with children. It is prescribed or bought over the counter depending on the country: ask for advice.
- Drinking enough beforehand, unless you have been told to fast.
- Looking away, and bringing someone with you.
- Exposure therapy, the reference approach for specific phobias, often very effective here.
On the day
- Say when you arrive that you are prone to fainting. It is the most useful thing on this list.
- Ask to lie down.
- Use applied tension before and during, if it has been explained to you.
- Drink enough beforehand, unless you are fasting.
- Look away and bring something to occupy your attention.
- Plan to stay seated for a few minutes afterwards, without standing up suddenly.
- Do not drive straight away if you have fainted before.
This advice does not replace what the person taking your sample tells you. If you have already lost consciousness during a blood draw, tell your doctor: it is useful information for them.
What Hypnosis can bring
It does not make the procedure painless and it replaces neither applied tension nor lying down. It guarantees no result.
What an accompaniment aims at:
- The three weeks before. That is often the worst part, and it is where hypnosis is most useful: the anticipation that starts with the prescription and makes you postpone the appointment.
- Defusing a specific memory. There is almost always a founding episode: a botched blood draw in childhood, fainting in public, being held down. It is often the heart of the work.
- Working in imagination. Nothing real comes into the room. The scene can be revisited from a distance, with everything toned down as needed, and approached again gradually.
- Setting up an anchor you can use in the chair, combined with applied tension rather than instead of it.
- Diverting attention during the procedure, something hypnosis does particularly well — it is also what is practised in pain management.
- Taking back the tests you gave up on, starting with the simplest.
What research says
On applied tension, the data are clear. A review in the *Journal of Psychiatric Research* describes it as the technique generally recognised as effective for this phobia. In Öst and colleagues' reference trial, after five sessions, 90% of those treated with applied tension were clinically improved, and the improvement held a year later. A later trial compared a single session with five: both formats leave benefits at one year, the gap showing mostly just after treatment.
And on the point that concerns us, two clinicians writing in *Clinical Case Studies* put it plainly: people with this phobia generally respond less well to relaxation techniques, which may even prove counterproductive. That is exactly what we explain above.
One note of honesty: the two-stage reaction is not seen in everyone, and a 2010 review critically re-examined the empirical basis of the model. The mechanism is solid, it is not absolute.
On hypnosis, there is no study looking specifically at the fear of blood draws. What is documented is its effect on anxiety and its use in care settings to support unpleasant procedures, ground on which it is solid — we review it on our page what science says about hypnosis. That is consistent, and it is not proof.
An example of accompaniment: Isabelle's case
Isabelle (name changed) had a paralysing fear of blood draws. Walking into a laboratory was enough to bring on cold sweats and intense dizziness, and she had put off important tests because of it. The work began with a specific episode, a blood draw that had gone badly years earlier, which she had never talked about. Then on the days leading up to it, and on arriving at the laboratory, rehearsed in imagination before being lived. She learned to combine an anchor of calm with applied tension, which keeps blood pressure up and which her doctor had explained to her.
This case describes one possible path. It predicts no one's. The pace and the results vary from person to person, and no accompaniment can guarantee a result.
Children
This is where the essential is decided, because a fear installed early often becomes an adult phobia. What really helps rests mostly with the adults present, and comes down to a few simple things, listed below. What hypnosis brings at that age: children enter imagination easily, and diverting attention with a story during the procedure works very well. Preparation before the appointment often changes how it goes, as our page on hypnosis for children describes.
- Do not lie. "You won't feel a thing" destroys trust at the first prick. You can say it stings a little and that it is quick.
- Do not warn three days in advance for a young child: it only prolongs the anticipation.
- Avoid holding the child down by force as far as possible. A child held down keeps a lasting trace of that episode.
- The numbing cream, very useful and under-used.
- Holding the child on your lap rather than laying them down alone, when possible.
- Leaving a choice, however small: which arm, when to start.
Beyond blood draws, this applies to the whole care environment: MRI, X-ray, a dreaded appointment.
Book an appointment
Do you have a test on a set date? Tell us, it changes how we organise the work. Ask us your question or book an appointment. Wherever you are in the world, video consultation offers the same conversation and the same session as in the consulting room. We see people this way from France, Quebec, Morocco and well beyond. Here is how it works. Tell us too if you have already fainted during a blood draw: it is useful information for preparing the work.
Where would you like to consult?
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Frequently asked questions about Hypnosis and the Fear of Blood Draws and Needles
It is the most common reason to consult on this subject. Two levers combine: applied tension, which acts on the physical mechanism, and work on anticipation. Talk to your doctor about it too.
Because this is the one phobia where blood pressure drops. Relaxing deeply can accompany that drop instead of preventing it. It is a real feature, and very little known.
No. Everything happens in your imagination, with images you can move away or erase at any moment.
That is workable, and it is a common reason to consult. Say so at the first contact so the work is organised around the deadline.
See the section devoted to children. Preparation and a numbing cream often change a great deal, and hypnosis works well at that age.
It is a legitimate and important reason to consult, since avoidance here has direct consequences for your follow-up. Talk to your care team too: the equipment has changed a great deal.
That is discussed at the first appointment, depending on your deadline.
That is common during pregnancy. See also our page on preparing for birth, and talk to the anaesthetist at the consultation arranged for that.
Sources and references
On applied tension
- Öst, L.-G., & Sterner, U. (1987). *Applied tension: A specific behavioral method for treatment of blood phobia*. Behaviour Research and Therapy. The founding paper.
- Öst, L.-G., Fellenius, J., & Sterner, U. (1991). *Applied tension, exposure in vivo, and tension-only in the treatment of blood phobia*. Behaviour Research and Therapy, 29, 561-574.
- Hellström, K., Fellenius, J., & Öst, L.-G. (1996). *One versus five sessions of applied tension in the treatment of blood phobia*. Behaviour Research and Therapy, 34, 101-112. pubmed.ncbi.nlm.nih.gov/8741718
- Ayala, E. S., Meuret, A. E., & Ritz, T. (2009). *Treatments for blood-injury-injection phobia: A critical review of current evidence*. Journal of Psychiatric Research. sciencedirect.com
- Wannemueller, A. et al. (2018). *Large-Group One-Session Treatment: Exposure Combined With Applied Tension or Diaphragmatic Breathing in Highly Blood-Injury-Injection Fearful Individuals*. Frontiers in Psychology. frontiersin.org — detailed protocol, open access.
On relaxation and on the limits of the model
- Mednick, L. M., & Claar, R. L. (2012). *Treatment of Severe Blood-Injection-Injury Phobia With the Applied-Tension Method*. Clinical Case Studies. journals.sagepub.com
- Ritz, T., Meuret, A. E., & Ayala, E. S. (2010). *The psychophysiology of blood-injection-injury phobia: Looking beyond the diphasic response paradigm*. International Journal of Psychophysiology. sciencedirect.com
In French
- Perte de connaissance : réagir en cas d'urgence — Ameli, French national health insurance. On the vasovagal response and lying down at the first signs.
- Traitement des troubles anxieux de l'adulte — Ameli. On exposure therapy, the reference approach for specific phobias.
Hypnosis as practised by the members of Solutions Hypnose is a complementary support approach. It is neither a medical act, nor a diagnosis, nor psychotherapy in the regulatory sense, and it in no way replaces a consultation, follow-up or treatment prescribed by a health professional.
Our practitioners do not assess and do not treat mental disorders or illnesses. They never ask for an ongoing treatment to be stopped or changed: that decision rests exclusively with your doctor.
No result can be guaranteed. The testimonials and examples presented on this page describe individual experiences and do not predict what you will experience.
In case of significant distress, unexplained physical symptoms or suicidal thoughts, contact a doctor, emergency services or a helpline without delay.
Page written by Sabine Chapuis
hypnotherapist
partner at Solutions Hypnose.
English version reviewed by David Veilleux