Fear of needles [belonephobia]

Belonephobia (also known as trypanophobia) refers to the pathological fear of needles, pins, or any sharp or pointed object, and the physical and psychological manifestations of the sufferer are accentuated when the use of the sharp object is associated with the possibility of injury or blood loss. Belonging phobia is therefore often associated with hemophobia, the fear of blood. A person with abject phobia often experiences fear at the sight of ordinary, everyday, seemingly harmless objects such as needles and knives.

Fear of needles is an officially recognized psychiatric disorder and as such appears as a specific phobia in the Diagnostic and Statistical Manual of Mental Disorders (DSM) compiled by the American Psychiatric Association.

People who suffer from agoraphobia and cannot control their fear of needles may not only be afraid of having a trivial blood test, but may also experience severe discomfort at the sight of someone using a knife. If not properly managed, this phobia can lead to panic attacks with cold sweats, rapid heartbeat, shortness of breath, and nausea.

Fear of sharp objects also has two different conformations depending on the nature of the object itself: aicmophobia or aicmophobia, which is the specific fear of needles, and trypanophobia, which mainly identifies the fear of injections, needle sticks and syringes. With regard to the specific phobic stimulus, the terms enetophobia are used alternatively, in the case of fear of needles, and vaccinophobia, when the subject suffers from a morbid fear of vaccines.

We can also see other problems related to this phobia, as a direct consequence, namely hemophobia (fear of blood) and traumatophobia (fear of injury).

The combination of these phobias makes it really complicated to manage one’s reactions: the fear can become so strong that it frightens the person to the point of refusing even necessary medical interventions. The consequences and impact on health status can then be very serious.

The negative effects can also have an impact on the health of others; in fact, the most common reason cited by non-donors (60%) for not donating blood or blood derivatives seems to be a fear of belonging.

It seems to be a fairly common disorder, as it seems that about 10% of the world’s population suffers from it, although it is not better specified to what extent. It is thought that this phobia may have a genetic cause, as many of those who suffer from it have a relative with the same fear, but this has not been proven in any way. It also seems to affect men more than women, although statistically women are more phobic than men.

People who suffer from agoraphobia may experience high levels of anxiety in situations where the objects in question do not pose a real, concrete threat. For example, having to go to a laboratory to get a blood test can be an extremely strong anxiety stimulus for a beloved phobic; or seeing someone handle a knife while cooking can lead to a full-blown anxiety crisis.

In extreme cases, in an attempt to cope with their fear, people with agoraphobia avoid handling the feared objects or even eliminate them from the environments they frequent; they try to avoid situations in which the risk of coming into contact (even if only visually) with such objects is very high; they avoid tests, medical examinations, dental examinations, and whatever else, simply because they are afraid of having to handle needles or sharp objects.

In the most severe cases, as with all other types of specific phobias, people with agoraphobia end up avoiding more and more any environment, context, or person for fear of involuntarily coming into more or less direct contact with the object of their fear; this can lead these people to isolate themselves socially and affectively, limiting contact with the outside world as much as possible and making it at least difficult for their lives to unfold normally.

Although it seems that this phobia is usually present from adolescence, although it is possible for the person to report having gone through different stages of severity of the problem, a specific time for women when this can suddenly become acute and disruptive to their health can be pregnancy.

In these cases, women manifest great difficulty in facing blood tests (which are now scheduled monthly by the national health system), in the case of possible invasive prenatal examinations (such as amniocentesis or villocentesis), and finally in the case of the need to undergo local anesthesia for delivery.

Other situations in which the problem may cause great difficulty for the person affected and concern for those around him or her include surgery (even if planned and non-emergency), traffic accidents, simple vaccinations, treatments involving the use of syringes or intravenous drips, blood sugar sampling in the case of diabetes check-ups, etc.

Cognitive-behavioral psychotherapy can play a central role in helping the person to recognize the problem immediately, to obtain a diagnosis as soon as possible, and to overcome it within a few weeks thanks to the use of specific techniques.

In fact, precisely because this phobia risks endangering one’s health and jeopardizing the possibility of clinical analysis, finding the most appropriate solution is the first step following the diagnosis, and in this, properly trained specialists in the field can play a decisive role.

Objects and situations that trigger belonephobia

With respect to the objects that trigger the phobia, people with belonephobia are intimidated by or cannot tolerate the sight of sharp and/or sharp objects, including needles, syringes, knives, pieces of glass, and hacksaws.

Even situations that do not pose a potential threat are capable of evoking anxiety, such as, for example, the thought of having to undergo a blood test or seeing someone handle a knife.

Importantly, belonephobia can also be triggered by just watching a movie or television program.

Symptoms and consequences

Symptoms and severity vary from person to person, but in general, agoraphobia manifests as discomfort, disgust, or a sense of distress with sharp objects and instruments such as needles, syringes, knives, and needlesticks. This disorder can cause anxiety and, in extreme cases, panic attacks.

For those with agoraphobia, the sight of sharp objects can also cause physiological reactions such as

  • chills and goosebumps
  • cold sweat
  • heart palpitations
  • tingling and itching
  • distortions or optical illusions
  • nausea and/or vomiting
  • feeling faint or dizzy
  • shortness of breath
  • dry mouth
  • tremors
  • crying
  • confusion.

In severe cases, these symptoms are triggered by even thinking about the images that trigger the fear of needles. In some patients, this fear is associated with anxiety disorders and other specific phobias such as hemophobia (fear of blood), algophobia (fear of pain), and iatrophobia (irrational fear of doctors).

Possible consequences of fear of needles

Needle phobia may correlate with avoidance of diagnostic tests and medical treatments.

For example, individuals may find it difficult to:

  • Go to the doctor;
  • Undergoing routine blood tests;
  • Adhere to prescribed treatment protocols when ill; Use injectable medications.

Belonephobia can expose the patient to very serious problems: think of vaccinations, or a person with diabetes skipping glucose monitoring or insulin injections.

Treatment and remedies

The phobia of needles can be treated with different methods (psychotherapy, relaxation techniques, medication, etc.), also in combination.

These interventions aim to get the patient to rationalize his or her phobia, trying to focus on the possibility of responding to anxiogenic thoughts and addressing the negative beliefs associated with the fear of needles.

Exposure and desensitization therapy

One approach that has proven effective in the treatment of agoraphobia is to expose the patient to phobic stimuli under controlled conditions until systemic desensitization is achieved. Therapy involves gradual and repeated exposure over time to sharp or pointed figures, objects, and tools to address the negative ideas associated with the fear of needles.

Cognitive behavioral psychotherapy

Desensitization can be practiced in combination with cognitive and behavioral techniques to change the vicious cycle of agoraphobia and work on the meaning of needles or other sharp objects to the patient.

In this way, the person with agoraphobia is exposed to the feared situations and has the opportunity to learn emotional self-control techniques that will enable him or her to reduce the fear.

Relaxation techniques

To effectively treat agoraphobia, cognitive behavioral psychotherapy can be combined with relaxation techniques such as autogenic training, breathing exercises, and yoga. These treatments can help manage anxiety associated with fear of needles.


Medication is prescribed by a psychiatrist in more severe cases of agoraphobia, especially to control symptoms of conditions associated with the phobic disorder, such as depression and anxiety.

Medications that are usually indicated include benzodiazepines, beta-blockers, tricyclic antidepressants, selective serotonin reuptake inhibitors (SSRIs), and monoamine oxidase inhibitors (MAOIs).

Some advice

People with this condition are advised to tell doctors and nurses about their fear before having a blood sample taken or an injection given. Since the health care professional is aware of the fear of needles, they can ask questions to try to reassure the patient and reduce stress during the procedure.

Measures to distract from the phobic stimulus can be varied and include making small talk, watching a video on a smartphone, listening to music, applying cold and vibration, etc.

Other useful tips for those who have to undergo a blood draw or injection may include:

  • Try to look away from the phobic stimulus if it causes discomfort;
  • Breathe slowly and deeply;
  • Ask a family member or friend to accompany you.
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