Extreme fear accompanies the 33-year-old to a vaccination appointment. She has the feeling that she has to go to the butcher. “I would definitely call the fear the fear of death,” says the woman, who does not want to be named. She has been struggling with a so-called blood injection injury phobia since childhood. The puncture of a syringe needle causes her to faint. For this reason, she had not had a blood drawn for 29 years, and for years she had not been able to attend vaccination appointments.
Then the corona vaccination came and the pressure rose. By chance, the lawyer became aware of a short therapy program of the Max Planck Institute (MPI) for Psychiatry in Munich, which is supposed to help people with an injection phobia to control their fears.
The program is aimed, among other things, at people who suffer from an injection phobia and still want to be vaccinated quickly. In individual sessions, they are informed about the illness and symptoms, among other things, as Angelika Erhardt, the senior physician of the MPI’s psychiatric outpatient clinic and project group leader of the program, explains. In the meetings, photos and videos of syringes are viewed and syringes are picked up. The core of the short therapy is the exposure, in which those affected are confronted directly with the fear.
The interest in the program is high, says Erhardt. The MPI can treat ten patients simultaneously in individual therapies. Since younger generations have also been vaccinated, the number of inquiries has increased – mainly patients between 20 and 35 years of age have shown interest.
It was only through the program that the lawyer became aware that she had been suffering from a serious illness for years. She always thought she would get in line. She classified her fear as a sensitivity “that I have to somehow get over myself, but actually don’t know how”. She can now deal with her fear better. The corona vaccinations were accompanied by the program. With the second vaccination, she already felt a clear improvement from the first vaccination. “You learn to endure this fear,” she says.
In the case of a syringe phobia, the short therapy is covered by the health insurance companies, according to Erhardt. “It’s a disease. We are then not moving within the framework of a little fear of the syringe, ”she says. Those affected would have negative consequences because of the phobia. In children and young adults, the number of those affected is up to 20 percent. Over the entire lifespan, about three percent are affected, since the incidence of the disease decreases in old age as far as is known, explains Erhardt. The chances of improvement are good: 90 percent of the participants left the program with a vaccination or a blood sample. You might still be afraid of syringes, but you would know how to handle them.
The psychotherapist Enno Maaß also treats people with an injection phobia in his practice in Wittmund, Lower Saxony. He sees those affected in his practice who sometimes have serious secondary diseases – for example poor dental condition or undetected diabetes diseases. Out of shame and fear, some of those affected no longer went to the doctor, says the deputy federal chairman of the German Association of Psychotherapists (DPtV). The decision and motivation to undergo therapy is the biggest step for those affected. “The rest is usually easy to treat,” says Maaß.
It also plays a role how long someone has been plagued by the phobia. From the first occurrence of a mental illness to psychotherapy, it would take between seven and twelve years for many illnesses, explains the psychological psychotherapist. In some cases, long-term therapy helps better than a short program. In an outpatient therapy, in contrast to the short program, you get a tailored and individual offer that also deals with the personal context such as the family environment and previous biographical experiences.
According to Maaß, one problem is that anxiety disorders are aggravated by avoidance behavior. With every avoidance, there is a learning curve that confirms to the person concerned that the situation is really dangerous. “By avoiding something, I am giving myself the signal that it is probably better to avoid it,” he explains.
The lawyer concerned knows this vicious circle. “You put it all off a bit,” she says. She deliberately did not take the vaccination booklet with her to doctor’s appointments; the fear of asking questions was too great. She tried to avoid vaccinations and especially blood tests. As soon as an injection was announced or occurred in an examination, the 33-year-old thought to herself: “No, I definitely won’t do that”. According to the anxiety disorder expert Borwin Bandelow, it is typical that one cannot control the phobia with the help of reason. Phobias played out in a part of the brain that was out of control.
The 33-year-old in Munich had to work against fainting at the corona vaccination appointments – using a technique that she learned in the MPI’s short program. For them, the needle puncture, the injury, is the worst. She is also afraid of the pain that occurs when the needle is inserted. The origins of such fears lie far in the past, says Bandelow, psychiatrist and psychologist at the psychiatric clinic at the University of Göttingen. Once you shouldn’t have been allowed to injure yourself as much as possible – even stabbing yourself on a thorn could have meant death in the course of an infection. “Everyone avoided a prick like the plague.”
For the lawyer, taking blood is even worse than vaccinating. “Before that, I was really close to crying. It was very, very bad that when you were 33 you were sitting somewhere with tears in your eyes, ”she remembers. Sentences like “Look the other way” or “Don’t act like that” don’t help, but have the opposite effect.
Anxiety researcher Bandelow advises those affected to confront fear directly and get vaccinated. If you have a very strong phobia, you can have a sedative prescribed if necessary and take it with you to the vaccination. Relatives should be careful with those affected and accompany them to a vaccination appointment. “Doing and doing is more important than talking,” he explains.
At the end of the program, the lawyer overcame her fear, had herself vaccinated and blood drawn – without sedatives. She was proud and surprised at the same time afterwards. “It triggers a joy and a liberation,” she says. Now she finally wants to know whether everything is okay with her blood values. Thanks to the short-term therapy, she can do that – but “I probably won’t be a blood donor,” she says and laughs.