Phobias

I've been getting a lot of comments/feedback from many people about my needle phobia, and most people seem to think I'll just "get over it" when the pain hits. While I appreciate all of the insight, I am definitely frustrated by all the comments because I think most people do not understand the nature of a phobia. For me, I do not just have a fear of needles; I have an honest-to-goodness extreme phobia. I know everyone is trying to be sympathetic and supportive, but many of the comments about my phobia have been upsetting me because I know that no one really understands.

While some of you are lauding my efforts about hanging tough for this baby through the contractions, I also should confess that my phobia is also playing a significant role in the decision-making process. While I do have a genuine desire to put my baby's interests first, I also have a genuine desire to avoid needles and a c-section at all costs.

Instead of getting offended by some of the "you'll forget about the needle when you are in labor" comments, or the "you can't see the needle so it won't bother you," statements, I decided to take this opportunity to blog a little bit about phobias. I'm sure that my phobia won't make sense to most of you, and I can honestly say it defies my own logic as well. My phobia is actually overwhelming to me right now, and I wish it was not part of my reality. I understand that it is totally irrational and yet . . . it still controls me. That is particularly difficult for me because I like to believe I am a fully rational being with control over myself and my decisions. Control over myself and my emotions is very important to me, and with this phobia, I really do not have any sense of control.

A phobia is defined as an irrational, intense fear of an object or situation that poses little or no actual danger. Like a needle. At first glance, a phobia may seem similar to a normal fear, however "fear" is the normal response to a genuine danger. With phobias, the fear is either irrational or excessive - it is an abnormally fearful response to a danger that is either imagined or irrationally exaggerated. This is my problem - and no amount of "logic" seems to help the brain comprehend that the perceived danger is either nonexistent or irrationally exaggerated in the moment.

It is the degree to which a person is affected that determines whether that fear has become a phobia. Phobias are emotional and physical reactions to feared objects or situations. Each person’s symptoms are a little bit different, but may include the following:

• Dizziness, rapid heartbeat, trembling, or other uncontrollable physical response
• Sensation of terror, dread, horror or panic
• Reactions that are automatic and uncontrollable, practically taking over the person’s thoughts
• Preoccupation of thoughts; inability to change focus from the feared situation
• Fight or flight response - need to defend against the perceived danger and/or an intense desire to flee the situation
• Recognition that the fear goes beyond normal boundaries and the actual threat of danger
• Extreme measures taken to avoid the feared object or situation

I pretty much have all of those symptoms. My phobia manifests in an actual uncontrollable physical response in addition to the terror/panic. I shake, I have difficulty breathing and can give myself an asthma attack from the panic, and my heart rate skyrockets. I am currently preoccupied with the possible needle encounters that an induction could bring, and I can't really seem to let it go. My desire when exposed to a needle is either to run, or if I feel trapped, my instinct is to fight. And fight I do - it is like I leave my head and I am fighting as if my life depends on it. I hit, scream, kick, and generally wreak physical panic on anyone who is unlucky enough to be in my path. It is embarassing because I do not really know that I am doing it and I seem to be powerless to stop myself from behaving that way.

It is generally accepted that phobias arise from a combination of external events and internal predispositions. Many specific phobias can be traced back to a specific triggering event, usually a traumatic experience at an early age. That is actually my problem - I had two traumatic needle encounters as a very young child, and as a result, I have created this ridiculous, overexaggerated belief in the danger of needles that, despite all logic, I cannot seem to release.

Phobias are more often than not linked to the amygdala, an area of the brain located behind the pituitary gland. The amygdala secretes hormones that control fear and aggression. When the fear or aggression response is initiated, the amygdala releases hormones into the body to put the human body into an "alert" state, in which they are ready to move, run, fight, etc. This defensive "alert" state and response is generally referred to in psychology as the Fight-or-Flight response. Phobias vary in severity among individuals. Some individuals can simply avoid the subject of their fear and suffer only relatively mild anxiety over that fear. Others suffer fully-fledged panic attacks with all the associated disabling symptoms. I fall into this latter category. To the extent I can avoid needle encounters, my phobia presents no problems in my daily life. I do not have issues with seeing needles, or medical procedures performed on others, or even seeing a needle injected into someone else - my fear is solely focused on an actual needle touching ME.

Most individuals understand that they are suffering from an irrational fear, but are powerless to override their initial panic reaction. This is how I feel - I know my fear is irrational, and I start each encounter with the best of intentions to have my logic govern my responses, but somehow, the panic reaction always sets in, and there is nothing I can seem to do to stop the panic once it starts.

Over the years, I have come a long way. I can usually have blood drawn, but I've created a lot of "rules" for the phlebotomists that help me avoid my initial panic response. For example, I can only have blood drawn with a butterfly needle. Why? Somehow, I believe that the smaller needles cause less danger. They also have to be able to draw blood with one stick, and not move the needle around once it is inserted. Somehow, I believe that they are more competent or I am in less danger if the stick is done once and the needle isn't moved around. Speed is also important to me - the stick needs to be done quickly, the blood needs to be drawn immediately, and they need to get the needle out fast before wasting time labeling the vials or separating the vials from the tube. If the phlebotomist fails somehow to draw blood this way, the panic still sets in, and I turn into a holy terror.

Shots are another issue for me. I still haven't figured out how to get a shot in my arm. I have not had any vaccinations since I was 15 years old. I won't get a tetanus shot and I won't get the flu shot. I have refused allergy testing and allergy shots, choosing instead to suffer. I've been able to justify my fear with issues of scheduling and time commitments, but the bottom line is I'm too afraid of the shots to even seriously entertain the idea. I have recently discovered that I can handle some subcutaneous shots if I have to . . . as long as I can use numbing cream first. Ridiculous, right? It isn't like the shots actually hurt, but somehow I need to not feel anything in order to distance myself from the panic response.

IVs are a whole other level of panic for me - for some reason, much worse than a blood draw or a subcutaneous shot. Yes, I have a hierarchy of danger for needles. My second traumatic experience with needles related to the placement of an IV, so I have a particular fear of IVs. I have yet to figure out how to get beyond that one. I had surgery earlier this year, and they were unable to get an IV in me while I was awake - ultimately, laughing gas was required. So, while I'd like to say that for the good of myself and my baby, I can "get through" the uncomfortable placement of an IV, I think the greater likelihood is I am going to panic out of some ridiculous and exaggerated belief that the IV is a threat to my safety.

For those of you that are still here, you probably now think I should be checked into the closest psych ward somewhere. I can understand that - I don't understand phobias that other people have, but I do know that phobias are real, and right now, my phobia is making my life quite challenging. So, I guess I would ask that before you tell me about how I won't even see or feel the needle, or I'll get over it in the moment, or it is no big deal, try and remember that I am dealing with an irrational, overriding fear. Just know that in my head, it IS a big deal. Your support is welcome and much appreciated, but the reassurances actually create more anxiety for me. I do not find ANYTHING reassuring about not being able to see the needle - inability to see somehow makes me believe that the needle poses an increased danger to me - probably a control thing. Even hearing it didn't really hurt, or it was over quickly, or it only hurts for a minute also does not reassure me - it isn't really the pain I fear - it is the process itself.

Thanks for listening!