John Ernst, PhD, LPC

Talks About…



In my practice, I frequently treat patients who struggle with a variety of fears and phobias, as well as the uncomfortable anxiety that accompanies these conditions. A fear of needles or getting a ‘shot’ (injections, vaccinations, blood draws, etc.) ranks high on their lists of worrisome life events. The continuum of these concerns can range from mild situational distress to the extreme of a phobic condition known as trypanophobia – a daunting 6-syllable word for a potentially treatable problem.

A Shot and a Fear

Some symptoms of trypanophobia may include dizziness, fainting, acute anxiety, fluctuating blood pressure or a racing heartbeat when a person is about to have a needle procedure. The American Psychiatric Association Diagnostic and Statistical Manual of Mental Health Disorders (DSM-5), describes some Specific Phobias (300.29) as being related to a “marked and persistent fear that is excessive and unreasonable, cued by the presence or anticipation of a specific object or situation (e.g., receiving an injection).”

But even if you are mildly afraid of getting a shot, you are not alone; a significant number of people have concerns about medical needle procedures. Please rest assured that mild and moderate anxiety about needles is much more common than phobias about them. Nonetheless, too many people fear and avoid beneficial medical treatments because of irrational fears and this can affect them in ways far greater than their perceived worries.

The Sticky History

The origin of human fears about needles is complex and unique to each individual; there is no simple answer to explain why some people easily tolerate medical needle procedures and why others may loathe them. Having a needle pierce us is certainly not a natural phenomenon. Our skin is a protective organ – how dare we allow a sharp object to breach our defensive armor? Historically, puncture wounds have been a cause for concern, whether from a spear, a sword or an arrow; if you became a victim it was often a bad sign for survival.

Maybe as an infant, used to unconditional care and comfort, a baby received soothing words from an anxious mother only to be subjected to the unfamiliar sensation of a vaccination from a stranger in a white coat – was this maternal betrayal? Perhaps as a grade schooler a youngster heard from peers that ‘shots’ hurt and this was stored in their ‘cognitive data bank’ of potential threats. Yet with maturity, most people develop the ability to rationally manage emotions about receiving an injection.

Numerous people easily tolerate injections every day if they are undergoing medical procedures or if they have to self-administer medications (such as insulin). In contrast, some individuals’ brains react and needlessly go on ‘alert’ before and during a simple vaccination in their doctor’s office. The fear of a shot ironically becomes more uncomfortable than the sensation of receiving one.

Coping with the Poking

Fortunately, there are numerous cognitive (thinking) and behavioral (action) ways to reduce and manage your fear of needle procedures; here are a few of them:

  • Re-think and perceive the procedure as something you are choosing for your ultimate benefit, rather than something that is being forced on you. You are in control; the situation is not controlling you.
  • Remember that a quick ‘pinch’ of discomfort can protect you for a very long time. Consider the difference between a brief procedural moment versus an extended stay in a hospital. Two seconds out of your life is astonishingly small compared to how long you’ll eventually live.
  • Get ‘healthy angry’ at your fear and win the battle. Do not let fears and anxiety intimidate and manipulate your existence. Go to ‘war’ with negative thinking and be the proud champion of the moment.
  • Rather than expecting your anxiety to completely and instantly vanish, minimize and manage its existence. A recognized anxiety ‘hamster’ that might occasionally ‘nip’ you is certainly easier to pet than an exaggerated anxiety ‘monster.’
  • Admit you may have fears as a part of being human and then take steps to accept and normalize them to take away their (undeserved) power over you. Have the courage to be imperfect.
  • Create helpful distractions as coping tools. Focus on items in the medical procedure room and identify similarly colored objects or count ceiling tiles.
  • Close your eyes and visualize a pleasant thought (mental picture) from the past while taking slow, deep breaths.
  • Admit to the ‘shot-giver’ that you might feel nervous – they are trained to help and they care about your welfare.
  • Hum a favorite song or simply ‘think it in your head’ for a while.
  • Plan a reward for after your shot, such as getting a favorite coffee, going to the zoo, buying a new book, or going out to lunch with a friend.
  • Increasingly pinch your thumb and forefinger together as hard as you can on your non-injection arm. It can distract you from being hyper-focused on the inoculation; this technique has worked for many of my patients.
  • For persistent and significant fears, consider consulting with a mental health professional who can help you with cognitive-behavioral strategies that examine how thoughts affect emotions and ultimately shape a person’s behavior.

A Final Point

There is no need to let anxiety intimidate and prevent you from getting a ‘shot’ or a medical procedure that might enhance or save your life and possibly contribute to the well-being of others.

Living intentionally and keeping rational promises to ourselves can provide us with a sense of purpose and accomplishment, often enhancing self-worth, increased personal satisfaction and happiness. Learning to have the courage to face and overcome irrational fears can be a powerful and liberating component in our human journey of personal growth.


Copyright 2021 – John Ernst, Ph.D., LPC


John Ernst, PhD, LPC treats children, adolescents, families, individual adults and couples. He is presently accepting new patients. To establish an appointment, please contact Dr. Ernst at 414-329-7000 and ask for him specifically to discuss your initial questions.