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"Shot Phobia"
By Mary Beth Lodge
History:
A 16 y/o girl came to my office with her mother with the complaint of “shot phobia”. During the interview she shared that she has been afraid of injections for as long as she could remember. Her mother validated this information and described that for every vaccination and injection, the client was restrained by the healthcare staff, especially as a small child. During her most recent medical visit in which she needed an injection, she tried taking her friends with her, because she thought she would be able to keep herself calm in front of her friends. This was not the case and she found herself trying to figure out how to escape from the room and then becoming very upset, crying and struggling while the healthcare workers again forced her to receive the injection. She feels that they do not give her enough time to calm herself before they force her to take the injection. But she is also aware that if they gave her more time she would only think about how to escape from the room and is not able to focus enough to calm herself. She is quite embarrassed by her behavior, especially when it occurred in front of her friends, but she is unable to control it from the cognitive level.
MetaModel:
The client describes her fear as “always lurking inside of me”. She remembers “screaming my head off” as a child. She wants to “stop being afraid of shots”. Currently her phobia interferes with her life because she is supposed to go to Costa Rica but if it means getting any shots she would decide not to go. She wants to be able to decide for herself to get an injection as opposed to being forced by the health care workers. “I imagine the needle so much bigger than it really is.” She feels angry before she gets the injection and then following the event feels embarrassed and angry at her behavior. She also is angry that she is not in control of her actions or choices.
She can clearly state that being free of her phobia would give her more of a sense of control and choice. She wants to take the trip to Costa Rica with her family. The difference she wants to see is the ability to calm herself and remain calm when receiving an injection.
Intervention:
1) Added resource: I anchored the fear state, and then anchored distance from the fear, by having her imagine the scene on a movie screen and then diminishing the size of the needle. I then added laughter, since it is impossible to maintain a fear state and laughter at the same time.
2)I taught the client a quick self induction for hypnosis. Using imagery I taught the client to achieve calm by imagining her favorite beach in Hawaii. I enhanced all of the senses in this imagery and gave her a post hypnotic suggestion to be able to access this image whenever she wanted or needed it.
3)Future pace: I guided the client through several situations in which she might need an injection, linking her calm state to the images.
Response:
The first intervention almost worked too well. The client thought of a situation that dissolved her into helpless giggles. Once I anchored it and chained it with her fear state she was unable to stop laughing. It almost appeared to be an emotional release, so I allowed it for a few seconds before calming her. The imagery and future pace were very effective and the client reported a sense of empowerment and hope.
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