The Author Talks with Us About This Important Book

New Harbinger Publications: What are the most effective treatments for phobias of blood, needles, and other medical situations?

Martin M. Antony: In the case of blood and needle phobias, exposure to the feared situation is the treatment of choice. For people who have a history of fainting in the situation, combining exposure with exercises involving tensing muscles has been found to temporarily raise blood pressure and prevent fainting, thereby making the process of treatment much easier.

NHP: Doesn’t the phobia prevent people from being able to do exposure?

MMA: When overcoming phobias, exposure practices are designed to be manageable. People begin with situations that are only mildly frightening and gradually work their way up to the more difficult situations. Exposure practices are designed to be predictable (with no surprises), and the individual is always in control so he or she can stop the exposure if necessary. Exposure also works best when the practices are frequent and prolonged.

NHP: How soon can readers of the book expect to see changes as the therapy begins to help?

MMA: In most of the research on phobias of blood or needles, individuals are able to overcome their fear in as little as one long session of exposure under the supervision of a trained therapist. In cases of more general medical phobias or dental phobias, treatment may take several sessions. Depending on how frequently people practice, they can expect to see changes quickly.

NHP: How common is it for patients to experience relapse after the use of these methods? Is there something that readers can do to reduce the chances of relapse?

MMA: Relapse rates tend to be fairly low in the treatment of phobias. Many studies follow people up for up to two years following the end of treatment and generally people maintain their gains over time. To reduce rates of relapse, the best thing that people can do is not to fall back into their old patterns of avoidance. In other words, they should take advantage of opportunities to confront situations they fear when available. Stress can also increase the risk of relapse; so finding ways to manage general stress in one’s life may help to protect individuals from experiencing a return of their fear.

NHP: Are medical phobias more problematic for sufferers than other phobias, and if so, how?

MMA: Medical phobias can be quite problematic. For example, we have seen people who have avoided getting necessary surgery because of their fear of surgery or their fear of blood work needed before the surgery. We have also seen women who wanted children avoid getting pregnant for fear of having to deal with various medical situations during their pregnancy. Many people with dental phobias have serious problems with their teeth as a result of their fear. However, medical phobias are not necessarily more problematic than other phobias. Almost any phobia can cause extreme problems in a person’s life depending on the severity.

NHP: Can exposure therapy be used in conjunction with other types of therapy such as hypnosis, in order to increase the patient’s chance of overcoming their fears?

MMA: In the case of blood and needle phobias, there is almost no evidence supporting any other kinds of therapies in the treatment of these problems, except for the muscle tension exercises described earlier for people who have a history of fainting in these situations. In addition, it is possible that the cognitive strategies described in this book may be a useful addition to exposure-based treatments. There is some evidence supporting the use of cognitive strategies and relaxation based strategies in the treatment of dental phobias, for example. With respect to hypnosis, there have been no well-controlled, properly conducted studies to evaluate whether this treatment approach is effective for medical phobias.