Needles, Scanners, and the Trouble With "Just Relax"

Last week I wrote about the dentist. This week I want to move down the corridor.

Two things get postponed more than almost anything else in medicine, and neither of them is the treatment itself.

It's the blood draw and the scan.

Why Blood Tests Can Make People Faint

Let me take the needle first, because there is something about it that almost nobody explains properly.

A great many people who dread blood tests are not simply anxious. They faint, or come close to it. And the reason that happens is genuinely different from ordinary fear, which is why the usual advice fails so badly. If you have ever wondered whether what you feel is just nerves or something more specific, it is worth reading Fear or Phobia? Why the Difference Matters.

With most frightening things, the body's response is to speed up. Heart rate rises, blood pressure rises, everything gets ready to run.

But with blood, needles and injury, a proportion of people do the opposite: after a brief rise, the blood pressure drops sharply and the world goes grey at the edges. This particular pattern, known as vasovagal syncope, is well documented by the Cleveland Clinic's overview of vasovagal syncope, which explains why the nervous system reacts this way to needles, blood, or medical instruments.

This is why "just relax" is not merely unhelpful. It is pointing in precisely the wrong direction.

Someone in that state does not need to be more relaxed. Physiologically, they need the opposite for a moment.

Anyone who has had this happen usually feels humiliated by it, and has often been treated as though they were being dramatic.

They were not being dramatic.

Their body was doing a very old and very specific thing, and nobody ever told them what it was. It belongs to a wider group of fears people rarely admit to out loud, the kind I wrote about in The Phobias We Don't Mention.

Knowing what is actually happening is, on its own, worth a great deal. Working with it changes the experience further, because underneath the physiological response there is nearly always an association, and associations are what 1:1 hypnosis is good at.

The Problem With Scanners

The scanner is a different animal.

The machines have changed, and the old picture of a narrow tube is largely out of date. Newer scanners are wider and more open than most people expect.

What has not changed is what is being asked of you: lie still, for twenty minutes or more, while it makes a noise like roadworks.

For scans of the head or neck you may be fitted with a mask, rather like a fencer's, clamped shut over the face.

Some people find all of this unremarkable. Others discover, often to their considerable surprise, that they cannot do it, and they only discover it once they are in there. That sudden discovery is not unusual. I explored how these reactions form, often without warning, in How a Phobia Is Born.

The distress is rarely about the space.

It is about not being able to move, and not being able to stop it.

The stillness is required, the duration is fixed, and the sense of having handed over control is total, which is exactly the kind of state that keeps the nervous system on edge long after the appointment ends, something I go into in Is Your Brain Stuck on High Alert?.

A mammogram, by contrast, involves no confinement at all. Though I have yet to meet the woman who is happy to be there.

Finding Somewhere Else to Be

What helps is having somewhere else to be.

This is closer to what most people imagine hypnosis to be, and for once the popular picture isn't far off.

Given a vivid, absorbing internal focus, and given it in advance and practised so it is available when needed, a great many people can go through a scan that they previously could not tolerate. This is the same principle behind Inside a Session: Resetting the Alarm, where I describe what it looks like to retrain the body's alarm response in practice.

They are not unconscious and they are not tricked.

Their attention is simply somewhere more comfortable than the inside of a magnet.

The Cost of Postponing Medical Tests

Both of these have a cost that goes well beyond the discomfort of the appointment.

People do not skip a blood test in isolation.

They skip the blood test, and so the medication doesn't get monitored, and so the dose doesn't get adjusted.

Or the test was the one that would have caught something early, and instead it gets caught late, when there are fewer options and harder ones.

They postpone the scan, and the question the scan was meant to answer stays open for another eight months.

And spare a thought for the doctor.

A patient who cannot be tested cannot really be followed. There is no trend to plot, no numbers to adjust against, nothing to compare this year to. It's a gap I hear about often from the physicians I work alongside, which is part of why I put together dedicated resources for medical professionals.

Every decision has to be made on less than it should be, and the patient almost never realises they have put their doctor in that position.

From where they are sitting, all they did was not make one appointment.

Fear is a small thing.

What it prevents is not.

Book a Consultation Call

If fear of needles, scans or other medical procedures is causing you to postpone necessary appointments, you can book a consultation call to discuss your concerns and explore whether hypnosis could help.