THE HUMAN CONDITION NEEDLE PHOBIA : Point of Anxiety

She had to submit, her marriage was at stake. So the nervous bride-to-be, with small veins and a fear of needles, faced her worst nightmare: an inexperienced lab technician--armed with a syringe.

The technician tied off her arm with a tourniquet and thumped it to bring up a vein. She poked in the needle. Nothing.

She thumped again and poked again. Nothing.

Thump. Poke. Thump. Poke.

Drawing no blood, she turned to the other arm and started again.

Poke. Poke. Poke.

Finally she called in a more experienced technician, explaining: “I just don’t want the veins to collapse.”

“At the sound of the word collapse , I went white as a sheet,” the woman recalls.

She nearly fainted, but finally it ended happily: The second technician found a vein and the patient got married.

Why does one little, itty-bitty needle trigger so much anxiety?

Why does it cause otherwise intelligent people to shun doctors and dentists, put off medical tests and base health-care decisions on whether they might encounter a needle?

One Palos Verdes Estates housewife admits that she picked a maternity hospital by checking whether it required an IV during delivery.

Another woman, faced with a verrrry long aspirating needle for a diagnostic test, says she considered telling the doctor: “That’s OK; I’ll just die.”

She survived the test, she says, because the sympathetic nurse told her: “Now look at me ; we’re just gonna maintain eye contact”--and then held her hand throughout the procedure.

And, not surprisingly, serious needle avoiders don’t hang around blood banks.

“We don’t get ‘em. Anybody who has a real phobia about needles just does not come in to give blood,” says Bette Juneau of the American Red Cross of Los Angeles and Orange counties.

But why does that thin shaft of metal inspire so much fear?

“For some people, it’s a fear of pain,” explains Elizabeth Alden, a Santa Barbara psychotherapist. “For others, it’s a sense of body integrity. Body integrity is a concept of the skin as a cover, protecting them, around them . . . a sense of self. If the skin is cut or punctured, this isn’t the way it’s supposed to be. It’s disruptive.”

Just ask Stephani Bankett.

“It hurts,” says the 27-year-old data processor for a Houston oil company. “Well, it really doesn’t always hurt. It’s aggravating to be punctured--and that’s what it is . . . somebody puncturing your skin.”

But others say it’s more a mental thing.

“One thing I’ve learned is that the anticipation is worse,” says Hadrian Lesser, 19, a reporter for radio station KGIL who, since March, has been treated for his fear of needles at the USC Anxiety Disorder Clinic.

“Once the needle is in you--drawing blood or whatever--it’s not that bad. It’s the . . . buildup. I think it’s in the mind.”

While no one really likes needles, some people cope better than others.

“I’m great at dissociating when I have to,” psychologist Alden says of needles. In other words, she simply thinks about something else.

The method worked well when Alden, the mother of a 2-year-old, underwent amniocentesis during her pregnancy. Her husband, however, “turned green,” she says.

Alden’s husband, Jack Clymer, concedes he has to “look away,” and says his worst encounter came when he needed an IV while hospitalized with a broken leg:

“I’ve got great big veins, but the nurses always missed them.

“They would always poke and withdraw, then poke again. They finally found a vein in my left arm and left the needle in for four days. My left hand was numb for six weeks after that.”

Clymer, a contractor in Carpinteria, says he once considered acupuncture to help him quit smoking. “My fear of smoking was greater than my fear of needles,” he thought at the time. But he eventually dismissed the idea--and still smokes.

The fear of needles is called belonephobia , from the Greek belone (needle) and phobos (fear). (It’s not to be confused with blennophobia --the fear of slime.)

Technically, belonephobia is the morbid fear of needles, pins and other sharp-pointed objects.

According to the Encyclopedia of Phobias, Fears and Anxieties, the fear of needles is related to the fear of blood-injury and blood. Studies show that from 3.1% to 4.5% of the population suffer from such phobias.

That percentage may sound small, but it was enough to lead producers of the play “Miss Evers’ Boys” to take special precautions last year at the Mark Taper Forum. A nurse was on duty each night to help the squeamish in the audience deal with an agonizingly long scene that involved a painfully long needle for an onstage dramatization of a spinal tap.

People afflicted by belonephobia “tend to pass out, tend to faint when confronted with the fear,” says Dr. Dennis Munjack, associate professor of psychiatry at USC and director of the USC Anxiety Disorder Clinic. “Most fears will cause an increase in heart rate. With this, it might speed up initially, but then it falls and blood pressure falls and people faint.”

So when patients come to Munjack for treatment, he says, “we usually have them lie down because some people get a little lightheaded or woozy.”

The trait can run in families, he notes. “It’s not clear if it’s genetic partly or whether you learn it,” Munjack says. An affected person may have overheard someone talking about it.

Often, the fear can often be traced to a childhood trauma. That was the case for one clinic patient, he says:

“When she was in the fourth grade, she received an injection at school. When the nurse removed the injection, the needle was left in her arm. The nurse became hysterical and ran out of the room.”

Similarly, data processor Bankett recalls a grisly childhood incident at her grandmother’s home:

“My grandmother warned me not to go outside barefoot, but I was hard-headed. I walked out into the grass and stepped on a sewing needle. I have no idea what it was doing in the grass. It went through my left foot. I tried and tried, but I couldn’t pull it out.”

She was carted off to the family doctor, who couldn’t remove it either.

“He cut into my foot from the top to reach it and he still couldn’t remove it. . . . And I couldn’t understand why it wouldn’t come out.”

Months later, she says, the needle--rusted and bloodied--came out by itself.

Munjack notes that when patients finally seek treatment they are often motivated by circumstance.

“Most of the cases we see are people who have to get a blood test for some reason. One woman was going to deliver a baby; one was a medical student. Or they are people who have neglected their health,” he says.

“When they finally come in, treatment is very specific--desensitization. We start out by teaching them to relax, and then we start to bring out the various materials of the blood test.”

Those materials start out on the opposite side of the room. As the patient gets used to them, they are moved closer and closer until the patient can hold them.

“Next we might tie on a tourniquet or simulate it. We might tap on the skin with needles. It’s not really painful. Many people think that it’s painful, but it’s not. They see that it’s unpleasant, but it’s nothing that they can’t stand,” Munjack says.

But, belonephobes of the world, take heart. According to Munjack, treatment is effective for 80% to 90% of patients: “It’s one of the simplest fears to treat.”

Radio reporter Lesser, one of Munjack’s patients, says, “I don’t know if I’m completely over it, but I’m 98% better. All along, I was aware it was the most idiotic fear. I wanted to get over with it.

“I didn’t go to the doctor that often. One time, in fact, I went to the podiatrist with a hangnail. Because of my fear of drawing blood and needles, I had to have it (removed) in a hospital under general anesthesia. I had to be hospitalized for what should have been an office procedure.”

Others just work it out for themselves.

The belonephobic bride says when faced with blood tests she now asks for a verbal resume: “When they sent me over to a lab for test recently, I walked in and I asked the technician, ‘How long have you been doing this?’

“When he said 10 years, I figured it was OK.”