Treatment of Severe Blood-Injection-Injury Phobia With the Applied-Tension Method: Two Adolescent Case Examples

Blood-injection-injury phobias can be so severe that they interfere with receiving necessary medical care. Compared with most other phobias that typically increase heart rate, blood-injection-injury phobias are unique in their association with vasovagal responses. Thus, patients with blood-injection-injury phobias are typically less responsive to relaxation techniques, which in fact may be counterproductive. The current case studies describe use and clinical effectiveness of applied tension for treatment of severe blood-injection-injury phobia in two adolescent patients. Treatment included in vivo gradual exposure to feared stimuli combined with mastery of the tension technique to cope with anxiety, reduce vasovagal responses, and ultimately receive recommended medical treatment. Both patients experienced a significant decrease in anxiety and successfully underwent medical intervention without experiencing syncope. Directions for future research are discussed.