Blood phobia (also known as hemophobia or hematophobia in

American English American English, sometimes called United States English or U.S. English, is the set of varieties of the English language native to the United States. English is the most widely spoken language in the United States and in most circumstances ...

and haemophobia or haematophobia in

British English British English (BrE, en-GB, or BE) is, according to Oxford Dictionaries, "English as used in Great Britain, as distinct from that used elsewhere". More narrowly, it can refer specifically to the English language in England, or, more broadl ...

) is an extreme irrational fear of

blood Blood is a body fluid in the circulatory system of humans and other vertebrates that delivers necessary substances such as nutrients and oxygen to the cells, and transports metabolic waste products away from those same cells. Blood in the cir ...

, a type of

specific phobia Specific phobia is an anxiety disorder, characterized by an extreme, unreasonable, and irrational fear associated with a specific object, situation, or concept which poses little or no actual danger. Specific phobia can lead to avoidance of the o ...

. Severe cases of this fear can cause physical reactions that are uncommon in most other fears, specifically vasovagal syncope (fainting). Similar reactions can also occur with

trypanophobia Fear of needles, known in medical literature as needle phobia, is the extreme fear of medical procedures involving injections or hypodermic needles. This can lead to avoidance of medical care, including vaccine hesitancy. It is occasionally refe ...

and

traumatophobia According to the DSM-IV classification of mental disorders, the injury phobia is a specific phobia of blood/injection/injury type. It is an abnormal, pathological fear of having an injury."Oxford Textbook of Psychopathology" by Theodore Millon, P ...

. For this reason, these phobias are categorized as

blood-injection-injury phobia Blood-injection-injury (BII) type phobia is a type of specific phobia characterized by the display of excessive, irrational fear in response to the sight of blood, injury, or injection, or in anticipation of an injection, injury, or exposure to b ...

by the

DSM-IV The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM; latest edition: DSM-5-TR, published in March 2022) is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common langu ...

. Some early texts refer to this category as "blood-injury-illness phobia."

Causes

Blood phobia is often caused by direct or vicarious trauma in childhood. Though some have suggested a possible genetic link, a study of twins suggests that social learning and traumatic events, rather than genetics, is of greater significance.. Blood-injection-injury phobia (BII) affects about 4% of the population in the United States. The inclusion of BII within the category of specific or simple phobias in classificatory systems reflects a perception that fear has a primary role in the disorder. Consistent with this assumption, blood-injury phobia appears to share a common etiology with other phobias. Kendler, Neale, Kessler, Heath, and Eaves (1992) have argued from data comparing monozygotic with dizygotic twins that the genetic factor common to all phobias (agoraphobia, social phobia, and specific phobias), strongly predisposes a person to specific phobias. The recognition of an inherited vulnerability common to all phobias is consistent with the notion that elevated trait anxiety predisposes one to anxiety disorders. Trait anxiety provides a background of affective arousal that permits a more rapid activation of the fight or flight response. With respect to specific activating events, conditioning is one way that stimuli become able to elicit anxiety. It is believed that these changes are controlled by the vagus nerve, which affects activity in the chest and abdomen. Accordingly, painful experiences can condition fear to blood-injury stimuli. Investigators typically classify around 60% of self-reported onsets of blood-injury phobia as beginning with conditioning experiences. However, examinations of available case-by-case verbal summaries call into question the conclusion that conditioning episodes are as prevalent as reported. For example, Thyer et al. (1985) identified a conditioning episode when a "patient received an injection at age 13 and fainted", and in another person when "at age six she heard her elementary school teacher give a talk on the circulatory system. This frightened the patient to the point of syncope."

Symptoms

Physical

*Rapid heart rate *Trouble breathing *Shaking or trembling *Tightness or pain in chest *Lightheadedness *Sweating *Hot or cold flashes *Violation

Emotional

*Extreme feelings of anxiety or panic *Overwhelming need to escape situations involving blood *Feeling as if you will die or pass out *Concerned that you have lost control *Feeling powerless over your fear

Treatment

The standard approach to treatment is the same as with other phobias—

cognitive-behavioral therapy Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (suc ...

, desensitization, and possibly medications to help with the anxiety and discomfort. In recent years, the technique known as ''applied tension'', applying tension to the muscles in an effort to increase blood pressure, has increasingly gained favor as an often effective treatment for blood phobia associated with drops in blood pressure and fainting. Because the fear of blood is extremely common, it is frequently exploited in popular culture. Horror movies and Halloween events prey on our natural aversion to blood, often featuring large quantities of fake blood.

References