A colleague talking about a silly accident they had – cut their finger or broke their toe – and I feel the fear creeping up inside of me. If I tell them, I can’t handle it, they will insist on just quickly telling me the funny story how they got their wisdom teeth removed – then it is upon me – the actual sensation of fainting at any second, losing all control, bang my head on the way down, coming to my senses again, concussion, headache, and vomiting. This is how it has played out many times, fortunately not always all the way. When I find myself in a situation like that, I have decided not to alert anyone to my predicament because people that don’t suffer from Blood-Injection-Injury (BII) phobia are mostly unable to empathize.
Interestingly, Blood-Injection-Injury (BII) phobia is understudy and yet quite different from other phobias. Fear of spiders of example is studied way more frequently although it doesn’t come with the health risk that people with BII phobia face since they often avoid medical treatment and preventative care.
BII is the only phobia in which sufferers faint. What happens is easy to observe, first the sympathetic nervous system is activated as a response to fear, the heart rate and blood pressure raise like in all other phobias. But then the unusual thing happens, and the parasympathetic nervous system takes over. So from „fight and flight“ the body turns to „rest and digest“. With this comes a sudden drop in heart rate and blood pressure and consequently people faint.
In a study they took images of the brain while exposing BII sufferers with blood, injection, or injury related pictures (1). This is what they found:
• First the region that prepares movement is activated in BII sufferers but not in the control group. Apparently wishing to avoid the threatening situation.
• Also, a region of the brain is activated that evaluates ongoing behavior and estimates punishment. This then leads to a change in behavior. In this situation the ongoing behavior is the fear reaction, which BII sufferers wish to change. Maybe this is why there is a sudden switch to the parasympathetic nervous system which results in the sudden drop in blood pressure.
• Thirdly the region in the brain that lets us cognitively control our emotions (e.g. anticipation) is less active in BII sufferers. Unable to keep fear at bay the scientists concluded that BII sufferers must actually experience more fear. And I can confirm this assumption, it is terror that spirals out of control.
People that experienced child abuse are very prone towards all kinds of anxiety disorders which is ultimately that BII phobia is. It has been known since the 50s that children that don’t get enough affection grow up to be fearful adults. Moreover, when my mother wanted to feel needed – she induced fear in me. And when my father wanted to feel important – he induced fear in me. Family, friends, and kindergarten teachers however told me this is what care and protection looks like. Growing up with this utter confusion of emotion I am not surprised that I turned out unable to adequately regulate my fear.
