Abstract
Blood-injection-injury phobias, which have a specific somatic response known as vasovagal syncope, respond well to behavior therapy. Applied tension (a technique for raising the blood pressure by tensing muscles) and in vivo exposure have been reported to be the core components of behavior therapy for this phobia. The present paper reports a behavioral treatment for the severe injection phobia of a woman in her twenties. We hypothesized that applied tension was important for preventing vasovagal syncope, and that special considerations were warrant-ed when treating severe cases. The woman had had the phobia since when she was a toddler, and had avoided hospitals and also words related to the feared objects. In the initial assessment, she was unable to read, write, speak, or listen to any word relating to the feared objects. Because she could not cooperate in developing a hierarchy for exposure, the therapists developed it on their own. In the first 2 sessions, she was taught the tension technique for preventing lowering of the blood pressure. The initial treatment goals were achieved after verbal exposure with songs and 3 in vivo exposure sessions. After that, the woman started to carry out self-exposure tasks, and at a 1-year follow-up was found to be able to function as a health care worker.
