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Clinical Case Studies
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Circumventing the Vasovagal Fainting Response

A Novel Method of In Vivo Exposure for Injection Phobia

Richard W. Seim

Western Michigan University

Matthew S. Willerick

Western Michigan University

Scott T. Gaynor

Western Michigan University, scott.gaynor{at}wmich.edu

C. Richard Spates

Western Michigan University

A novel method of in vivo exposure therapy was administered to a 26-year-old female with injection phobia. She had a history of fainting at the sight of syringes, needles, and other medical devices and went to great lengths to avoid physicians and optometrists, putting off receiving necessary examinations and vaccinations. The patient was treated in one long session. The session began with presentation of a series of noninvasive fear-evoking stimuli (i.e., still and video images) shown briefly, but repeatedly, with increasing trial durations, followed by invasive exposures (i.e., finger pricks & a sham injection). Self-report measures showed significant changes that were maintained after 10 months. In addition, the patient donated blood, had an eye examination, and received three vaccinations, all without fainting. Traditional treatments employ prolonged exposures to fear-evoking stimuli; the results of this intervention suggest that a massed series of brief exposures might provide a less aversive alternative.

Key Words: vasovagal • fainting • exposure • injection phobia

This version was published on October 1, 2008

Clinical Case Studies, Vol. 7, No. 5, 409-422 (2008)
DOI: 10.1177/1534650108316932
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