JUDY The Girl Who Fainted at the Sight of Blood
Judy, a 16-year-old, was referred to our anxiety disorders clinic after increasing episodes
of fainting. About 2 years earlier, in Judy’s first biology class, the teacher showed a
movie of a frog dissection to illustrate various points about anatomy.
This was a particularly graphic film, with vivid images of blood, tissue, and muscle.
About halfway through, Judy felt a bit lightheaded and left the room. But the images did
not leave her. She continued to be bothered by them and occasionally felt slightly queasy.
She began to avoid situations in which she might see blood or injury. She stopped
looking at magazines that might have gory pictures. She found it diff cult to look at raw
meat, or even Band-Aids, because they brought the feared images to mind. Eventually,
anything her friends or parents said that evoked an image of blood or injury caused Judy
to feel lightheaded. It got so bad that if one of her friends exclaimed, “Cut it out!” she felt
faint. Beginning about 6 months before her visit to the clinic, Judy actually fainted when
she unavoidably encountered something bloody. Her family physician could find nothing
wrong with her, nor could several other physicians. By the time she was referred to our
clinic she was fainting 5 to 10 times a week, often in class. Clearly, this was problematic
for her and disruptive in school; each time Judy fainted, the other students flocked around
her, trying to help, and class was interrupted. Because no one could find anything wrong
with her, the principal finally concluded that she was being manipulative and suspended
her from school, even though she was an honor student.
Judy was suffering from what we now call blood–injury–injection phobia. Her reaction
was quite severe, thereby meeting the criteria for phobia, a psychological disorder
characterized by marked and persistent fear of an object or situation. But many people
have similar reactions that are not as severe when they receive an injection or see
someone who is injured, whether blood is visible or not. For people who react as severely
as Judy, this phobia can be disabling. They may avoid certain careers, such as medicine
or nursing, and, if they are so afraid of needles and injections that they avoid them even
when they need them, they put their health at risk.