Colleagues of Peter Royal have to be careful not to embellish the tales they tell him of their operations; nurses must clear the decks when (rarely) he has an injection, and a trip to the dentist can be an ordeal both for him and the staff: will he, or won't he?
'I have an almost abject fear of injections, whether they are dental anaesthetics, blood samples or inoculations and they cause me to become dizzy and pass out,' says Mr Royal, a 45-year-old quantity surveyor.
'I have managed to control things a little, but I still come close to fainting if I'm not careful.' When his family doctor showed him detailed photographs of what would happen during his vasectomy operation, he collapsed. 'He asked me if I knew it was going to happen, and strangely I don't think I did,' says Mr Royal.
With Mr Royal it is just needles that trigger the fainting. He believes it is the anticipation of pain that makes him 'shut down'. With Debbie Williams-Conley it is blood - and her problem, which began eight years ago, was compounded because she struggled to cope as a nurse. 'It happened quite regularly when people were having injections into the vein, so I avoided that situation. I could give injections into muscles, but not veins, which fortunately as a nurse you don't generally do. An added anxiety was that as a nurse I was expected not to faint - I was the one who was supposed to be in control.' She is now a behavioural psychotherapist treating people with phobias.
Researchers say blood, needle and injury phobias are extremely common and thought to affect 3.1 per cent of the adult population - around 1.4 million people. Some have all three; others, like Mr Royal, are just phobic about one.
While most phobics are women, blood, needle and injury phobias affect men and women equally. Sufferers range from those who have to steel themselves to visit the dentist to those who even perform the extractions themselves. Harold Fisher, of the Manchester-based Phobics Society, says he has come across three men who have extracted their own teeth rather than visit a dentist.
Many are terrified of hospital investigations and procedures and some would rather suffer - and in some instances put their lives at risk - than expose themselves to the feared object. Some faint in the street if they overhear the words 'needle' or 'blood', though this is rare. Others spend their lives avoiding Casualty and late- night news bulletins. Hard-core cases have their newspapers vetted by friends.
'I've seen women who wouldn't have a baby even though they wanted a family because of what that would involve in terms of needles and blood,' says Jane Wardle, a clinical psychologist at the Institute of Psychiatry.
'There are people who won't travel abroad, even for work. I've even seen someone who always fainted if her children injured themselves and consequently had to have someone with her all the time in case one of her children had an accident. She was an instant and out-cold fainter as soon as she saw any glimpse of an injury.'
Blood, needle and injury phobias are the only ones associated with fainting. When confronted with the feared object, the heart rate quickens and the blood pressure rises, then both plummet. The heart slows down and often stops beating for several seconds. …