What is Aichmophobia?

Aichmophobia, an extreme fear of sharp, pointed objects, is a type of specific phobia. Although accurate statistics are not available, it is thought that between 168,000 and 336,000 people across the UK have aichmophobia.

Today, we are going to look at aichmophobia in more detail, including the common causes, triggers, symptoms and treatments.

What is aichmophobia?

Aichmophobia is an extreme and overwhelming fear of sharp, pointed objects, most commonly scissors, pins, needles, pens, pencils and knives. Because many of these objects are encountered in everyday life and are considered to be household objects, aichmophobia can make it extremely difficult to perform everyday tasks and can result in avoidance of places or situations where you may encounter sharp objects, including work, school, the supermarket and medical settings.

A person with aichmophobia may physically and visually avoid sharp objects. Aichmophobia can be a serious mental health condition as it can cause people to avoid medical settings and medical procedures where they could encounter needles. This can result in someone avoiding necessary or life-saving treatments.

Because some sharp and pointed objects, such as knives, scissors, pins and needles, can be dangerous, especially if used incorrectly, many people may dislike or avoid using them or may handle them with particular care. However, a dislike or fear of sharp objects differs from a true phobia where a person experiences fear, anxiety and/or panic that is extreme and overwhelming and out of proportion to the true risks.

To be categorised as a phobia, your fear of sharp, pointed objects will:

• Create feelings of intense fear, panic or anxiety that are difficult to manage.
• Be out of proportion to the potential danger.
• Last for at least six months.
• Interfere with your day-to-day life, your overall wellbeing or your sense of safety.

It is thought that a phobia of sharp objects has an evolutionary basis. Humans are predisposed to recognising sharp objects as dangerous and may be conditioned to avoid them. Although some sharp objects can pose a danger, a person with aichmophobia will experience fear that is out of proportion to the danger.

The fear will also occur in situations where the risks are minimal or non-existent. It may interfere with a person’s ability to function in social and professional situations.

Some people with aichmophobia may not only experience symptoms when faced with sharp, pointed objects. They can also experience a phobic response when in places or situations where they might encounter sharp objects or when they think about sharp objects. Even if you know that your fear and anxiety are unrealistic and out of proportion, you may be unable to control your fear or prevent your symptoms from occurring.

Aichmophobia is related to other phobias, including:

• Trypanophobia: An extreme fear of needles in a medical setting.
• Belonephobia: An extreme fear of pins and needles.
• Iatrophobia: An extreme fear of doctors or medical tests.
• Stylophobia: An extreme fear of pens.
• Haemophobia: An extreme fear of blood (link to haemophobia article when published).

Because aichmophobia can be related to blood, injury and needle phobias, with many people with aichmophobia being afraid of needles, this can result in a vasovagal response, with needles and other sharp objects acting as a vasovagal syncope trigger. Exposure to needles or other triggers can result in a sudden drop in heart rate and blood pressure, which can lead to fainting.

How common is aichmophobia?

Many people experience fear, anxiety, panic or discomfort when faced with sharp, pointed objects. Negative thoughts and reactions to sharp objects can occur on a spectrum, ranging from low levels of fear, anxiety and dislike to severe fear, panic and anxiety that can impact your ability to function in your day-to-day life, prevent you from having medical procedures done or affect your overall wellbeing.

It is not known exactly how many people experience aichmophobia in the UK, as many phobias go undiagnosed. However, studies estimate that between 2.5% and 5% of people experience an extreme fear of sharp objects. This is between 168,000 and 336,000 people in the UK.

Someone can develop aichmophobia at any age, although the condition most commonly occurs during childhood and adolescence.

Who is at risk of aichmophobia?

Although anyone can develop aichmophobia, there are certain risk factors that can increase the likelihood of you developing a fear of sharp, pointed objects.

These can include:

• Having another related phobia, such as trypanophobia or belonephobia.
• Having another blood, injury, needle phobia.
• Having a history of anxiety, depression, panic attacks or another relevant mental health disorder.
• Having a close family member, such as a parent or sibling, with aichmophobia.
• Having a close family member, such as a parent or sibling, with another phobia.
• Being exposed to the fear of sharp objects during childhood or adolescence.
• Having a negative, traumatic or painful experience involving sharp objects.
• Being a naturally more anxious or fearful person.
• Experiencing high levels of stress or a significant life stressor.
• Having a substance use disorder.

However, even if you have more than one of the above risk factors, this does not necessarily mean you are going to develop aichmophobia. For example, if you have a parent with aichmophobia and experience panic attacks yourself, this does not necessarily mean you will develop a phobia of sharp objects.

How to deal with aichmophobia

You may think that the best way to deal with your aichmophobia is to avoid sharp, pointed objects. However, although it is possible to avoid some encounters with some sharp objects, such as by avoiding haircuts, it is not possible or realistic to avoid all sharp objects and situations or places where you could encounter sharp objects.

Failure to address your phobia could result in your symptoms becoming more severe in the future. If you haven’t learned any coping strategies, this could result in a more severe phobic reaction, which could be particularly problematic if a situation arises in the future where you encounter sharp objects or require medical treatment involving needles.

Coping strategies can help you to reduce and alleviate the symptoms of your phobia and reduce the impact it has on your day-to-day life and overall wellbeing. They can also help you to reduce avoidance behaviours and manage your phobia more successfully.

Some long-term and short-term coping strategies you can implement to help you deal with your aichmophobia include:

• Learn about your phobia
  Thinking about what initially caused your phobia and what your triggers are can help you to understand your phobia and rationalise your thoughts and emotions. This can help you to manage your symptoms more effectively.
• Educate yourself
  Learning about how to use sharp objects safely and how to be around them without the presence of risk and danger can help you to feel more comfortable and less fearful. Instead of focusing on the dangers of sharp objects and negative statistics surrounding sharp objects, learning about why they are essential can be beneficial. For example, understanding the role of needles in medical settings and how essential they are to your health can help you to overcome your fear.
• Create a fear ladder
  A fear ladder can help you to analyse your phobia and determine whether certain sharp objects or situations create more severe fear and anxiety. A fear ladder organises your triggers from least severe to most severe.
  For example, your fear ladder can look like this:
  – 1 = Having a needle in a medical setting.
  – 2 = Having a haircut using scissors.
  – 3 = Using a knife to chop vegetables or other food.
  – 4 = Using scissors or someone using scissors near you.
  – 5 = Hammering nails or seeing someone hammering nails.
  – 6 = Someone knitting close to you.
  – 7 = Using a sharp pen, such as a fountain pen.
  Once you have created your fear ladder, you can then tackle your triggers one at a time, starting at the bottom of the ladder (the situation that results in the lowest phobic response). This can help you to build up the tolerance of your triggers gradually.
• Challenge negative thoughts
  Negative thoughts can exacerbate your symptoms and worsen your phobia. Remind yourself that the risks are minimal and that you are not in danger. If you begin to experience symptoms of aichmophobia, remind yourself that the feelings will soon pass and that your fear is irrational.
• Use the show and tell approach
  This approach is particularly successful with children with aichmophobia, particularly if they fear needles, knives or scissors. Showing them the sharp object ahead of time and showing them how it works and why we need it can help to take away the fear. Many people fear the unknown, so having a greater understanding of the function of the sharp object can be beneficial.
• Implement distraction techniques
  If you are in a triggering situation or if being close to a sharp object is necessary, implementing distraction techniques can help to reduce your physiological and psychological responses to your trigger. Distraction techniques could include listening to music, engaging in conversation, reading, playing a game or watching a video. Focusing on something external, such as a ticking clock or passing traffic, can also help.
• Implement visualisation techniques
  Visualisation has been found to be an effective coping strategy for reducing the symptoms of phobias. When faced with your trigger, visualise a place or memory that keeps you calm or elicits positive emotions to help alleviate your symptoms.
• Reduce the risk of the vasovagal response
  The fear of fainting and the physical symptoms you feel in the lead-up to fainting can reinforce your phobia and exacerbate your fear. Lying down with your feet elevated and repeatedly tensing and relaxing your hands, feet and leg muscles can help to prevent the vasovagal response, particularly when faced with a needle in a medical setting.
• Practise yoga, meditation or mindfulness
  Yoga, meditation and mindfulness teach you how to control your breathing and your body’s response to your triggers and can help you to feel more in control and calm. This can help to reduce the physiological and psychological responses you may have when faced with a trigger. It can also help to reduce anticipatory anxiety.
• Practise deep breathing techniques
  Deep breathing is an effective way of lowering stress and relieving tension in your body. This is because it sends a message to your brain to relax and calm down. Breathing exercises help to reduce anxiety and can help you to control your nervous system, which is central to your phobic responses. Practise deep breathing before and during any encounters with sharp objects.
• Implement lifestyle changes
  Phobias and other mental health conditions can be made worse by factors such as lack of sleep and excessive stress. Take steps to reduce stress in your everyday life, eat a healthy balanced diet, exercise regularly and ensure you have a good sleep routine. These lifestyle changes can help to reduce the symptoms of your phobia long term. This is because these lifestyle factors can impact your anxiety levels, your stress levels and your feelings of depression. You should also avoid caffeine, sugar and other stimulants in the lead-up to an encounter with sharp objects, as these can increase your heart rate and blood pressure and worsen your physiological symptoms.

What triggers aichmophobia?

Aichmophobia can have different triggers for different people. Your triggers can vary, depending on what initially caused you to develop aichmophobia, your perception of dangers, the severity of your symptoms and your current mental health and mindset.

Some of the most common triggers for aichmophobia are:

• Seeing or using sharp, pointed objects, such as knives, scissors, pins, needles and pens.
• Going to a place where sharp objects are likely to be, such as a hairdresser or doctor’s surgery.
• Hearing a sound you associate with a sharp object, such as the cutting of scissors or the clacking of knitting needles.
• Being told you need a medical procedure that involves a needle.
• Seeing a picture or video containing sharp objects.
• Hearing stories about knives or stabbings or a scary story involving sharp objects (such as don’t run with scissors in case you fall and stab yourself).

What are the symptoms of aichmophobia?

The symptoms of aichmophobia, similarly to other phobias, can differ from person to person and situation to situation. It may be that some sharp objects create a stronger phobic response than others. The severity of your symptoms can also change depending on your current mental health and overall wellbeing and the effectiveness of your coping strategies.

Sometimes your symptoms may be mild and other times they may be more severe. Your triggers and the proximity and perceived threat of the sharp object can affect the severity of your symptoms.

Although different people experience different types of symptoms, the symptoms of aichmophobia are often similar to the symptoms of anxiety and panic attacks.

The symptoms can be both physiological and psychological and can include:

Physiological Symptoms:

• A rapid heart rate, heart palpitations or feeling like your heart is pounding.
• Shaking or trembling.
• Shortness of breath, rapid breathing, hyperventilating or difficulties breathing.
• Feeling dizzy or light-headed.
• A sudden drop in your heart rate and blood pressure (vasovagal response).
• Fainting or feeling like you are going to faint.
• Sweating, chills or hot flushes.
• Feeling confused or disorientated.
• Nausea, vomiting or stomach upset.
• Insomnia or difficulty sleeping (particularly in the lead-up to encountering sharp objects or when thinking about sharp objects).
• A dry mouth.
• A choking sensation, feeling like something is stuck in your throat or that you cannot swallow.
• Unusual paleness or flushing in your face.
• A loss of appetite.
• Numbness or tingling.
• Unusual headaches.

Although not common, some people with aichmophobia experience a vasovagal response, where they experience a sudden and potentially dangerous drop in their blood pressure and heart rate. In extreme cases, this reduction in cardiac activity can result in cardiac arrest and even death. If you are concerned that the symptoms that you or someone else are experiencing are serious, seek medical help immediately, by calling 999 or 111.

Psychological Symptoms:

• Intense feelings of fear, anxiety and/or panic.
• Avoiding sharp objects or places and situations where you could encounter sharp objects.
• Having a strong desire to run away or escape.
• Irritability.
• Feeling detached from reality.
• Freezing and being unable to move.
• Feeling you are losing control or have lost control.
• A sense of impending doom.
• Anticipatory anxiety in the lead-up to encountering sharp objects or triggering situations or places.
• Inability to function normally when faced with your triggers.
• An inability to control your fear, panic or anxiety, even if you are aware that they are out of proportion to the threat.
• Feeling like you are going to die.

What causes aichmophobia?

There is not one specific cause of aichmophobia. Instead, there are several reasons why someone might develop aichmophobia. It could be that your phobia has one single cause or that multiple factors contributed to you developing aichmophobia.

Some of the most common causes of aichmophobia are:

• A negative, traumatic or painful experience involving a sharp object
  Having a previous negative or traumatic experience involving a sharp object, either as a child or an adult, can result in a person developing aichmophobia. This experience is usually direct, meaning it happened to you. However, it can also be indirect, meaning you witnessed the event happening to someone else, for example, a child witnessing a younger sibling being extremely upset and in pain after hurting themselves on a knife can cause them to develop aichmophobia.
• Associating sharp objects with pain
  Creating a negative association between sharp objects and pain can cause you to develop a phobia. Associating needles with pain and fear can result in avoidance behaviours. This is known as a learned phobic response and may happen after a person (usually a child) has had a negative experience with sharp objects or witnessed a traumatic experience. The negative association can also occur in people who are hypersensitive to pain.
• Fear rumination
  Fear rumination is when you engage in a repetitive negative thought process and persistently and repetitively recap a negative experience with sharp objects or think about them in a negative way. Over time, these memories can become increasingly distressing and intrusive and can make you remember your encounter with the sharp object as being more painful and scary than it actually was. Fear rumination reinforces your fear responses and can result in you developing a phobia.
• A learned phobia
  A learned phobia most commonly occurs if you have a close family member, such as a parent or sibling, who has aichmophobia or a fear of sharp objects. Learned phobias commonly occur if you are exposed to the fear during childhood or adolescence.
• Exposure to information that scares you
  This is known as an informational learning experience and can happen if you discover facts or information about sharp objects that scare you. For example, if you hear statistics on the number of people who were stabbed to death with a knife or died from accidental injury from scissors, this can cause you to consider them as dangerous and can develop into a phobia.
• Significant stress
  Significant, long-term stress can result in disproportionate fear responses or an inability to manage intense situations. This can make it more likely that you will develop a phobia. A stressful and distressing event, such as a death, can also trigger a phobia, as people may be less able to manage their emotions and thought processes when experiencing grief.

How is aichmophobia diagnosed?

To receive a diagnosis of aichmophobia, you will first need to visit your GP. However, many people who feel fear or anxiety in relation to sharp, pointed objects never seek a diagnosis. They may not realise that their fear is extreme and overwhelming and may instead choose to avoid sharp objects. Additionally, many people have never heard of aichmophobia and do not realise that what they are experiencing is a phobia.

If you experience negative thought patterns, emotions such as fear and anxiety or physiological and psychological symptoms when faced with sharp objects, you may be experiencing aichmophobia.

If you are unsure whether you are experiencing aichmophobia, consider whether:

• Your fear and anxiety are out of proportion to the actual risks.
• Your fear impedes your ability to function in your everyday life.
• Your fear has a negative impact on your quality of life.
• Your symptoms occur when you are faced with a trigger or if you think about sharp, pointed objects.
• Your fear or anxiety causes you to avoid sharp objects or places and situations where you could encounter sharp objects.
• Your fear has a negative impact on your mental health or wellbeing.

If you think you may be experiencing aichmophobia, you should make an appointment with your GP to discuss your symptoms. Your GP will look at your medical history, including whether you have previously experienced an anxiety disorder, panic disorder or another phobia or extreme fear, any other medical conditions you are diagnosed with, and any medications or supplements you take.

This is to ensure your symptoms cannot be attributed to anything else. They will also likely ask about your family history (e.g. whether you have a close family member with aichmophobia or another phobia).

Following your appointment, your GP may refer you to a psychologist or another mental health professional who will do a more thorough psychological assessment.

The psychologist will conduct a phobia questionnaire and ask about:

• Your triggers.
• The type of symptoms you experience.
• The frequency and severity of your symptoms.
• How much your phobia interferes with your everyday life.
• When your phobia began and what caused the onset of symptoms (if you know).

Because aichmophobia is a type of specific phobia, meaning it is a lasting, overwhelming and unreasonable fear of a specific object, situation, activity or person, in this case, an overwhelming fear of sharp, pointed objects, the psychologist will compare your symptoms to the diagnostic criteria for specific phobias.

To receive a diagnosis of aichmophobia, your symptoms must fit into the seven key criteria listed below:

1. The fear must be persistent, excessive and unreasonable. It can occur either when sharp, pointed objects are present or when they are not present, e.g. if you see a picture or video of them.

2. Exposure to sharp, pointed objects leads to an immediate anxiety response in the majority of situations.

3. The fear is excessive and disproportionate to the threat, and this is recognised by you.

4. You avoid places or situations where you could encounter sharp, pointed objects. If you encounter sharp, pointed objects, you will experience extreme fear, anxiety or distress.

5. The anticipation of encountering sharp, pointed objects and the avoidance behaviours you may implement can have a significant impact on your day-to-day life.

6. The fear has lasted for a minimum of six months.

7. The phobia is not associated with another disorder or mental health condition.

If your symptoms fit the diagnostic criteria, you will receive a diagnosis of aichmophobia. Depending on the severity of your phobia, you may be offered treatment.

How is aichmophobia treated?

There are several different types of treatment that are available for people with aichmophobia. In the majority of cases, psychotherapy will be preferred, although other treatment options, such as medication, may be chosen. However, not all people with aichmophobia require treatment. If your symptoms are mild, you have implemented successful coping strategies or your phobia doesn’t significantly impact your day-to-day life and your wellbeing, you may not require treatment.

However, if your symptoms occur regularly or are more severe or you regularly engage in avoidance behaviours, treatment may be recommended.

Your doctor will create a treatment plan that is personalised to you, your triggers and your symptoms.

When creating your treatment plan, they will consider:

• How severe your symptoms are and how frequently they occur.
• What the root cause of your phobia is.
• How significantly your phobia impacts your life.
• Your overall health and wellbeing, including your mental health.

The most common types of treatment for aichmophobia are:

Exposure Therapy:

Exposure therapy is a common treatment option for specific phobias, including aichmophobia. Also known as systematic desensitisation, you will be exposed to your triggers in a systematic way in a safe, controlled environment.

During your sessions, you will work with your therapist to create a fear ladder of different objects, triggers and situations to determine which are the most severe. The psychologist will then create a collection of exposures for you to face.

Your exposure will be gradual, starting with the situation that results in the least phobic response, for example, looking at a picture of sharp, pointed objects or talking about using sharp objects. Once you are comfortable with this level of exposure, you will then progress to the next level, for example, being in the same room as a sharp object.

Exposure therapy can also help you to address the negative thoughts and emotions you experience when faced with sharp objects and can help you to change your physiological and psychological responses. You will also learn relaxation and coping techniques.

Cognitive Behaviour Therapy (CBT):

CBT is another popular treatment option for phobias. It is commonly known as talking therapy and can be done 1:1 or as part of group therapy. CBT is designed to help you identify and change your negative perceptions and harmful, flawed or negative thoughts surrounding sharp, pointed objects and can help you address the associated emotions and behaviours you experience.

During your sessions, you will also try to identify and address the root cause of your fear and overcome any negative patterns of thought.

Your sessions will include:

• Discussing your triggers and symptoms.
• Exploring what caused your fear of sharp, pointed objects.
• Exploring your fears in more detail.
• Learning how to recognise your negative thoughts and change the way you are thinking.
• Learning coping strategies and calming strategies, such as deep breathing exercises, distraction techniques and coping statements.

Hypnotherapy:

Clinical hypnotherapy sessions involve guided relaxation techniques and focused attention to help you to identify the root cause of your fear and help you change your thought patterns and any negative feelings you have about sharp objects. Hypnotherapy can help you to change your perception of situations and reduce your phobic response when faced with sharp, pointed objects in the future.

Hypnotherapy usually involves the therapist putting you into a relaxed, hypnotic state. A combination of techniques will then be used to re-pattern your negative thoughts and memories. Hypnotherapy can also teach you calming strategies, such as deep breathing and relaxation techniques which can help you to reduce your symptoms in the future.

Medication:

Although medication is not a common treatment option for someone with a phobia, it may be recommended if other treatment options fail, if your phobia is particularly severe or whilst you are waiting for psychotherapy to work. You may also be prescribed medication if you experience anxiety or depression alongside your phobia.

Medications that may be recommended include:

• Beta-blockers.
• Benzodiazepines.
• Anti-anxiety medication.
• Selective serotonin reuptake inhibitors (SSRIs).