Fear of needles: What to do when nothing else works

Yesterday, I took my nine-year-old daughter to the dentist to get two fillings. She was nervous, but it was a reasonable amount. That all changed once she saw the needle. She abruptly closed her mouth, looked at me, and calmly said: “I’m not doing this.”

Recently, my daughter has developed a fear of needles. She became hysterical when she got her flu shot, but the paediatrition reassured me that it was an age-appropriate response, and not to worry. So I didn’t. I was confident about the dental appointment because she had already had received a filling two weeks prior and skipped out of the office laughing about the weird numb feeling in her lips.

However, two weeks ago she hadn't realized she received a needle because she'd been so intent on watching Full House while in the dentist chair. This time, the dentist had to fix the TV and wanted to do it while he was waiting for the freezing to set in. And that's how the needle ruse was ruined. So there I sat, trying to talk her down from her anxiety perch. But I was confident—I have lots of practice with anxiety talks thanks to her anxious 14-year-old brother. This is my parenting superpower.

I knelt on the floor so I was at eye level. I held her hand. I was empathetic, and I told her I had faith that she could do this because she'd already done it once before. I asked her to reflect her on her feelings after her last dental appointment and she did. But she still wouldn’t open her mouth.

I tried to bribe her. I told her we could get her nails done after the dental appointment. She looked interested, but nothing came of it.

I didn’t want to use a threat, but I did remind her about her best friend’s root canal. I told her that kids who refuse to get their fillings may have to be put to sleep to get their cavities filled at the hospital. She looked frightened, but still wouldn't open her mouth.

I curbed my inclination to yell—I know from experience that leads nowhere. I tried to give her choices so she could feel more in control of the situation. In turn, she talked about her fear and didn’t cry.

I started to get the sweats because I feared that the dentist was going to run out of time and charge us for the appointment, but I squashed the image of my husband freaking out over wasted money.

You know what didn’t happen, though? The dentist didn’t step in and help me out. He looked more frightened than she did, and kept asking if he should leave the room. I started to get more angry at him than her. He could have offered some solutions, or calming words.

Finally, my daughter looked at me and said, “I am going to do it next week. I can’t do it today. I can do it next week.” And I knew the gig was up. She got out of the chair and held my hand. As soon as we got to the waiting room she started to cry and apologize. We hugged and I told her she didn’t have to be sorry.

I promised not to tell her brothers about what happened and we went on with our day. But something was still bothering me—and it wasn’t the wasted money, because the dentist didn’t charge me. I do my deepest parenting when one of my kid’s is having an anxiety attack. I take them with me into a little bubble of calm. But once we leave that bubble I wonder—did I do the right thing? Should I have forced her to stay and get the filling done? My inner parenting critic said I was too soft. I confirmed for her that she couldn’t do it by letting her leave. I wondered what the dentist, my husband, my mother and the critical readers on Facebook would think. So I called an anxiety specialist to ask what I did wrong. (A definite perk to my job here at Today’s Parent!)

Michele Kambolis is a child and family therapist and author of Generation Stressed: Play-based Tools to Help Your Child Overcome Anxiety. Happily, she said I did the right thing. She said that I met my daughter where she’s at, I was empathetic and I reassured her through my parental presence. (Talking to her was like a mini therapy session for me, and was very reassuring!) Even the bribery or, Michele put it,“offering a preferred activity” was a good idea. Reminding a child that there are natural consequences to their actions is also a good move. She said that if the dentist had stepped in as a partner and tried to build her trust, that could have made the difference.

But how to prepare for next time?

Kambolis said that it's important to remember that anxiety is not a behavioural response—it comes from the body’s "fight or flight" response. It can’t be threatened or bribed away. But it can be worked on, and lessened with the right techniques. She says that cognitive behavioural techniques (CBT) are the most effective in dealing with anxiety.

CBT works on the premise that small bits of exposure can help change the way your brain and body reacts to something. You have to teach the body to stop entering the cortisol-heavy "flight or fight" stage when it encounters the stimulus. In other words, anxiety is partially a physical response—the body remembers what it feels like to be deeply afraid and will return to that state unless you train yourself out of it. And what a person thinks directly affects how she feels and faces challenges. A fear can become a phobia over time. So you can’t let your kids (or yourself) avoid the feared stimulus, or even the idea of the stimulus. To keep phobias at bay you have to teach your brain to stop sending warning signals to your body.

Kambolis recommended that I sit down with my daughter and ask her some questions about her fear and try and unpack the thought processes before the next appointment. She offered these suggestions of things we could try:

Thinking and reflecting: What do you tell yourself about needles? What you tell yourself can have a huge impact on how you handle situations. Do you tell yourself you can’t handle it? What does that feel like and then sit for 30 seconds. Then ask: “OK, now let’s pretend we are going to the dentist with a different thought—how about telling yourself “I can do this.” How does that feel in your body?

Drawing: Have her draw a picture of what she is afraid of, as well as pictures of what it would look like to be successful and experience the situation without fear.

Dramatic play: Take turns playing dentist and let her guide the play.

Going back to the scene: Visit the dentist or doctor. Lie in the chair, look at the instruments. Even take pictures of her laying calmly in the dentist chair.

Calming activities: Deep breathing helps the dopamine take over so the body doesn’t go into a frightened state. Imagine breathing in a colour, and ask her to choose the calming colour, or imagine blowing up a balloon.

I know what it is like to be judged for your child’s behaviour when they are having an anxiety attack. You can’t let the judgment of bystanders affect how you handle the situation. Anxiety is not a choice, or learned behaviour. Someone who is terrified is being held hostage by very powerful feelings, says Dr. Kambolis. Our job as parents is to teach our kids that they can handle their fears and give them the tools to do so.

And sometimes that means leaving the dentist office without getting the fillings done.

If you do have a child with anxiety I recommend checking out Kambolis’ book, it has lots of activities and strategies in it.

Emma Waverman is a writer, blogger and mom to three kids. She has many opinions, some of them are fit to print. Read more of her articles here and follow her on Twitter @emmawaverman.

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