Many situations involving blood are things we all probably want to avoid, and for good reason. It can be a sign of wounds or spread serious diseases, and the sight of blood tends to be at least slightly unpleasant for everyone. But for some people, a fear of blood feels so strong, so overwhelming, that it can get in the way of their lives, shrink their social world, and cause intense anxiety.
As a therapist who specializes in OCD, I’ve seen this fear show up quite frequently in the people I work with, and it can be devastating. Sometimes people are reluctant to seek treatment, believing that their fear is rational or that disclosing their fears may be too embarrassing.
However, we know that OCD is highly manageable—no matter what topic it focuses on. People who suffer from any theme of OCD can go on to live a life that is not impaired by these fears, as long as they develop the tools they need to confront OCD.
Let’s take a look at what an intense fear of blood can look like, how it can impact people’s lives, and how they can learn to overcome it with the help of a trained professional.
What fear of blood looks like in OCD
OCD focusing on the fear of blood likely falls under the larger subtype of health or contamination-themed OCD, as people’s fears are often rooted in underlying fears about injury or transmissible illness. It may also be related to the general fear of disgust, as people can find unpleasant sensations almost impossible to tolerate. Fears about blood may also be involved in harm OCD, a trigger for intrusive thoughts about harm or a carrier of disease, causing people to fear for their safety and the safety of their loved ones. They may irrationally believe that even trace amounts of blood can be harmful or pose a great risk, feeling that their “worst-case scenario” could happen in any situation involving blood.
In their day-to-day lives, people with these fears may believe that the risk of coming into contact with blood is much higher than it actually is, becoming hyper-aware of any substance that resembles blood and avoiding it or performing excessive cleaning rituals in order to feel better. Often, they’re highly aware that their fear is irrational and their behaviors are excessive, but they have a hard time accepting any shred of uncertainty surrounding their fear. So when intrusive thoughts or fears are triggered, the anxiety that comes can feel too intense to bear. This leads to the vicious cycle at the core of OCD, involving symptoms called obsessions and compulsions.
Obsessions and compulsions
Obsessions and compulsions are the driving force behind OCD. Obsessions are the persistent intrusive thoughts, fears, and images that cause people with OCD such distress, and compulsions are the repetitive behaviors, mental or physical, that they do in an attempt to feel better in the short term. While obsessions do not pose any tangible harm, they do feel real, and the compulsions help to neutralize that feeling. Therefore, though compulsions bring about relief, they actually make OCD worse in the long term.
This cycle can look far different in different people, even when they struggle with very similar fears, and it would be impossible to create an exhaustive list of all of the ways in which a fear of blood may show up, but some of the more common obsessions that people might experience include:
- How do I know for sure that this substance isn’t blood?
- What if I walk in blood and track it into my house?
- What if there are traces of blood that I can’t see?
- What if I don’t clean something with blood on it and I get infected?
- What if I infect someone I care about?
- What if I see blood and have a panic attack?
- What if I contract HIV or another severe illness?
People with OCD try to counteract or neutralize their obsessions with compulsions to neutralize the anxiety or distress these thoughts cause. Some more common compulsions that people might do in response to these types of fears include:
- Excessive hand washing
- Excessive cleaning of surfaces or areas they feel may have had contact with blood
- Avoidance of hospitals, restrooms, or other areas where there may be a perceived higher threat of contact with blood
- Reassurance seeking: asking others if they had contact with blood, etc.
Unfortunately, even otherwise important and helpful actions like hand washing only serve to make one’s fears more intense and persistent when they’re done in order to relieve anxiety about one’s obsessions. That’s why resisting these behaviors is the key to beginning recovery from OCD.
A real-life example: Dennis
When Dennis first began therapy he was living his life full of fear and isolation. By the time he finally decided that he needed help, he had been unable to go out socially, attend college, or even visit friends and family. He worried incessantly about contracting a disease if he should encounter any substance that even resembled blood. His mind told him that nearly anything could be tainted with blood, and the risk simply felt too great.
OCD convinced him that it was easier to control his environment in his small one-room apartment. But eventually, even that became overwhelming. He found himself spending countless hours washing and sanitizing everything he owned, just in case there might have been blood somewhere and he had missed it.
One time, Dennis became really ill and required medical attention. There was no way to avoid it: he had to go to the hospital. This was a worst-case scenario for him. The idea of stepping foot into a hospital was always one of his biggest and most terrifying fears. He was so afraid that he might have to have his blood drawn for tests—what if they improperly cleaned the needle?
Dennis ended up delaying his hospital visit out of fear, and days later a family member had to call an ambulance for him. Without the skills he needed to tolerate any uncertainty or hint of risk relating to his fear of blood, he was inadvertently putting his own life in danger
How can I overcome OCD fears about blood?
OCD focused on fear of blood or contamination can be debilitating for people who struggle with it, but it is highly treatable. By doing exposure and response prevention (ERP) therapy with an OCD specialist, you can find freedom from the OCD cycle.
ERP is the gold standard of treatment for OCD and many other anxiety disorders. It is backed by decades of clinical research proving its effectiveness and it shows significant results in 80% of people with OCD. With ERP, you will learn effective ways to accept uncertainty about the thoughts and feelings associated with blood and the fears surrounding contaminating yourself or others.
ERP works by exposing you in a safe, controlled manner to the thoughts and situations that are likely to trigger your fears. This is done in planned exercises called exposures, which provide the opportunity for response prevention: resisting the urge to engage in compulsions that provide short-term relief, only for obsessions to return again and again.
Even for a specific theme like the fear of blood, exposures will be highly individualized and vary from person to person. Here are just a few potential examples:
- Looking at pictures containing blood
- Watching a gory scene from a movie
- Feeling your pulse
- Donating to a blood bank, if medically approved
With your therapist’s guidance and support, you will resist the urge to respond to these exposures with compulsions, interrupting the vicious cycle of OCD. That is what we call response prevention, and it is the most important part of the treatment. By doing this continually over time, you learn that you are able to tolerate anxiety, uncertainty, and uncomfortable feelings regarding contact or potential contact with blood or contamination.
The ERP process is difficult, but it can help people feel in control of their own lives once more. Even if your fears feel impossible to overcome today, ERP can give you the tools you need to conquer OCD and manage it long-term.