Needle phobia - Anxiety UK

an appointment, waiting in the waiting room of your GPsurgery, going into the room where the injection will beadministered, seeing the needle, and then having theinjection). The important point is that items included in ananxiety hierarchy describe situations which produce varyinglevels of anxiety, some more worrisome than others; this iswhat hierarchy means, and the details of this are presentedlater in the booklet.You should describe the items in your anxiety hierarchy insufficient detail to enable you to vividly imagine each step.It might be sufficient to say “standing in line at the ticketcounter,” but saying “standing in a long line at the crowdedticket counter with nothing to do but wait to get myluggage checked” might be more graphic. Remember thatitems are most effective if they can help you experience theevent in your imagination, not just describe it.Creating an anxiety hierarchyYou should attempt to create about 16 or 17 situations atthe beginning. Most people tend to discard some itemsin the sorting process, so you can expect to end up withabout 10 to 15 items in your final hierarchy. To aid insorting the items, write each one on a separate index card.As was mentioned earlier, the situations or scenes in yourhierarchy should represent a fairly well-spaced progressionof anxiety. The best way to achieve this goal is to firstgrade the anxiety of each item by assigning it a numberon a scale from 0 to 100, where 100 is the highest levelof anxiety imaginable and 0 is no anxiety (completerelaxation). Write this number on the back of the indexcard for the item being graded. At this point, you need notworry about how well-spaced the items are; just give eachitem the first number grade that “pops into your head.”12