A patient with a 24-year history of blood-illness-injury phobia associated with bradycardia and syncope was treated behaviorally. He was taught to prevent bradycardia and resulting syncope occurring in the presence of phobic stimuli by provoking anger in himself using appropriate imagery. Within a few weeks, the patient was able to use the procedure successfully to prevent syncope in everyday situations. At 6 months follow-up he remained comfortable in the presence of previously phobic stimuli and he no longer needed to use self-induced anger to prevent syncopal episodes.