On 07/01/2009 10:51 PM, David Thomas Jackemeyer wrote:
> This is a response to a portion of message 1964.
>
>>> An example involving a physical-psychological phenomenon: I have
>>> never enjoyed drawing blood, even for a small sample used for
>>> determining my blood content and their respective concentrations. I
>>> would like to respond differently, more focused on the benefits
>>> (rather than the sickening feeling of being sucked dry) and less
>>> likely to steer away from opportunities to learn more about my body.
>>>
>> I think it is unlikely that *anyone* actually enjoys the direct process
>> of having blood taken from hir body. It is slightly painful (as is any
>> puncture wound), but that should be all the harm that you
>> physiologically receive. It the phlebotomist is competent, then that
>> should be the only negative of the process.
>>
> I can recall only competent blood draws, yet I've always experienced
> some sort of "shut down" by my body.

Since most humans do not experience this and it is hard to even imagine
any physiological cause for it, the experience is almost certainly a
psychosomatic (literally mind-body) result of your mind and the anxiety
within it. But such mind generated causes are ultimately under your
conscious and reprogrammed subconscious control.

>> Any "sickening feeling of
>> being sucked dry" is merely your own emotional (psychological) baggage
>> (it is a very tiny amount of your total blood, so the whole idea of
>> being "sucked dry" is simply nonsense) which you can and would best work
>> to eliminate.
>>
> I have tried lying in bed at night and envisioning the mechanics of the
> draw, and to date I have been surprised at how anxious I get right there
> in the bed, tensing up, breathing shallow and quickly.

First, quit even imagining the "mechanics" of the draw. Simply dwell
on all the peripheral events involved and the benefits of the whole.
Second, squelch any anxiety by strongly telling yourself what an idiot
you are to feel that way and how counterproductive it is again because
of all the benefits of the blood letting and the test results. Think
about all the times that you have cut, scraped or otherwise caused your
skin to be punctured and bleed profusely and how these did not cause you
to have this same shut down due to anxiety. In fact, likely quite the
opposite, your reaction was either to ignore it if small (sometimes not
even to consciously be aware of its existence until much later,
particularly if you were intent on a particular task while the
cut/scrape occurred) or, if large, to immediately take action to stem
the blood flow and patch the wound. Why should there be any difference
(except from a foolish mind) between the exact same thing being caused
by an intentional act rather than a chance accident or error of
carelessness.

> I have attended two blood draws within the past year, one where the
> needle was very small and the phlebotomist very competent, one where the
> needle was relatively large and the phlebotomist new but fairly steady.
>
> I definitely had a greater physical response (much like the one
> described above) to the draw with a larger needle.

You are making a major mistake by even looking at the needles or any
other mechanics of the draw. I can do this with interest and without
anxiety problems and so I do this to get added benefit from the
procedure - partly to myself to be able to do a venipuncture for IV
purposes, if I ever need to. However, Kitty, even though a former
registered nurse, is still a little squeamish about having herself
intentionally pricked and purposefully does not watch the mechanics of
the procedure but rather keeps her eyes and mind on something else.
Perhaps long after you have stopped this anxiety attack from occurring
during blood draws, then you will be able to once more view the
mechanics and gain the added benefits of doing so.

[I agree with Paul. The best thing I would suggest under your
circumstances, which are similar reactions to what I experienced in the
past, is to *not* look at the phlebotomist preparing for or actually
doing the procedure. I converse with hir on other or even related
matters, but purposely do not look. This method and the others that I
took when I first joined Paul have enabled me to have venipunctures for
multiple tubes of blood without any of the awful sensations - and even
blacking out - that occurred in the past. I don't spend any time
thinking about the actual procedure itself - I think that this too is
important. Maybe sometime in the future I will look, but I'm not
especially motivated to doing so. Everything goes quite well now and
that is my interest.

Another suggestion, is requesting that a draw, which will require
multiple test tubes for samples, be done using a butterfly. This is a
very small bore needle attached to flexible tubing that enables the
phlebotomist to change test tubes without disturbing the needle in the
vein. I regularly request this since the sensation at the venipuncture
site when the test tube is changed is not at all pleasant to me and I
think it has in the past contributed to the anxiousness I have
experienced. Phlebotomists do not want a patient to pass out, so if
you firmly request a butterfly for that reason, they will almost
always readily comply. Yes, this extends the time it takes to complete
the withdrawal of blood - but not greatly - and a phlebotomist in a
hurry may balk. But if you insist, s/he will not refuse to comply. **Kitty]

> Since many years ago, I have always prepared myself with very positive
> thoughts about the usefulness of the draw along with the interesting
> physics of pressure differences between vein and tube/needle, plus I
> always watch the needle enter and leave.

At least for the time being until the anxiety has been eliminated, you
would do best to totally quit thinking about and watching the mechanics
of the draw.

Jack, having observed for some years now, both your actions and your
descriptions of your thoughts and feelings, it appears to me that you
have a strongly ingrained approach to yourself as an outside spectator
viewing the strange but very interesting actions of another person. In
fact, you are so fascinated by the activities of this other person
(actually yourself in this case) that you do not wish to interfere and
cause any changes to that other person. IOW, rather than directly
experiencing the life you are living, you act as a vicarious and
dilettante spectator of your own life. I urge you to do your utmost to
stop this approach. Get fully involved with and fully connected to
your life instead of merely viewing its passing scene. Life is for fully
living and directly experiencing rather than for amused vicarious
titillation. It may be okay to view the lives of others as merely actors
on a big stage (although to the extent that their actions also affect
you this too is not conducive to increasing your lifetime happiness),
but it is most certainly a grave and anti-life error to view your own
life that way.

> I typically am slightly tense
> just before the needle goes in, then I wait a little bit (breath,
> breath), then a rush of something comes over my body accompanied by
> emphysema-like shortness of breath and I feel warned that I am in danger
> ("sucked dry" is what I used before, but it's not clearly related to
> blood loss, maybe something to do with "invasion" too -- hard to say
> because there are no relevant thoughts prior to or during).

Have you never had a splinter or other foreign object "invade" your body
accidentally or due to carelessness? When this occurred did you feel
the same anxiety of "invasion" over that occurrence? If you did not
(as I am pretty sure is the case) then your mind is just being foolish
to react differently to the exact same occurrence happening in a
controlled manner rather than by chance. Tell yourself that and try
your best to eliminate it every time you have that emotion. (Note that
I am not talking here about a major stab wound or other trauma which
can result in both great pain and immediate major blood loss, both of
which will physiologically cause immediate blood pressure reduction
and possible loss of consciousness, but rather the scrapes and cuts
that a person as active as yourself gets as a part of everyday living,
particularly for someone who uses tools.)

> When this first happened to me (my first blood draw in many years,
> between 12 and 16 years ago), I was naive about the whole process.
> Again, I watched the needle go in and was slightly tense from the pain
> but really just naive, and suddenly in a few seconds, that same rush
> came over me. I ended up blacking out (sweating profusely and reality
> almost disappeared into a small round dot), followed by recovery within
> minutes, though I was still weak in the knees from the novelty.
>
> I was shocked and interested in why it happened. "Low sugar" and
> "sudden drop in blood pressure", were suggested, with only the blood
> pressure drop making any sense to me.
> Is it possible that my initial anxiety causes a drop in blood pressure,
> further escalating my anxiety, like a feedback loop?

The anxiety attack is sufficiently intense to initiate release of blood
pressure decreasing hormones. No feedback was necessary and did not
likely occur because the lower BP could not cause any immediate
psychological anxiety. It is the opposite of the fight or flight effect,
which increases heart rate and BP.

>> As with any other irrational emotion, you work to
>> reprogram yourself so that it no longer occurs. You do this by first
>> having at your mind's edge, all the positive reasons why getting blood
>> drawn is beneficial to you and even the benefits of the process itself
>> (enjoying the interesting mechanics of it: the competence of your body
>> pumping out the blood to fill the tubes, the competent work of the
>> phlebotomist and the technically neat way that such a blood draw can be
>> accomplished, the friendly chatting with hir, particularly if s/he is
>> someone who you see regularly, the way your own competent body
>> quickly seals and heals the puncture).
>
> These are VERY helpful, thank you. I am practicing these perspectives
> and learning more details of the healing puncture.

Except note that I have now changed my recommendations to totally cease
any thinking about or interest in the mechanics of the procedure, at
least until you have eliminated all anxiety.

> I have a blood draw for LEF/Labcorp to accomplish this month...
>
>> So as soon as this "sickening
>> feeling" occurs you tell yourself what an idiot you are to feel this
>> way, you strongly squelch and deny the feeling (effectively tell it to
>> "get lost and do not bother me any more"), you then concentrate on
>> all the
>> short and long range positives of the procedure and its end results.
>>
> Thank you -- I will practice this as well, maybe even write it on an
> index card for reminders in case I distract myself with other thoughts.
> I have not been well-focused in past personal blood draws thus
> inviting hazard to the outcome, so being prepared and maintaining focus
> will help.

Not just focus, but also distraction of your thoughts away from the
mechanics of the blood draw.

> (Thanks for the word "hazard" -- I gained it from your exchange with Chad)

Good, both to the word and to the news that you read the exchange.

>> If
>> you keep doing this, then in time the emotion will be eradicated and you
>> will be *free* of it (similar to the way your immune system rids your
>> body of a pathogen - an inconsistent emotion is a pathogen of the mind).
>>
> "Pathogen of the mind" -- I will remember this :)

It is another one of those potentially problematic metaphors, but in
this case I think it is a sufficiently accurate correspondence to be
useful.

>> Actually, I have been through all this before in past posts on the
>> subject of changing emotional habits, so I am surprised that you did not
>> realize that those posts about other emotions and emotions in general
>> apply to this one also. You must sometime get to the point where you
>> fully understand that your emotions do not come out of nowhere and are
>> not in control of you, but rather they are products of your values and
>> rational thoughts and are totally under your control with respect to
>> making them consistent with those values and thoughts.
>>
> I recognized the similar methods and have been practicing a few as I
> described above. However, I have not *strongly* squelched or denied
> feelings before, as I always thought of them as interesting in addition
> to debilitating. I gained some happiness from considering the strange
> phenomenon,

These last two sentences, in the light of my previous experiences with
you, are what caused me to think that you are far too much a vicarious
spectator of your own life events rather than a direct experiencer of
those events. I say "far too much" because some such self analysis and
introspection is definitely both enjoyable and useful - I have certainly
done lots of that and continue to do so. However, because it is almost
always done afterward the events being recollected and analyzed, my
self observation and analysis does not prevent me from also directly
experiencing my life events, but rather helps me to put them into
perspective, to understand them and to help/modify them to be more
successful in similar future circumstances.

> but I also realize that I have missed out on much more
> happiness regarding future blood draws.

I hope you will now give some thought to this being a symptom of more
"missing out" than of merely the benefits from blood draws.

> --David Jackemeyer
> (left the remainder for context and review)

I also left it in for now.

--Paul

>> [I was a person who for many years dreaded venipunctures and even
>> fingersticks - to the point that I actually felt faint when they took
>> place. (Having been a nurse for 16 years didn't change this.) I knew
>> that this was a psychological reaction but also knew no way to really
>> get rid of the awful emotional reaction/physiological sensations that
>> occurred. I went through the process because I was well aware of the
>> importance and physical benefit to me; I just tried to not look or
>> even think about it and hope that I wouldn't pass out.
>>
>> It wasn't too long after joining Paul that the periodic fingersticks
>> for fasting blood glucose started - he'd been doing it for years. I
>> couldn't bring myself to prick my own finger but let Paul do it to me
>> - while I was lying in bed because the first couple times I felt
>> faint. With explanation by Paul as to how to take control of these
>> (and other) emotions (and Paul has improved his explanation since
>> then), I began to do just that. Within a couple weeks I was sticking
>> myself with the automatic gadget without any sickening fear. (Changing
>> the lancet at the first indication that it's beginning to get dull -
>> it then starts to hurt - makes a big difference.)
>>
>> I still don't watch the phlebotomist do the actual draw on me - though
>> I don't mind watching Paul get stuck and had little problem doing
>> numerous venipunctures on others for starting infusions when I was a
>> nurse. But I no longer get faint, even when the phlebotomist is not
>> the very best and misses my excellent veins.
>>
>> I know from personal experience that ridding oneself of these
>> pathogenic emotional responses (as Paul has newly named them) can be
>> done - this experience above is just one where I've succeeded. Maybe
>> some others on the group will share their experiences. **Kitty]
>>
>>
>>> Instead of comfortably avoiding blood drawings, I ought to seek them,
>>> possibly even participate in training to learn to safely and
>>> effectively draw from myself.
>>>
>> Any puncture to the body is a chance for infection and should never be
>> done intentionally unless there is a good overall benefit from its
>> occurrence. With respect to doing it to yourself, while it would always
>> be beneficial to learn such a technique, and you could perhaps draw
>> your own blood from a leg vein, it would be both difficult and possibly
>> error prone (harmful to yourself) to draw blood from your own arm
>> (injecting a fluid is far easier than drawing/removing blood).
>>
>>
>>> With the right schedule and attitude, I think I could eventually lean
>>> toward drawing blood rather than avoiding it.
>>>
>> You will never do so without conscious action to eliminate your
>> irrational negative emotions (not to say that negative emotions are
>> always irrational or that positive ones are always rational) about it
>> and replace them with positive ones. You will never succeed for very
>> long at any attempt to act counter to your emotions. Rather you will
>> only succeed in such action if you eliminate the negative emotion and
>> replace it with a positive one. Put another way, you cannot for long
>> make yourself do anything that you do not feel good about, and it is
>> folly to try, because the ultimate result will only be a feeling of
>> failure and a resultant loss of self-esteem.
>>