Hey if you own it that’s totally cool and fairly noble. And frankly even if you don’t it’s cool too. Not my job to decide who to take on as long as you’re within my practice scope and not actively suicidal, murdering people, or diddling kids, which are like three main dealbreakers for getting your therapist to snitch (varies by state and there are other exceptions check the fine print)

One of the things I explain to people when I’m doing needle desensitization is that the phobia does make sense to a degree. At its core there is a threat. We know that it will hurt. It’s why I fucking hate it when people use bullshit lies to get people to get shots, “oh it won’t hurt at all!”. No, that’s a lie, it by definition will cause some pain. And it’s pain you see coming. A scrape is different. We generally get those accidentally and often don’t notice it’s happened until the pain registers. But a shot or blood draw is more analogous to torture: I get a sharp needle, put you in a weird chair, and let you know that I will absolutely stick this into your body, piercing your flesh. You anticipate it. You tense up.

The thing to remind yourself is that it’s irrational and your anxiety is magnifying the intensity. The pain is real and will happen, that is true, but it is generally not that big of a deal outside of certain scenarios that are uncommon for most people. And even in some of the more painful scenarios like lumbar punctures there is an anesthetic involved (trust me I’ve had one. It’s not awesome but not as bad as you’d think).

Desensitization can help for the obvious reason of lowering your anxiety in reaction to the aversive stimuli. Avoiding it only serves to sensitize you and lower resilience to the stimulus. However this is the challenge of the phobia. Often they’re things we don’t have regular exposure to: vomiting, spiders, air travel, etc. so we desensitize, do much better, and then don’t have to deal with the thing for months or years and end up with it being an issue again. Maintenance is always necessary.

But with needle phobia there is a specific benefit. If you can calm yourself down during blood draws and relax your body the blood draws will actually hurt less. Tension held in your body makes the piercing of the needle sting a bit worse. It’s not a huge difference but apparently a noticeable one.

I hate needles too. What helped me was a small town clinic I used to go to pre-internet. One of the techs decided to tape a few single-panel comics to the separator walls so we would have something else to focus on instead. It worked wonders.

Nothing like that anymore, so just turn my head away and try to think of funny stuff. I still flinch but it does help.