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Sarah, Psychologist
Category: Mental Health
Satisfied Customers: 143
Experience:  Chart'd Psych, 12 yrs exp. English prisons, Clinical Hypnotherapist, EMDR Therapist, BPS, HPC reg'd.
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I have a developmentally disabled dialysis patient afraid of

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I have a developmentally disabled dialysis patient afraid of needles. How can I help him let us use his fistula?



I wonder if you have considered asking a hypnotherapist to help your patient? They have techniques that can be used to remove phobias and can also help the patient to relax to a deep level, particularly useful if they know they are going for a dialysis session.


It might also be useful to seek an EMDR therapist, who can help your patient to process away any previous anxiety that has been caused through needles - your patient is probably experiencing a return of previous anxiety that is held in the subconscious mind when the trigger (in this case, needles) is anticipated or seen. Such anxiety should be processed away during REM (rapid eye movement) sleep at night, but because the emotion is high, it becomes 'stuck' in the subconscious mind. producing a needle for this patient on a regular basis will be adding to the trauma each time they are introduced, so the situation will only really get worse without intervention. Have a look on for more information and local therapists, or search for a local hypnotherapist online. Obviously you would need to explain your patient's developmental needs to the therapist before agreeing to go ahead - try and find someone who has worked with such difficulties before, if possible. The people at the website should be able to assist you. The great thing is that this works in the subconscious mind without the patient/client having to talk too much, or consciously verbalise and comprehend what is happening - it works for babies who haven't yet learned to speak.


I wish you the very best with this for your patient's sake. Well done for searching for extra help for him - I think it's nice when someone is prepared to go the extra mile.

Customer: replied 7 years ago.
I don't feel a hypnotherapist is the way to go. I was looking for more of a behavior mod approach. I think I misspoke. It is not that the pt is phobic, he just doesn't like needles. Any thoughts?



Sorry it wasn't helpful. I'll have another try. If you're looking for something more cognitive-behavioural, you need to try and break the cycle that exists between thoughts, feelings, behaviours, thoughts, feelings, behaviours, etc. etc. A thought is always followed by a feeling and the behaviour is a consequence of that feeling - so, for example,


thought: this needle will cause me pain

feeling: fear

behaviour: pulls away


Someone tries to encourage him to have the needle in -


thought: this person is going to hurt me

feeling: increased fear

behaviour: struggling to get away. etc. etc.


You can try and break this cycle at any point using your experience of the individual - what does he enjoy doing (behaviours), thinking about (thoughts) or feeling. These can be established before the needle is introduced, so he is distracted and engrossed before the needle appears.


Will he watch a programme, sing a song, have his skin stroked by a feather to evoke a feeling, recall a happy day, stroke a pet, etc.etc. They only seem to be distracting techniques (which they are) but they break the cycle so you have a lower anxiety level before you begin with the needles.


You might want to encourage him to accept the needles more by changing his opinion of them (ie the original thought) which will change the consequential chain of feelings and behaviours, for example,


thought: yes, it might hurt me a little, but it is making me so much more healthy, so it is my friend OR I am big and strong so I can accept it,

feeling: more accepting of the pain

behaviour: less pulling away.


Could you combine this with breathing exercises, which also need concentration but allow the body to relax - deep breathing in for 4, hold for 4, breath out for 6.


You would need to adapt the above for your patient. is this more of what you were looking for? Hope so. Best Wishes, Sarah

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