Loading ...
Sorry, an error occurred while loading the content.

Re: vigorous exercise followed by single meal

Expand Messages
  • Paul Wakfer
    ... One point that Olafur did not mention is that if a person has stores of easily available triacylglycerols, then glucose (and other other ATP production
    Message 1 of 17 , Mar 22, 2009
    View Source
    • 0 Attachment
      On 03/18/2009 06:58 AM, David Thomas Jackemeyer wrote:
      > --- In morelife@yahoogroups.com, Ólafur Páll Ólafsson <olafurpall@...> wrote:
      >
      >> --- In morelife@yahoogroups.com, Paul Wakfer <paul@> wrote:
      >>
      >>> This is my response to the second part of the original for which the
      >>> subject title is still appropriate.
      >>>
      >>> On 01/07/2009 11:30 PM, David Thomas Jackemeyer wrote:
      >>>
      >>>> --- In morelife@yahoogroups.com, Paul Wakfer <paul@> wrote:
      >>>>
      >>>>> On 12/31/2008 11:21 AM, David Thomas Jackemeyer wrote:
      >>>>>
      >>> <big snip of what was previously responded to>
      >>>
      >>>
      >>>>>> I would like to fast for extended periods, and one 2hr meal per day
      >>>>>> has been working fine for me. I would also like to exercise 45 min
      >>>>>> per day. BTW, I have completely cut out alcohol from my diet, in
      >>>>>> response to the posts related to message 1809 on Morelife Yahoo Group
      >>>>>> posted 06/04/08:
      >>>>>> http://health.groups.yahoo.com/group/morelife/message/1809
      >>>>>>
      >>>>>> Question: If I finished my (one per day) meal by noon, to what extent
      >>>>>> would exercising seven hours later disturb the important pathways
      >>>>>> hypothesized to occur during a long fast period?
      >>>>>>
      >>>>> Exercise will always enhance the beneficial biochemical activities of
      >>>>> the fasting state. The time you give appears to be quite ideal.
      >>>>> Exercise is best in relation to fasting if done as long as possible
      >>>>> after eating, but not so close to sleeping that it will interfere with
      >>>>> that important activity - ie it is probably best to end exercise by at
      >>>>> least 2 hours before sleep so that the body can wind down and get into
      >>>>> a very relaxed state by sleep time.
      >>>>>
      >>>> I was concerned that when exercising, my body might retard autophagic
      >>>> response to fasting because of the increased liberation of energy
      >>>> stored in liver, muscles, fat, and ingested ingredients (whey
      >>>> protein, e.g.). Is this a concern?
      >>>>
      >>> I don't think so. If there is a great deal of stored energy, the
      >>> autophagic effects of recycling proteins will not be high anyway,
      >>> since the energy stores of carbohydrates (and fats, but to a lesser
      >>> extent because they are harder to liberate) will tend to be used first
      >>> for fuel as they are more easily converted to fuel. WRT, ingested
      >>> ingredients, the whole purpose of fasting and exercising in a fasted
      >>> state is precisely because there are no longer any ingested
      >>> ingredients available - they have all gone past the point where they
      >>> can be absorbed.
      >>>
      >> I agree with Paul here. Jack, I don't know how familiar you are with
      >> autophagy, but autophagy is basically a process whereby the body eats
      >> itself because it is lacking energy stores and the building blocks
      >> required to support anabolism. Now here is a logical exercise for you
      >> Jack (This relates to the use of logic Paul spoke about in your last
      >> post). The question you have to ask yourself here is *why* is there an
      >> increase in the liberation of energy stores during exercise? Why does
      >> your body start liberating fat and increasing glucose output from the
      >> liver when you exercise, and how does that relate to autophagy?
      >>
      >> If you think about the answer you can come to realize that it doesn't
      >> make sense that exercise would cause autophagy to decrease. The answer
      >> is that energy stores are being liberated because the muscle tissue is
      >> burning up so much energy and it needs more of it to keep the exercise
      >> going. The energy stores thus are being liberated in order for the
      >> muscles to take up the energy they need (glucose and fat) to keep
      >> functioning at high efficiency. Now this energy has to come from
      >> somewhere and since you have not eaten for a long time it makes sense
      >> that the body has to turn to itself by both breaking down stored
      >> energy (glycogen and fat) as well as by eating itself through
      >> autophagy. Note that the liver can not store much glycogen and as it
      >> starts to empty it will have to increase gluconeogenesis (the
      >> synthesis of glucose from noncarbohydrate precursors such as amino
      >> acids). Now where do the amino acids required for gluconeogenesis come
      >> from? Again the answer is from autophagy, if you haven't eaten for a
      >> while that is.
      >
      > This last part helped me understand that the increase in
      > gluconeogenesis is fueled by amino acids liberated during
      > autophagy -- I did not understand the details, so this has
      > spurred my further investigation.

      One point that Olafur did not mention is that if a person has stores
      of easily available triacylglycerols, then glucose (and other other ATP
      production precusors) will be generated first from decomposition of
      those triacylglycerols (stored in fat cells) into free fatty acids and
      glycerol (a three carbon hydroxylated chain), with the glycerol
      portion then used to produce glucose.

      [Recall that triacylglycerol is the correct biochemical term for what
      is often still referred to as triglyceride - http://morelife.org/glossary/stu.html#triacylglycerol **Kitty]

      Because this process is always third in line after glucose production
      from digestion and from glycogen stores, it is only natural that the
      body "eats" its own fat before it then starts eating its own proteins,
      particularly muscles (since fat takes far less work to store as a
      source of energy than does production of protein, and proteins are
      more important for continuation of survival).

      In fact, the whole point of taking acipimox is to *prevent* the
      decomposition of triacylglycerols and the consequent use of the
      liberated glycerol as a glucose source in order to force the body to
      recycle its own proteins. It should thus be clear that acipimox is not
      something that a person attempting to lose weight from reduction of
      calories and fasting should be taking. Acipimox is only beneficial for
      enhancing autophagy for people such as me and Kitty who have no more
      fat to lose and do not care to go through a fat storage and release
      cycle every 3 days. Rather we want to go through a mainly protein
      breakdown, recycling and buildup process at as high a rate as
      possible. Again the reason for this is because the greater "pressure"
      (need by the body) for energy substrate, the greater will be the
      likelihood of breaking down dysfunctional proteins.

      > Is there known to be a self-reported difference in the quality
      > of performance of subjects between fueling vigorous exercise
      > with gluconeogenesis versus fueling with stored gylcogen or
      > fat stores? Quality of performance meaning relative
      > sluggishness, alertness, or emotional motivation in response
      > to physical performance.

      This is a good question that I will leave it to Olafur (and his twin
      Egill - who is even more into exercise physiology than is Olafur). My
      own thoughts on this are that theoretically the level of physical
      exertion capability should decrease in the order of glycogen, fat and
      protein use. See my recent post in this thread for a personal example
      relative to this point.

      > I'm wondering because if yes, then maybe it be wise to
      > exercise vigorously when stored glycogen and fat stores
      > are available to ensure peak physical performance,

      That would probably be true if you had any good reason to want to
      "ensure peak physical performance". This again raises the question
      about the purpose of the physical performance and why it needs to be
      "peak" (and what constitutes "peak", for that matter). There is a huge
      difference between exercise for the purpose of health and longevity
      and exercise to achieve some sports, other cultural or personal
      enjoyment goal.

      [The phrase "ensure peak per performance" most definitely requires
      from the speaker/writer definitions of "performance" and "peak". These
      are very subjective terms and rely entirely on the value judgments of
      each individual - the choice of what activity is being performed and
      the level that is considered to be "peak". **Kitty]


      > with the remaining hours of regular caloric demand between
      > exercise and meal expected to be powered more-so by autophagy.

      Ignoring "peak performance", yes, it makes sense that sufficient
      exercise to burn up your glycogen and easily available fat, and then
      consuming acipimox to prevent further fat decomposition, should enable
      protein autophagy to take place for the longest period. However, the
      overall effect of the amount of protein autophagy would only be
      increased by any such method given that the amount of exercise and the
      fasting period remained the same and your amount of stored fat
      reserves had not yet reached a minimal level (where each fat cell
      contained so little actual stored triacylglycerols that any left were
      not easily released).


      >> Energy depleting exercise increases insulin sensitivity in the muscle
      >> tissue being exercised, which increases uptake of nutrients such as fat
      >> and glucose into the muscle tissue being exercised. The muscles are
      >> basically creating a funnel for nutrients. This increased insulin
      >> sensitivity in the muscle tissue being exercised also lasts a while
      >> after the exercise is over causing increased nutrient uptake into the
      >> exercised muscle for a while after the exercise. But this effect is
      >> strongest right after exercising and fades somewhat afterwards which
      >> is one reason it is beneficial to eat immediately after exercising as
      >> opposed to eating later on. If you eat right after exercising more of
      >> the nutrients will be taken up by the muscle tissue. Much of the
      >> glucose f.ex. will go towards filling the muscles glycogen stores
      >> leaving less of it left to cause harmful elevation of blood glucose.
      >
      > Understood -- these are good reasons for scheduling a meal
      > to immediately follow exercise.
      >
      >>>> If this is viable, are these concerns mitigated if exercise instead
      >>>> immediately precedes the 2hr large meal?
      >>>>
      >>> That would be an even better time for it. The more deeply fasted state,
      >>> the better effect of the exercise on promotion of autophagy. And 2 hrs
      >>> should give your body sufficient time to recover before the large meal.
      >>>
      >> Since he wrote "immediately precedes" I think Jack was speaking of
      >> exercising immediately prior to eating the meal not 2 hrs before
      >> eating it as you appear to have understood it.
      >>
      >
      > Yes, for 8 weeks now I have exercised followed ~40 min later
      > by a 2-hour meal. Since I take a shower, gather my study
      > material, then walk to the cafe, I must be missing an important
      > period of nutrient uptake since my heart rate, sweating, and
      > overall physical exertion has decreased to pre-workout status.

      See my other message in this thread for reasons and evidence that eating
      *immediately* after a strenuous workout is *not* healthy. I think your
      40 min delay is likely quite excellent and you should not change it.

      >> Anyways your point
      >> still stands, that the more deeply fasted state, the better effect of
      >> the exercise on promotion of autophagy.
      >>
      >> BTW in case anyone is wondering which is better I think it would be
      >> better to exercise immediately prior to eating the single meal rather
      >> than 2 hours before eating it (I know Jack didn't ask this question
      >> but I'm on a roll here:-). There a few reasons I think this is the case:
      >>
      >> 1) If you exercise immediately prior to eating there will be longer
      >> since you last ate when you exercise compared to if you exercise an
      >> hour or two before eating. Not having eaten for so long will increase
      >> the demand for autophagy to provide the energy required for the
      >> exercise, not to mention that autophagy will already have been
      >> increased considerably if it is so long since you last ate. Exercising
      >> at this time should strongly induce autophagy.
      >
      > Regardless of the time of day of exercise, as long as all other
      > things were equal, one would always end up metabolizing the
      > same amount from both normal body stores (glycogen and fat)
      > and autophagy.

      Yes, if you are not eating less calories than you are using and if you
      are not taking acipimox. And note that if you are not losing weight,
      then you are also restoring those same body stores of glycogen and fat
      every eating, sleeping and exercising cycle of your body.

      > However, what I gather from each of you is
      > one can increase the autophagic effect by pushing exercise to
      > later in the day, but this seems false because, calories-in
      > calories-out, there is no difference in the number of calories
      > taken in and likewise, no difference in the amount/type of
      > energy-expending exercise.
      > The difference I do see, which does not strike me as significant,
      > is: during a much earlier bout of exercise, one will rely less on
      > autophagy for energy, but the autophagy will show an increase
      > earlier in that day, whereas during a much later bout of exercise,
      > one will rely more heavily on autophagy for energy, and the
      > autophagy will show an increase later in the day-- but this
      > difference is only in timing exercise to match with autophagy,
      > which does not necessarily change the calorie count.
      >

      Your logical is impeccable and is similar to what I wrote above (about
      the timing not mattering overall). With regard to calories, the only
      thing that can be changed is the amount of energy that is from protein
      autophagy versus that from usage of stored fat. I have no more fat to
      lose and by the usage of acipimox, I am forcing my body into protein
      autophagy (moreso than it would normally be) and saving it from having
      to use up and then restore fat. This is very different from Olafur's
      considerations for himself since he has more fat than I do and is more
      concerned with retaining muscle mass and strength (for no good reason
      that I have ever been able to discern).

      However, the consideration of protein recycling via autophagy is not
      the only one of concern to Olafur nor to me. Also highly important is
      the contribution of blood glucose toward glycation and ultimately to
      AGE formation. It is for this purpose that Olafur's scheme of
      exercising soon before eating (moderated by my information about the
      digestive needs) is important, since it should reduce the highest
      blood glucose levels if not the average blood glucose level. Recall
      that glycation rate increases faster than directly proportional
      (linearly) to blood glucose.

      > Are you suggesting that timing exercise so one relies more
      > heavily on autophagy as a source of energy brings an additional
      > calorie-burning advantage versus timing exercise to rely more
      > heavily on glycogen and fat stores as a source of energy (and
      > thus leaving autophagy for later, relaxed states)?

      Actually this is true to a certain extent because usage of protein for
      energy takes more usage of energy and is highly wasteful of chemical
      components (all the nitrogen containing amine groups are ultimately
      excreted by the kidneys). The energy needed to reclaim each calorie
      from stores increases in the order from glycogen, fat, protein (which
      is why the body reclaims that energy in that order).

      --Paul
    • David Thomas Jackemeyer
      This is a response to a portion of message 1964. ... I can recall only competent blood draws, yet I ve always experienced some sort of shut down by my body.
      Message 2 of 17 , Jul 1, 2009
      View Source
      • 0 Attachment
        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.

        > 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.
        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.

        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. 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).

        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?

        > 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.

        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.

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

        > 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 :)

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

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

        > [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.
      • Paul Wakfer
        ... 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
        Message 3 of 17 , Jul 3, 2009
        View Source
        • 0 Attachment
          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.
          >>
        • David Thomas Jackemeyer
          Meta Hi Paul Hi Kitty, When I preview this message, it s a mess! I have not changed any settings in either Yahoo Groups nor Thunderbird Compose. Any
          Message 4 of 17 , Jul 14, 2009
          View Source
          • 0 Attachment
            Meta
            Hi Paul
            Hi Kitty,

            When I preview this message, it's a mess! I have not changed any
            settings in either Yahoo Groups nor Thunderbird Compose. Any thoughts?
            Possibly the preview is inaccurate and you will receive a well-groomed
            message...

            -Jack

            [Except that your response lines were not ended by hard returns (Yahoo
            seems to have stopped inserting these for a text only group), which
            are easy enough to insert, the formatting, as received in Kitty's
            email notice and in the group queue, is perfect. --Paul]
            /Meta

            --- In morelife@yahoogroups.com, Paul Wakfer <paul@...> wrote:
            >
            > 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.

            I understand that my "anxiety attack" is something I am creating in subconscious, likely as a response to avoid pain or suffering. More below...

            > >> 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.

            OK, I'll start here, but do you mean all together?
            I planned to continue learning the "mechanics", only stopping before
            or during a draw. I have enjoyed reading about and envisioning how
            the skin organ and vein are disturbed by the entry of the needle,
            followed by platelet plug formation and blood coagulation at the
            vessel walls, etc.

            > 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.

            "How counterproductive", agreed.

            I don't understood why you use "idiot" since the word does not apply
            to me, since in present day refers to those with especially abnormally
            poor intellects. The Greek "idiote" referred to one who was static in
            hir learning of subjects outside of hir "private station". I could
            become that idiote if I ceased to educate myself; for example, I could
            move back to Indiana and live on my father's farm as a Jack-of-all-trades.

            Why do you choose to use "idiot"?

            > 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.

            Thanks for the suggestion of considering examples, of which I realize
            if and only if I watched the puncture event did I react with anxiety.
            All other times I react as you describe:

            > 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.

            Great suggestions for consideration (intentional vs not).

            > > 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.

            Your last sentence is my hope!

            > [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.

            Funny thing is that until recently, I thought this technique was my
            evasion of reality, so I decided to cut the small talk, etc., instead
            taking interest in the mechanics by watching with deep interest and
            asking the professionals about the strategies/methods. Maybe I "took
            too large of a bite".

            > 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.

            Do you think about the procedure when far from having a blood draw?

            > Another suggestion, is requesting that a draw, which will require
            > multiple test tubes for samples, be done using a butterfly.

            Interesting, thanks for the suggestion -- I will inquire.

            > 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 agree that at times I have practiced delightful examination of my
            activities, since I have become interested in dealing with two
            difficulties: 1) making sure my presentations were palatable and 2)
            discovering actions that conflicted with my intentions.
            For an example regarding 1), when I've given a presentation of something important to me, I am often nervous that
            a) I am considered far beneath those in attendance, and
            b) none of them (know how to) care to participate in my development.
            In class, at a lab meeting, and at Meetup groups, I get the sense that
            most are inwardly obsessed and socially careless. Since I notice this
            attitude often, I want to do my best to not exaggerate the distance
            between myself and them by replacing a set of poor habits that are
            related to protecting myself from embarrassing jesters (stemming from
            middle and high school experiences).
            Instead of self-protection, I hope redirect my focus toward reading
            the audience well and coupling this with a presentation that draws
            them (as many as possible) in for a deeply meaningful exchange, both
            in terms of fully addressing the subject and my own personal growth in
            presenting information for consideration.

            To address this, I watch myself and look for distracting qualities; I
            also attempt to model others who I consider to be inviting and
            intriguing. I do gain delight in real-time self-reflection.

            It is possible that I spend too much time doing this and also for the
            wrong reasons (e.g. to make sure I look pop-culturally attractive).

            Vicariously, I highly doubt; the concept suggests that I am
            developing a second personality, one that can mostly independently
            judge the original. In addition to doubt, I am confused why you have
            chosen this word; if you have the interest and time, will you
            elucidate?

            > 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.

            Intuitively, I think I had been doing both, fully living and delightfully
            studying my responses.
            I am fascinated that I do become so deeply engaged in some activities
            whereas others are sleep-inducing (yawns, disinterest, much reduced
            excitement for the moment). More surprising is that I can create a
            philosophy that discourages most reasoning for participation in an
            activity, say playing basketball, and then demand of myself that I
            cease a particular action for two years -- yet -- that activity,
            basketball, might bring me hours of continuous joy, even after the two
            year drought!

            Likewise, I can create a philosophy that brings to the top the most
            important reasoning for participation in an activity such as learning
            about my body/health/wellness, and then demand of myself that I
            practice the related activities for two years -- yet-- I will cease
            that activity 100% the day after two years and feel no loss!

            I like to watch and analyze myself now and then to discover the secrets
            to my failures and successes.

            > > 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?

            Only if I visually witnessed the puncture -- to this day, I can
            vividly recall two 15-18 year-old acquaintances of mine wrestling for
            control of a tool they each found in the basement of their home -- it
            had a long wooden handle, like that of a garden hoe and the end
            equipped with a metal hook. I visually witnessed the hook end enter
            (1/4 to 1/2 inch) and leave the right calf of the older (brother).
            Even though it happened to someone else, I experienced the suddenly
            intense response.

            I can recall one vivid visual removal of 1/2 inch of Honey Locust thorn http://www.mitzenmacher.net/blog/wp-content/uploads/2006/01/thorn.jpg
            from the area just below my knee cap. That caused quite a horrified
            reaction as I yanked it out and immediately after as I comprehended
            the entry and removal of the thorn.

            All other foreign objects (splinters, scratches, etc) that I do not
            see enter, do not bother me a bit (besides some pain). All rougher
            damage that I do see, such as deep scratches, smaller thorns with
            barbs, splinters, etc. do not bother me either.

            > 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.)

            I agree that I have been acting counter to my values, and for some
            unknown reasons, treating similar occurrences very differently, which
            is wrong.
            I do not consider myself foolish nor idiotic however. IMO, these two
            terms should be reserved for one who cannot improve hir intellect.
            Those who can improve intellect yet lack in judgment and act contrary
            to their values can be described with words such as naive and immature.

            The last "note" is understood.

            > > 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.

            Noted.

            > > 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.

            I am glad that you are thinking about me and offering critical
            analyses for my consideration. I expand/explain a little above and I
            have no intention of brushing aside your comments; instead, I am
            deliberately considering what you have shared and looking for
            opportunities to practice directly experiencing events coupled with an
            awareness to postpone introspection to afterward.
            Thank you for the suggestions!

            > > 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.

            I am thinking about it.

            --David Jackemeyer

            > > --David Jackemeyer
            > > (left the remainder for context and review)
            >
            > I also left it in for now.
            >
            > --Paul

            <snipped the remainder previously left in>
          • Paul Wakfer
            On 07/15/2009 01:14 AM, David Thomas Jackemeyer wrote: Meta Snipped meta comments. /Meta ... Its intensity may be connected to some of the vividly recalled
            Message 5 of 17 , Jul 16, 2009
            View Source
            • 0 Attachment
              On 07/15/2009 01:14 AM, David Thomas Jackemeyer wrote:

              Meta
              Snipped meta comments.
              /Meta

              > --- In morelife@yahoogroups.com, Paul Wakfer <paul@...> wrote:
              >
              >> 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.
              >
              > I understand that my "anxiety attack" is something I am creating in
              > subconscious, likely as a response to avoid pain or suffering. More
              > below...

              Its intensity may be connected to some of the vividly recalled
              experiences that you relate below. You do not have to continue
              creating it, particularly when you do want to experience the minor
              pain of the blood draw in order to gain its major benefits.

              >>>> 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.
              >
              > OK, I'll start here, but do you mean all together?
              > I planned to continue learning the "mechanics", only stopping before
              > or during a draw. I have enjoyed reading about and envisioning how
              > the skin organ and vein are disturbed by the entry of the needle,
              > followed by platelet plug formation and blood coagulation at the
              > vessel walls, etc.

              Jack, why is it that if I leave any detail out you always miss my
              meaning? (This is a rhetorical question, not requiring an answer, but
              merely for you to think about.)
              Perhaps the following written above would have enabled you to understand:
              "First, quit even imagining the "mechanics" of the draw *on yourself*.
              When you are having blood drawn do not think of the physical procedure
              with respect to yourself, do not watch the needle, tubes, etc, rather
              dwell on all the peripheral events involved and the benefits of the whole."

              Yes, it is always beneficial to learn about any physiological
              operation of the body. But when you are doing the learning approach it
              as if it applies to humans in general not yourself.

              [When I was learning to start intravenous infusions, I practiced
              getting the feel of lower arm and hand veins on others and myself. But
              I did not imagine inserting the needle into my own veins. Even now I
              can view and palpate the veins on my arms and note which ones are good
              for IVs (if that were ever needed - last time was when I had the
              ureteral stone Jan 2003). But I do not envision the puncture of skin
              and vein. I do not see any point in getting this graphic on *myself*
              and I do not think it is a good idea for you to do it for *yourself*
              either. **Kitty]

              >> 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.
              >
              > "How counterproductive", agreed.
              >
              > I don't understood why you use "idiot" since the word does not apply
              > to me, since in present day refers to those with especially abnormally
              > poor intellects. The Greek "idiote" referred to one who was static in
              > hir learning of subjects outside of hir "private station". I could
              > become that idiote if I ceased to educate myself; for example, I could
              > move back to Indiana and live on my father's farm as a Jack-of-all-trades.
              >
              > Why do you choose to use "idiot"?

              1. Most important, please note that I was not calling you an idiot. I
              was telling you to say to yourself: "What an idiot I am to feel that
              way", "What a silly emotion to have." or "How foolish to be so
              concerned and have such a reaction to such a simple procedure which is
              both overall beneficial and has far less pain attached to it than many
              things that happen to me more often (stubbed toe, banged elbow or
              knee, other cuts scrapes, bruises, etc.)"

              2. My use of the word "idiot" is always with the meaning 3b from
              /Webster's Third New International Dictionary, Unabridged/.
              Merriam-Webster, 2002. http://unabridged.merriam-webster.com ( 15 Jul. 2009)
              "a person who fails to exhibit normal or usual sense, discrimination, or
              judgment especially at a particular time or in respect to a particular
              subject <I don't know why I was such an /idiot/> <a perfect /idiot/
              about budgeting>
              Note particularly, the phrase "at a particular time or in respect to a
              particular subject". I never use the word for a person as a whole.

              3. I rarely ever use the word these days. I only did so here as a way
              to emphasis to you the message that when you feel the anxiety, your
              conscious part of mind should very *strongly* chastise the emotional
              subconscious part of your mind and tell it to: "stop being so foolish"
              and "stop acting inconsistently with what I (the conscious) knows is
              best for me". This is what I mean by squelching, denying, scolding
              and refusing to sanction your emotional response of anxiety.

              4. The Greek meaning to which you refer is effectively obsolete in
              current English language usage. However, since I do like to keep my
              word usages close to root meanings, I will try hard to replace all
              usages of "idiotic" with either "foolish", "silly", or, perhaps best
              of all, "irrational" - because inconsistent.

              >> 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.
              >
              > Thanks for the suggestion of considering examples, of which I realize
              > if and only if I watched the puncture event did I react with anxiety.
              > All other times I react as you describe:
              >
              >> 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.
              >>
              > Great suggestions for consideration (intentional vs not).

              So use this fact also to remind yourself how foolish you are being
              when you feel anxiety before and during a blood draw. If you scold
              your emotional subconscious hard enough for long enough and tell to it
              to stop behaving this way, then it will eventually do so.

              >>> 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.
              >
              > Your last sentence is my hope!
              >
              >> [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.
              >
              > Funny thing is that until recently, I thought this technique was my
              > evasion of reality, so I decided to cut the small talk, etc., instead
              > taking interest in the mechanics by watching with deep interest and
              > asking the professionals about the strategies/methods. Maybe I "took
              > too large of a bite".

              Yes, you tried to get your emotional subconscious (which has irrational
              behavior to this particular event) to run before it was even crawling
              correctly. Think of this way - if you are capable of rational action
              toward reality, then it should never be evaded, but rather faced head on. However, to the extent that you are not capable of facing the full
              reality of something then it may be necessary to circumvent, ignore or
              intentionally evade it until you are capable of fully facing it and
              reacting effectively to it. Note the difference between intentional
              evasion, which remains under your control and can later be altered
              when it is useful to do so, and unintentional habitual or subconscious
              evasion which is always negative (mainly because you don't even know
              that it is happening and therefore are totally missing whatever it is
              that you are evading).

              >> 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.
              >
              > Do you think about the procedure when far from having a blood draw?

              [I think of it only in regard to planning what day and approximate
              time so that it fits appropriately with our eating. I do not at all
              think about the venipuncture itself. I know from experience that if I
              get it done with a butterfly and that even if the phlebotomist is not
              the best, the procedure will not be unduly uncomfortable. What really
              bothers me is the probing for a vein by a less experienced person or,
              if a butterfly is not used, the movement every time the test tube is
              changed out for another one. This last is many times when we have a
              large set of tests. But I've had no real anxiety episodes since using
              Paul's method. The blackouts occurred in previous years - I used to
              dread going to get lithium levels every 6 weeks and that was only 1
              tube. **Kitty]

              >> Another suggestion, is requesting that a draw, which will require
              >> multiple test tubes for samples, be done using a butterfly.
              >
              > Interesting, thanks for the suggestion -- I will inquire.
              >
              >> 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 agree that at times I have practiced delightful examination of my
              > activities,

              I too am (and always have been) highly analytical of my thoughts and
              actions, but I would never call this a "delightful" examination.
              Rather it is strictly for the purpose of ascertaining, understanding
              and modifying for the better, if necessary and to the extent that that
              can be done. The only times that I actually "delight" in something
              about myself is when I accomplish things that I consider worthwhile or
              even just difficult and when my body reacts in a thoroughly healthy
              and capable manner to some event. I remember an incident many years
              ago when I had not had the flu for a very long time and I was actually
              pleased to see my body react positively and normally to getting it.

              [Jack, the way you describe "delightful examination of [your]
              activities" sounds like taking part in a spectator sport. **Kitty]

              > since I have become interested in dealing with two
              > difficulties: 1) making sure my presentations were palatable and 2)
              > discovering actions that conflicted with my intentions.
              > For an example regarding 1), when I've given a presentation of something
              > important to me, I am often nervous that
              > a) I am considered far beneath those in attendance, and

              Jack, you need to get it strongly into your head that you are not
              "beneath" any other person nor is anyone "beneath" you. There are things
              that you know and understand which no one else does and for any other
              person there are things which s/he knows and understands which you do not.

              > b) none of them (know how to) care to participate in my development.

              What you are missing here is that it is only right and proper for others
              to be primarily interested in their own knowledge and development.
              However, if they rationally and most efficiently pursue that objective,
              then the actions that they take will automatically contribute to your
              knowledge and development. I also do not "care to participate in [your]
              development". I am only taking actions which aid your development so
              that I will have a friend who is better developed and will return values
              to me in various forms and ways, some of which will hopefully even aid
              my own development.
              Once again the purpose is maximizing lifetime happiness. Development of
              oneself as a person is only an important and necessary means to that end.

              > In class, at a lab meeting, and at Meetup groups, I get the sense that
              > most are inwardly obsessed and socially careless. Since I notice this
              > attitude often, I want to do my best to not exaggerate the distance
              > between myself and them by replacing a set of poor habits that are
              > related to protecting myself from embarrassing jesters (stemming from
              > middle and high school experiences).

              I am baffled about how all the above inter-relate.
              1) How do you *reasonably and surely* "get the sense that most are inwardly obsessed and socially careless"?
              2) Why are you trying to assess others as a group? They are all
              individuals with enormous variations of egoism, social attitudes and
              social actions of all kinds. Concentrate on those who seem to have
              qualities that you find interesting and to your own benefit, and
              ignore the others.
              3) What is the connection between "inwardly obsessed" and "socially
              careless"?
              4) How do these two characteristics (to the extent that they exist)
              relate to "exaggerate the distance between myself and them"? - Note
              again that you are lumping everyone else into a collective who is
              going to act as one toward you, when in fact, each of the others
              around you acts totally as an individual in hir relationship to you.
              Lumping people together like this is a certain way to not be ready to
              gain anything positive from some individual one of them.
              5) How is any of the above related to "a set of poor habits that are
              related to protecting myself from embarrassing jesters (stemming from
              middle and high school experiences)"?
              6) Why were you embarrassed by these clowns, rather than just telling
              them what idiots they were? I can only remember two incidents of
              embarrassment from my school years and they were both due to high
              school teachers chiding, in one case, an uncharacteristic foolishness
              and, in the other, a harmless habit in front of the whole class.

              Note: All the above are rhetorical questions, not requiring answers here, but merely for you to think about.

              > Instead of self-protection, I hope redirect my focus toward reading
              > the audience well

              Any audience is composed of individuals. One cannot "read" an audience
              even as well as one can "read" one person (and that is not much at all
              either). All that one can do is to present to a stereotype of what one
              expects and/or wants the typical person in the audience to be. I say
              this as a teacher of many, many years of many types of courses.

              [I am getting the impression that you view yourself as always "on
              stage", as if in some performance. However the facts of reality are
              that wherever you and whatever you are doing (short of actually being
              part of some entertainment for others) very few people around you are
              actually examining you at all. This is because most people are mainly
              concerned about themselves, as it is right and proper that they should
              be. **Kitty]

              > and coupling this with a presentation that draws
              > them (as many as possible) in for a deeply meaningful exchange,

              Again you are going way overboard. You are never going to have a
              "deeply meaningful exchange" with a whole group of people at once. At
              best, you may provide some information that is "deeply meaningful" to
              a few of them, but whether or not it is "deeply meaningful" is more up
              to them than it is to you. A few of those few may return some "deeply
              meaningful" information as comments. However, depending on the subject
              matter, there may be nothing "deeply meaningful" to possibly be
              communicated at all. In addition, what is "deeply meaningful" in your
              consideration may not be so in the consideration of most others, or
              perhaps even of anyone who is listening to you.

              > both in terms of fully addressing the subject

              Unless a subject is very narrow, small and simple, it can never be
              "fully addressed" within any verbal presentation.

              > and my own personal growth in
              > presenting information for consideration.

              Your personal growth is mostly dependent on you rather than your
              listeners or readers, except perhaps for some valuable comments if you
              are so lucky as to get them.

              > To address this, I watch myself and look for distracting qualities;

              I don't see how you can know what is "distracting" to others since
              that is a very subjective characteristic. Instead just be yourself and
              seek to attract similar others.

              > I also attempt to model others who I consider to be inviting and
              > intriguing.

              It is essential to first analyze just why and how such people are
              "inviting and intriguing". Only if their "inviting and intriguing"
              characteristics are rationally and honestly based and presented, are
              such role models positive to emulate.

              > I do gain delight in real-time self-reflection.

              As I explained before, I find it strange to label the benefit of a
              psychologically healthy self-analysis as a "delight".

              > It is possible that I spend too much time doing this and also for the
              > wrong reasons (e.g. to make sure I look pop-culturally attractive).

              Once again, be yourself (if you really have a self of which you are
              proud). Act as you consider to be appropriate and effective and ignore
              the cultural notions, particularly the trendy-pop ones.

              > Vicariously, I highly doubt; the concept suggests that I am
              > developing a second personality, one that can mostly independently
              > judge the original. In addition to doubt, I am confused why you have
              > chosen this word; if you have the interest and time, will you
              > elucidate?

              Vicarious:
              *1* *:* having the function of a substitute *:* serving instead of
              someone or something else *:* acting for a principal *:* representing or
              taking the place of something primary or original *: DELEGATED
              <memory is /vicarious/ experience in which there is all the emotional
              value of actual experience -- John Dewey>
              *2* *:* performed or suffered by one person as a substitute for another
              or to the benefit or advantage of another *: SUBSTITUTIONARY
              </vicarious/ sacrifice>
              *3* *:* experienced or realized through imaginative or sympathetic
              participation in the experience of another <was getting a /vicarious/
              kick out of watching a fellow female preening herself over the
              capitulation of the male -- Helen Howe>
              /Webster's Third New International Dictionary, Unabridged/ .
              Merriam-Webster, 2002. http://unabridged.merriam-webster.com (16 Jul. 2009).

              In the context of yourself it means that you have a somewhat "split
              personality". One part of you gets great delight (jovial amusement) in
              watching the other part of you (as if it were another person) and for
              that reason, does not attempt to change the other part of you, since
              doing so would spoil the continuing delightful enjoyment. This is how
              you appear to me.

              [As I noted above, your descriptions remind me of someone who is watching
              hirself perform, always assessing for a better *performance*. **Kitty]

              >> 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.
              >
              > Intuitively, I think I had been doing both, fully living and delightfully
              > studying my responses.

              You can't simultaneously do both effectively. The second is bound to
              inhibit the first.

              [It seems to me that one can reasonably examine one's own past actions
              or an ongoing situation, but it is not possible to effectively examine
              *at the very time* of engaging in some action or exchange with
              another. If, during an exchange, a person is paying strong attention
              to hir own actions, thoughts and words, then s/he is not really
              listening to and noting the behavior of the other person. And
              conversely, if that same person is giving hir undivided attention to
              the other person's actions and/or words, then s/he is not at that time
              examining hir own behavior, thoughts, emotions, etc. **Kitty]

              > I am fascinated that I do become so deeply engaged in some activities
              > whereas others are sleep-inducing (yawns, disinterest, much reduced
              > excitement for the moment). More surprising is that I can create a
              > philosophy that discourages most reasoning for participation in an
              > activity, say playing basketball, and then demand of myself that I
              > cease a particular action for two years -- yet -- that activity,
              > basketball, might bring me hours of continuous joy, even after the two
              > year drought!

              Again I don't understand this "fascinated" relating to something about
              which you ought to instead be puzzled, concerned and even unhappy at
              the inconsistency.

              The above shows that your new ideas (your newly created philosophy of
              life) has not yet been fully integrated - your emotions are still not
              consistent with your consciously held convictions. "Creating" a
              philosophy does not *integrate* it fully into your mind. Consciously
              reasoning out why some actions will be more long-run beneficial than
              others (if that is what you mean) does not automatically teach and
              train all parts of your mind to act in accord with these new ideas.
              Rather your mind is a highly complex interconnection of somewhat
              independent parts (using computer language, I call them background
              subprocessors), the conscious reasoning part being only the one of
              them that you are directly aware and in control of. (Although the
              later is also debatable since conscious awareness has been shown to
              arise milliseconds after some other clearly connected brain response,
              so perhaps the conscious is merely a form of presenter of what some
              other part of the mind considers to be the most important current
              information of which it should be aware.)

              Only rooting out and modifying emotional attachments to the previous
              philosophy, now deemed incorrect, will enable such total integration.
              This applies to both old positive emotions for things that you no
              longer consciously value as much and old negative emotions ("yawns,
              disinterest, much reduced excitement") for things which you now value
              highly.

              [I don't understand why you had been berating yourself for playing
              some basketball and then denied yourself that pleasure for 2 years. A
              couple hours a week isn't any obsession and its good physical
              activity. It sure beats spectator sports that so many spend many more
              hours on weekly.

              We have lots of foods that we enjoy eating but we do not do so
              chronically or even periodically because we are convinced that doing
              so would be harmful. But we do eat them once or twice a year - because
              we enjoy them and we are highly confident that this frequency is not
              detrimental to us. I suppose that we could eliminate them entirely but we do not think it is overall cost productive. Food tastes (and other sensual pleasures) are not directly substitutable one for another.

              Another related thought - even thinking excessively can be detrimental if the person then avoids actually doing things physical, activity which is necessary for health maintenance. Both mental and physical activities are needed to maintain overall good health. **Kitty]

              > Likewise, I can create a philosophy that brings to the top the most
              > important reasoning for participation in an activity such as learning
              > about my body/health/wellness, and then demand of myself that I
              > practice the related activities for two years -- yet-- I will cease
              > that activity 100% the day after two years and feel no loss!

              This makes no sense at all to me. If the knowledge gained and the
              practices undertaken during those two years is of benefit to you how
              can you not feel a loss (at least a concern for your ongoing health)
              at not continuing such practices and more learning to make them even
              more beneficial.

              The remark above also applies to this - you haven't integrated fully
              into your mind (Branden's word is "owned") the ideas that your
              conscious reason considers to be most correct and beneficial for you.

              > I like to watch and analyze myself now and then to discover the secrets
              > to my failures and successes.

              It is clear that you have been watching far too much and analyzing the
              reasons for your inconsistent behavior far too little.

              >>> 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?
              >
              > Only if I visually witnessed the puncture -- to this day, I can
              > vividly recall two 15-18 year-old acquaintances of mine wrestling for
              > control of a tool they each found in the basement of their home -- it
              > had a long wooden handle, like that of a garden hoe and the end
              > equipped with a metal hook. I visually witnessed the hook end enter
              > (1/4 to 1/2 inch) and leave the right calf of the older (brother).
              > Even though it happened to someone else, I experienced the suddenly
              > intense response.
              >
              > I can recall one vivid visual removal of 1/2 inch of Honey Locust thorn http://www.mitzenmacher.net/blog/wp-content/uploads/2006/01/thorn.jpg
              > from the area just below my knee cap. That caused quite a horrified
              > reaction as I yanked it out and immediately after as I comprehended
              > the entry and removal of the thorn.
              >
              > All other foreign objects (splinters, scratches, etc) that I do not
              > see enter, do not bother me a bit (besides some pain). All rougher
              > damage that I do see, such as deep scratches, smaller thorns with
              > barbs, splinters, etc. do not bother me either.

              Then think about the inessential difference (the end result of a
              wound, loss of blood and tissue healing requirement is the same) and
              tell yourself strongly how silly you are for making such a distinction.

              >> 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.)
              >>
              > I agree that I have been acting counter to my values, and for some
              > unknown reasons, treating similar occurrences very differently, which
              > is wrong.

              The "unknown reason" is that you still have not understood the concept
              of integrating, and making internally consistent, your consciously
              held desires/values with your emotional reactions. Your emotions were
              all programmed by your values and experiences of your past, and they
              can be reprogrammed to react differently and consistently with your
              new ideas, values and desires. You are ultimately the ruler of your
              emotions. Your emotions are not there to rule you. Their purpose is to
              be both tools of cognition and the means by which you experience the
              positives and negatives of the external world as it relates to your
              values.

              > I do not consider myself foolish nor idiotic however. IMO, these two
              > terms should be reserved for one who cannot improve hir intellect.

              It is up to you if you do not wish to apply such terms to yourself in
              particular aspects. I have always applied them to myself whenever I do
              foolish, idiotic or stupid things. That is the way that I chastise
              myself and impress on myself the need to not do such a thing again.

              [I can readily say that I consider 2 points in my life when I was
              foolish. The first was when I was 16 and a junior in high school, I
              took without questions the guidance counselor's statement that physics
              was not a field for women. I don't even recall considering that I
              should discuss it with my father (I do recall though that this was a
              period in time when he was very involved with getting a new career
              started after retiring from the Navy - retirement pay was not going to
              pay all the bills.) But many years later I looked back and thought how
              foolish I'd been at the time. Even much later than that when I
              mentioned it to my Dad in the late 1980s, he was so surprised that I
              hadn't told him. His comment was that "we'd have found some way to get
              you that kind of education."
              The second incident was one I acknowledged fairly soon afterward -
              that was in not taking my Dad's advice about the fellow I was dating
              and then got engaged to right after completing my nursing education.
              Dad was right about Rudy and I was wrong, but I at least didn't keep
              on being so foolish as to marry him.

              Of course I've done some silly things on occasion and even said so out
              loud. Mostly these have been as a result of not paying close
              attention. **Kitty]

              > Those who can improve intellect yet lack in judgment and act contrary
              > to their values can be described with words such as naive and immature.

              It is not improvement in your "intellect" that is needed here. But if
              you wish to scold yourself by applying the terms "naive" or "immature"
              to yourself when you catch yourself in an emotion which is contrary to
              your consciously held values, then that should work fine too.

              > The last "note" is understood.
              >
              >>> 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.
              >
              > Noted.
              >
              >>> 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.
              >>
              > I am glad that you are thinking about me and offering critical
              > analyses for my consideration. I expand/explain a little above and I
              > have no intention of brushing aside your comments; instead, I am
              > deliberately considering what you have shared and looking for
              > opportunities to practice directly experiencing events coupled with an
              > awareness to postpone introspection to afterward.
              > Thank you for the suggestions!

              Yes Jack, I am still trying to get my ideas through to you. I have not
              totally given up on you, even though I fear that we are so extremely
              different from each other that we will never be able to be kindred
              spirits. So I am far from certain that I will ever see a return of
              value of the kind that I mostly want from others. I do not mean this
              comment to be any criticism of you or to even suggest that you are not
              a responsible returner of value - it is only that you are not (and I
              strongly suspect that you never will be) capable of returning the
              types of values that I most desire.

              >>> 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.
              >>
              > I am thinking about it.

              That is good, but you need to do more than just "think about it".

              --Paul
            • olehenry1
              ... I can now recall one incompetent phlebotomist...more about this near the end of this message. ... This last sentence is what I have been taking ownership
              Message 6 of 17 , Aug 23, 2009
              View Source
              • 0 Attachment
                --- In morelife@yahoogroups.com, Paul Wakfer <paul@...> wrote:
                >
                > On 07/15/2009 01:14 AM, David Thomas Jackemeyer wrote:
                >
                > > --- In morelife@yahoogroups.com, Paul Wakfer <paul@> wrote:
                > >
                > >> 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. If 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.

                I can now recall one incompetent phlebotomist...more about this near the
                end of this message.

                > >> 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.
                > >
                > > I understand that my "anxiety attack" is something I am creating in
                > > subconscious, likely as a response to avoid pain or suffering.
                > > More below...
                >
                > Its intensity may be connected to some of the vividly recalled
                > experiences that you relate below. You do not have to continue
                > creating it, particularly when you do want to experience the minor
                > pain of the blood draw in order to gain its major benefits.

                This last sentence is what I have been "taking ownership" of through
                daily reminders of Paul's statement and by listing the potential
                benefits along side the costs.
                As a physical animal, the pin prick hurts! But as a big-brained animal,
                I have abilities to look past the pin prick and generate a strategy that
                supports participating in a blood draw in anticipation of future benefits.

                > >>>> 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.
                > >
                > > OK, I'll start here, but do you mean altogether?

                meta
                <changed from "all together" to altogether>
                /meta

                > > I planned to continue learning the "mechanics", only stopping before
                > > or during a draw. I have enjoyed reading about and envisioning how
                > > the skin organ and vein are disturbed by the entry of the needle,
                > > followed by platelet plug formation and blood coagulation at the
                > > vessel walls, etc.
                >
                > Jack, why is it that if I leave any detail out you always miss my
                > meaning? (This is a rhetorical question, not requiring an answer, but
                > merely for you to think about.)

                Very little was missed -- I came to the same conclusion as you describe
                below, that I should continue learning the application to humans in
                general, and stopping when the blood draw was on myself.
                I asked the question above in case your suggested method began with a
                period of temporary but complete refrain.

                > Perhaps the following written above would have enabled you to
                > understand:
                > "First, quit even imagining the "mechanics" of the draw *on yourself*.
                > When you are having blood drawn do not think of the physical procedure
                > with respect to yourself, do not watch the needle, tubes, etc, rather
                > dwell on all the peripheral events involved and the benefits of the
                > whole."
                >
                > Yes, it is always beneficial to learn about any physiological
                > operation of the body. But when you are doing the learning, approach it
                > as if it applies to humans in general not yourself.
                >
                > [When I was learning to start intravenous infusions, I practiced
                > getting the feel of lower arm and hand veins on others and myself. But
                > I did not imagine inserting the needle into my own veins. Even now I
                > can view and palpate the veins on my arms and note which ones are good
                > for IVs (if that were ever needed - last time was when I had the
                > ureteral stone Jan 2003). But I do not envision the puncture of skin
                > and vein. I do not see any point in getting this graphic on *myself*
                > and I do not think it is a good idea for you to do it for *yourself*
                > either. **Kitty]

                Understood.

                > >> 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.
                > >
                > > "How counterproductive", agreed.
                > >
                > > I don't understood why you use "idiot" since the word does not apply
                > > to me, since in present day refers to those with especially abnormally
                > > poor intellects. The Greek "idiote" referred to one who was static in
                > > hir learning of subjects outside of hir "private station". I could
                > > become that idiote if I ceased to educate myself; for example, I could
                > > move back to Indiana and live on my father's farm as a
                > > Jack-of-all-trades.
                > >
                > > Why do you choose to use "idiot"?
                >
                > 1. Most important, please note that I was not calling you an idiot. I
                > was telling you to say to yourself: "What an idiot I am to feel that
                > way", "What a silly emotion to have." or "How foolish to be so
                > concerned and have such a reaction to such a simple procedure which is
                > both overall beneficial and has far less pain attached to it than many
                > things that happen to me more often (stubbed toe, banged elbow or
                > knee, other cuts scrapes, bruises, etc.)"
                >
                > 2. My use of the word "idiot" is always with the meaning 3b from
                > /Webster's Third New International Dictionary, Unabridged/.
                > Merriam-Webster, 2002. http://unabridged.merriam-webster.com ( 15 Jul.
                > 2009)
                > "a person who fails to exhibit normal or usual sense, discrimination,
                > or
                > judgment especially at a particular time or in respect to a particular
                > subject <I don't know why I was such an /idiot/> <a perfect /idiot/
                > about budgeting>
                > Note particularly, the phrase "at a particular time or in respect to a
                > particular subject". I never use the word for a person as a whole.

                I did not conclude that you were calling me such nor using the word to
                describe me as a whole. And if I were to witness your verbal use of
                "idiot", I know well that you are likely in an emotionally charged state
                and describing the irrational thoughts and behavior, rather than the
                whole being.

                > 3. I rarely ever use the word these days. I only did so here as a way
                > to emphasis to you the message that when you feel the anxiety, your
                > conscious part of mind should very *strongly* chastise the emotional
                > subconscious part of your mind and tell it to: "stop being so foolish"
                > and "stop acting inconsistently with what I (the conscious) knows is
                > best for me". This is what I mean by squelching, denying, scolding
                > and refusing to sanction your emotional response of anxiety.

                In my experiences, once anxiety begins, I respond by reasoning that I do
                not sanction further anxiety, yet it still comes (probably with less
                power each time). I predict a long-term contribution with this practice.
                Further, since beginning university studies in 1996, I've been reducing
                strong chastising behavior because I understood there to be insufficient
                quantitative or qualitative benefits:drawbacks ratios. Instead, my
                practice has been to calmly address the problem through 1) timely and
                time-consuming discovery/introspection of my thoughts and actions, 2)
                determination whether the thoughts and actions conflicted with my
                esteemed values, 3) estimation of whether the conflict (problem) was
                severe enough to dedicate energy/time to, and whether the conflict was
                easily addressable (probably due to prior "game plan" set up to address
                that very problem), then 4) "self talk" in an effort to a) try again
                using different thought process and actions or b) repeat reminders of
                the idea enough times in hopes that desired future changes in thoughts
                and actions would occur.

                What are the benefits to strongly chastising and scolding the emotional
                subconscious part over *or* in-addition-to diligently addressing and
                redirecting the emotional subconscious part?

                Without good data nor vivid experience (naivety), I suppose the former
                would have a faster effect.

                > 4. The Greek meaning to which you refer is effectively obsolete in
                > current English language usage. However, since I do like to keep my
                > word usages close to root meanings, I will try hard to replace all
                > usages of "idiotic" with either "foolish", "silly", or, perhaps best
                > of all, "irrational" - because inconsistent.

                Increasingly, I too am curious about the root meanings, which is greatly
                aided by my use of Merriam Webster's Unabridged Online Dictionary
                http://unabridged.merriam-webster.com/
                and the Online Etymology Dictionary.
                http://www.etymonline.com/

                > >> 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.
                > >
                > > Thanks for the suggestion of considering examples, of which I realize
                > > if and only if I watched the puncture event did I react with anxiety.
                > > All other times I react as you describe:
                > >
                > >> 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.
                > >>
                > > Great suggestions for consideration (intentional vs not).
                >
                > So use this fact also to remind yourself how foolish you are being
                > when you feel anxiety before and during a blood draw. If you scold
                > your emotional subconscious hard enough for long enough and tell to it
                > to stop behaving this way, then it will eventually do so.

                Addressed and questioned above.

                > >>> 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.
                > >
                > > Your last sentence is my hope!
                > >
                > >> [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.
                > >
                > > Funny thing is that until recently, I thought this technique was my
                > > evasion of reality, so I decided to cut the small talk, etc., instead
                > > taking interest in the mechanics by watching with deep interest and
                > > asking the professionals about the strategies/methods. Maybe I "took
                > > too large of a bite".
                >
                > Yes, you tried to get your emotional subconscious (which has irrational
                > behavior to this particular event) to run before it was even crawling
                > correctly. Think of this way - if you are capable of rational action
                > toward reality, then it should never be evaded, but rather faced head on.
                > However, to the extent that you are not capable of facing the full
                > reality of something then it may be necessary to circumvent, ignore or
                > intentionally evade it until you are capable of fully facing it and
                > reacting effectively to it. Note the difference between intentional
                > evasion, which remains under your control and can later be altered
                > when it is useful to do so, and unintentional habitual or subconscious
                > evasion which is always negative (mainly because you don't even know
                > that it is happening and therefore are totally missing whatever it is
                > that you are evading).

                Yes I agree, and until the very recent past, I naively placed both types
                of evasion into [one negative category] which I think led me to "bite
                off more than I could chew" in more than one area of my lifestyle.

                > >> 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.
                > >
                > > Do you think about the procedure when far from having a blood draw?
                >
                > [I think of it only in regard to planning what day and approximate
                > time so that it fits appropriately with our eating. I do not at all
                > think about the venipuncture itself. I know from experience that if I
                > get it done with a butterfly and that even if the phlebotomist is not
                > the best, the procedure will not be unduly uncomfortable. What really
                > bothers me is the probing for a vein by a less experienced person or,
                > if a butterfly is not used, the movement every time the test tube is
                > changed out for another one. This last is many times when we have a
                > large set of tests. But I've had no real anxiety episodes since using
                > Paul's method. The blackouts occurred in previous years - I used to
                > dread going to get lithium levels every 6 weeks and that was only 1
                > tube. **Kitty]
                >
                > >> Another suggestion, is requesting that a draw, which will require
                > >> multiple test tubes for samples, be done using a butterfly.
                > >
                > > Interesting, thanks for the suggestion -- I will inquire.

                I decided to make a visit to the local Mesa, AZ LabCorp for my a.m.
                blood draw (no caloric intake for 15 hrs, no exercise for 42 hrs), which
                is to be assessed per LEF's $189-sale-price Male Panel:
                http://tiny.cc/iJ03z

                The night before, I had a stressful time falling asleep, taking over 1.5
                hours to initially fall asleep, then waking throughout the night. I
                actually did not think much about the blood draw that I planned to
                complete in the morning; instead, my brain was concerned with EVERYTHING
                else!

                Without an alarm, I woke at 8:20am, shaved, showered, packed my bags for
                work, and brought ice water and a book in case of a long line at the
                LabCorp; I left the house at 9am.

                Arriving to a mostly empty parking lot and only nine people in the
                waiting room and no line for signing in, I did so, and within 5
                minutes, was called; in fact I was the first to be called since I had
                arrived. Fast service, a plus :)

                {Anxiety creeps up to 5%}
                A female named Joe P was assigned my draw. She left the door to the
                room open, which felt good because in an 8 x 8ft room, I might have felt
                restrained.
                (On second thought, I might have enjoyed the enhanced focus that comes
                with privacy.)
                I requested a butterfly-style needle and tubing -- Joe hesitated and
                said she was not well-practiced with the butterfly. I thought for a
                moment, "fine, first and foremost, I want her to be confident and calm".

                {Anxiety 10% -- things are not going according to plan}
                So I suggested an ordinary needle and tubing would be fine, in fact,
                that *her choice* of apparatus would bring me most comfort.
                But she responded, "No, no, if you'd like a butterfly, then we'll do the
                butterfly."

                OK, whatever, just do your job and I'll do mine!

                {Anxiety 15% -- can I trust this person?}
                I stated out loud that I had a little trouble in the past controlling my
                response to blood draws, but that I was more confident now that I was
                thinking of the plethera of benefits of such a procedure coupled to a
                small cost, the prick of a needle.

                I avoided all visual contact with the apparatus as she neared and
                strapped on the tourniquet, drawing from my right arm. Small prick and
                an increase in {Anxiety 20% -- feeling the needle prick, but not
                imagining entry}, so I continued to think about the relative gain versus
                the small cost of minimal pain PLUS the fact that this was a controlled
                situation, not some accidental puncture wound...

                "You're all done", said Joe.

                Wow, that was fast! Yippee! I am a champion!
                I glanced over at the two tubes of blood and commented to Joe that in
                the past, the tubes were a little smaller, and *five* in number.
                Just as I was leaving the room, she called me back in -- oops, only did
                half the draw!

                {IDIOT! -- Oops! That slipped out... I'm angry and would like her to
                step down. Anxiety bumps up to 25%}
                So, I sat back down and requested the left arm, where she found a new
                vein...and failed! I did not look, but I could not avoid her nervous
                call to the supervising nurse -- "We have a bleeder" coupled with my
                now throbbing left arm.

                {This MUST be a joke! Why would she say THAT out loud? Anxiety up to
                50%, doubling as I don't trust Joe to improve at this point and both
                arms are throbbing.}

                I'm getting pretty flustered, but before I can bolt for the door to
                escape whatever wrath lay before me, the supervisor glides in, expertly
                eyes the appropriate vein, and without more than a expert's nod, slips
                the third butterfly almost perfectly between nerve endings -- I felt no
                new pain.

                Supervisor says, "Take care of this one -- I've got to go."

                {No, please don't go... at least don't leave me here with her! Anxiety
                caps at 50%}

                Needless to say, my chest was full of anxiety. I kept breathing and
                making small talk as Joe wrapped up the draw, without further incident.

                I was out of there! I still managed to walk out with a smirk on my face
                but only because of the unusual timing and circumstances surrounding my
                experience, where I intended to simplify my blood draw to a few
                manageable details.

                Subsequent, I drove to work and really worked on my self to appreciate
                the valuable information from this and future blood draws. I HAVE NO
                NEED FOR THE ANXIETY! I am uninjured!!
                Nevertheless, the anxiety took awhile to decrease as my arms pitifully
                throbbed (slightly) painful reminders of the draw(s).

                When I phoned Kitty, I described some of these details to her and shared
                one of my heartiest laughs of 2009 while discussing the ridiculous
                parts along with the important growth.
                This was an important part of my experience, thank you Kitty :)

                --Jack (David Thomas Jackemeyer)

                > >> 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.

                <snipped remainder about living as a stranger in one's one experience>
              • Paul Wakfer
                ... Exactly! There is a real sense in which the human brain/mind is at once several distinct and somewhat independent entities. All of these entities can be
                Message 7 of 17 , Aug 25, 2009
                View Source
                • 0 Attachment
                  On 08/24/2009 01:26 AM, olehenry1 wrote:
                  > --- In morelife@yahoogroups.com, Paul Wakfer <paul@...> wrote:
                  >
                  >> On 07/15/2009 01:14 AM, David Thomas Jackemeyer wrote:
                  >>
                  >>
                  >>> --- In morelife@yahoogroups.com, Paul Wakfer <paul@> wrote:
                  >>>
                  >>>
                  >>>> 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. If 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.
                  >>>>>
                  >
                  > I can now recall one incompetent phlebotomist...more about this near the
                  > end of this message.
                  >
                  >>>> 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.
                  >>>>
                  >>> I understand that my "anxiety attack" is something I am creating in
                  >>> subconscious, likely as a response to avoid pain or suffering.
                  >>> More below...
                  >>>
                  >> Its intensity may be connected to some of the vividly recalled
                  >> experiences that you relate below. You do not have to continue
                  >> creating it, particularly when you do want to experience the minor
                  >> pain of the blood draw in order to gain its major benefits.
                  >
                  > This last sentence is what I have been "taking ownership" of through
                  > daily reminders of Paul's statement and by listing the potential
                  > benefits along side the costs.
                  > As a physical animal, the pin prick hurts! But as a big-brained animal,
                  > I have abilities to look past the pin prick and generate a strategy that
                  > supports participating in a blood draw in anticipation of future benefits.

                  Exactly! There is a real sense in which the human brain/mind is at once
                  several distinct and somewhat independent entities. All of these
                  entities can be somewhat "controlled" (perhaps a better word than
                  "ownership" for such an interactive state). Some of these entities are
                  autonomic and cannot totally be controlled (eg. pain response). Some of
                  them are rapid (preceding even conscious awareness) which is highly
                  important for those that warn one of real potential danger. However,
                  most of these rapid but non-autonomic response entities of the
                  brain/mind are effectively learned habits (a result of the learning that
                  takes place as a human grows and develops - and all emotions are
                  examples of such learned habits) which can be "unlearned" and modified
                  in the same manner as any other habit. Rationally, any such habit needs
                  to be modified if the habit caused a decrease in overall value to some
                  action, which in overall evaluation, apart from that habit response,
                  optimally increases one's lifetime happiness. (More about the
                  independent entities approach later).

                  meta
                  Snipped portion not needing response.
                  /meta

                  >>>> 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.
                  >>>>
                  >>> "How counterproductive", agreed.
                  >>>
                  >>> I don't understood why you use "idiot" since the word does not apply
                  >>> to me, since in present day refers to those with especially abnormally
                  >>> poor intellects. The Greek "idiote" referred to one who was static in
                  >>> hir learning of subjects outside of hir "private station". I could
                  >>> become that idiote if I ceased to educate myself; for example, I could
                  >>> move back to Indiana and live on my father's farm as a
                  >>> Jack-of-all-trades.
                  >>>
                  >>> Why do you choose to use "idiot"?
                  >>>
                  >> 1. Most important, please note that I was not calling you an idiot. I
                  >> was telling you to say to yourself: "What an idiot I am to feel that
                  >> way", "What a silly emotion to have." or "How foolish to be so
                  >> concerned and have such a reaction to such a simple procedure which is
                  >> both overall beneficial and has far less pain attached to it than many
                  >> things that happen to me more often (stubbed toe, banged elbow or
                  >> knee, other cuts scrapes, bruises, etc.)"
                  >>
                  >> 2. My use of the word "idiot" is always with the meaning 3b from
                  >> /Webster's Third New International Dictionary, Unabridged/.
                  >> Merriam-Webster, 2002. http://unabridged.merriam-webster.com ( 15 Jul.
                  >> 2009)
                  >> "a person who fails to exhibit normal or usual sense, discrimination,
                  >> or
                  >> judgment especially at a particular time or in respect to a particular
                  >> subject <I don't know why I was such an /idiot/> <a perfect /idiot/
                  >> about budgeting>
                  >> Note particularly, the phrase "at a particular time or in respect to a
                  >> particular subject". I never use the word for a person as a whole.
                  >
                  > I did not conclude that you were calling me such nor using the word to
                  > describe me as a whole. And if I were to witness your verbal use of
                  > "idiot", I know well that you are likely in an emotionally charged state
                  > and describing the irrational thoughts and behavior, rather than the
                  > whole being.

                  I am pleased that you understand that now, since when I am "emotionally
                  charged" (as you well phrased it), I do not take the time to phrase my
                  words nearly as well as is needed for full comprehension and as I almost
                  always do when writing.

                  >> 3. I rarely ever use the word these days. I only did so here as a way
                  >> to emphasis to you the message that when you feel the anxiety, your
                  >> conscious part of mind should very *strongly* chastise the emotional
                  >> subconscious part of your mind and tell it to: "stop being so foolish"
                  >> and "stop acting inconsistently with what I (the conscious) knows is
                  >> best for me". This is what I mean by squelching, denying, scolding
                  >> and refusing to sanction your emotional response of anxiety.
                  >
                  > In my experiences, once anxiety begins, I respond by reasoning that I do
                  > not sanction further anxiety, yet it still comes (probably with less
                  > power each time).

                  Yes, habits ( whether of the emotional type or not) take time to unlearn
                  and the more deeper, earlier ingrained and rapid the habit, the longer
                  such reprogramming will take.

                  > I predict a long-term contribution with this practice.
                  > Further, since beginning university studies in 1996, I've been reducing
                  > strong chastising behavior because I understood there to be insufficient
                  > quantitative or qualitative benefits:drawbacks ratios. Instead, my
                  > practice has been to calmly address the problem through 1) timely and
                  > time-consuming discovery/introspection of my thoughts and actions,
                  > 2) determination whether the thoughts and actions conflicted with my
                  > esteemed values, 3) estimation of whether the conflict (problem) was
                  > severe enough to dedicate energy/time to, and whether the conflict was
                  > easily addressable (probably due to prior "game plan" set up to address
                  > that very problem), then 4) "self talk" in an effort to a) try again
                  > using different thought process and actions or b) repeat reminders of
                  > the idea enough times in hopes that desired future changes in thoughts
                  > and actions would occur.
                  >
                  > What are the benefits to strongly chastising and scolding the emotional
                  > subconscious part over *or* in-addition-to diligently addressing and
                  > redirecting the emotional subconscious part?
                  >
                  > Without good data nor vivid experience (naivety), I suppose the former
                  > would have a faster effect.

                  This is a good question which definitely needs some psychological
                  research (maybe there is some - if someone would care to do the work
                  then I would be highly receptive to finding out). From the point of
                  view of my own analysis and understanding of human brain/mind/body
                  operation, as long as the psyche involved is not overly delicate (ie,
                  it already has a strong self-esteem), I think that the self-chastising
                  will most definitely speed up the unlearning and reprogramming
                  process. My reasoning relates to the description posed above of the
                  brain/mind being essentially several somewhat independent entities. If
                  that is true then chastising is a form of internal social
                  preferencing. It is the conscious mind making an evaluation of some
                  other one of the independent entities, and, just like any other
                  person, that entity has its own self-esteem and does not want to be
                  negatively evaluated, particularly not by someone (another internal
                  entity) whom it respects. Another way to look at this, particularly
                  for reprogramming an emotion, is that that emotional entity will be
                  more responsive to another emotion (scolding/chastisement).

                  >> 4. The Greek meaning to which you refer is effectively obsolete in
                  >> current English language usage. However, since I do like to keep my
                  >> word usages close to root meanings, I will try hard to replace all
                  >> usages of "idiotic" with either "foolish", "silly", or, perhaps best
                  >> of all, "irrational" - because inconsistent.
                  >
                  > Increasingly, I too am curious about the root meanings, which is greatly
                  > aided by my use of Merriam Webster's Unabridged Online Dictionary
                  > http://unabridged.merriam-webster.com/
                  > and the Online Etymology Dictionary.
                  > http://www.etymonline.com/

                  Thanks for the link. I had not used that one, but it is now in my bookmarks.

                  >>>> 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.
                  >>>>
                  >>> Thanks for the suggestion of considering examples, of which I realize
                  >>> if and only if I watched the puncture event did I react with anxiety.
                  >>> All other times I react as you describe:
                  >>>
                  >>>> 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.
                  >>>>
                  >>> Great suggestions for consideration (intentional vs not).
                  >>>
                  >> So use this fact also to remind yourself how foolish you are being
                  >> when you feel anxiety before and during a blood draw. If you scold
                  >> your emotional subconscious hard enough for long enough and tell to it
                  >> to stop behaving this way, then it will eventually do so.
                  >
                  > Addressed and questioned above.

                  To which I answered above. And see how well my previously described
                  method above fits that reasoned answer just now provided above. Of
                  course, just as one should never tell a child to change some behavior
                  merely "because I say so", so you should never try to change a habit
                  without having fully elucidated the reasons for doing so and constantly
                  reiterating these to yourself.

                  >>>>> 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.
                  >>>>
                  >>> Your last sentence is my hope!
                  >>>
                  >>>> [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.
                  >>>>
                  >>> Funny thing is that until recently, I thought this technique was my
                  >>> evasion of reality, so I decided to cut the small talk, etc., instead
                  >>> taking interest in the mechanics by watching with deep interest and
                  >>> asking the professionals about the strategies/methods. Maybe I "took
                  >>> too large of a bite".
                  >>>
                  >> Yes, you tried to get your emotional subconscious (which has irrational
                  >> behavior to this particular event) to run before it was even crawling
                  >> correctly. Think of this way - if you are capable of rational action
                  >> toward reality, then it should never be evaded, but rather faced head on.
                  >> However, to the extent that you are not capable of facing the full
                  >> reality of something then it may be necessary to circumvent, ignore or
                  >> intentionally evade it until you are capable of fully facing it and
                  >> reacting effectively to it. Note the difference between intentional
                  >> evasion, which remains under your control and can later be altered
                  >> when it is useful to do so, and unintentional habitual or subconscious
                  >> evasion which is always negative (mainly because you don't even know
                  >> that it is happening and therefore are totally missing whatever it is
                  >> that you are evading).
                  >
                  > Yes I agree, and until the very recent past, I naively placed both types
                  > of evasion into [one negative category] which I think led me to "bite
                  > off more than I could chew" in more than one area of my lifestyle.

                  Aha! I think that I know at least one other person who is guilty of not
                  distinguishing intentional from unintentional evasion (the former is
                  probably better termed "rational avoidance", generally temporary, but
                  not always or necessarily so).

                  >>>> 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.
                  >>>>
                  >>> Do you think about the procedure when far from having a blood draw?
                  >>>
                  >> [I think of it only in regard to planning what day and approximate
                  >> time so that it fits appropriately with our eating. I do not at all
                  >> think about the venipuncture itself. I know from experience that if I
                  >> get it done with a butterfly and that even if the phlebotomist is not
                  >> the best, the procedure will not be unduly uncomfortable. What really
                  >> bothers me is the probing for a vein by a less experienced person or,
                  >> if a butterfly is not used, the movement every time the test tube is
                  >> changed out for another one. This last is many times when we have a
                  >> large set of tests. But I've had no real anxiety episodes since using
                  >> Paul's method. The blackouts occurred in previous years - I used to
                  >> dread going to get lithium levels every 6 weeks and that was only 1
                  >> tube. **Kitty]
                  >>
                  >>>> Another suggestion, is requesting that a draw, which will require
                  >>>> multiple test tubes for samples, be done using a butterfly.
                  >>>>
                  >>> Interesting, thanks for the suggestion -- I will inquire.
                  >
                  > I decided to make a visit to the local Mesa, AZ LabCorp for my a.m.
                  > blood draw (no caloric intake for 15 hrs, no exercise for 42 hrs), which
                  > is to be assessed per LEF's $189-sale-price Male Panel:
                  > http://tiny.cc/iJ03z
                  >
                  > The night before, I had a stressful time falling asleep, taking over 1.5
                  > hours to initially fall asleep, then waking throughout the night. I
                  > actually did not think much about the blood draw that I planned to
                  > complete in the morning; instead, my brain was concerned with EVERYTHING
                  > else!
                  >
                  > Without an alarm, I woke at 8:20am, shaved, showered, packed my bags for
                  > work, and brought ice water and a book in case of a long line at the
                  > LabCorp; I left the house at 9am.
                  >
                  > Arriving to a mostly empty parking lot and only nine people in the
                  > waiting room and no line for signing in, I did so, and within 5
                  > minutes, was called; in fact I was the first to be called since I had
                  > arrived. Fast service, a plus :)
                  >
                  > {Anxiety creeps up to 5%}
                  > A female named Joe P was assigned my draw. She left the door to the
                  > room open, which felt good because in an 8 x 8ft room, I might have felt
                  > restrained.
                  > (On second thought, I might have enjoyed the enhanced focus that comes
                  > with privacy.)
                  > I requested a butterfly-style needle and tubing -- Joe hesitated and
                  > said she was not well-practiced with the butterfly. I thought for a
                  > moment, "fine, first and foremost, I want her to be confident and calm".
                  >
                  > {Anxiety 10% -- things are not going according to plan}
                  > So I suggested an ordinary needle and tubing would be fine, in fact,
                  > that *her choice* of apparatus would bring me most comfort.
                  > But she responded, "No, no, if you'd like a butterfly, then we'll do the
                  > butterfly."
                  >
                  > OK, whatever, just do your job and I'll do mine!
                  >
                  > {Anxiety 15% -- can I trust this person?}
                  > I stated out loud that I had a little trouble in the past controlling my
                  > response to blood draws, but that I was more confident now that I was
                  > thinking of the plethera of benefits of such a procedure coupled to a
                  > small cost, the prick of a needle.
                  >
                  > I avoided all visual contact with the apparatus as she neared and
                  > strapped on the tourniquet, drawing from my right arm. Small prick and
                  > an increase in {Anxiety 20% -- feeling the needle prick, but not
                  > imagining entry}, so I continued to think about the relative gain versus
                  > the small cost of minimal pain PLUS the fact that this was a controlled
                  > situation, not some accidental puncture wound...
                  >
                  > "You're all done", said Joe.
                  >
                  > Wow, that was fast! Yippee! I am a champion!
                  > I glanced over at the two tubes of blood and commented to Joe that in
                  > the past, the tubes were a little smaller, and *five* in number.
                  > Just as I was leaving the room, she called me back in -- oops, only did
                  > half the draw!
                  >
                  > {IDIOT! -- Oops! That slipped out... I'm angry and would like her to
                  > step down. Anxiety bumps up to 25%}
                  > So, I sat back down and requested the left arm, where she found a new
                  > vein...and failed! I did not look, but I could not avoid her nervous
                  > call to the supervising nurse -- "We have a bleeder" coupled with my
                  > now throbbing left arm.
                  >
                  > {This MUST be a joke! Why would she say THAT out loud? Anxiety up to
                  > 50%, doubling as I don't trust Joe to improve at this point and both
                  > arms are throbbing.}
                  >
                  > I'm getting pretty flustered, but before I can bolt for the door to
                  > escape whatever wrath lay before me, the supervisor glides in, expertly
                  > eyes the appropriate vein, and without more than a expert's nod, slips
                  > the third butterfly almost perfectly between nerve endings -- I felt no
                  > new pain.
                  >
                  > Supervisor says, "Take care of this one -- I've got to go."
                  >
                  > {No, please don't go... at least don't leave me here with her! Anxiety
                  > caps at 50%}
                  >
                  > Needless to say, my chest was full of anxiety. I kept breathing and
                  > making small talk as Joe wrapped up the draw, without further incident.
                  >
                  > I was out of there! I still managed to walk out with a smirk on my face
                  > but only because of the unusual timing and circumstances surrounding my
                  > experience, where I intended to simplify my blood draw to a few
                  > manageable details.
                  >
                  > Subsequent, I drove to work and really worked on my self to appreciate
                  > the valuable information from this and future blood draws. I HAVE NO
                  > NEED FOR THE ANXIETY! I am uninjured!!
                  > Nevertheless, the anxiety took awhile to decrease as my arms pitifully
                  > throbbed (slightly) painful reminders of the draw(s).
                  >
                  > When I phoned Kitty, I described some of these details to her and shared
                  > one of my heartiest laughs of 2009 while discussing the ridiculous
                  > parts along with the important growth.
                  > This was an important part of my experience, thank you Kitty :)

                  That was a great (and funny) description! You did an excellent job of
                  managing it and I strongly congratulate you on a job well done and an
                  important lesson learned.

                  [For others, the phone call from Jack was not for the purpose of
                  telling me about this related experience but something totally
                  unrelated and at the end he mentioned that he had had the blood draw
                  done (a day or two before as I recall). He then asked if he should
                  just wait to write about it for the group or would I like to hear the
                  details. I was definitely interested in hearing how it all went - and
                  Jack has related most of what I remember. But Jack, what about your
                  exit from the "back room" into the lobby displaying your 3 band-aids
                  and warning those waiting about the ordeal? ;>) I forget what term you
                  used to describe the tech who was responsible - ?vampire?.

                  My understanding during our phone conversation about the lab draw
                  "adventure" was that there was nothing amusing about it at the time.
                  It was only afterward during your relating of it that you could look
                  back - somewhat with relief and satisfaction that you'd managed to
                  block the rising anxiety, from my interpretation - and you could laugh
                  at the near calamitous events. I know that I would not consider it
                  funny - and told you I didn't - that the technician really was not
                  well practiced in using a butterfly. But the entire episode and how
                  you related it brought out the humor - and many times I have found
                  that laughing at a situation that is not life threatening or major
                  asset losing is better than getting angry. This is especially true
                  when there are other individuals involved over whom you have little if
                  any control.

                  You did all the right things, kept your anxiety level under control
                  and proved to yourself that you can do just that - avoid a panic
                  attack. This then becomes evidence that you can do it again - and with
                  other similar situations too, though the exact techniques will likely
                  be different. **Kitty]

                  meta
                  Snipped portion not responded to.
                  /meta

                  --Paul
                Your message has been successfully submitted and would be delivered to recipients shortly.