The Anticipatory Anxiety Is Worse Than The Needle

It is the anticipation that causes most of the suffering…. The stress of anticipation has a chemical signature and physiological consequence. Every moment we spend anticipating what is about to happen is a moment of unnecessary agony. If it is going to be, get it over with and put it behind you. Even if the only up side is the elimination of this suffering, you are further ahead.

When I was younger I used to give blood. There are three reasons why I did it. First, it’s a good thing to do. It may help someone who needs blood, it could save a life. Second, there are the cookies and peach drink. When they sit you down to recover, they give you this super sweet peach drink and as many cookies as you want. They want your blood sugar to stay up given that they have just taken a pint of blood and in response, your body very likely initiated a stress response that moves blood sugar into the cells to power a fight or flight response. When this happens, it’s important to replenish the blood sugar quickly to prevent it dropping.

The third reason why I liked doing it is because it’s slightly painful but in a manageable way. It’s a safe type of pain, in a very control environment with almost no long term risk for a healthy adult male.

I remember the first time the blood bank came to our school and I excitedly decided to participate. There were a few of us who did it as a sort of dare – peer pressure / trash talk can have a big impact on the actions of people who are susceptible to social pressure. I filled out the paper work and waited for my turn. There was an anxious / excited feeling building which is kind of pleasant. It was a lot like the feeling I would get before teaching a cycling class. It’s a feeling that indicates an unknown in about to happen. I have no idea what would be next, just that in a few minutes a needle would be pushed through my skin into a vein in my arm and a quantity of blood would be removed. What that would feel like was a mystery, one that would be solved in the very near future.

It turns out that the pain associated with the needle is very small in magnitude and duration. It isn’t as intense as a bee sting, it doesn’t linger like a mosquito bite, and the sensation of blood leaving the body is almost imperceptible. At worst there is a slight lightheadedness initially and when you first sit-up but it’s closer to nothing than everything. Even the needle being in the arm doesn’t feel like much. The idea of it is a little more uncomfortable than the physical feeling of it. The thought “there is a needle in my arm” isn’t one that I had had before and given that it isn’t a natural part of life, it’s nothing that we innately put to rest or naturally habituate. In all the times I gaven blood, the thought of the presence of the needle was always the worst part, indicating just how trivial the actual pain is or just how profound the impact can be of thought, particularly when pair with focused attention.

The anticipatory anxiety was worse than the needle. It has always been worse than the needle. Vaccinations, at least since I have been 9 or 10 have always been the same way. In fact, the only time I recall a vaccination as being negative was when I was 5 or 6 and had to get the needle in the glut. In fairness thought, the process was awful.

It was at school and all the kids in a class were vaccinated at one time. In their wisdom, the process they came up with was tailor designed to make it as traumatic as possible. A small group of us were led into a room. There was bed set up, but it was behind a curtain. In front of the curtain was a couple of rows of chairs. The front row contained the “next to be vaccinated” kids and they would, when their turn came, stand-up and walk behind the curtain. Once the front row was empty, the second row kids would move forward and wait their turn. A new batch of kids would be brought in and take their place in the second row.

From an adult perspective, this process makes sense. After all, it’s just a small needle in the buttocks. They know that it is mostly painless because they have experience with it.

From a child’s perspective, it is terrifying. And rightfully so. If you were to be able to occupy the mind of any of the children, what is so horrible about it would become obvious immediately.

First off, we don’t know any of the players. We’ve never seen the doctor or nurse before. In fact, they only show-up at the school to put the kids through this ordeal. All we know is what we have heard from the older student had been thought it before (and they had the same miserable experience we were about to have). We don’t really know our teachers at this point – the brain of a five or six year old doesn’t really have much concept of social roles – and by default we trust every adult because we have to. But it isn’t a real trust that is based off of experiences, it is a trust that is a consequence of having next to no skepticism or critical thinking skills. So the fact that they are walking us into this room does little to put the mind at ease.

Second, the whole situation is kind of scary. Kids wait their turn to go behind a curtain for something to happen to them. Every child who goes behind the curtain ends up screaming and crying, and every child that is about to go behind the curtain witnesses this. They hear the shreeks of fear and then the cries of pain. And they never see the child again. Keep in mind that we were at the most 6 years old. The concept of there being a future does not yet reside in our brains. All we know is what we see / hear / feel and right now that is telling us that everyone who goes behind that curtain screams in pain and disappears.

Third, our time is coming. We know it is coming because a few minutes ago we were in our class room. Then some students are lead away. Then we’re lead away to take our place in a row of chairs behind the first group. Those kids are taken one at a time behind the curtain for God knows what, but it sure as hell hurts, and then we move forward to wait our turn. It makes no difference what anyone says because we don’t have a point of reference or experience to process this. Telling us that it doesn’t hurt for very long, that it isn’t very painful or that we have had vaccinations before is like telling us that we are made-up of billions of atoms. We don’t know what any of it means because we have no memories that we can access to help make sense of the situation. All we know is that, one by one, our friends and classmates go behind a curtain where a couple of strangers hurt them.

When my time came, I was told later, I didn’t handle it very well. I freaked out because I knew, not feared, knew I was going to die. And I was held down by strangers to have a needle stuck into my buttocks by another stranger. I was a hero and I fought valiantly, but I was no match for the nurse and doctor. I was a 10th their size and they had the benefit of being well versed professionals knowing a thing or two about leverage. There is a gap in my memory covering the last few moments before I was led behind the curtain and up until I was in the school yard recovering with the rest of the just traumatized kids.

Sure we wouldn’t get lockjaw, but would we ever feel safe again?

As I got older, the immunization process improved. Our triceps became the target muscle and that alone was enough to overwrite the impact of the buttocks ordeal. The health care practitioners stopped doing needles to us and began to let us consent. I suppose it was quicker to hold the kids down and get it over with, and there’s a very good chance that no a single child would consent to that first needle but I don’t actually care if their job was hard. They were doing something to us that was really negative given that any pain at all cannot be understood in rational terms by 6 year olds.

Needles do not hurt all that much. Breaking a finger or smashing your foot off of the leg of the coffee table in the dark is actual pain. The difference between the needle and the broken bone is that we KNOW the needle is coming. If we knew we were about to break a finger, we’d change course and just not break the finger.

It is the anticipation that causes most of the suffering. In almost every case, this anticipatory anxiety is worse than anything the world is going to bring us. The stress of anticipation has a chemical signature and physiological consequence. Every moment we spend anticipating what is about to happen is a moment of unnecessary agony. If it is going to be, get it over with and put it behind you. Even if the only up side is the elimination of this suffering, you are further ahead, but that is never the case, there is always another upside that makes the experience very worthwhile.

Our thoughts have a lot more power in manufacturing suffering than anything the physical world will reasonably bring our way. The needle is never as bad as the thought of the needle.