Hello, I am a neurotypical GP. I have changed some of the details below to protect a patient's identity.
I saw a 21 year old today with autism. We had a long chat together with her mum about her fear of needles. She had a life threatening condition a while back which required her to have some blood tests and a cannula put into her arm.
She found that she was unable not to look at the vein etc. when they were going to try to take blood and could not stand the thought of anyone taking her blood.
She does not currently need any blood tests, but her mum is worried what might happen if she ever does need one in the future.
On the previous occasion when she did need the blood tests / a cannula, she had to be sectioned in order for this to be done.
She does not wish to try a local anaesthetic or counselling.
I have said I would be happy to work with her, for as long as it takes, to help her overcome her fear of needles. I have said she would never have to do anything she does not want to do, and that she can decide what we do when we have an appointment. I thought maybe I could gradually introduce the equipment at the first appointment and take it slowly from there.
Does anyone have any suggestions about how best to approach this?
I think that gradually introducing the equipment, and letting her have as much time as she needs to become accustomed to it, is a good way to go but it might take some time - especially if it's the equipment itself that's scaring her. Being allowed to eventually pick up and examine the equipment, a little like self-directed exposure therapy, might eventually take some of the fear out of such appointments.
I say 'some' because I feel that the equipment itself isn't the only problem. Speaking for myself, it's the invasion that's the problem.
Having a person stand so close as to feel 'on' me is what makes me feel very tense. Having that person then 'take control' of me / a part of my body, is SO much worse. It's suffocating, I start to hyperventilate and have to consciously control my breathing - really concentrate on it to try to stay calm - and It's made so much worse when the person then demands my attention by asking questions.
I've found it helps if I'm able to swab my own arm with the alcohol wipe, even better if I'm able to apply the elastic band above the area. The more I'm able to do myself the better, really (without the doctor / nurse leaning right into my space while I do it). I don't like it when my arm is grabbed and / or manipulated either, even although I know that this is only being done to examine the area or look for a suitable injection site - it just feels like too much of an invasion. At the end I prefer to hold the cotton ball to the area myself and apply my own elastoplast.
I don't know how much help any of this will be but these are the things I experience and also the reason why I have to see what's being done during the procedure. I could never just turn away and let someone 'do' whatever it is. I've never found it painful and don't care about the sight of blood.