Needling...

Holding the needle gently yet firmly between the thumb and the index and middle fingers. The needle bends slightly as the thumb presses securely on the needle between the index and middle finger. This makes the middle finger the guide and stability, and the index is the power and stability finger. The midfinger and thumb are within 1 cm of the tip of the needle. This allows for accurate sufficient initial depth insertion.

The insertion should be somewhat of a strike from very close distance (2cm) to the skin surface. The other index finger should be used to press the skin making it taut and taking away some of the focus of the needle insertion. This readies the area by causing very slight pain to lessen the sensation of needle entry. This technique also makes insertion of thinner needles easier when treating very sensitive clients. The client should be instructed to continue to breathe in a relaxed manner. Tell them that they will feel a mosquito-like bite on insertion but to continue to breathe through it.
After initial insertion the client should know that the needle will then be manipulated in order to obtain De Qi. Explain that this is a sensation, not pain. If there is pain the needle more than likely is irritating a blood vessel and should be removed or adjusted. Explain that the sensation that is being sought after could be numbness, heaviness, achy, warmth, dullness, grabbing, electrical jolt-like, or pins and needles, that may be felt locally or travel along any given channel. Once any sensation is obtained the client should be instructed to inform you somehow and needle manipulation should cease. Also sometimes you may feel De Qi when the client does not, this is also an indication that manipulation should cease. This becomes a dance that builds a team between doc and client which establishes consistency and ultimately treatment effectiveness.
On some clients that seem to be quite sensitive, it may be advisable to wait to obtain De Qi until the second visit, once trust has been established.

Extraction: cover or not
Twisting: fast to sedate, slow to tonify
Awareness: focused
Re-stimulate part way through treatment
Thicker needles work better for the ears
Take away the clients visual sensation (eye pillow) so that mid-body connection is more easily obtained.
Environment should be quiet/calm
Smell should be a relaxing
Temperature of room should be comfortable (remember people cool off after the lay still for a period of time)
Security/trust: clients should be equipped with a way to contact the practitioner while the needles are in (i.e. buzzer).