View Full Version : A sudden panic attack.
A (poorly trained) therapist told me that I must be thinking negative things for a panic attack to happen. I don't know if she was right or not.
80% of the time I don't have negative thoughts I just have a sudden wave of overwhelming emotion despite the fact that I often know and understand that I'm in no danger.
I know what sets me off and I begin to feel uneasy a few seconds before hand, but it's a feeling not a thought. The entire time I'm thinking rationally but my emotions overwhelm me and THEN I panic. Even when I panic I don't loose much rational thought I just can't control the feeling of panic.
Thoughts?
I've not had a pa for a long time but triggers then and even the triggers that fail now don't necessarily have to be negative thoughts.
They can be self monitoring or environment monitoring thoughts asking myself if a feeling or something in my environment is familiar to those times and places where I DID have one. Especially room temperature, to this day I more than likely have a window open. That goes back to the very first time it happened. Windows straight open and I needed loads of chilly fresh air in the room.
I think of it more as PTSD, associations. I suppose sometimes your subconscious can be aware of those familiarities, associations even if you're not conscious of them.
"Is it going to" can be enough. Is that a negative thought ?
Mine were all probably preceded by A thought though.
Something would cross my mind first.
I don't let trigger thoughts complete anymore though.
I just get the hell out of their quick and forget I had the thought as soon as possible.
I'm the same with room temperature, if I get too hot I get a little flustered. Not panic level but I always have a window open too. I'm really glad it's not just me!
I suppose is it going to is worrying so it's probably on the negative side of the spectrum. I do have some panic attacks due to negative thought but I can deal with those OK because I know what the problem is. But the sudden ones are proving harder to manage, I'll feel fine and positive about going somewhere I know is crowded (I'm agoraphobic) but then panic when I get there or half way through the day.
I often get physical symptoms of stress like chest pains or the shakes, before I'm even aware of any worry at all. If I knew I was about to panic or that something was going to be a problem I'd take myself out the situation.
I don't panic that often now, but it's more than I'd like and I'd like more control over it.
MyNameIsTerry
12-04-14, 01:52
Like you said, a poorly trained therapist because thats not the case.
Triggers can be thoughts or feelings or environmental factors.
I've just posted this link in another thread which was about a 3 minute window to stop them.
http://www.anxietycoach.com/support-files/panicattacksworkbookchapter7.pdf
Have a look at the diagram in this and review the Event, Reflex Reaction & Interpretive Reaction.
It's important to realise that the Event will happen but it's how you stop the Reflex Reaction & Interpretive Reaction from feeding each other back and forth. Once they build up to a certain level, a PA occurs.
I'm the same with room temperature, if I get too hot I get a little flustered. Not panic level but I always have a window open too. I'm really glad it's not just me!
I suppose is it going to is worrying so it's probably on the negative side of the spectrum. I do have some panic attacks due to negative thought but I can deal with those OK because I know what the problem is. But the sudden ones are proving harder to manage, I'll feel fine and positive about going somewhere I know is crowded (I'm agoraphobic) but then panic when I get there or half way through the day.
I often get physical symptoms of stress like chest pains or the shakes, before I'm even aware of any worry at all. If I knew I was about to panic or that something was going to be a problem I'd take myself out the situation.
I don't panic that often now, but it's more than I'd like and I'd like more control over it.
Yeh I see what you're saying. There's all this talk of think this way or don't think that way and you're thinking "well I'm not thinking anything so what am I supposed to do ?? I'm the one who falls through the pa loophole, great !"
Are you sure you're not thinking ANYTHING beforehand though ? You're not stressed or anxious about your situation and you're not thinking a thing about it ?
Because if you weren't, I'd be wondering what physiologically would be triggering it.
Eg if I was out and looking round my favourite shop, bought something great, thinking about the next shop, laughing about something I remembered on TV and had a pa that would be completely random and wouldn't make sense considering my state. I'd wonder if some physiological condition had caused it.
But you say " I'll feel fine and positive about going somewhere I know is crowded (I'm agoraphobic) but then panic when I get there or half way through the day. "
See now I would say that MAYBE wasn't random because there are elements that are consistent
Going somewhere.
Being there at some point.
Now considering you battle against the feelings of agoraphobia it would make it a possibility that when you HAVE gone somewhere and are there you could still very well be tense, nervous even if it's on a suppressed level.
After all if you say "no, I'm completely unworried, at ease, happy, I love it" then you'd be cured wouldn't you.
Me, Ive experienced feeling where I've been in a situation I was previously phobic about and I've been doing it for years but I'll suddenly and randomly go "oh no, I'm doing it aren't i. I can't do this. Now I have to go in/down there and face them".
An instant loss of confidence, an attack of doubt.
It's almost like it came because I remembered a feeling or saw myself in an old way.
Surely you'd be prone to that kind of thinking when you're out and then have a thought/feeling/image, anything that makes you aware that you're out and makes your bottle go. I'm not saying you do by the way. I'm just trying to understand what it could be.
Your symptoms , like chest pain, also suggest that they're not completely random as they're signs that your body is stressed at that time and possibly in that environment, which makes sense because you're agoraphobic and outside.
Also you were looking at hypnotherapy which means you're probably thinking its something on a subconscious level.
I think if there isn't any thought or feeling that precedes it then there's something going on subconsciously that you're not aware of.
Just because you're not currently aware of it doesn't mean it's not there.
Maybe until you work out what that triggering feeling, thought, image, memory is you could concentrate on feeling you have control of the escalation.
I always recognised this as the bigger problem. And you do say you " can't control the feeling of panic".
Common sense told me that panic had always been there.
Someone jumps out on you, that feeling is panic. It explodes in a split second but then automatically is dampened and you go "phew".
But as we know it stops being that and your biggest fear is escalation.
Maybe the trigger feeling isn't as important as the belief you CAN control the escalation.
Well that's how I learned to see it. I used the automatic dampening effect.
"It always was that way, somewhere along the way the dampening effect stopped doing its job. I need to put it back. It's quick, it's instant. It's like a candle flame and at will, naturally I drop a wet blanket on it and extinguish it. Just like when somebody jumps out, scares the life out of me, I panic and then it's capped, extinguished, GONE. Don't think about it. Just like a car that comes out of nowhere and makes you jump. Panic-cap it-"IDIOT!"-forget. "
That's what I use to this day.
You need to convince yourself you're back in control.
And there's probably the root fear of every anxious person - loss of control.
Maybe you're trigger feeling IS your fear (which is a feeling) of loss of control.
You're petrified of the escalation.
All just theorising and thinking out loud. I might be completely wrong. Just trying to help you explore it.
Thanks once again My Name Is Terry! That diagram makes it really clear.
You make a lot of interesting points Oosh.
I think it's likely I repress it or am in denial/unaware of how stressed I am. I take the effects of my anxiety seriously but perhaps not the anxiety itself?
Fear of loss of control/escalation is probably exactly right. I don't know how I'd make myself feel more in control, ever since I had anxiety problems I've felt vulnerable. I thought that was an unavoidable just part of it, I never considered that would be something worth working on or breaking down, until today :)
Haha next time I start to panic in a crowd I'm going to think "CAP IT IDIOT" and I'll probably laugh instead.
I'm not aware of thinking "oh no this happened last time" but now you mention it, a few of the places I have had "random" panic attacks are places in which I've had very bad experiences in the past. I thought I'd gotten over them, perhaps not.
I'm looking into hypnotherapy for my phobia of dentists and needles. Full on phobia, I can't handle them at all.
I find it as hard to trust a stranger with a hypodermic in an office as I would a stranger with a gun in an alleyway. I don't get scared when my friends go to the dentist, just when I'm there so I know deep down I don't really believe that they are going to hurt me. I definitely need a brain reboot in that area! Then again that could relate to all my other problems with anxiety too. Oh my...
MyNameIsTerry
13-04-14, 02:00
It's common to have PA's in places where you expereinced them before HalfJack, I know I've read that somewhere - the subconscious connecting the physical feelings to the thoughts at the time.
The brains 'Fear Centre', the amygdala, is a storage so it makes sense.
Breaking it down does make sense. Break it into elements and plan against them. Sometimes tackling the smaller parts effects the sum of them.
If you feel vulnerable, ask yourself why. What can you do to feel confident? Can you boost your confidence in general so you feel more comfortable in all situations?
littlepecos
13-04-14, 12:38
- Some really interesting thoughts here. I had a PA last night after stomach pains from eating something funny, there werent negative thoughts just the loss of control and the fear of escalation. I too am going to use this "cap it idiot!' I love it and hope to laugh! Take care x
ankietyjoe
13-04-14, 12:56
A (poorly trained) therapist told me that I must be thinking negative things for a panic attack to happen.
Completely and utterly untrue. Pay no attention to it.
Thanks guys, that's good to hear!
I constantly feel vulnerable, I know when I started to feel like that and why, but how to work on it? No idea. Not sure it's even possible but hey ho.
I'll talk to a doctor, see if they can recommend me to some therapy or something. Or google.
MyNameIsTerry
14-04-14, 01:38
Psychotherapy works like that, delving into the past to find the point of origin so you are one step ahead of the game since you know when it started. Do you also know why?
For me, working on vulnerability would seem to be about self confidence, self trust, self worth and self esteem .
Can you apply a practical solution e.g. if you felt vulnerable to attack, you could learn martial arts. I know thats a very basic one, it's just to give a feel of a practical solution.
That's a real life changer, and actually a very good idea.Basic but I hadn't thought of it. I was struggling to comprehend how I could break it down but that makes a lot of sense.
I don't think I could handle the classes right now because I'm too self conscious but I think if I worked on my fitness a bit beforehand (something I'm already doing) I'd be OK with it. It's a huge relief to have some positive goals ahead of me :)
I don't have self worth or self esteem, no idea where to begin on improving that. I can muse it over some though, knowing is half the battle I'd imagine.
Actually I've been trying to get in the habit of asserting myself more and making sure I look after myself even when I'm alone. I guess that's a start. Looks like I'm a better deductress than I thought!
---------- Post added at 20:17 ---------- Previous post was at 19:52 ----------
Oh and I kind of assumed knowing when it started would automatically allude to why? Or is that not the same thing? Semantics!
MyNameIsTerry
15-04-14, 04:32
Knowing when it started would be close to the 'why's' if it was linked to a specific event but it wouldn't be if you know all these symptoms starting occurring around X date.
If you know the event, write it down and underneath write down your thoughts, feelings and emotions. Also right down any environmental factors i.e. those outside your control.
Then you have a fairly clear picture of how this began.
You can use tools like these, Schema Activation Formulation & Schema Bias.
The first could be used to work ouk out the input (event where it happened) and then write your behavious, thoughts, feelings, etc about that event.
http://media.psychologytools.org/Worksheets/English/Schema_Formulation.pdf
http://www.psychologytools.org/schema-bias.html
The second could be used to consider what sits outside your belief that is actually true e.g. if you feel vulnerable in X place your schema (or belief) would distort or disguard certain information that tells you that you are not vulnerable but it will definately use any stimili that says you are as it fits within your schema.
Remember that self help group I told you about? They run assertiveness courses throughout the year so maybe join one.
In terms of self esteem and self worth, I think thats anxiety & depressions hidden outcome as it justs happens subconsciously until it's a big enough problem for us to see it consciously.
Volunteering is a good way to gain confidence and boost self worth. Take stock of things, think of everything you offer to people and why they appreciate you.
Self confidence is a big part of self esteem so you need to do things that will enhance this element which in turn will increase your self esteem. Self confidence could be boosted by joining clubs, societies, even things like this site as self confidence has a lot to do with interaction with other people. I know you've mentioned Agoraphobia before so thats bound to be quite a limiting factor in self confidence so challenge it with exposure therapy, see the Moodjuice link below about ways to challenge it and your thinking.
http://www.moodjuice.scot.nhs.uk/pdfGuides/Panic.pdf
Martial arts is what I want to start but I'm like you in that I want to get a bit fitter first. I'm sure I could do it without but I want to make sure I have built up a tolerance of the physical sensations that mimic anxiety so that I feel more comfortable. It's a good way to boost confidence and build up trust with other people, trust is essential is you are going to be throwing people around!
Thats all really useful! I love having things to read. I feel like I've been talking about myself A LOT on this thread, apologies guys!
Before I got anxiety, I had severe depression due to long term problems at school and home, so 0 self esteem was already deeply in the mix when anxiety joined the party. Now they are married with kids.
I had exposure before, it helped me a lot but only so much. Hit a bit of a wall now but psychotherapy or reading up on psychotherapy will probably help me get a bit further on.
I think volunteering is something I should push myself into again too, it was great the last time. Maybe if I did that joining a support group wouldn't seem so scary after a while. I tried going to the one you mentioned, but I saw the building, saw people, freaked out and went home.
Thanks MNIT x
ankietyjoe
15-04-14, 13:02
Anxiety often occurs after a prolonged period of stress, and may not in fact be linked to one specific event.
My own personal opinion is that psychotherapy is a bit of a red herring when it comes to dealing with anxiety, wheras CBT is a far more effective solution.
The issue isn't understanding why it happens, it's getting on with things when it does.
It almost flies in the face of everything we've been taught about 'dealing' with psychological issues, but when it comes to anxiety it's almost better to ignore it and get on with your life than analyse it to death. That's kind of the message with CBT, and definitely the message when it comes to using meditation etc to cope with those feelings.
Thats an interesting perspective.
Meditation is not for me, I can't take it seriously. I find going for a run or drawing does the trick though.
I'm not sure if CBT works for me. I'd argue that it treats the symptoms and not the cause but I'm not 100% decided on it. From the little I've experienced, it was stuff I did already so I didn't find it that useful.
I'm going to look into it again because all the therapy I've had has been poor so it could just be that, I'm open minded about trying anything. A lot of people here sing it's praises for sure.
MyNameIsTerry
16-04-14, 05:41
It depends on the issues, the NHS highly endorse both. For instance, if your anxiety & depression stem from abuse or bereavement, CBT isn't going to be as helpful because it doesn't analyse the root cause and make you see that it isn't what your perception is telling you or isn't your fault. Personality disorders are seen as long term problems because they are well ingrained into your character so take longer to deal with, which CBT doesn't offer.
If you anxiety & depression is based on poor lifestyle choices, like mine, it will steer you into better choices. Or less intense events, singular, etc. I don't think it great for GAD though since it likes to aim for specific issues hence it good for such as phobias, OCD, etc.
The same with Mindfulness meditation. It asks you to recognise the thoughts, feel the sensations but to attach nothing to them, let them float around, pull them back into focus if they stray, etc.
So, in terms of what therapy is best, it's one for the professionals to determine based on your circumstances.
Psychotherapy is harder to access due to the longer waiting times and the fact it's a long term therapy. CBT is quick to access and quicker to complete. So, that might explain partly why CBT has been put at Level 3, as opposed to Level 4 for the more complex interventions like psychotherapy.
If sitting meditation is not for you, what about Mindful walking meditations? What about Tai Chi or QiGong which are movement based forms of meditation?
Whilst CBT doesn't treat the cause, it aims to analyse how you think, feel & react. So, you can reason with what is happening to you and pass beyond. It's not that its about forgetting, it's about learning what the thoughts, sensations, behaviours, emotions, etc are and to work on breaking their hold over you.
CBT is only one tool used within Level 2 (self help) and Level 3. I experienced elements of exposure and behavioural activation in mine.
I think you had a poor therapist personally. That person clearly doesn't understand the panic cycle which is well documented...going back into decades ago with Claire Weekes. Was this person private or public? To become a therapist, you can do a very basic certificate and start advertising so my therapist said to use the BACP register as they have to pass their courses under supervision which continues throughout their registration.
---------- Post added at 04:45 ---------- Previous post was at 01:18 ----------
HalfJack,
I've found some worksheets that might be useful for you.
A Hotspot Record - to write down thoughts about specific events, their strength, how they made you feel, what you know now, etc. Maybe you could do it retrospectively?
http://media.psychologytools.org/Worksheets/English/Hotspot_Record.pdf
ABC belief monitoring sheet - similiar to the above.
http://media.psychologytools.org/Worksheets/English/ABC_Belief_Monitoring.pdf
EMDR protocol - to evaluate the strength of the memory, event, set negative & positive cognitions, etc.
http://media.psychologytools.org/Worksheets/English/EMDR_Protocol.pdf
Beahvioural experiment - for anything you may plan to try so you can evaluate it.
http://media.psychologytools.org/Worksheets/English/Behavioural_Experiment.pdf
Compassion formulation - to understand historical influences, safety behaviours, how you feel about yourself and how they influence you.
http://media.psychologytools.org/Worksheets/English/Compassion_Formulation.pdf
Friendly formulation - to understand what made you vulnerable in the first place, recent triggers, the problem and what keeps it going. Also, a section on what you have got going for yourself at the bottom. It might be easier to populate the problem first and work out what made you vulnerable in reverse.
http://media.psychologytools.org/Worksheets/English/Friendly_Formulation.pdf
Trap & Trac - you understand short & long term consequences and understand avoidance.
http://media.psychologytools.org/Worksheets/English/TRAP_TRAC.pdf
So, as you said you like to keep busy and work on your issues, there some ideas there on how to break things down.
On the subject of the self help group, don't worry as others do that too. One of the coordinators told me he did that for months and then tried sitting in reception for a while before he could progress into the meetings. If doing something else will help you to get into these, try it out.
---------- Post added at 05:41 ---------- Previous post was at 04:45 ----------
HalfJack, just to confirm - CBT is a form of psychotherapy but with it being offered at Level 3 as opposed to the larger treatments at Level 4, I tend to talk about it as a separate intervention. Sorry if thats confusing, I think a lot of us do as with AJ.
hi sorry but the poorly trained therapist is actually quite right but I believe not explained properly to you
you are scared of your own thoughts/symptoms you 'think' they are 'real' therefore your body will only take so much before it releases all that heart pounding fear
if this wasn't the case we wouldn't have so many 'scared im going mad' posts or health anxiety or people "scared there a paedophile" posts
so take me for instance im in good mental shape this last month and infact the slightest twinge or negative thought doesn't bother me AT ALL !!!!however me one month ago would steam round the living room at the sight of a burst blood vessel in my eye or a negative thought activated my fear button I "thought" I was going mad"
Infact it seems surreal looking back now how much mental time it took during my day
the trouble is with most of on here is your anti meds anti this anti that youll read the symptoms the pills give you and youll have that symptom ive been there.............youll read a book do people with cancer read books ???? if the doctor told you to take pills then youd take them!!
but youll all still be on here in 6 months time with a new symptom dwelling on each others negativity and comparing books!!!!
the sooner you all realise serious anxiety is a chemical inbalance and your mind needs help like any other body organ would the sooner you will recover
look at all the people who specialise in Anxiety they always admit don't DRINK ALCOHOL or at least limit intake thus prooving it is a chemical inbalance if you dont drink perhaps you've already got the chemical inbalance anyway ie: just cause people don't smoke doesn't mean they wont get lung cancer
RANT OVER
take care
kris
"the sooner you all realise serious anxiety is a chemical inbalance and your mind needs help like any other body organ would the sooner you will recover"
I don't really know how to approach a reply because I'd like to believe what you said came from a good place, but it's not constructive.
I've never doubted information from a doctor or that a chemical imbalance is involved.
I am pro medication. I'd say most people on here are, at least from my experience on here. The therapist in question told me outright that she did a 2 month course to do her job, that is nothing compared to a doctor who has to study about 40 times that to do theirs.
MyNameIsTerry
17-04-14, 01:44
The therapist in question told me outright that she did a 2 month course to do her job
Oh no, thats one of the courses any of us could do.
There is a Bill raised by Geraint Davies MP to regulate this sector and these types of counsellors will find themselves edged out.
For perspective, it takes around 2.5 years of study plus a minimum of 100 supervised hours to be allowed onto the BACP register. To stay on it, you have to undertake CPD and continued supervision and they have now started randomly auditing to make therapists prove they are adhering throughout the year.
There are courses on the internet such as certificates or diplomas that you could pass in a matter of weeks and then set up a private business.
Was this a private counsellor? If so, I would avoid them. My CBT therapist told me to only use the BACP register because of the strict criteria involved. There are other organisations such as BPS which requires degrees and BABCP which the NHS mention on their advice pages so these look ok.
hi my constructive information has came from my own time in st georges Stafford down to Pure O Intrusive thoughts urges to carry out the thoughts or "THINK" I will carry out the thought so avoid certain situations Ruminating constantly
All stem from anxiety
what im saying is your therapist is right but has not explained it properly to you
I feel I have explained it quite fairly that generally when you are in a good state of mind you can have a twinge or a negative thought and pass it off get on with your day but when you are mentally low these things can trigger more fear/anxiety which will bring on more sypmtoms etc etc people then attach importance to there negative thought/symptom which fuels more anxiety you are then stuck in the overload loop of constant worry as you are telling your body something is wrong
hope that helps
kris
Yeah, I was asked to go on one of those myself once but it was aimed at counseling children, I really wanted to do it but it didn't feel right.
I was referred to her by my Dr! In my hometown in Essex, their metal health service for people with depression or anxiety is a small group of 2 month trained therapists at your disposal for 5 weeks if you go on citalopram. It made me feel incredibly nauseated all the time but they wouldn't take me off it.
I changed my Dr, she put me on another medication and was baffled why they'd refused to do that.
When I moved to a posh area in the midlands I was given 2 advanced Dr's appointments if they increased my dosage and a support worker to help me with exposure therapy. I don't know where I'd be if I hadn't had that support.
---------- Post added at 13:04 ---------- Previous post was at 12:52 ----------
Although I will say one thing for Essex, when I worked with service users (not for the council for a non profit business) it was in Essex, so there were some services around but none that were widely available. 20 -30 y/os tended to slip through the net a bit too.
Thanks again for all the info MNIT, you should get paid for this!
MyNameIsTerry
18-04-14, 01:46
Well if you look at the BACP training, the introduction to counselling is 8-12 weeks and to become registered there is a further 2 courses for another 2 years.
So, that sounds like they are set up to offer Guided Self Help which sits at Level 2. Without any supervision of the counsellors though, it's a very flawed model and a couple of months of training is very poor.
The sooner that Bill is made an Act, the better as these services will have to be cut off.
It sounds like that surgery are very poor as well. I had this issue with mine initially and I was pretty unhappy a couple of years later when I did my research and found that the NHS advise GP's to swap SSRI/SRNI's if the side effects are detrimental as not everybody can tolerate them.
At least you have got a good GP now.
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