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Helencollins
23-02-15, 01:38
This happened to me unplanned on Saturday morning. I was tired and travelling on trains (sometimes a trigger for me) I got on my last train (a 20 minute journey after the 2hr one I had just done) and felt the panic start. I ALWAYS run and remove myself as my coping tactic. So I got off the train before it started. Normally that would mean leaving the station and getting a taxi or bus, something less chlaustrophobic. But I felt like this was ridiculous this time, I had just sat on a train for 2 hours and I was okay, I was tired and and I didn't want to walk out of the big station and put up with the extra expense/time or money. I was angry at my panic. So I got
On the next train. Same thing happened as soon as I stepped on and I got off, back into the platform. I told myself one more try and I'd give up. I got
On and tried to distract myself but it wasn't working. I made my way to the door and pressed the open button furiously but it was too late, it wouldn't open. I have never been more terrified in my whole entire life. The panic attack started to engulf me and I was sure I would either pass out or pull the emergency cord (I once got off a plane after security and boarding before the plane doors closed so it wasn't a big stretch to think that's how badly I would freak out) for the first time ever I had no escape and It was horrific. I tried breathing technique for the first time ever and it worked. I'm
Not saying It was pleasant but after about 3 minutes my heart rate and hyperventilating slowed and I stayed the 20 minute journey. I didn't get off at the next stop which I could have after about 4 minutes.

I have felt emotional and drained all weekend .

Has anyone else tried exposure without distractions or escape routes planned and do you think it works? I feel it may but by god it was tough. Any thoughts?

MyNameIsTerry
23-02-15, 07:19
Well done Helen!!!

Yes, I would put myself in large open plan busy supermarkets and just stay in there for about an hour. With ERP its all about habituation and you need a certain amount of time to allow for this because after a certain time, your anxiety levels will drop. I think my therapist showed me a diagram with a 20 minute marker on. Panic attacks only last a very short time and then the adrenaline is left causing a load of residual anxiety until it can be metabolised (deep breathing and exercise cause it to be metabolised, so do this to get rid of it quicker).

From here its all about doing it again and over time extending the exposure so you learn to tolerate it over a longer period of time.

Distraction during ERP is actually frowned upon for OCD sufferers as it can cause new rituals.

Maybe these threads will provide some useful information about exposure:

http://www.nomorepanic.co.uk/showthread.php?t=160784

http://www.nomorepanic.co.uk/showthread.php?t=159265

The ERP for therapists might have some useful ways to deal with exposure without distraction.

You definately need to work out of having an escape route. That automatically creates the thoughts of a possible panic attack and you will probably be checking for your route and this just reminds the subconscious that its an issue because you place such emphasis on it. It will come in time though.