View Full Version : Cognitive Behaviourial Therapist caused Panic Attack
star2sparkle
15-11-10, 10:22
Hi everyone
I just wondered if any of you had ever experienced what happened to me last week.
I have been seeing a therapist for a couple of weeks and we have been getting on fine, building up the rapport, but last week he wanted to really get to the nitty gritty (which I appreciate as I'm not there to talk about the weather) and I have told him several times what causes my anxiety (suffer from phobias, since a little girl) what triggers it, etc, etc. He said that he wanted me to stand up and deliberately hyperventilate to bring an attack on and see what happened! I have had anxiety/panic disorder for over 20 years, agoraphobia and OCD and I know what it's like to shake hands with the devil, so obviously I know what a panic attack is like, I have probably had hundreds in my life. I refused to do this, but ended up having a panic attack anyway in front of him (perhaps because of what he wanted me to do?). He didn't deal with it very well and I haven't returned. I'm worried now that I will be too anxious to have any therapy with him.
I want to do anything to help myself and I have managed to overcome a lot in my life but CBT doesn't sit well with me. I didn't think it was entirely ethical to induce a panic attack but perhaps that's part of it :ohmy:
What do you think?:shrug:
It must have been really horrible for you. I am having cbt at the moment and I must say I do find it very challenging. I have had some cbt in the past (group) which was more like a friendly chat, however this cbt is called high impact cbt and it is very hard. I cry most of the way through it! I am sticking with it as I am determined to get to the bottom of all this 'nonsense'! Perhaps you should go back and tell him exactly how you felt about the last session and why and see what he says. I think we are supposed to be a bit more assertive so this might be a good opportunity to put that to the test. I wish you luck! Take care x
hi star, it sounds a bit harsh to me! but i guess he thought it might help you?
i am currently waiting for fear fighter, its a sort of cbt with telephone and online support, i am hoping it helps me as i am not good with travelling to see people face to face... yet :blush: maybe one day.
if you arent comfy with seeing this guy, maybe you should see if you could have someone else?
i wouldnt leave it tho, i would keep going as its only early days.
take care xxx
Martin Burridge
15-11-10, 12:57
This is a commonly used technique in CBT. I don't know the particular reasons for doing it in this case but often it is to demonstrate that hyperventilating can make you feel dizzy but you will never actually faint. This is because the fear of fainting from a panic attack is a common cause of panic and anxiety itself. Fainting is caused by low blood pressure but during a panic attack your blood pressure goes up so you cant faint. The hyperventilating experiment is to prove this to yourself. However it is unpleasant and can bring on a panic attack
I prefer to do the hyperventilating experiments on myself at first rather than my clients but even the sight of someone else hyperventilating can bring on panic for some people. However it is considered more effective if the client does it.
What is important is that the therapist then shows you how to get through a panic attack if its does occur. Learning how to manage a panic attack is a key milestone on the road to recovery.
My advice is to go back to your therapist and discuss your concerns.I know its hard but avoiding the therapy would be the worst thing to do in the long term.
Star2 - I am uncertain as to why anyone would want to bring on an attack deliberately in a session ..... though I do feel that you ought to return and find out what the method was attempting to achieve!?
In regard to being 'too anxious' - I think you need to realise that the very reason you are going is to deal with your anxiety - so being anxious is par for the course, I imagine - and if you are experiencing 'some' of the problem whilst attending, then it will bring out things to talk about - in regard to the specific feeling(s) you experience at the time. So this should hopefully add useful info to the sessions - and again - I suggest you may wish to ask what the process is likely to involve, so you can feel comfortable knowing what is to come!
I come from the opinion that you have experienced your attacks too often already [even once is too often in my view] and the methods I use do not require anyone to re-live the event as a result.
One of the beauties of Time Line Therapy(R) is that it can be done 'content free', so you can let go of negative emotions - such as Fear, Anxiety, Anger ...... without having to relive the event - making the entire process much more comfortable for the client. Additionally, it is swift and gives a tangible outcome by the end of the session .... not weeks later.
Have a look at www.timelinetherapy.net [by Tad James who formalised the methodology]
click on the title sections for Negative Emotions, Limiting Decisions/Beliefs and Anxiety to read them...... should give you some good background.
Let me know if you have any questions
Nig
star2sparkle
15-11-10, 17:51
Thank you for all your replies :-) Much appreciated. I will look at Time Line Therapy most certainly.
I don't see the point in making a client feel that bad in a session. The thing is, there is no way I could have concentrated on the therapy I was meant to be receiving. I appreciate I need to feel anxious in a way but not to that level! I mean, I hate to think how many panic attacks I have had in my life and of course I already know that you don't pass out for I have experienced not passing out through having an attack! However, I still fear it and I can't for the life of me see how inducing a panic attack that I have had so many times before will suddenly convince me! The fear sadly remains. Without trying to be negative, that wouldn't have worked. If it works on others thats great. Perhaps I'm too complicated!
Also, the therapist was unable to assist me when I had the panic attack, so it wasn't as if he was teaching me how to deal with such high levels of anxiety either.
Consequently, I really don't wish to return to him. I felt pressured. He only has so long and said that after 15 sessions there is normally an improvement with most anxiety sufferers. I said I can't be like most anxiety sufferers then! You can't categorise people in this way and its all about money at the end of the day.
But I won't give up :D
God, is it really normal to need that many sessions ..... 15 ?
Anxiety and Panic behaviour is run at an unconscious level, so that's the level you need to deal with it at. If you could have learned to 'consciously' think your way out of attacks, then surely you could have done that by now, with the amount of time you have likely devoted to 'thinking' about the problem!
TLT will allow you to remove the root cause of the problem, so you would have no further need to create the anxiety and fear that lead in to a panic state.
Glad to help in any way I can.
Nig
Ooooh I'm on the waiting list for CBT and don't think I like the sound of it now.
Must have been awful for you Star2sparkle and it's a shame that it has put you off. I once had hypnotherapy (how on earth do you spell that ha ha) some 12 years ago, first one was great... second one was awful and scared me half to death I couldn;t even raise my arm to stop him which he said I should do if I felt uneasy.. never went back again and couldn't even listen to the relaxation tapes I was given because of the experience.
Maybe you should just go back BUT tell them you never want them to do that to you again even if it is supposed to help UNLESS someone is there who actually knows what to do to help you during your frightening moment.
I really feel for you as you are obviously doing what you can to sort yourself out but then this has thrown you back a bit.
Take care and don't give up but tell them x x x x x
mmm i start mine next week - was feelling quite positive about it not so sure now. However the ATOS doctor reckons i will be fun to do CBT with???? Not quite sure how we came to that conclusion ??? I was crying at the time.
I kind of get this though and it must have been awful.
I have to overcome staying in the hospital first lolx
I think people need to remember that ‘They’ are the clients, and as such have a say in how the sessions proceed. They should feel entitled to question anything they feel uneasy about, and even refuse if they feel really strongly about something.
The whole idea is for a person to come away from a session feeling better, not worse.
star2sparkle
16-11-10, 16:49
I really do agree with Nigel above. That certainly didn't happen for me, I didn't come away feeling better, or feeling more able to manage my anxiety. if anything it made a significant dent in my confidence that echoed throughout the week.
I must say that I'm sure not all cog-beh therapists will do the same and that we are all unique; some people respond better to different therapies, so please, no one rule it out :smile:
I would love to receive Time Line Therapy that Nigel H was talking about but I'm not sure if there are any therapists in my area. It certainly is the case that I am so very aware of my fearful thoughts and I have tried so many times to convert them, yet they persist. I know I catastrophise...but it happens even though I work so hard to overcome these thoughts.
I am sure others feel the same.
It's good we can support and understand each other. :biggrin: Helps so much
Sorry to hear you had such a horrid experience.I've tried cbt too its very hard to take it all in,i've taken some of it in and i have to keep going back over all my worksheets to remind myself of things i have been taught.
Why he wanted to induce a panic attack in you i cannot imagine because as you say he didnt deal with it anyway.I've never experienced a therapist doing that.
I've found a cd for panic attacks very helpful that i got off the internet.Relaxation and meditation is very important in reducing the stress that builds up inside us.Its well worth looking into as well.I've not had a pa for months and months but unfortunately had one yesterday but i'm sure it was just a build up of stress again and that they will keep on getting further and further apart.
Ali xxx
I think people need to remember that ‘They’ are the clients, and as such have a say in how the sessions proceed. They should feel entitled to question anything they feel uneasy about, and even refuse if they feel really strongly about something.
The whole idea is for a person to come away from a session feeling better, not worse.
This is a very good point. The guy I am seeing for CBT said at the start that it is a collaborative process and that in effect, I am an expert in "myself" as I know me, and know the experiences I have been through, and how I react to situations. Therefore although he is steering me through the process, it's also up to me to set the agenda and what I want to achieve through the sessions.
Martin Burridge
17-11-10, 17:36
The hyperventilating technique is something that may be used in CBT but it is not essential. If you are not comfortable with it tell your therapist. Im relatively new to CBT (background is hypnotherapy) so haven't used this on clients but the theory is that although you tell yourself that you will not faint your brain learns more from your behaviours than from your words.
If you feel dizzy (from shallow breathing in a panic attack) and you flee home to avoid fainting in public your brain (the hippocampus to be precise) learns that there must be a danger of fainting. Hence you continue to panic more about fainting in the future even though you know its illogical.
I believe there is a risk of a panic attack in any therapy (just as in any daily situation) but therapy (whatever variant) is still the most effective treatment but you have to see it through.
CBT works for some, hypnotherapy for others, EFT for others (dont know Timeline so can't comment) but whatever you choose it is best to complete the therapy. Hope it all works out.
Its quite a common intervention in treating panic through CBT, and it can have very good results if the groundwork is done first.
Basically, if anyone fully understands panic attacks they should have no fear of having one and to encourage them to come on if they can.
However, it might be that your therapist did not fully discuss the reasons before doing the experiment, therefore it might be worth going back and questioning him why you done it/what did it prove/what was the purpose, etc., and dont have fear of questioning your CBT therapist as it is supposed to be a collaboration.
I think the only reason why people think this is a bad thing to do in a session is because they still fear having a panic attack.
thetube82
tube82 - It may be 'one' way to help - if set up correctly ... and I am of the belief that having ONE panic attack in a life-time is once too many ... so would not wish to encourage it in the setting whereby the client expects to let the problem go - preferring to assist the client in dealing with things in a more comfortable way!
To Star
I can recommend a CBT site that I use, it really helps me. It is www.glasgowsteps.com (http://www.glasgowsteps.com) it is defo worth checking it out.
B xx
ladybird64
18-11-10, 20:26
Its quite a common intervention in treating panic through CBT, and it can have very good results if the groundwork is done first.
Basically, if anyone fully understands panic attacks they should have no fear of having one and to encourage them to come on if they can.
However, it might be that your therapist did not fully discuss the reasons before doing the experiment, therefore it might be worth going back and questioning him why you done it/what did it prove/what was the purpose, etc., and dont have fear of questioning your CBT therapist as it is supposed to be a collaboration.
I think the only reason why people think this is a bad thing to do in a session is because they still fear having a panic attack.
thetube82
Seems quite a logical reason really!
I know that you are trained in CBT, I am curious if you have ever had any kind of anxiety problem yourself, particularly panic attacks?
I think people need to remember that ‘They’ are the clients, and as such have a say in how the sessions proceed. They should feel entitled to question anything they feel uneasy about, and even refuse if they feel really strongly about something.
The whole idea is for a person to come away from a session feeling better, not worse.
I really agree with this. It should be a joint effort by both parties. I am sure the CBT therapist hoped to help you confront your fears...he may have a strong belief in this method. That said, it wont suit everyone and clearly its not for you.
There are many other things he can do to help and methods to teach you to help yourself. No need for the "lets get right to it" style unless you are responsive...which you aren't. Tell him you would like to take it more slowly
Ladybird, yes i have, but many year ago
thetube82
Wow quite shocked that a therapist would try and induce those feelings as others have said you are the client and if something makes you feel uncomfortable then you should not do it period- I am session 14 of my own CBT and have pretty much daily attacks I don't tend to hyperventilate and when it happens I concentrate very much on slowing my breathing. My own therapist wont even push me to continue talking about painful stuff just gradually brings it back into the discussion until it all comes spilling out usually with a wave of tears and very often an attack but its at my own pace.
hi. just recently i have had my psychiatrist and my new counsellor suggest inducing me into a panic attack. the reason they gave me is that you can reverse the effect ie if you can induce a panic attack you can do the exact opppsite . bring yourself out of one. i declined both offers as i think with most people i wouldnt fancy inducing anyone into a panic attack regardless of what the experts say. i have been through a lot of panic attacks and yes i know im still here but i find them terrifying to say the least. who knows if someone can master panic attacks would that mean they wouldnt be a bother to them as they could reverse it at will? and im wondering is an induced panic attack the same as a normal panic attack?
My therapist has said similar - that he wants to make me as anxious as possible, work out what triggers it then use these triggers to make me upset, then teach me how to calm myself down. I'm not happy about it at all and I'm getting myself all worked up now before getting these sessions; away to try and speak to my GP about it on Friday to see what she says..
Hi Everyone
Hopefully I can shed some light on this subject. I am a Cognitive Therapist and I also had panic disorder many years ago. This technique of inducing symptoms is called 'Interoceptive Exposure'.
Can I just clear one thing up that everyone is getting a bit confused about. CBT doesn't try to induce a 'panic attack' as such. Interoceptive exposure is designed to induce SIMILAR sensations that one might experience during a panic attack.
Before I explain more - can I also say that I myself would never take anyone through this exercise until they have a very thorough understanding of why panic attacks occur and plenty of coping skills to deal with any anxiety should it arise. I would also very carefully work it out very gradually and would not proceed unless the client understood the rational and was willing to partake in the exercise.
So - the rational is this
With panic attacks we are afraid of the physical sensations produced by the fight or flight response. ie. rapid heart beat, tingling sensations, dizziness and so on.
We panic because we mistakenly believe these sensations mean we are seriously ill, are about to collapse, go crazy and so on.
The truth is these feared consequences won't actually happen but since we continually avoid and resist these feelings we never get to learn that ultimately we are in no danger.
Imagine a person afraid of swimming. They believe that if they tried to let go of the edge they will surely drown. If they keep clinging on to the edge the fear remains even if someone tells them that they can swim. The best way to actually know for sure that you CAN do it is to TEST it - VERY gradually. First you learn about swimming and the laws of floatation - then you go into the water up to your waste - you may use a floatation ring - you may then kneel down in the water and so on until you eventually let go and venture into the deep end. This is when your fear of water is vastly decreased.
So - you do the same with these SYMPTOMS and SENSATIONS of panic. Rather than avoiding and resisting rapid heart beat or dizziness (which just maintains the fear) you move TOWARDS these sensations gradually - and Interoceptive Exposure allows you to do this in a CONTROLLED way.
So - if you are afraid of rapid heart beat because you believe you are about to have a heart attack or stroke - then why not test it gradually - and repeatedly to see what ACTUALLY happens. So everyday - you make your heart beat fast - just a bit - and see what happens - Nothing, no heart attack. Next day do it again and so on until eventually you REALLY see that rapid heart beat is a NORMAL thing and it's OK for the heart to beat rapidly. Of course your therapist will have explained that fight or flight CAN make your heart beat even out of the blue and this is harmless too.
You can then do this with each symptom on a daily basis. If you are afraid that feeling dizzy will make you pass out then MAKE yourself dizzy by spinning around for a minute - then use your coping skills to allow yourself to experience the feeling. You will see that you didn't pass out - and again, if you do this every day you will LOSE YOUR FEAR of dizziness.
So overall the reason why these exercises are incredibly helpful (if carried out in the correct way) are
• Rather than ‘waiting’ for panic to happen before you can practice your coping skills you get to TAKE CONTROL of when and how often you practice.
• You get to practice your coping skills in a safe, controlled environment.
• You obtain PROOF that the feared consequences DON’T happen
• The more you experience a sensation the more you ‘get used to it’
• You ‘NORMALISE’ the sensations because you see that they can
happen for normal, harmless reasons
• You feel more CONFIDENCE in facing and experiencing these sensations
• You feel less ‘anticipatory anxiety’ (worry about panic or such sensations)
I hope this has helped those of you who are afraid of CBT because of what you have read on this thread. What I suggest is that you print out everything in this thread and give it to your therapist and explain that you feel some concern about the exercise.
All the best
Robin
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