Thursday, 5 July 2012

Why put off 'til tomorrow what you can do today?

I have seen a few therapists over the last few years as I have been diagnosed as suffering from both anxiety attacks and depression. The anxiety attacks became so bad that I couldn't go to work. It was the most awful thing ever and I felt so helpless. I'm very lucky that in my area the provision for mental health care is actually rather good (comparatively speaking) and I was referred for counselling with what is known as 'Talking Therapies'. Essentially this is a service designed to offer a 'quick fix' to people who need help to get them back to work and cope with everyday life. It is primarily based around teaching the patient CBT (Cognitive Behavioural Therapy) techniques so that they can manage their mood by changing how they think about things and deal with situations.

Panic attacks are a very natural response.....
Imagine you are a caveman and you are out collecting wood for your fire. A bear approaches. Your heart beats faster, you might feel sick, sweat etc. This is your body warning you that there is a very real threat. You then have two options. This is known as the 'fight or flight response' and is a very basic, instinctive reaction. You either stay and fight the bear, or you run for your life! Getting it right could be the difference between life and death. So the caveman makes a very instinctive decision. He assesses the threat (the bear) and he then assesses his ability to cope with that threat (his strength, weapons etc) and makes a snap decision to either stay and fight or to turn around and run. Got the idea?
Now there are few occasions in a modern world when we have a true need for the fight or flight response. We mostly have sedentary lifestyles, work in offices and our employers are covered by so much legislation and red tape that we are mostly protected from life endangering situations. We no longer have to hunt for our own food and live in the wild. Ergo, the fight or flight response is not needed as much as it did in the days of the caveman.  In people suffering from anxiety/panic attacks, the individual comes across an everyday situation and somehow they feel panic.  There are various ideas about why the panic occurs.  Sometimes it can be a response to a one-off trauma.  For instance, you have a car accident on a specific road and each time you go along the same road you believe the road poses the same risk as it did on a previous occasion. Other theories suggest that it may be from over-stimulation of specific hormones.

So in people who suffer from panic attacks, they come across certain situations, consider the situation a threat to the point of exaggerating the enormity of the threat, then they underplay their ability to cope with that threat.  The see-saw effect of this combination is what creates the panic attack.  What CBT does is firstly help you to identify the sensations that alert you to the attack. Next you are taught how to identify the root cause of the threat - what the counsellors often call 'the hot thought'. Once you have identified the 'hot thought' , you are taught how to rationalise yourself through the panic by challenging it.  This often means questioning the validity of your instinctive beliefs and can be quite tricky to work through. Finally, you are then encouraged to  teach yourself a different response.  The idea is that eventually by forcing yourself to challenge your thought process and try something different, you realise that the situation was not life threatening and your confidence and ability to cope grows.  As your confidence grows, the threat diminishes in size.  When this is challenged by the individual often enough, it becomes a 'learned response/conditioned reflex' (see Pavlov's Dog experiment! -  Eventually balance is restored.

In my particular case, I've finally identified that my hot thoughts (or triggers) normally originate in my feeling that 'people always leave me' (abandonment) or that 'I'm not good enough'. Whenever I a situation occurs that reinforces either of these deep rooted beliefs of mine, it triggers my panic.

The next step for me is being able to challenge these deep rooted beliefs, however these beliefs are so ingrained that its not so easy to suddenly convince myself that these thoughts are irrational.  This is  what I'm currently working on. :-)

I guess the moral of today's blog is Carpe diem.

 Challenging the 'hot thought'  - This is the worksheet used to challenge 'hot thoughts'.