Panic Care

Ideas and suggestions to help you better manage anxiety over the coronavirus pandemic.

How to cope with Covid 19 anxiety The current Covid-19 or coronavirus pandemic creates worry and fear for everyone. However there are many things that can be done to better weather this emoti...

INTRODUCING MY NEW BEST FRIEND: "TAPPING"

I have recently been combining a new technique with Cognitive-Behavioral Therapy (CBT) to enhance the benefits of CBT and quickly reduce the physical and emotional symptoms triggered by fearful thoughts. This technique falls in the category of what are referred to as Emotional Freedom Techniques (EFT) but more commonly referred to as Tapping. It derives from eastern medicine techniques such as acupuncture and acupressure. It involves light touch or tapping on certain body points, or acupoints, of the body’s energy meridians – the same meridians targeted in acupuncture. But with tapping there are no needles, just light touch or tapping.

Though the technique is purported to be effective due to the activation of these meridians, one does not need to believe in these meridians to benefit from tapping. Aside from the possible effect on energy meridians, tapping is a powerful CBT technique alone -achieving the fundamental goals of CBT – cognitive reframing and desensitization.

My personal and professional experience with the technique clearly demonstrates its CBT value but it also seems to act directly on the limbic system – the amygdala – the emotion center of the brain. The result is a very quick shift in feelings, thoughts and sensations and a drop in the fear hormones of adrenaline and cortisol, and an increase in endorphin levels – “the feel good” neurotransmitters. The speed of these changes suggests something else occurring beyond the rationality of CBT. As a person with an empirically verifiable, scientific perspective I believe that tapping is indeed also acting on the energy meridians that acupuncture targets. There have been more than 100 valid and reliable studies demonstrating the efficacy of the technique and this is one of the largest, most recent studies that confirms the physical and mental health benefits:

Clinical EFT (Emotional Freedom Techniques) Improves Multiple Physiological Markers of Health

I am very excited to have found this technique as it fills a void that I have struggled with throughout my years of treating people with anxiety – a technique that can very quickly target, reduce or even eliminate the powerful physical and emotional symptoms of anxiety. It is a technique that can reduce the symptoms of distress without reliance on a logic process, because too often anxiety is impervious to logic. Tapping can figuratively tap into the feeling brain without having to go through the thinking brain so to speak – it can quickly reduce negative emotional and physical symptoms – often to the surprise of the tapper. The quick shift in feelings, thoughts or sensations often peels down to an underlying layer – peeling the onion so to speak – resulting in rapid resolution of the symptoms. In my next post I will begin examples of these success stories starting with an example of a woman with intense anxiety the result of a recent cancer diagnosis.

TAPPING AWAY CANCER FEAR
Blog Posts, Tapping
Before I begin to detail the process and specifics of tapping I want to introduce it by describing an overview of the process and an example of its effectiveness.

Fear of Cancer

The first client I used the technique with was a young woman I will refer to as Susan, who had just been told by her MD that she probably had thyroid cancer. She was a client because she struggled with frequent anxiety that was often health related anxiety – her doctor’s words therefore were the worst trigger for her worst fear. She was an anxious wreck to say the least so I felt the need to help reduce her fear despite my intention to further practice tapping on myself and friends before using it with a client. So it was my first use of the technique with a client but something I felt obliged to use to reduce her intense fear. I explained Tapping to her including the eastern medicine foundation as well as it’s proven value as a CBT technique. I showed her the 11 acupoints we would tap on and explained the process we would follow.

The Reminder Phrase

It was easy to formulate a simple statement, called the Reminder Phrase, that expressed how she was feeling: “I’m terrified I may have cancer”. The reminder phrase is a negative thought, feeling or sensation that is repeated when each of the 11 acupoints are tapped and constitutes one complete tapping sequence.

The Setup Statement

A positive statement is added to the reminder phrase when the first acupoint is tapped – called the Setup Statement. Thereafter just the negative statement is repeated on the other points. I helped her give a rating from 0 to 10 to rank the level of fear she had with the statement and she labeled her fear as being a solid 10. I will make this sound less confusing in the next blog post when I more clearly describe the acupoints and the process.

So I proceeded to have Susan follow along with me as we started tapping the first point on her hand, saying out loud the setup statement: “I’m ok even though I’m terrified I have cancer”. We went to the next point on the top of her head, and tapped on it saying out loud the reminder phrase “I’m terrified I have cancer”. Onto the 3rd point above her eye, tapping, saying “I’m terrified I have cancer”. Then to the next point at the outer edge of her eye saying “I’m terrified I have cancer”. We continued this process until we tapped on all 11 points. At this point one should take a deep breath and observe what is going on inside and whether there has been any shift in thoughts, feelings or sensations. Any decrease in the feelings about the reminder phrase should be identified, and Susan noted a 2 to 3 point drop in her anxiety, giving it now a rating of 7 or 8. We then did another full sequence of tapping on all 11 points, with the setup statement at the first and the reminder phrase at the rest. Frequently the amount of decrease in distress after a sequence is about 2 to 4 points as it was for Susan. After 2 sequences her anxiety was about 4 or 5. We did a 3rd and perhaps a 4th sequence and at the end of it she took a couple deep breaths, was quiet, thoughtful and then said with a genuine look of pleasant surprise that her anxiety was gone. She followed that with a wry smile, and said “oh my god, did you hypnotize me? My anxiety is gone. I’m still remembering what the doctor said but I’m not feeling afraid”.

Success

This first experience in using tapping convinced me there is significant validity to this technique and something I must further research and practice. It is indeed the missing tool I was unaware I was missing to facilitate a quicker drop in anxiety by directly tapping into a person’s fear and tapping it away. This is but the first of many similarly amazing examples of the power of tapping that I will later describe.

https://paniccare.org/travelling/

How CBT Helped a Patient Fulfill Her Dream of Travelling I was seeking help for anxiety due to fear of flying. Back then, the goal was to take a vacation with the family, which I successfully did.

https://paniccare.org/internal-gyroscope/

Your Brain is an Internal Gyroscope: The Natural Ability to Become Normal Our human brain has an amazing ability to make us feel good as well as make an anxious person feel bad. I tell clients this brain function is like an internal gyroscope like that on a cruise ship. What in the hell am I talking about you wonder. Well, let me explain...

Progress Report On
“Acting Normal”

(AND OTHER SECRETS TO BECOMING NORMAL)

The following audio link is a clip from a recent session with a client who – since she is unidentified – wanted to share her success with others who struggle with OCD or other forms of intrusive worry. She has struggled with OCD since . . .

Techniques to Reduce OCD Anxiety - a progress report on "Acting Normal" Audio clip of a client that struggles with OCD and other forms of intrusive worry. She describes overcoming moments of panic with a series of techniques, including..

https://paniccare.org/act-normal/

Act Normal to Be Normal (It's easier than you may think). - Panic Care When I say, "act normal", I mean: try to behave like a normal person in that situation. It condenses the cognitive work they have been doing especially with Step 1 Labeling of their anxiety and Step 2 Devaluing of the threat...

HOW AN OCD PATIENT STOPPED FEEDING INTO HER FEARS
Blog Posts
A few days ago a client with very significant OCD reported much success in reducing her recurring fearful intrusive thoughts about muscle twitching she had been experiencing. She would have catastrophic fears that the twitches were the result of a disorder such as Parkinsons, MS, or ALS or another serious neurological disorder. The vicious cycle of anxiety causes the attention given the sensation to increase and intensify the sensation which further intensifies the catastrophic thoughts which in turn further increases the attention and fearful thoughts and so on and so on it goes. The result being the spinning of sensations, thoughts and fears.

In our prior session I helped her do Step 2 work to talk back to the fear she experiences with OCD and have a rational dialogue about the situation. I had her talk about times in the past when she has had similar muscle twitches and what seemed to have been their cause. I had her write down other explanations for the twitches other than a neurological disorder. She was able to immediately describe times in the past she has had muscle twitches that were the result of stress and tension. She was also able to relate some past twitches due to muscle strain after exercise. I had her write down the fact that she knows when she focuses on a sensation it intensifies it – what is called Amplification. I had her write down the fact that she knows if she has a fearful explanation for a sensation it also makes it feel worse and continue – another aspect of Amplification. I then had her write down what had recently been causing her to be tense and anxious before the twitches started. She was able to identify a few different issues that had indeed been making her stressed. She was going to be traveling for the next couple weeks and was to take the paper she wrote this down on with her and review it when she experienced her sensations – including talking out loud to herself.

She returned after her travels this week and was very happy and also surprised at how well she had been doing with not catastrophizing her sensations and therefore having very little of the twitching. She was amazed at how well it worked for her but was able to understand that it was because the words she read and at times spoke out loud were all very simple facts – she was just reminding herself of the facts that indicated she was safe. She was able to bring her spinning brain to a slow spin and then to no spin – and succeed in further retraining her brain.

IF YOU HAVE OCD, HERE ARE SOME TIPS TO DO THIS YOURSELF:

When experiencing a recurring fear, talk out loud to yourself and tell yourself other explanations for what you are fearing. Write down times in the past you experienced similar sensations.OCD
Write down the cause for the sensation in the past.OCD
Read what you wrote out loud so you hear the ideas – the spoken words activate another more rational part of your brain when it actually hears the words.

HOW JANE QUICKLY STOPPED AN ANXIETY ATTACK:

A few days ago a client told me of an episode of anxiety she experienced in the prior week and how she responded to it and succeeded in eliminating it. Her story was so compelling I asked her to repeat the story after our session into her phone so I could post it for the benefit of others as an impressive example of effective use of the 1-2-3 method. The entire episode from onset of symptoms to resolution was brief which can give much needed hope to others who also struggle with anxiety. The following is the exact transcript of her recording:
https://paniccare.org/category/client-success-stories/

https://paniccare.org/irrational-thoughts-and-fears/

Devalue or Discredit Irrational Thoughts and Fears - Panic Care The Devalue or Discredit step where one engages in a rational dialogue with the irrational idea or fear, talking back to the fear so to speak...

Do you suffer from anxiety or panic attacks? Here's is helpful technique to get you through the moment.
https://paniccare.org/negative-thoughts/

Accurately Labeling Negative Thoughts - Panic Care “Labeling” negative thoughts or feelings is a way to successfully neutralize escalated emotions a person may be experiencing during an anxiety attack

The dreadful text messages your fear brain sends you activate a physical sense of terror so strong that it convinces you the threat is realistic though in a cool head you know it's not very reasonable. That's where "Step 2" helps - in a cool head you realize these texts are unreasonable and that helps you recall that fact in the heat of the moment.
To read more about the 1-2-3 Brain Retraining method:
https://paniccare.org/cbt/ #1485090319818-d8ab196a-d35d

Cognitive Behavioral Therapy - Panic Care Cognitive Behavioral TherapyAn in-depth explanationIf you've been told that you need to see a "Cognitive Behavioral Therapist", then you've come to the right place. I am what you would refer to as a Cognitive Behavioral therapist." I use Cognitive Behavioral Therapy (CBT) along with other types of t...

The fearful text messages your anxious brain sends you warn of medical, mental or social catastrophes that may, or certainly will, happen to you. Like the twitch you're having is MS, Parkinson's, ALS. Or you're crazy or will go crazy. Or you're going to melt down in front of people.

Anxiety and intrusive fearful thoughts are like a horrible text message sent to your brain alerting you to a dreadful threat. You don't have immediate control over that text message, you have power to control how you respond to it.

It has been very gratifying in the past few weeks to get so many positive reports from clients of little to no anxiety by staying focused in the PRESENT MOMENT WHICH IS INCOMPATIBLE WITH ANXIETY as I explain in earlier posts. For example: the young person who had no anxiety on long international flights; the young mom who enjoyed her drive with her family to northern Michigan; and the teacher with OCD better managing intrusive fears in her role as a summer camp counselor.

A corollary to anxiety being incompatible with being engaged in the present is the inherent "power of the now."

I have several clients traveling in the next couple weeks who complain of anxiety about the traveling. I help them see they fear their fear: they fear they will become very anxious in the process of traveling - they are fearing what will happen in the future. Therefore I have been stressing "BEING PRESENT IN THE PRESENT IS INCOMPATIBLE WITH ANXIETY" because anxiety is about what will happen in the future. If you're fully engaged in the "now" - you can't be anxious.

I have been stressing to clients lately:
"Being present in the present is incompatible with anxiety."
- S. Pravel

An interesting session with someone this week. A client said that the day after I suggested he think of the 3 most likely explanations for a fearful physical sensation - he realized he was having to do it much of the day - his brain was so often generating fearful ideas about health problems ranging from MS to heart issues to cancer. He was surprised to realize how the technique helped him become aware of how often his brain would come up with possible medical catastrophes. It caused a significant decrease in the power and frequency of the thoughts as the week progressed.

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Panic Care I am a therapist with over 20 years experience treating panic and other anxiety disorders. My CD pro

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To help people who are hypocondriacs - whose brain automatically wants to consider worst-case diagnoses, I suggest this technique:

Identify the top 3 most likely explanations for your symptoms despite what your fear is inclined to make you think/feel. Even talk out loud and in as rational a mind as possible: verbalize the 3 MOST LIKELY explanations for your symptoms.

As I was saying . . . the anxious brain works backward or counter-clockwise again. It seeks to prove 100% the absence of a problem - which can almost never be done. This is a fundamental philosophical issue. Does something exist unless you can provide 100% proof of it's non-existence, or does something NOT exist unless you can provide 100% proof of it's existence. In law this is the principle of "Burden of Proof". It is required that sufficient evidence be provided to prove the existence of a crime, absent that - it is hard to demonstrate a crime occurred.

When the anxious brain immediately considers a possible catastrophe they want to find evidence that would mean there would be 0% chance of a threat. The typical brain tends to immediately consider no catastrophe exists unless there's evidence of such. So . . . the anxious brain works backward or counter-clockwise again. It seeks to prove 100% the absence of a problem - which can almost never be done.

The anxious brain tends to immediately create a worst case scenario and look for evidence of the threat vs. immediately consider the evidence for a harmless scenario. In other words: the anxious person looks for evidence of a threat vs. evidence for the absence of a threat.

The core of the paradox of anxiety is simple: Our fear creates what we fear.

When the anxious person considers their headache as a possible brain tumor, it amplifies the headache and could likely make it last longer. Paradox: they are creating what they fear - at least creating or intensifying symptoms they fear - and around and around it goes.

The anxious brain tends to work in reverse, or counter-clockwise, as compared to a non-anxious brain. In the face of a potential threat or problem, the average person has what is called - "healthy denial" - where they will automatically search for benign explanations to reduce their fear. The anxious brain/anxious person tends to automatically look for negative explanations i.e. the worst case. The typical person will tend to explain their headache as a routine, benign headache but the anxious person may consider a worst case explanation such as a brain tumor.