"I don't think
you can help me," said Jack. "I've never told
this to anybody at work, and I certainly don't want it to go any further than you, but I
sometimes get panic attacks so bad I have to go to the emergency clinic!"
"Great!" I
said, to his puzzlement. "We have an opportunity to make a difference in your
life that's so significant you'll find everything else we do a piece of cake."
Though we'd talked for almost two hours, this was our first meeting and I knew I was
taking a chance to challenge Jack in this way, but he'd been responsive so
far, and I thought
he'd
at least try what I suggested. "Raise up that feeling of panic right now,"
I said.
"Are you
nuts?" he asked, with (I might add) rising panic.
"I promise you it
won't get out of hand," I soothed, "just think of the last time you felt panic
and do the best you can to recapture the feelings. Where did you feel it in your
body?" Using this paradoxical strategy, we worked
with Jack's
unconscious to undercut the assumption that he had no control over the panic attacks (if
he could bring them on, they were within his control). Once he focused on the
sensations associated with panic, I had him exaggerate them, assuring him all the time
that to his surprise the symptoms would eventually diminish. And they did. Not
only that, but he was able to use the technique whenever the symptoms began to arise, and
he never again had a full-blown panic attack. This approach is "paradoxical"
because you might logically expect that bringing the symptoms on would make them worse.
The paradox: inviting the symptoms leads to their diminishment or even
extinction.
There are a number of
terrific resources
available on this topic. I have a fondness for
Dr. R. Reid Wilson, partly
because panic is his particular area of expertise and partly because he has a great sense
of humor. I first encountered Wilson at a brief therapy conference, where he started
his session with a Far Side cartoon showing a cut-away view of two moles below
ground. One of them was shaking and perspiring profusely, saying to the other mole,
"It's O.K.! It's O.K.! The tunnel was closing in on me there for a while, but I'm all
right now!"
In
Don't
Panic, Wilson writes:
"Our instinctual
defenses fail to overcome panic. In fact, they actually support the recurrence of anxiety
attacks. We encourage and strengthen the power of panic by treating it as our 'enemy,' to
be avoided or to be battled...Whenever you resist something, that something will
persist."
He suggests the
following ways to cooperate with symptoms instead of competing with
them:
-
Take a calming
breath and begin natural breathing.
-
Don't fight the
symptoms or run away.
-
Consciously
decide to use a paradoxical strategy.
-
Observe your most
predominant physical symptom at this moment.
-
Say "I
would like to increase___"
-
Consciously
increase the predominant symptom.
-
Now increase all
other symptoms you notice.
-
Continue natural
breathing while consciously increasing symptoms.
-
Don't get trapped in
worried, critical, or hopeless comments.
Deeper work
may be needed to address the issues behind the symptoms, but this is much
easier once the individual is relieved of focusing on the symptoms. According to
Wilson, "Panic says, 'Wake up! You're not facing something!'"
A Simple Cure for
Anxiety and Depression
Systematic Desensitization (Ned got over
his fear of snakes)
Afraid
of Flying? (Emily no longer fears it)
