This week and next I will take time to answer questions submitted by by Instagram friends. I had over 130 questions sent in for this episode so lets break it into two episodes. This is part one. Part two will be next week in episode 122.
“I just started therapy, how do I make the most out of it to get the most out of it?”
Find the right therapist, then accept and commit to the fact that you will be active participant the recovery process. The right therapist will give you homework and will make you face your fears in an active way. Be OK with that, and do the work.
“What’s the best way to deal with the urge to talk about feelings often and seek reassurance?”
Just understanding that this is a safety behavior is a good start. Try inserting a 30 second pause before you launch into talking about how you feel, your symptoms, and your fear. After the pause, see if you can do another 30 seconds. After those pauses, then you can talk about it. You will likely find that you have given yourself enough of a break to allow your brain to get a bit more objective about the situation. You will likely not talk about it and you will move on with your day for the time being. This is a strategy that works well for many people.
“I always think you need to go to A&E (the ER in the US) when you have a panic attack because you can’t breathe. Any tips?”
Every day I’m going to get questions that end … “Any tips?”
“Any tips for heart anxiety?”
“Any tips for sleep?”
“Any tips for nausea?”
“Any tips for dizziness?”
“Any tips for leaving the house?”
The question “Any tips?” would seem like a very small question for you to ask. What you are really asking is, “Can you please tell me what the true nature of this disorder is and how I can recover from it?” That question has a big answer. It’s a very simple answer, but it’s a big answer. It requires learning, understanding, and action – changing your behaviors. You are not going to solve this problem by getting “tips”. I urge you to start to really understand the true nature of these disorders. The earliest episodes of my podcast are totally free and will explain most of it to you. Start learning before you ask for tips.
As far as going to the A&E or emergency room, you must understand that approaching this disorder as a symptom problem, where you need to save yourself from your symptoms, sensations and thoughts … is wrong. This is perpetuating the problem. You have NEVER saved yourself from any horrible fate by doing ANYTHING in response to panic, anxiety and fear. You never have and never will, because you have never and will never need saving. You are afraid and uncomfortable, but this does not equal being in danger in this case.
You’ll have to accept that this is the nature of the disorder. Then you’ll have to learn how to experience these things without trying to save yourself. This is really hard and scary, but you’re already scared so you might as well do scary things productively. We must learn to to experience these things in a new way, with a new set of non-reactions and still wind up okay. Instead of running to the A&E, you learn to do nothing. It will pass anyway and you wind up OK. Over time The fear center in your brain learns that it never had to do any of those things. That’s when things change.
“Any advice on how to deal with pain due to a medical condition triggering anxiety?”
There were three different things happening there. Each one of them has a border around it. The first thing that’s happening is a medical condition causing some pain. That’s issue number one – ut it on the side and draw a line around it. That’s the border. It’s its own independent thing. Number two is that you are a human being. Any human being whether they have an anxiety problem or not, is going to experience a bit of uncertainty, fear, worry and anxiety when they are ill. That’s just part of being human. It’s to be expected. That is issue number two. Draw a box around it so there’s a border around that issue. Now take the first box (the condition) and the second box (the normal human anxiety and fear) and glue them together because they do go together. Now we have box number three. That’s the anxiety disorder. That’s the part that doesn’t need to be there. You have to begin to recognize that you experience discomfort because of your condition which triggers some feelings of uncertainty and anxiety. You then interpret that discomfort to an extreme degree. That is not required. You take the normal uncertainty, discomfort and fear, and you magnify it 100 times by engaging in what if thinking – trying to predict the long term future. You’re thinking about the worst possible outcome. You’re thinking that you can’t handle it. You’re thinking that the feelings themselves and the emotions are disastrous,. You hit the panic button because you feel things. Those are the things that you don’t have to do.
The pain that comes along with your medical condition – and the uncertainty that comes along with that – is going to be your new exposure. You’re going to have to learn to say, “Right now, I’m really uncomfortable physically. I don’t like it and it’s making me agitated, but I can sit with it. I can handle this. I will handle it, I don’t have to add fear of fear.”
That is how you deal with that. You’ll have to work on NOT turning normal worry and normal discomfort into a five alarm fire that doesn’t have to exist.
“How do I tell the difference between anxiety and an actual medical issue?”
Two things. One, you can never be 100% certain of anything in life. This is just part of being human. You might not want to hear this, but it is true. Second, an actual medical issue exists in the present. When you are ill or injured you are experiencing a real functional impairment right now. When you are dealing with anxiety, you are worried that you MIGHT be ill or injured in 5 seconds, 5 minutes, 5 days, or 5 years. Medical issues happen now. Anxiety makes you worry about medical issues that haven’t happened yet.
“Benzo/antidepressant withdrawal issues.”
These are real issues with physical implications. We cannot stop the withdrawal process because only time will “heal” that, but we can use the tools I talk and write about to help us avoid developing bad cognitive and behavioral habits as a result. Withdrawal is difficult. Adding escape and avoidance behaviors on top of it is not required and can lead to longer lasting issues if we are not careful. As always, please work with your doctor(s) when deciding to stop taking medication. That is VERY important.
How can I make my husband believe that anxiety is lying to him?
Unfortunately, you can’t make him believe this. His anxiety disorder doesn’t understand any words you say to him. You can temporarily make him feel better by soothing his fear and giving him reassurance, but that doesn’t last. The disorder will come right back in short order and demand more of the same, perpetuating the cycle. The best thing you can do for your husband (or any loved one) is to help him learn about the nature of the disorder and what they must to do teach himself through action and experience that anxiety is lying.
“What part do other approaches like teas, oils, crystals and inner child work play in the recovery process?”
I am in favor of any practice that promotes good physical, mental and spiritual health. If those things make you feel better in some way, then there is no harm … UNTIL you see them as anxiety cures. Be honest with yourself in the quiet moments. If all those things are “helping” your anxiety, then why are you reading this now?
“How do I prevent or deal with setback or relapse?”
There is no setback or relapse. Anxiety is not a disease out of your control that magically returns on its own. “Setback” and “relapse” are terms that actually mean that you have stopped doing the things that you know you should be doing, and starting doing things that you know you should be doing. Specifically, you have decided to stop doing exposure and other work, and you have decided to fall back on old non-productive habits based on avoidance and escape. This could be because you think you’ve reached and “acceptable” recovery state and stopped working for more. It could be because you experienced panic or anxiety that you hoped was gone and declared your recovery a total failure. Either way, the result is the same. If you want to avoid setback and relapse, keep working until you have no more “comfort zone” or restrictions on your life. Want to break out of a “setback”? Get back to doing the work you were doing at one point before the dreaded setback. You’ll see how things change.
“Is recovery harder when OCD is involved?”
OCD presents real, significant challenges to recovery. This is true. But so do other anxiety disorders. Be mindful of the pitfall of labeling yourself based on diagnosis, or predicting failure before it ever happens. You may have OCD. Or agoraphobia. Or panic disorder. Or GAD. We all have what we have, and we are ALL capable of dealing with these issues and making progress toward full recovery.
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Podcast Intro/Outro Music: "Afterglow" by Ben Drake (With Permission)