How does a highly respected psychologist approach panic attacks? This week on The Anxious Truth we’re going to find out as we talk to Dr. Dave Carbonell about panic, panic attacks, and the second edition of his book, The Panic Attacks Workbook.
- Dave is fond of conceptualizing panic attacks and panic disorder as a “trick”, rather than as an attack by some kind of monster or enemy that can’t be defeated. Rather than approaching recovery as a war against some kind of demon, approaching it as a trick that has simply been fooling you leads the reader into a more productive direction.
- Relax or I’ll shoot! Everyone wants to try to calm down and stop panic when it happens, but demanding relaxation and demanding that the panic stop is almost guaranteed to have the opposite effect. We cannot force panic to end by fighting it. It’s always paradoxical with panic and anxiety. This is no exception.
- There is no such thing as continuous panic. No matter what you do, panic attacks always end even when you are sure that they won’t.
- Is it chemical? If it is, how do the chemicals know where you are and why you should panic? They don’t. The chemicals are only doing their job once you tell them to do that job. The thought comes first. The chemicals just follow along obediently. When you decide that the supermarket is dangerous, the chemistry of your body will be happy to treat it as such. Understanding this shows us that we have a role in the process, which gives us power.
- Shame and Secrecy. Shame is the feeling. Secrecy is the action you take to try to hide that feeling from the world. But when you feel ashamed and try to hide your anxiety problem, this becomes another safety behavior that reinforces the idea that panic is evil or dangerous and can often get in the way of recovery.
- Safe people. In Dave’s view, “safe people” are really just support people. These should be cheerleaders, not soothers or accidental enablers. The support person is just along for the ride, waiting for direction from you. They do not take charge or “create safe space” for you because the safe is already space and you need to learn that.
- Over time, Dave has shifted away from cognitive restructuring and old-school CBT and more toward the concepts of cognitive de-fusion and acceptance. Trying to change thought content does’t work so well. Changing the way we relate to those thoughts is far more effective.
- Control in recovery is not about how you feel or what you think. Control in recovery is measured by and reflected by what you do – your behavior. You are not “out of control” because you feel a certain way or think a certain thing,
About The Panic Attacks Workbook (Second Edition):
The Panic Attacks Workbook, first published in 2004, is a book for people who experience panic attacks in a variety of circumstances from full blown panic disorder and agoraphobia to panic confined to specific fears and situations. The book is designed to “coach” the reader through a step-by-step approach to getting past this problem.
Dave doesn’t just talk about panic and panic attacks in the book. He wrote the book to read like a session in his office might sound. The book is full of concepts, lessons, and activities that Dave has learned through his many years of working with many clients in his practice. For example, the specific fears that Dave has included in the new edition of the book were included based on feedback from a large number of clients. These include DPDR, nervous sweating, and emetophobia.
Specific fears such as fear of vomiting or fear of sweating is seen as just a subset of panic disorder. The book walks the reader through applying the principles of panic disorder recovery to these specific fears.
Psychoeducation comes first. As always, the first step is to educate. Recovery from panic attacks is such a paradoxical experience that without understanding WHY the steps in the workbook must be taken, it would be easy to conclude that the approach Dave advocates is ridiculous and can’t possibly work.
Dave not only explains concepts but then sets out tasks and activities for the reader to complete. He takes extra time to help the reader relate what they’ve just read to their own personal experiences BEFORE sending them out the door to do their activities and homework.
Find The Panic Attacks Workbook on Dave’s website at https://anxietycoach.com
About Dave Carbonell:
Dave Carbonell is a Clinical Psychologist who specializes in the treatment of anxiety disorders as a therapist, author, and teacher. He offers exposure-based treatment of fears and phobias in Chicago; is the author of four anxiety self-help books; and teaches workshops for therapists who want to learn more about the treatment of anxiety disorders. He has personally written all the materials on this site, except as otherwise noted.
Effective treatment methods for anxiety disorders were just starting to enter the mainstream when Doctor Carbonell began his career as a psychologist in 1985. He’s been helping people overcome fears and phobias, and developing new treatment strategies ever since. He founded the Anxiety Treatment Center in Chicago in 1990, one of the first psychological practices in the United States devoted exclusively to the treatment of clients who sought help with anxiety disorders, and continues to offer treatment today to people who seek recovery from panic disorder, social anxiety disorder, generalized anxiety disorder, obsessive compulsive disorder, and phobias of all kinds.
Find Dave and his work online at https://anxietycoach.com
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