In the early two thousands, I worked for a residential treatment program. This program provided treatment services for youth offenders who had been convicted for various offenses through the juvenile courts. One day the program director, summoned me into his office, he was making me a job offer, specifically, he wanted me to take over the resident director’s job. I found two problems with this offer, this first was that the resident director was still in that position, the second was that it was not a therapeutic position. My primary issue with the offer, was that he had just had a heated disagreement with the resident director, in front of witnesses and his gesture in offering me the job was a power move. I knew that he would be offended if I did not accept the offer, and that he might see it as a political strategy of sorts on my part. Perhaps he would think I was aligning myself with the resident director against him. I simply did not want the job, because I enjoyed being a therapist and I also considered it immoral to accept a job position that was already filled. I did not want to walk around the facility engaging with the resident director, knowing that he was soon going to be fired and that I would take his place. I also did not want to lose my job.
So I took a deep breath, said a short prayer in my mind and politely declined the offer. To no surprise he gave me a look of surprise and annoyance. I happened to understand that if he could so easily throw the resident director under the bus, my acceptance or decline of the offer would not protect me from similar treatment.
This is my understanding of what courage is, understanding that there are no guarantees or shortcuts in life. Courage isn’t necessarily about sacrifice, this is because without realizing it, most human being put their lives on the line in certain everyday activities. Most notably would be driving. Courage is the recognition that challenges or struggles in our everyday lives are inevitable and that avoiding them or putting them off only makes these challenges more difficult to overcome in the long run.
Most of us have been led on to believe that if only we would submit to some type of lifestyle or entity that everything will end up being okay. From cultural beliefs, attending institutions of higher learning to being employed by certain employers. We surrender beliefs in our personal powers to buy into the illusion of an easier life, all the while failing to recognize the role we play in maintaining the illusion.
As a therapist, when working with clients who have difficulty in making what may seem as a risky or out of the ordinary courageous decision; I guide them through an exercise designed to help them recognize how much of their personal power goes into maintaining the current situation that they are currently unhappy with. It is after they have come to understand and accept this revelation that the conversation shifts into how they can use their personal power into creating the new type of life they desire and deserve.
Ugo is a psychotherapist and life coach.
Have you ever played Pac Man? You know the addictive video/computer game where the main character is a yellow circle with a mouth, chasing down dots and consuming ghosts when they turn blue? Well if you have ever stood behind someone playing the game, you would notice that the ghosts all move in specific sequences. As a matter of fact, if you focused on the red ghost, you will soon come to memorize the sequence of movements for the red ghost, which remain the same as the player advances through each level, with the only thing changing being the speed with which the ghosts move through their sequences. The obvious reasons the ghosts move in sequences is because they have been programed to move that way. So while it may seem that the ghosts are busy collaborating with each other, to chase down and catch the Pac Man, (which adds to the excitement of the game) in actuality the Pan Man is busy trying not to bump into the ghosts as it makes it’s way around the maze collecting dots.
I have used this analogy before in a previous post, and I am using this analogy in today’s post to emphasize the importance of self forgiveness and how to forgive oneself. Some people find it hard to forgive themselves due to a cognitive bias, where they come to learn new information which changes their beliefs, but they come to see themselves as having always believed the new information in their past. This makes it especially hard to forgive oneself for past transgressions, because even though you did not know better, you have come to convince yourself that you did.
This is where the Pac Man analogy comes in, just like the ghosts in the game are programed to execute a sequence of movements regardless of what the player does, our beliefs program us to execute a sequence of behaviors, with the exemption that the behaviors are modified depending on the stimuli. However, if a person is raised to have a negative view of the world most of the time, while his or her behaviors may vary from one stimuli to the next, they will generally be mostly negative.
If you have recently come across new information which caused a paradigm shift in your beliefs and values, and you find yourself experiencing significant guilt over past behaviors, it may stand to reason that your previous beliefs motivated you to commit such transgressions. It’s not that you should not be held responsible for actions that may have hurt others or otherwise, but that understanding is the key to forgiveness.
Our beliefs dictate our actions.
If you have recently experienced an awakening to a brand new you, and you find your enmeshed with feelings of guilt and disgust with your previous actions, then forgive yourself. Understand how your beliefs at the time influenced your judgment, then make amends to those who you harmed, to include yourself.
Recently I have spent quite a bit of time on forums dedicated to people who struggle with various forms of anxiety. While most of the exchange I have observed and been a part of have been encouraging, I couldn’t help but notice an unhealthy trend. Specifically I am speaking to people’s tendency to seek and render pandering to and from each other. So in this post, I am going to outline the difference been having empathy for another human being and pandering to another human being.
Empathy is the practice of placing yourself in someone’s position, particularly having to do with a misfortune and imagining how you would genuinely feel if you found yourself in such a circumstance.
Let’s say I come across an amputee, while I can never fully understand what life as an amputee would be like, placing myself in the person’s situation, I could easily come to appreciate the desire to be treated and regarded with dignity from others. For example, understanding that staring at the amputated area could be considered disrespectful.
If someone in that situation where to seek counseling from me, in regards to his difficulty adjusting to the emotional strain of daily living after the amputation, the extent of my empathy would be acknowledgement of his current hardships.
After which I would focus on his strengths and what he has control over. In focusing on these variables, I would guide him towards developing practical solutions for some of his hardships, while acknowledging his need to grieve.
This is what empathy looks like when applied. Now take the same example of the an amputee seeking counseling and say instead of empathizing, I pandered to the person.
If I pandered to such a person, I would encourage him to become angered and perhaps enraged at others who have not been sympathetic towards him and his situation.
Every time the person where to bring up a conflict he has experienced and is deeply upset about, I will never encourage him to explore his own role in the conflict, instead I will focus on the audacity of others to upset him. If the client has any shortcomings, or reports engagement in any irresponsible behavior, I would offer plausible thinking errors to help explain away the irresponsible behavior. With all the errors centered around his recent amputation.
This is the difference between showing empathy and pandering. Now there are some who may be worried about coming across as being judgmental, when their true intent was to be helpful. A work around this concern, is to focus on people’s strengths, people are less likely to get offended after you have acknowledge an empowering attribute about themselves.
To change our realities, we have to first change our thinking.
My book, “How to End Your Panic Attacks” will be out on Kindle by April 25th 2014.
According to this study published in the September 2009 issue of the Journal of Neuroscience, researchers identified a major connection of nerve fibers between the prefrontal cortex and the amygdala as playing an important role in the severity and reduction of anxiety in people.
The strength of the connection called the uncinate fasciculus (UF) was inversely correlated to the severity of anxiety in people. Using functional magnetic resonance imaging (fmri) and diffusion tensor imaging (dti) the researchers where able to test the strength of the connection with 20 healthy subjects.
In order to understand how the uncinate fasciculus plays a role in anxiety and panic attacks, you have to understand the relationship between the prefrontal cortex and the amygdala in the human brain.
The prefrontal cortex is located in the frontal lope region of the brain and is also located directly behind the forehead. The prefrontal cortex is responsible for planning for the future, short term or working memory, organization of thoughts and problem solving.
The amygdala is located in bottom of the temporal lope region of the brain, close to the brain stem. The amygdala has been called the emotional center of the brain, but is also more known for the processing of fear. The popular theory regarding the role of the amygdala and fear is that its location, so close to the more autonomous region of the brain, increased our survival rate as early humans in the wilderness. Meaning that if we became frightened for our lives, the distance between the amygdala and the brain stem was so small that it allowed our more autonomous or primitive brain to spur the body into action before we actually processed what was going on.
You can witness this phenomenon in this youtube video of top ten pranks.
A good prank, will trigger the fear response in a person, at which time that person will resort to his or her natural response to the perceived threat without thinking about it.
So back to the study regarding the nerve connection between the prefrontal cortex and the amygdala. The researchers, by introducing test subjects to fear arousing stimuli, were able to test the subjects reactions by tracking the signals sent through the unicinate fasciculus (UF) from the amygdala to the prefrontal cortex. According to the results of the study, it appears that the stronger and thicker the UF in a subject was, the faster the amygdala communicated with the prefrontal cortex and the less severe the subject’s experience with anxiety was. This also means that a thinner UF, meant a slower and weaker communication between the amygdala and the prefrontal cortex and increased experience of anxiety in subjects.
The results of this study would make sense, given that the amygdala is the emotional center of the brain and with it’s location in the primitive brain region it would stand to reason that reduced communication with the prefrontal cortex would increase the likelihood of reactivity, mainly a fight or flight reaction. Further, given that the prefrontal cortex is primarily responsible for rational thought processes, it would also stand to reason that increased connection between the prefrontal cortex and the amygdala would increase a more rational and calmer response to fear.
As a former soldier, I can testify from first hand experience that the military through repeated exposure and repetition in drills teaches soldiers during combat training on how to exercise calm during life threatening situations in order to make rational decisions.
Now it could be that such trainings,could lead to soldiers developing a stronger connection between their amygdala and prefrontal cortex for situations that would trigger panic in the average person. However, could the same measure be applied to people who suffer from panic attacks?
Could there be some sort of training regimen that panic attack sufferers could benefit from, which could lead to their ability to induce calm at the onset of an episode?
In my upcoming ebook, “How to End Your Panic Attacks” I will introduce the reader to six cognitive behavioral strategies designed to help people bring their episodes with panic attacks to an end.
I currently have a publication date for the end of March.
What we believe helps or hinders our ability to get past fear.
I recently came across an article that discussed how scientists at Cold Spring Harbor Laboratory discovered a pathway that links to the memory of fear in the amygdala to the brain stem which controls behavior.
I was disappointed when I read the post because the role of the amygdala as a memory bank for strong emotional support like fear is old news, and it has also been long theorized that the amygdala’s proximity to the brain stem, makes it easier for us to resort to immediate action under life threatening situations, real or perceived.
The article also discussed the discovery of neurons that are central to learning fear, but then again this is also not surprising. I now suspect that a follow up article will discuss a drug the scientists are working on the help sufferers of chronic fear and panic eradicate their fears.
Regardless, given the the brain has been scientifically proven to the neuroplastic, it stands to reason that for any thoughts which contribute to the learning of fear, there exist opposite thoughts which contribute to the unlearning of fear.
Two popular ways to go about influencing this paradigm change in thinking would be the use of one fear as a motivator to get past the other and extinction through exposure.
It Takes Fear to get Past Fear
This is by far my favorite thought influence I use with clients. For example let’s say I want to get a parent to set firmer and healthier boundaries for her child, and that parent is reluctant to do so because she does not want to experience any conflicts with her child in the immediate future. I then paint a picture for the parent regarding what her relationship with her child will look like during that child’s adult years if the child’s behaviors continue to go unchecked.
This works about 99% of the time, as because that parent comes to hold her child’s future as more valuable than her child’s present anger with her, she uses her fear of setting her child up for failure in the future to push past her child’s anger towards her in the immediate future.
Exposure to Discomfort = Comfort
With exposure, it becomes a matter of chronically being exposed to an undesirable situation which forces the brain to reevaluate and downgrade it’s original threat assessment of the situation. A good example would be using exposure to help a person get past her fear of spiders. Perhaps initially the person is introduced to spiders at a museum, and the person gets to view the spiders through a glass enclosure. Then the next step would be to have the person view the spiders outside of the glass enclosure, building up to when the person is able to hold the spider in her hand.
In my upcoming ebook on how to end panic attacks, I discuss in detail how to use these thought paradigms to bring panic attacks to a stop. I also discuss other specific cognitive behavioral strategies, I have successfully used with my clients to bring panic attacks to a stop. The ebook is near completion with a release date of March 31st.
Jay Gottfried a senior researcher for this study on sleep and the memories of fear, is quoted for saying to the extent, that we form memories more strongly during sleep. The study by Gottfried and his associates had to do with getting subjects to unlearn fears during their sleep. First, using by conditioning, they paired two pictures of faces with painful electric shocks to volunteers, (seriously who volunteers for this?). During the experiment, certain odors also accompanied the faces seen, while receiving electric shocks.
Then they later introduced the subjects to the faces which they had seen while been shocked. Gottfried and associates noted that the subjects experienced fear upon seeing these faces, which were measured through sweat and other physiological responses. The next stage of the experiment involved getting the subject to unlearn their fear of at least one of the faces. This was done by introducing subjects to the specific odors during deep sleep, they had been introduced to while seeing faces paired with the odors and receiving electric shocks.
The result, subjects stopped eliciting physiological fear responses to certain faces, whose paired odor they had smelled in their sleep. They also had no memory of being reintroduced to the odors in their sleep. So if a face of Denzel Washington was paired with a lemon scent while receiving electric shocks, then being introduced to a lemon scent in deep sleep without electric shocks, led to the brain learning to no longer fear Denzel Washington’s face.
I have written before about how sleep promotes learning, and I even have some cognitive strategies which I have introduced to clients to practice fifteen minutes before bed time so as to increase the likelihood of their learning the strategies in their sleep to get them past specific issues. I will be introducing this strategy to readers in my coming ebook on how to end panic attacks.
So the idea that sleep can be used to unlearn fears is a phenomenon that I have believed in for some time. However for sufferers of panic attacks, what type of fear needs to be unlearned? In a previous post in which I debunked two common myths of panic attacks, I spoke about how panic attacks are related to ongoing small traumas, we have become conditioned to create for ourselves.
An example would be growing up with an abusive parent and finding yourself in an abusive relationship as an adult. While the idea of being with an abusive partner may not be sufficient to provoke a panic attack, the idea of being unloved or unlovable certainly is.
The proposed point is this, perhaps panic attacks are triggered by the perception of never ending suffering?
So in the absence of an understanding of what triggers a person’s panic attack, a simple fear to work on are the reoccurring panic attacks themselves. Think about it, how much of a relief would it be to a panic attack sufferer to be able to experience panic attacks without fear?
Out of curiosity, for those who struggle with panic attacks, what type of fears do you relate to your panic episodes?
Typically most clients who struggle with panic attacks I have seen have already been to the emergency ward. Why? They found themselves experiencing heaviness in their chest, sharp pains in their chest, dizziness, nausea accompanied by a rapid increase in heart rate. Which led them to conclude that they were experiencing a heart attack, which led to trip to the emergency ward.
As you might have guessed, in all of the stories I have heard. they were all informed that their hearts were just fine and that they had indeed experienced a panic attack. Panic attacks and heart attack symptoms are so similar that even a former client of mine who had experienced a heart attack, struggled to recognize the difference between the two.
So here are the differences between panic and heart attacks.
During heart attacks, chest pain is begins in the middle of the chest. Survivors will describe this as a feeling of heaviness in the middle of the chest which compromises their breathing. The pain will sometimes radiate to the left arm, neck or back and will last for about fifteen minutes plus.
During panic attacks, the pain is localized just above the heart and doesn’t move. The pain is usually reported to come and go as the sufferer breathes and will last for less than ten minutes.
During heart attacks, sufferers experience nausea which is immediately followed by vomiting and sometimes diarrhea. While during panic attacks, sufferers do experience nausea, but with no vomiting.
Heart attacks sufferers do not hyperventilate unlike sufferers of panic attacks who do hyperventilate.
Then there is the most defining of characteristics, which is the onset of the attacks. With heart attacks the onset is gradual and will last for hours during which the intensity of the pain and general discomfort becomes more severe. With panic attacks the onset is sudden and the intensity and severity of the pain and discomfort are high from the start and remain that way for about five to ten minutes, after which it slowly goes away. For some panic attack sufferers they report that the attack goes away as suddenly as it came.
This would make sense given that in most cases the panic ends only because the hormones producing adrenaline have become depleted, thus leaving the body no choice but to return to it’s former state. In most cases with panic attack sufferers this former state maybe a state of chronic anxiety.
Regardless, even if you recognize yourself as going through a panic attack, it is always advisable to have a medical doctor give you a thorough physical, for the sake of ruling out any medical issues.
In my next post, I will discuss how an contradictions between our realities and our thoughts can lead to chronic anxiety and panic attacks.
In looking through research for my ebook, “How to End Panic Attacks”, I have become accustomed to finding false information on websites about panic attacks. These false pieces of information have become so redundant that I have broken them down into two myths.
Myth #1 Anxiety Attacks and Different from Panic Attacks.
For example, I came across a question and answer post in which the doctor discussed the difference between anxiety attacks and panic attacks. The author described anxiety attacks as being triggered by frightening stimuli, with the attack expiring once the shock over the stimuli is over or once you have gotten used to the stimuli. An example would be if you were startled by someone walking up behind you, your feelings of shock would go away once you turned around and saw that the person behind wasn’t a threat.
First of all anxiety attack is not an official term, no medical or psychological association uses that term. Often times when people do use the term anxiety attacks, they are referring to panic attacks, so there lies no difference between anxiety and panic attacks.
The good news is that the brain is neuro plastic and with understanding of oneself and triggers, people can learn to bring their experiences with panic attacks to an end and live more meaningful and purposeful lives.
Are panic attacks caused by genetics? Perhaps a singular mutated gene, or a host of multiple genes that trigger recurring panic attacks under certain conditions?
The problem with proponents for gene based illnesses and disorders is that they are usually right by accident. No doubt there are certain illnesses and psychological conditions that are caused by mutated genes, but my experience in industry has taught me that this most likely isn’t the case with panic disorder /panic attacks.
First, I say that proponents of the gene theory with panic attacks are right by accidents because our genetic factors play a constant role in our lives, specifically regarding to how we psychologically and physiologically respond to stimuli in our environment.
Even this article which calls for more research into the relationship between genes and panic disorder admits that evidence presented so far has been weak. The article goes on to list the types of studies and their outcomes which have been carried out to discover a link between genes and panic disorder.
To the extent I believe panic disorder to be genetic is based on the bio psychological disposition of an individual. More specifically, our genetic makeup determines the outcome of what illnesses and issues we are going to experience upon exposure to extreme and prolonged stress. For example, not all soldiers who experience combat develop PTSD, and not all soldiers with combat experience who don’t develop PTSD, go illness free. While PTSD is the most prevalent, other psychological illnesses that arise are obsessive compulsive disorder, panic disorder, etc…
The same phenomenon can be observed with a person whose childhood experience was traumatic. While that person may have developed panic disorder as a result of his or her ordeal, that person’s siblings may also struggle with panic disorder or other psychological illnesses, most commonly drug and alcohol addiction.
I don’t believe that there is a specific gene that causes panic attacks, I believe that panic attacks are a result of the brain improperly wiring itself in response to a prolonged and painful traumatic stressful experience, which results in panic attacks once triggered by certain types of stimuli.
This post discusses whether or not panic attacks are linked to heart attacks. I believe the relationship between panic attacks and heart attacks is a by product of the relationship between stress and heart attacks. If you notice in the article the researchers expressed being baffled by the low rates of people with panic attacks, actually experiencing heart attacks when the numbers where compared to the general population.
I agree that panic attacks are related to heart disease but I do not believe there to be a direct correlation. Especially given that there exists numerous research studies linking stress to heart attacks and the number one cause of panic attacks is stress.
Given that higher experiences of stress leads to prolonged production of the steroid hormone cortisol, it is also important to note that some of the symptoms of prolonged cortisol in the body is high blood pressure, low immunity and blood sugar imbalances to name a few. The identified symptoms of prolonged stress lends significant explanation to how stress, if left untreated can lead to heart attacks.
So if you are experiencing panic attacks it does not mean that you are experiencing a heart attacks, even if it feels like it. It stands to reason that it is not the panic attack that will kill, but prolonged stress likely will. Another aspect of this article on panic attacks and heart attacks I would like to point out is the hyper focus on the biological aspects of panic attacks.
Panic attacks are psychological phenomenons, caused by pent up distress, and triggered by old traumatic experiences. This is why as a psychotherapist, I have experienced a high rate of success getting people to bring their experiences with panic to stop, without any need for medication. Just about the only group of people with whom this feat is particularly challenging are people in recovery from traumatic brain injury, and this is because the brain is still in the process of slowly requiring itself.
The good news is that people can learn to bring their experiences with panic attacks to a stop and also practice cognitive strategies to prevent future attacks.