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Tag: panic attacks

November 14, 2016

Some years ago, while working for an agency, I found myself at odds with two therapists who were my coworkers. More specifically, they were at odds with me. They had learned about my verbal judo exercises and were offended about the scenarios I had practiced with clients where the clients would do their best to insult and upset me, while I got them to stop without retaliation.

They complained about me to our supervisor, alleging that my behavior was not professional. I defended my actions with solid arguments in addition to research to support my methods, and our supervisor gave me the green light. Shortly thereafter after one of the therapists who had complained about me, the most vocal of the two, experienced an incident in which he was verbally accosted and bullied by an aggressive client. I so happened to have witnessed the entire event in person. As the client laid into him, he became so flustered, he went speechless. I then decided to intervene and quickly deescalated the situation. I said nothing about the incident to him, and he never mentioned it on his end. However, by the time I had left the agency, he and I were on good terms.

The interesting thing about this guy is that among us, he was very vocal about demanding respect from the clients and would habitually communicate to us an air of importance about himself.

The point of this story is to elaborate a pattern with people who become easily upset and offended by the words of others. That pattern is this; they have no plans for a fight. No, I am not talking about a physical altercation (I do believe in self-defense), I am talking about practicing assertiveness to take care of oneself. People who place a lot of emphasis on how they should be treated, are mainly concerned with how they should be perceived by others because they have no intention, courage or comprehension of how to stand up for themselves when things get tough.  When we focus on how others should treat us, we delude ourselves into creating messages that convince us that we have control over the words and actions of others. This takes away from the process of learning and preparing for how to effectively respond to the unwanted words and actions of others.

The process of getting offended and harping on how one should be respected by others is an act to ward of bullies. The problem is, it is an act that seldom works with bullies. A proper bully sees through the facade and goes into attack mode.

If you struggle with confidence, assertive, courage and other anxiety related issues, you can learn cognitive behavioral strategies to rewire your brain to become more comfortable and embracing of conflicts.

Settling for the role of a pretentious tough guy or girl only alienates good people from your life, leaving for mostly bullies in your life. Even if you take on the role of a bully, the people in your circle will consist mostly of bullies, and fair weathered friends.

Ugo is a psychotherapist and owner of Road 2 Resolutions PLLC

September 19, 2016

I came across a question today regarding the treatment of PTSD, someone else then gave a long winded response regarding the treatment modalities for PTSD and concluded that there is no end to severe PTSD. In short the advocacy for CBT and EMDR was simply an advocacy for treatments that temporarily help relieve symptoms.

Sufferers of PTSD to include severe cases of PTSD can experience full recovery. It all boils down to what you believe. A common example given for the cause of PTSD is war. A veteran who suffers from PTSD as a result of combat makes sense. War is bad, war is bad because engaging in hostilities against other human beings resulting in the killing of those human beings is detrimental for the mind. Human beings are inherently good, this is why we function the best when we feel good, and we feel really good when we are helpful towards other people. Furthermore, people who experience good feelings from committing any form of harm towards other people are seen as mentally ill, with labels of sociopaths and psychopaths assigned to their character.

So you take a good person, introduce said person to propaganda about how awful another group of people are, train them for combat and then send them into combat. After everything has been said and done, they come to realize that they are not at peace with their actions. Those who are more astute realize that the people they fought against are also people like themselves who were fed similar propaganda against themselves and trained to engage in combat for what they believe was a good and greater cause. To make things even more complicated, most veterans who suffer from PTSD, will encounter people who strongly believe in combat against other groups of people and will praise them for their past actions. This creates a dissonance, where they receive significant acceptance and recognition for actions they have come to disagree with, which also contributes to their illness, and potential rejection if they voice their disagreement for their previous actions.

PTSD can be cured, it is a duel process of utilizing EMDR to engage both hemispheres in getting past the difficult feelings associated with the trauma and using CBT to address detrimental beliefs and practice new and healthier beliefs.

Consider another example, let’s a say you have two men who experience extreme physical assaults and both men develop PTSD. Of the two men, the one the most least likely to fully recover from the incident is the man with rigid beliefs associated with the assault he experienced. For example, if the idea of being assaulted signifies a blow to his manhood, and he continues to hold unto these beliefs throughout treatment, the best EMDR will do for him is to temporary alleviate his symptoms before his next meltdown. He will then experience a meltdown every time he reminded about being humiliated. Such meltdowns can easily be triggered by consumption of media or association with people who voice reminders of his rigid beliefs he still holds unto.

While if the other man is more flexible with his beliefs associated with the physical assault, he is most likely to experience a full recovery. This is because after he has learned to move past his difficult feelings related to his ordeal, he is least likely to be triggered into an emotional meltdown. He is least likely to be triggered because it would be relatively easy for him to abandon any beliefs and values that prevent him from accepting the true nature of his ordeal.

Ugochukwu is a psychotherapist and owner of Road 2 Resolutions PLLC

July 7, 2016

I recently came across an article regarding a neuroscientific intervention for sleep paralysis. What I find fascinating about the article is the heavy reliance of mindfulness and meditation the neuroscientist prescribes for sleep paralysis.

Depositphotos_89088270_s-2015

Sleep paralysis occurs when you find yourself awake but unable to move. This lack of movement can last from several seconds to a few minutes as the sufferers’ experience sheer terror and agony in their inability to move their bodies. In some cases, people who suffer from sleep paralysis also experience hallucinations, most commonly reported is a shadowy presence in the bedroom.

The four steps for regaining control of one’s body during sleep paralysis are:

  1. Reappraisal of the meaning of the attack
  2. Psychological and emotional distancing
  3. Inward focused-attention
  4. Muscle relaxation

Step 1, “reappraisal of the meaning of the attack” is another way of saying that you should give the attack another label. The idea of waking up from sleep without the ability to move is so terrifying for most people that some sufferers develop extreme anxiety about going to sleep in the first place. For some people they spend the entire experience of their paralysis in a state of fright until they are able to move again. This leads to learned dread and a host of other issues. By relabeling the paralysis, you begin to experience a shift in your perception of what’s going on. For example, if you found yourself in this situation, you could tell yourself that you are experiencing a phenomenon that occurs in 20% of the population and is temporary.

Step 2, “psychological and emotional distancing” means that you should practice adopting an objective view of the situation. Since you have already told yourself that this is something 20% of population already experiences and is temporary, you should readily observe that your feelings of fright and panic are understandable but irrational.

Step 3, “inward focused-attention” this means that you should practice positive thinking. The author of the article recommends focusing on a loved one or a positive event. I would recommend you envisioning yourself getting out of bed and walking about. A mindset that can help with this vision is to inform yourself that while your mind is awake, your brain and your body haven’t yet received the signal to awake and move and are merely playing catch up. So soon you will be out of the bed and walking about.

Step 4, “muscle relaxation” from what clients who have struggled with sleep paralysis have told me, while they may not be able to move, they discover that there are aspects of their body that they can still control, such as their breathing and their ability to flex certain muscle groups. As tempting as it may be, forcing yourself to move only worsens the experience. Instead you are recommended to practice easy breathing and relax your muscles, by doing this you are adopting an attitude of acceptance towards the entire situation, which reduces the likelihood of experiencing a panic attack during the paralysis and shortens the duration of the paralysis.

The more people are able to successfully practice these steps during sleep paralysis, the less dread and anxiety they will have about sleeping, which in all likelihood will reduce the frequencies of the sleep paralysis.

This is the link to the article.

Ugo is a therapistand professional life coach.

January 12, 2016

It is not uncommon for people to go through a period of difficulty in their lives, in which they find themselves trapped in a vicious cycle of anxious thoughts and feelings. They habitually ruminate about what could go wrong in their lives and what is currently going wrong in their lives, with no resolution in sight. A common symptom of this vicious cycle is poor sleep, this is because the brain remains active well into the night ruminating over anxious thoughts, preventing the anxious person from getting a good night’s sleep.

 

In this post I shall detail a three step process on how to bring an end to your anxious thoughts.

 

Step One.

Open a blank white notebook, pen and cup of coffee on the desk

The first step is to write down your anxious thoughts on a piece of paper. This might be problematic since if you have multiple anxious thoughts competing for space in your mind. The solution to this is to start with one thought, usually the most pressing one. By writing down the anxious thoughts on paper, it helps you to put things into proper perspective, and removes the factor of becoming easily overwhelmed.

 

Now that you have your most pressing anxious thoughts on paper, write down the most realistic worst case scenarios for that anxious thought.  It is best to limit your worst case scenarios to three. So take for example, in your place of work, your supervisor just announced that the company will be downsizing, and to make matters more worrisome a few of your coworkers have already been laid off. Your primary anxiety maybe your fear of losing your job. While your worst case scenario may by that you will lose your ability to support yourself and perhaps a family. The problem with ruminating over your fear of losing your job along with your ability to support yourself is that it will negatively affect your ability to fall asleep at night. If you fall into a pattern of getting by on less sleep than you are used to, your cognitive abilities and your body’s ability to produce energy will become impaired. Which may lead to your worst fears coming true due to reduced performance on your job.

 

Step Two.

 

Hot keys for Accept

The second step is to accept this problem as a part of your reality. Fundamentally this is the most challenging step in the process, as most people have hidden beliefs which dictate that they either “should not” suffer or are “above” suffering. One method of coming to place of acceptance with your situation is to write down on a piece of paper the following statement: “I accept this situation as is, this is my challenge and this is currently where I belong.”

 

Once you write this statement down, take ten slow breaths, breathing in through your nostrils and slowly exhaling through your mouth. Then pay attention to how you feel about the words you have just written down. If you find yourself still experiencing difficulty coming to a place of peace with these words, then you will probably benefit from working with a therapist to address what your core beliefs about challenges are.

 

If you find yourself feeling more peaceful with the primary thought which provoked feelings of anxiety for you, then you are ready to benefit from the next step.

 

 

Step Three.

 

Power of thinking and free your mind as a business or health care concept with a group of rocks in the shape of a human head glowing with a bright inner light as a symbol of freedom and intelligence.

Step three is about exploring solutions to your challenges. Notice the language has changed from anxious thoughts to challenges. This change will be seamless in your mind once you come to a place of acceptance about your worrisome thoughts. Now that you have written down your thought along with your worst fears and you have come to accept this as a proper part of your reality, exploring potential solutions is something that occurs spontaneously in your mind. In my professional experience, clients who come to a genuine place of acceptance with the challenges they experience will often come up with reasonable solutions on their own.

 

For example, reasonable solutions for the possibility of being laid off, is to review your spending habits, cut back on frivolous expenses, while beginning the process of exploring other job opportunities. It is amazing how clear our thinking becomes when we transition from a place of anxiety to a place of genuine calmness. Also, even if you are having a difficult time coming up with some solutions to what you are going through, it is important to remember that there exist people who have experienced the same types of challenges you have experienced before and subsequently found effective solutions to these challenges.

 

Ugo is a psychotherapist and life coach.

December 21, 2015

Anything that can go wrong, will go wrong and can go wrong in your life. So what do you have to lose? When it comes to practicing the change we need to practice in our life, there are people who become frozen with hesitation because their minds are filled with all kinds of possibilities of things that could go wrong and greatly inconvenience them.

Are you one of these people? Do you have reasonable ideas about changes you can make in your life, but are stuck with fear in regards to the prospects of proceeding? If you are stuck with fear in regards to the changes you need to make in your life here are two things to consider. The first thing to consider is what do you want to happen? The second thing to consider is what would happen if you did nothing to change your situation?

So lets say you have a job, and the recent hiring of a new supervisor has turned your work environment into an abusive atmosphere. You could file a complaint with human resources, but you fear this would make matters worse between you and your supervisor. You could talk to your supervisor, but you fear this would lead to you being targeted after the conversation. You could look for a new job, but you fear that your employer could find out and you could be terminated. To make matters worse, you are now working overtime for no overtime pay, because some of your co workers where fired by the new supervisor for making mistakes on the job. Yet, the excess time you are putting in, added to the stress you are currently experiencing, is leading you to make some mistakes on the job which you are already frightened about. So what do you do?

So the first question would be, “What do you want to happen?” Most people in this predicament would answer that they want to work in a peaceful and supportive environment, regardless of where that work environment maybe. This leads to the second question, “What would happen if you made no changes, and continued with things as is?” Looking at the scenario just prescribed the answer would be that it is a matter of time before you make a major mistake on the job and the new supervisor fires you. This most likely would be the case given that you have already agreed to the poor treatment you have received on the job to date and in the eyes of your supervisor you have agreed that the value of your contribution is very low, which leads to a lack of respect by others for your work.

Now some people would interpret this scenario as a “damned if you do and damned if you don’t.” However this is not true, because the consequences for doing nothing are detrimental and more likely to happen than the consequences for doing something. This is because with doing something there does lie a possibility that things would change for the better as opposed to doing nothing where things are almost guaranteed to get worse. Further more, the moment you start engaging in exercising the change you need to make, you inevitably through research, encounter information which increases the probability that change is going to happen. So it truth, when you find yourself in a bad situation, engaging in change means “blessed if you do and damned if you don’t.”

Our responses to fear in our lives are learned, and most commonly learned responses to fear that dictate that we should always play it safe, even when we are not safe come from the irrational core belief that nothing bad “should” happen to us.

In my practice, there are evidence based cognitive behavioral beliefs that I introduce clients to, which are effective in helping people become less fear based in their thinking and subsequently their action.

Ugo is a psychotherapist and professional life coach.

February 2, 2015

I recently came across a two year article about the popularity of Xanax, and it reminded me of the number of patients I have worked with who had already been taking medication for months and sometimes years, before they decided to try the therapeutic route. I suspect that most people who stick with their medication, even past the point of diminishing returns are unaware about the specifics of how anxiety and panic attacks are typically addressed in therapy.

When treating anxiety, there are three therapeutic models, I use interchangeably , the cognitive behavioral model, the exposure model and the hidden emotion model.

The cognitive behavioral model approaches anxiety from the idea that it is the beliefs and subsequent actions of the person that is making the person anxious. So when the person holds unto beliefs that create anxiety, that person becomes sensitized to situations that can arose anxious thoughts, with the anxious thoughts being a product of what he believes. Take for example, if a person believes that all dogs are dangerous and vicious. This person then becomes aroused by concerns for his safety whenever he finds himself in the presence of a dog, or when he learns that there is a dog close by. Furthermore this person’s anxiety might become even more amplified if he engages in behavior he believes will keep him safe from the dog. So in this situation, we can say that the person’s anxious thoughts are caused by his beliefs about dogs. So in order to help the person get past his fear of dogs, we have to work on helping him adopt a more healthier belief about dogs. In the short term we will get him to practice healthier behaviors to cope with his anxious thoughts about dogs, when he is in the presence of dogs.

The exposure model approaches anxiety from the idea that the anxiety is being caused by the person’s decision to avoid her identified stimuli for the anxiety. An example would be a fear of negotiating one’s way through a crowd of people. So the person’s anxiety would be triggered every time she encounters what she considers a crowd. Using the exposure model, the person would be encouraged to gradually immerse herself into crowed situations, during which she will go through the process becoming desensitized to crowds.

The hidden emotion model approaches anxiety from the idea that anxiety is caused by a fear of confrontation with others. As a result, people who fear confrontation mask their emotions through a facade of being nice. The hidden emotion model posits that through the chronic process of forcing niceness, people sweep their true feelings “under the rug.” Which leads to the repressed feelings being expressed through chronic anxiety and in worse cases, panic attacks. The hidden emotion model addresses anxiety through a process of helping the person become more aware of his feelings, alongside strategies for helping him become more assertive through the practice of assertive building strategies.

In practice what I have learned is that regardless of which model I use to address a client’s needs, it all comes down to identifying maladaptive beliefs the person holds unto and helping the person adopt and practice healthier beliefs. Anxiety is treatable, and in worse cases such as recurring panic attacks, a person can learn to bring the episodes of panic attacks to an end.

Ugo is a psychotherapist and life coach.

July 21, 2014

So what is an impossible reality? An impossible realities can be best described as an experience that you have determined to be detrimental to your well being. However this is an experience you have actively pursued, and quite possibly prepared for your entire life. An example would be an abusive relationship or a toxic work place.

What makes experiences like these impossible realities is that you will most likely have strong beliefs and values that encourage you to continue with the experience despite the fact that in the long run you will not benefit from the experience. In the video below I discuss more about impossible realities, how they lead to mental health issues such as panic attacks and how to get past impossible realities.


 

Ugo is a psychotherapist and author of

July 10, 2014

How to end your panic attacks is now published and available for download as an ebook at the following ebook retailers:

Amazon Kindle
Kobo
iBookstore
Barnes & Noble
Baker & Taylor
Copia
Gardners
eSentral
Scribd
Goodreads
Oyster
Flipkart
Ciando

In this video I briefly discuss what to expect when reading this book.

 

Ugo is a psychotherapist and life coach.

 

 

March 28, 2014

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.

pac man

 

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.

March 17, 2014

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.

Ugo is a psychotherapist and life coach.

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