Tag: cognitive behavioral therapy

I'm going to show you how to stop having panic attacks using exposure therapy, coping skills and grounding skills and you can start applying this to your life. Right now. I'm clinical psychologist Dr. Ali Mattu. Psychology took me from almost flunking out of high school to becoming an assistant professor at Columbia University. Now I've left academia so I can give away everything I've learned to you for free. Welcome to the psych show. The first step to stopping panic attacks is to understand what exactly is happening when someone has a panic attack.

They experience a sudden rise in at least four of these symptoms. It's normal to feel the sensations when we're in a real dangerous situation like an animal's chasing us or before an important event, like a presentation for school or work. But what's so scary about panic attacks is the sensations can feel like they're coming out of nowhere. Your mind is an association machine. It connects things together, ice cream and a beautiful summer's day movies in popcorn and email from your boss and stress. All of this happens automatically it happens without you even realizing it through a process called classical conditioning. This is the stuff Ivan Pavlov was working on when he got dogs to salivate when they heard a metronome, sometimes weird things get associated together.

And for some reason, your mind has associated normal physical sensations of anxiety with a real sense of danger. Maybe you were really sick one day and had difficulty breathing or you were driving across a bridge and there was a lot more traffic than usual and you felt stuck and unsafe or you were using a drug and had a really bad experience with it. There are so many ways in which your mind You can experience those physical sensations of panic and why it might associate those sensations with danger. If you avoid going to certain places because you're afraid you might panic or you might do something really embarrassing. You might also have agoraphobia. This gets us to step two exposure therapy. It doesn't matter too much how these associations formed, what matters is they exist now. So we have to understand what is it that you're afraid might happen? When you panic, I want you to take a moment and write that down, write down what it is you're afraid might happen when you panic.

Maybe you're afraid that the panic attack will end. Maybe you're afraid of having a heart attack, or something really embarrassing happening, like fainting or making a fool of yourself or the ambulance and all these people being called Your rescue when it was a panic attack and not a heart attack. Or maybe you're afraid of losing control of hurting yourself hurting someone else of losing your mind, or maybe even dying. I wish I could tell you to not worry about this stuff. But you've already tried that and it hasn't worked. You can't out think panic attacks, these associations have been formed. And the only way we can break them apart is by gaining new experiences and that is where exposure therapy comes in. Before I introduce you to exposure therapy exercises, there's a couple things you need to know first, these exercises require you to get physically active.

So if you have any health problems like any of these conditions, talk to your doctor first and make sure it's okay to try out these exercises. Number two, if you're someone who has gone through a traumatic event or traumatic events, you might want to skip ahead and master step three and four first and then come back to exposure exercises. The reason for that step three and four are going to help you to feel more in control of your emotions.

And if you're someone who's gone through a traumatic event, just going through exposures without gaining that sense of control can make the exposures really overwhelming and can make it harder to break apart those associations. Remember those fears we wrote down a moment ago. What we're going to do now is try out a variety of exposure exercises and see what gets us in closest contact with that fear.

These exposure exercises are designed to recreate those sensations that you experience when you panic. So it might seem scary at first, what I want you to remember is they're not painful. They're designed to get your body active in the same way as when you have a panic attack. I want you after every exercise to rate them, zero to 100% house Similar were the things you felt when you did this exercise to when you experience a panic attack hyperventilate for one minute, hold your nose and breathe through a straw for two minutes. Hold your breath for 30 seconds. Sit with your head covered by a heavy coat or blanket for one minute.

Place a tongue depressor on the back of your tongue Run quickly in place with high knees for two minutes. Step Up and down on the stair or a step stool for two minutes. Hold up push up position for 60 seconds or as long as possible. Sit in a hot stuffy room or sauna, a hot car or a small room with a space heater. wear a tie turtleneck or scarf tightly around your neck for two minutes. Drink a hot drink. Drink an espresso or coffee spin in an office chair for one minute spin around while standing up for one minute.

Shake your head side to side for 30 seconds while looking ahead. with your eyes open, put your head between your legs and then sit up quickly. Lie down for one minute and then sit up quickly. Stare at yourself in a mirror for two minutes. Stare at a blank wall for two minutes. Stare at a small dot posted on the wall for two minutes. Stare at an optical illusion for two minutes, stare at a fluorescent light and then try to read something What got you closest in touch with your fears? Usually 1-3 of these exercises should do it now that you know how to recreate your fears. You have to start practicing these exposure exercises. So I want you to take one week of your life. And each day that week. I want you to sit down and practice these exposure exercises. Write down on a piece of paper what you're afraid might happen when you do the exposure exercise. Then do the exposure completely fully be in that present moment.

Be aware of what's happening in your mind during the exposure, what's happening in your body. And then after the exposure on that same piece of paper write down. Did your fear come true? Yes or no? How do you know if it came true or not? And what did you learn through this exposure, then do it again, do it three times in a row. If you do this for one week in time, you should start to break apart those associations that have been formed. Once you start to make progress with these exposures, then you want to play with the details a little bit like maybe you do this when you're home alone, or when you're outside in a crowded space or after drinking a lot of caffeine. Check out this video right over here. It'll walk you through even more details.

To sum it all up. The goal is, I want to help you get comfortable being uncomfortable. I want to help you to learn about what it's like. experienced these difficult sensations and then what actually happens to you when you go through them. So these associations are starting to break apart. Now it's time to move to step three, which is developing coping skills. But before I explain some of my favorite coping skills, we have to talk about what a coping skill is and what a safety behavior is.

Safety behaviors give you some immediate relief, but they keep you from getting in contact with the thing you fear. And when that happens when you're relying on safety behaviors. These associations they don't break apart because you're not learning any new information, completely avoiding a situation being on the lookout for escapes, only being able to get through with a safe person. Those are some examples of things that can be safety behaviors, coping skills, reduce your anxiety and help you to stay in contact with the thing you fear So those associations do break apart. Because you are learning new information you are getting in contact with a thing that is difficult for you safety behaviors reduce learning, while coping skills enhance it. This can get really tricky because what's a safety behavior for one person might be a coping skill for another. And what starts off as a coping skill might eventually become a safety behavior. So it can get really confusing. All this stuff exists on a continuum from highly safe behavior to highly coping behavior. To keep it really simple.

Ask yourself these two questions. Is this skill helping me to reach my goal right now? is it helping me to be flexible in the situation I'm in? If the answers are, yes, that's probably a good healthy coping skill. If the answer is no, then you might be dealing with a safety behavior that you want to phase out over time. The first goal I want you to try is slow, deep controlled breathing. This slows down your breathing, which triggers your body's parasympathetic nervous system, the part of your body that calms you down. I got a whole video about this, so you can check that out. But the quick version of it is, you want to work your way up to breathing in for four seconds. Holding it and then out for four seconds, so you can start by breathing in for two seconds, holding it out for two seconds, breathing in for three seconds, holding it out for three seconds and then four.

And you can just keep doing that until you feel like you're a little bit calmer and a little bit more present the dive reflex. This is a awesome skill that is universal to all vertebrates on this planet. Basically you are fooling your body into thinking you're diving into the water that also triggers your body's parasympathetic nervous system that calms itself down. I've got a whole video on how to do that. So if you're interested in that skill, check out that video. Get physically active, your body is fired up.

So do something with that energized body. Go for run, go for a bike ride, do a ton of jumping jacks do something that gives your body something to do think about The Doctor. One of my favorite episodes of Doctor Who has The Doctor talking to a small child who's afraid of monsters under his bed. Now, there actually are monsters under his bed spoilers for those of you haven't seen this episode, but it's you know, Doctor Who that's going to happen.

But what's really amazing is what he tells this child it's one of my favorite quotations about panic, and I'm going to read it to you all here because I don't want this video taken down due to copyright violations filed from the BBC. Let me tell you about scared. Your heart is beating so hard. I can feel it through your hands. There's so much blood and oxygen pumping through your brain. It's like rocket fuel. Right now you can run faster and fight harder. You can jump higher than you've ever been able to in your life. And you are so alert. It's like you can slow down time. What's wrong with scared? Scared is a superpower your superpower there is danger in this room and guess what? It's you reach out to someone. Call text dm, connect with someone else. Ask them to send you support. Ask them to send you a funny meme to reassure you or talk to them about something that's completely not related to panic. Connecting with someone else might help you to get a little bit out of your head and help you to reach your Goal whatever it is in that situation question for all the Psychees What is your favorite coping skill? Let's flood the comments section with a ton of coping skills, so we can help whoever discovers this video in the future.

Step number four is to develop grounding skills. Some people who experienced panic also experienced depersonalization or Derealization. This is where you are going through the motions of your day. But you don't really feel that plugged in to yourself to your body to your mind, you might feel like you're on autopilot. Or you might not feel like the things around you are really happening.

One of my patients recently described it as having this brain fog and it was really hard to just kind of navigate through daily events. So if this kind of stuff happens to you, we need grounding skills that help you to feel plugged into your body plugged into your mind plugged into the present. moment, or they ground you in an important memory and important place or an important idea. Grounding skills can also be really helpful if someone around you is having a panic attack and you want to help that person through this difficult experience 54321 This is a skill that really engages all of your different senses. It starts by looking at five different things around you, then to touch four different things to listen to three different sounds, to pick up on two different smells. And to notice one taste, it's usually whatever taste is in your mouth. You really want to try to focus in on those sensations and if there's one type of sensation that works a lot better for you.

It's okay just to stick to that one. Like if you really like the touching to touch your hands or to touch your jeans or the material on your shirts. Stuff like that you can just focus on that sensation that's totally fine. Make a list pick something that you know well, and that you can't easily finish like your favorite movies or your favorite superheroes or the places you like to go and your local community. I like to pick my favorite starships from Star Trek and I just kind of cycle through those guys.

I'm a huge Trekkie. This is something that's going to ground you in an idea, something that you care about, and it's going to make that feeling of depersonalization Derealization, a little bit less scary, transport yourself to a place you know, well, this could be your home, your school, your work, doesn't really matter where it is only what matters is that you know a lot of details about it. Imagine walking through the front door of this place entering it. What do you see next? what's around you keep thinking about all the details as you navigate through the space.

This is going to ground you in a place that's very familiar to you. And again, take you away from those some of those feelings of depersonalization and derealization. Experience intense sensations. This includes listening to loud music or a really funny video on YouTube, drinking a hot beverage, or sucking on a lemon or peppermint candy. pinching the bridge of your nose, snapping a rubber band against your arm, anything that's going to shock your nervous system and focus your complete attention, get absorbed in an activity, do something that's going to completely require all of your focus maybe something that you do well or you know how to do well something that's really going to activate your mind and get your hands moving. Something like that would also get you out of depersonalization derealization and make you feel a bit more present If you've tried everything in this video and are still struggling there's two things I want you to consider.

The first is speaking with an anxiety expert, a therapist who can guide you through this process in a much more detailed way than I can in a short YouTube video. The other thing to consider is a consultation with a psychiatrist, they might be able to prescribe medication that can bring down the intensity of anxiety so that you can greater apply these things to your life.

If you want to learn more about anxiety check out this playlist that has all my anxiety videos, you can learn a lot more about exposure therapy and my own journey with anxiety or right over there. All right now it's time for the weekly Geck Boo (GCBU) challenge. This is where I share how I'm working on getting comfortable being comfortable this week. The big thing for me this week has been trying to catch up on my inbox over the summer and fall I really let things get out of hand.

I had hundreds and hundreds of emails that were that were needed a response. And I haven't responded to. So this week, the uncomfortable thing for me is to go through it because it's very overwhelming to even open that inbox and to write uncomfortable messages where I say, Hey, I'm sorry for this late response. I had a lot going on. And I'm now getting back to you like a year after I promised. I'm so sorry. So that's, that's my weekly Geck Boo challenge.

What are you working on? Let me know in the comments below. Or if you want to join me this Friday, I'm hosting my weekly office hours. This is a time where for one hour on Instagram, I go live to hear about what you are working on out there in the Psychee community, and how I can help and how we can help each other to reach our goals and to help each other get comfortable being uncomfortable. So if you want to join me for my weekly live office hours, come over to Instagram I'm @AliMattu and we'll talk about all this stuff and we'll support each other. Share this video with someone who struggles with panic in your life. And if you want more videos that celebrate mental health, make psychology fun and easy to understand.

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