{"id":72658,"date":"2020-06-17T16:46:14","date_gmt":"2020-06-17T16:46:14","guid":{"rendered":"https:\/\/effectsofanxiety.net\/archives\/72658"},"modified":"2020-06-17T16:46:14","modified_gmt":"2020-06-17T16:46:14","slug":"stop-having-panic-attacks-now-exposure-coping-and-grounding","status":"publish","type":"post","link":"https:\/\/effectsofanxiety.net\/archives\/72658","title":{"rendered":"Stop having panic attacks now: exposure, coping, and grounding"},"content":{"rendered":"I'm going to show you how to stop having panic\nattacks using exposure therapy, coping skills and grounding skills and you can start applying\nthis to your life. Right now. I'm clinical psychologist Dr. Ali Mattu. Psychology took me from almost flunking out\nof high school to becoming an assistant professor at Columbia University. Now I've left academia so I can give away\neverything I've learned to you for free. Welcome to the psych show. The first step to stopping panic attacks is\nto understand what exactly is happening when someone has a panic attack.

They experience a sudden rise in at least\nfour of these symptoms. It's normal to feel the sensations when we're\nin a real dangerous situation like an animal's chasing us or before an important event, like\na presentation for school or work. But what's so scary about panic attacks is\nthe sensations can feel like they're coming out of nowhere. Your mind is an association machine. It connects things together, ice cream and\na beautiful summer's day movies in popcorn and email from your boss and stress. All of this happens automatically it happens\nwithout you even realizing it through a process called classical conditioning. This is the stuff Ivan Pavlov was working\non when he got dogs to salivate when they heard a metronome, sometimes weird things\nget associated together.

And for some reason, your mind has associated\nnormal physical sensations of anxiety with a real sense of danger. Maybe you were really sick one day and had\ndifficulty breathing or you were driving across a bridge and there was a lot more traffic\nthan usual and you felt stuck and unsafe or you were using a drug and had a really bad\nexperience with it. There are so many ways in which your mind\nYou can experience those physical sensations of panic and why it might associate those\nsensations with danger. If you avoid going to certain places because\nyou'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\nformed, what matters is they exist now. So we have to understand what is it that you're\nafraid might happen? When you panic, I want you to take a moment\nand write that down, write down what it is you're afraid might happen when you panic.

Maybe you're afraid that the panic attack\nwill end. Maybe you're afraid of having a heart attack,\nor something really embarrassing happening, like fainting or making a fool of yourself\nor the ambulance and all these people being called Your rescue when it was a panic attack\nand not a heart attack. Or maybe you're afraid of losing control of\nhurting yourself hurting someone else of losing your mind, or maybe even dying. I wish I could tell you to not worry about\nthis stuff. But you've already tried that and it hasn't\nworked. You can't out think panic attacks, these associations\nhave been formed. And the only way we can break them apart is\nby gaining new experiences and that is where exposure therapy comes in. Before I introduce you to exposure therapy\nexercises, there's a couple things you need to know first, these exercises require you\nto get physically active.

So if you have any health problems like any\nof 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\nthrough a traumatic event or traumatic events, you might want to skip ahead and master step\nthree and four first and then come back to exposure exercises. The reason for that step three and four are\ngoing to help you to feel more in control of your emotions.

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

These exposure exercises are designed to recreate\nthose sensations that you experience when you panic. So it might seem scary at first, what I want\nyou to remember is they're not painful. They're designed to get your body active in\nthe same way as when you have a panic attack. I want you after every exercise to rate them,\nzero to 100% house Similar were the things you felt when you did this exercise to when\nyou experience a panic attack hyperventilate for one minute, hold your nose and breathe\nthrough a straw for two minutes. Hold your breath for 30 seconds. Sit with your head covered by a heavy coat\nor blanket for one minute.

Place a tongue depressor on the back of your\ntongue Run quickly in place with high knees for two minutes. Step Up and down on the stair or a step stool\nfor two minutes. Hold up push up position for 60 seconds or\nas long as possible. Sit in a hot stuffy room or sauna, a hot car\nor a small room with a space heater. wear a tie turtleneck or scarf tightly around\nyour neck for two minutes. Drink a hot drink. Drink an espresso or coffee spin in an office\nchair for one minute spin around while standing up for one minute.

Shake your head side to side for 30 seconds\nwhile looking ahead. with your eyes open, put your head between\nyour 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\ntwo minutes. Stare at an optical illusion for two minutes,\nstare at a fluorescent light and then try to read something What got you closest in\ntouch with your fears? Usually 1-3 of these exercises should do it\nnow that you know how to recreate your fears. You have to start practicing these exposure\nexercises. 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\nexposure exercises. Write down on a piece of paper what you're\nafraid might happen when you do the exposure exercise. Then do the exposure completely fully be in\nthat present moment.

Be aware of what's happening in your mind\nduring the exposure, what's happening in your body. And then after the exposure on that same piece\nof 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,\nthen do it again, do it three times in a row. If you do this for one week in time, you should\nstart to break apart those associations that have been formed. Once you start to make progress with these\nexposures, then you want to play with the details a little bit like maybe you do this\nwhen you're home alone, or when you're outside in a crowded space or after drinking a lot\nof 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\nbeing uncomfortable. I want to help you to learn about what it's\nlike. experienced these difficult sensations and\nthen what actually happens to you when you go through them. So these associations are starting to break\napart. Now it's time to move to step three, which\nis developing coping skills. But before I explain some of my favorite coping\nskills, we have to talk about what a coping skill is and what a safety behavior is.

Safety behaviors give you some immediate relief,\nbut they keep you from getting in contact with the thing you fear. And when that happens when you're relying\non safety behaviors. These associations they don't break apart\nbecause you're not learning any new information, completely avoiding a situation being on the\nlookout for escapes, only being able to get through with a safe person. Those are some examples of things that can\nbe safety behaviors, coping skills, reduce your anxiety and help you to stay in contact\nwith the thing you fear So those associations do break apart. Because you are learning new information you\nare getting in contact with a thing that is difficult for you safety behaviors reduce\nlearning, while coping skills enhance it. This can get really tricky because what's\na safety behavior for one person might be a coping skill for another. And what starts off as a coping skill might\neventually become a safety behavior. So it can get really confusing. All this stuff exists on a continuum from\nhighly 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\nright now? is it helping me to be flexible in the situation I'm in? If the answers are, yes, that's probably a\ngood healthy coping skill. If the answer is no, then you might be dealing\nwith a safety behavior that you want to phase out over time. The first goal I want you to try is slow,\ndeep controlled breathing. This slows down your breathing, which triggers\nyour body's parasympathetic nervous system, the part of your body that calms you down. I got a whole video about this, so you can\ncheck that out. But the quick version of it is, you want to\nwork your way up to breathing in for four seconds. Holding it and then out for four seconds,\nso you can start by breathing in for two seconds, holding it out for two seconds, breathing\nin for three seconds, holding it out for three seconds and then four.

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

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

But what's really amazing is what he tells\nthis child it's one of my favorite quotations about panic, and I'm going to read it to you\nall here because I don't want this video taken down due to copyright violations filed from\nthe 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\nyour brain. It's like rocket fuel. Right now you can run faster and fight harder. You can jump higher than you've ever been\nable 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\nis 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\nyou or talk to them about something that's completely not related to panic. Connecting with someone else might help you\nto get a little bit out of your head and help you to reach your Goal whatever it is in that\nsituation question for all the Psychees What is your favorite coping skill? Let's flood the comments section with a ton\nof 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\ndepersonalization or Derealization. This is where you are going through the motions\nof your day. But you don't really feel that plugged in\nto yourself to your body to your mind, you might feel like you're on autopilot. Or you might not feel like the things around\nyou are really happening.

One of my patients recently described it as\nhaving 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\nneed grounding skills that help you to feel plugged into your body plugged into your mind\nplugged into the present. moment, or they ground you in an important\nmemory and important place or an important idea. Grounding skills can also be really helpful\nif someone around you is having a panic attack and you want to help that person through this\ndifficult experience 54321 This is a skill that really engages all of your different\nsenses. It starts by looking at five different things\naround you, then to touch four different things to listen to three different sounds, to pick\nup on two different smells. And to notice one taste, it's usually whatever\ntaste is in your mouth. You really want to try to focus in on those\nsensations 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\nyour hands or to touch your jeans or the material on your shirts. Stuff like that you can just focus on that\nsensation that's totally fine. Make a list pick something that you know well,\nand that you can't easily finish like your favorite movies or your favorite superheroes\nor the places you like to go and your local community. I like to pick my favorite starships from\nStar Trek and I just kind of cycle through those guys.

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

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

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

If you want to learn more about anxiety check\nout this playlist that has all my anxiety videos, you can learn a lot more about exposure\ntherapy and my own journey with anxiety or right over there. All right now it's time for the weekly Geck\nBoo (GCBU) challenge. This is where I share how I'm working on getting\ncomfortable being comfortable this week. The big thing for me this week has been trying\nto 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\nwere that were needed a response. And I haven't responded to. So this week, the uncomfortable thing for\nme is to go through it because it's very overwhelming to even open that inbox and to write uncomfortable\nmessages 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\nafter 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\nhosting my weekly office hours. This is a time where for one hour on Instagram,\nI go live to hear about what you are working on out there in the Psychee community, and\nhow I can help and how we can help each other to reach our goals and to help each other\nget comfortable being uncomfortable. So if you want to join me for my weekly live\noffice hours, come over to Instagram I'm @AliMattu and we'll talk about all this stuff and we'll\nsupport each other. Share this video with someone who struggles\nwith panic in your life. And if you want more videos that celebrate\nmental health, make psychology fun and easy to understand.

Be sure to subscribe to the psych show and\nnow my favorite comment of the week.","protected":false},"excerpt":{"rendered":"

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 … Continue reading Stop having panic attacks now: exposure, coping, and grounding<\/span><\/a><\/p>\n","protected":false},"author":0,"featured_media":72660,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":false,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1,5,781,4771,409],"tags":[42560,35259,39759,39729,43577,43584,43586,957,2278,23,43587,41908,38147,33777,43321,43582,43588,5699,702,43573,43578,43585,42561],"class_list":["post-72658","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-anxiety","category-causes-and-prevention","category-crime-justice","category-disasters-accidents","category-health","tag-ali-mattu","tag-cbt","tag-clinical-psychology","tag-cognitive-behavioral-therapy","tag-grounding-technique","tag-grounding-techniques-for-anxiety","tag-interoceptive-exposure","tag-mental-health","tag-mental-illness","tag-panic-attack","tag-panic-attack-coping-skills","tag-panic-attack-relief","tag-panic-attack-treatment","tag-panic-attacks","tag-panic-attacks-and-anxiety","tag-panic-attacks-explained","tag-panic-disorder-treatment","tag-psychologist","tag-psychology","tag-stop-having-panic-attacks-now","tag-stop-panic-attack","tag-stop-panic-attack-right-now","tag-the-psych-show"],"jetpack_publicize_connections":[],"jetpack_sharing_enabled":true,"jetpack_featured_media_url":"https:\/\/effectsofanxiety.net\/wp-content\/uploads\/2020\/06\/72658_maxresdefault.jpg","_links":{"self":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/72658"}],"collection":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/types\/post"}],"replies":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/comments?post=72658"}],"version-history":[{"count":0,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/posts\/72658\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media\/72660"}],"wp:attachment":[{"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/media?parent=72658"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/categories?post=72658"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/effectsofanxiety.net\/wp-json\/wp\/v2\/tags?post=72658"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}