Grace, a nurse living in Oakland, CA, began our first therapy session saying she wanted to feel less anxious. I asked her to tell me about a recent example of her anxiety, and she told me about the previous night. Her husband was watching a movie and asked if she wanted to join him. She did, but complained the entire time about how much work she was not getting done. She told me that whenever she tries to take a break from work, she constantly feels anxious and is unable to enjoy herself. It had gotten to the point that it was beginning to create problems in her marriage, and she and her husband had begun to fight about her need to relax.
Curious about how her anxiety made sense, I asked her to imagine herself in the scene from last night and to let me know when she was there. After a few seconds, I asked her if she was feeling her anxiety. She told me that she was and I asked her to describe how it felt in her body. She said, "It's like a hot, burning sensation in my chest. I hate how it feels." I asked her to stay with that feeling for now, and really allow it to be present. Then I asked her to try something that might feel a little strange. I said, "Now ask that feeling -- that burning sensation in your chest -- what it's job is. Try saying something like 'What is your job?' or 'How do you help me?' and then just listen for an answer." She was willing to try and paused for a minute or so. She finally said, "All I'm getting is 'I keep you from slacking off.'"
At this point, I wondered how not "slacking off" was worth the price of feeling so anxious and uncomfortable. I told her that I would give her the beginning of a sentence and ask her to let it finish itself without pre-thinking the ending. The sentence-stem was, "It is so important not to slack off because..." and she quickly said "It is so important not to slack off because my whole f***ing family are a bunch of slack offs." We repeated this process a few more times as it became increasingly clear how important it was for her to be different than her family.
She told me about her family's history of drug and alcohol problems and how embarrassed she felt growing up with them. I now felt like I was starting to understand. I asked her to try saying, "My anxiety is what keeps me from ending up being a slack off like my family. That is more important than anything, including being able to enjoy myself." She repeated it back and said it felt true. We spent the rest of the session looking at this new discovery from different angles and phrasing it in different ways. We finally wrote "I refused to end up like my family, and I need my anxiety to keep that from happening."on an index card for her to read a few times a day.
I asked her to call if she needed another session. When she called a few months later wanting to do a couples session, she told me that she now felt entirely in control of her anxiety. It would still come up from time to time, but she would know what it was about. She said she would just recognize how different she is than her family and that would make her feel much better.
Do you consider yourself a worrywart? I know I am. If you are then you might be plagued by "The Worrier" as well. Any fears that we can write down that start with "What if..." is a horrible waste of our time and energy. However its probably what effects me the most. I am always worrying about things that haven't even happened yet. And how many times like the example above do I need to show myself that they are empty, worthless thoughts. They rarely come to pass and in the mean time all I have done is added a few more wrinkles and grey hairs.
Imagine all that you or I could accomplish if we could channel all the time and energy we use worrying into something positive. Easier said than done, but still an interesting thought.
I needed to hear this so maybe someone else will benefit as well:
You Can't Please Everyone
You may be generally an amiable and pleasant person. You may generally get along well with most people. But somehow, there is that one family member, that one friend, that one colleague, who doesn't take to you very well.
This might disappoint you, sadden you, or even disillusion you. Don't allow it to.
Every single person is unique. Every single relationship is different. Somewhere, somehow, there will be people who don't quite get along.
If you allow yourself to adjust your personal values, to change the person that you are, just to win over that one person or few people, you run the risk of adversely affecting the good relationships you do have.
Be positive. Focus on your happy relationships. At the same time, accept that there will be ones that don't go so well. Whatever you say or do, whoever you are, whatever character or personality you have, you won't be able to please everyone.
However today started a fresh wave of panic because the plans for 3 baby showers are starting to solidify. The invitations are being made, addresses are being collected, and I have to go register for baby stuff this week because I procrastinated as long as I could. Don’t get me wrong, I am very thankful for the baby showers because we really don’t have a lot of the supplies we need yet and it shows that people really care about me. However being in the spotlight has me starting to worry as it always does. In fact, the anticipatory anxiety over having a baby shower started soon after I found out I was pregnant.
It got me thinking about my wedding almost six years ago. (Man how time flies!) Most women have dreamt about every detail of their wedding day since they were very little and know exactly how they want it all to be. They envision and plan for years and when the day comes its all about the bride and how amazing they are. I never really thought much about my wedding day, only more about who the groom would be. I chose my dress to be pretty simple because I didn’t want to bring a lot of attention to myself. I didn't want any embroidery or eccentric bead work. I felt like everyone was thinking that I was too young to get married. I am sure there were some people that did think that. I was really young, I was only 19! But it hurts me now to know that I let myself harbor feelings of embarrassment and unworthiness and even more so that I gave into them and made decisions based off of those feelings. How silly and unfortunate looking back. I didn’t like being in the spotlight and I let myself get so caught up in what everyone else must have been thinking that I really didn’t enjoy the day the way that I should have. I should have really CELEBRATED and not cared what anyone else thought about it. But for me I know that is easier said than done.
I don’t want those feelings from my wedding day to happen again. I want to enjoy each baby shower the way I should instead of worrying throughout the entire thing just trying to survive it. Worrying about whether people are judging you or not is such a waste of time! I don’t even know what I am worrying about- is it the food thing? Is it worrying that no one will show up? I don’t even know and yet this anticipatory anxiety is lingering at the pit of my stomach. I want to celebrate this new life. What a fun word. "Celebrate". It has so much more brightness, goodness and uplifting fulfillment to it as opposed to the word "Worry".
So I know what I need to do. I need to figure out and analyze what negative thoughts I am putting in my head and swap them out with positive ones. Perhaps I will do it in a later post. For now, I just wanted to say that I am not anxiety free and it really sucks sometimes to feel the control slipping, or having to deal with the anxiety at all. It’d be nice to not dread every upcoming event. Every evening out on the town, every family get together, every company event all comes with different levels of anxiety, rarely anxiety free. Its especially frustrating because I want to be at these events but the worrying can sometimes make it hard to enjoy them. At least I can manage my anxiety to a certain degree. If I really think about it, I don’t think I have had a full blown out of control panic attack since September which is really great progress. Its just draining to the soul sometimes. But celebrating life instead of dreading it seems like a pretty good goal to keep working towards.
What a difference today’s meeting was for me. I walked upstairs alone to go to the conference not even consciously thinking about whether anxiety would be a problem. I also didn't know that I was going to be the first in line in front of all of my coworkers to get our lunch buffet style. This was a bit embarrassing but I tried to hurry through the line picking out just enough that I thought would fill me up and not more so that I wouldn’t have to worry about not being able to clean my plate.
I walked into the sitting area and out of habit I specifically chose a chair in the back corner so that I wouldn’t be in the midst of everyone, somewhere I could hide. Since I was the first employee in the room, as the other employees filed in they sat around me. I didn’t get to sit next to the few people that really had helped me last year.
And then the inevitable happened as it always does. Someone sitting near me who was slender in build but had a heaping plate full of food said in disbelief,
“Aimee, that’s not nearly enough food to feed you and your baby! You should go back and get more!”
This statement a year ago would have been devastating to me.
“She must think I am anorexic...”would have crossed my mind as well as
“Everyone is watching me to see how much of this I eat.”
The girl next to her offered to split some of her food with me, as if to spare me more embarrassment or to make it not awkward somehow.
Normally now my face would be bright red and my neck burning. My appetite would disappear and my stomach would turn into knots. Not today though.
Surprisingly, I calmly stated that I may go back for seconds in awhile but that I am ok for now. I then quickly redirected my thoughts to conversation with someone else at the table and started to dig in to a really yummy catered lunch.
The funny thing is when all was said and done I had selected the perfect amount of food for me. I ate everything on my plate and had room for desert. Meanwhile, the girls that had commented on my plate had a
It made me feel great to know that I can assess what my body needs all by myself no matter what others may think of me. I can eat what I want when I want and I am the one who knows what is best for me and my family.
I walked into this luncheon unprepared which was a mistake because things could have gone a lot worse. But I must admit that today I relied not so much on breathing, or coping strategies, but more on my own self esteem and confidence which rarely happens. It’s a great feeling to see that progress.
I have friends who are very open about their feelings. They are able to communicate the good and the bad very easily and openly. I on the other hand have always leaned toward not expressing them. This is hard for me to do as a friend, and was even a manager. For some reason having to look one of the employees in the eyes and tell them what a great worker they were was really hard for me. Easier to understand why it was hard to tell them they were slacking or needed to do better, but it’s a little strange that even positive feedback is hard to express. I think it’s all wrapped around what they will think of me for saying that, or it is just embarrassing for some reason. I think growing up that was just how it was in my family. Positive feelings or problems weren’t openly discussed or expressed very often or maybe just not often enough.
It got me wondering if that behavior somehow contributed to my panic attacks. Because had I been more open about feelings with people, than it would be easier for me to let them know when something made me uncomfortable. But years of holding things inside only makes them fester until they are out of control.
So I want to throw it out there- are you the same? Is expressing how you feel to others something you struggle with? Do you think it could somehow contribute to your anxiety? Or are you very open about your feelings to others?
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How to Avoid Help Hazards:
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For those that don’t know what the heck I am talking about, what this means is that when you leave a comment from now on, it will ask you to type in some letters/ numbers in a box first to make sure you are a human and not some spam. It only takes a few seconds to do, but it is an annoyance that I wish we didn’t have to do.** Update- 5/7/08: Also another annoyance is when people leave comments that are simply to sell something they are promoting. They don't leave anything valuable except a few words and a link. If someone wants to promote their product on my site, they can email me with permission and I can look into it for them. But if comments are left that are just advertisements in disguise then they will be deleted.
"I am part of a research group from The College of New Jersey interested in gaining information on the views of authors of mental health blogs. This study is part of a research project of Dr. Yifeng Hu, a professor in the Communication Studies department at TCNJ. You have been contacted because you are the author of such a blog. Participation will involve responding to surveys about your mental health and blogging habits. The results are completely confidential. No respondent's personal identity will be requested or associated with any set of answers. We appreciate your time and help with our study and as a thank you for participating you will receive a $5 gift card (or you can choose to donate your amount to Mental Health America). If you are interested, please send an email to firstname.lastname@example.org and be sure to include a link to the home page of your blog as well as your preferred contact email address. The survey will be sent to you via email within the next few weeks. Thank you in advance for your participation!"The reason I am posting this is because in a follow up email they requested to pass along this invitation to any other interested bloggers. I have my online support group many of which are fellow mental health bloggers and so I am putting this out there for any of you that may want to participate in the study. I am planning to participate because its a small way I can get involved in the community and help out. Enjoy!
Mental Health Blog Research Group
The College of New Jersey
I have written about this in many different ways here on the blog in my own journey to finding answers and has evolved into what the heart of this blog is all about. This is what we are all looking for, striving for- a way to live our lives without the constant feelings of panic that tag along wherever we may go. A way to not give into those fears and be able to enjoy ourselves. I am not all the way there yet, and truthfully I may never be. But I have learned how to minimize the effects that the panic has over me so it doesn't effect me as often or as tough as it used to, and that is a great step in the right direction. So lets share the knowledge. I've collected some of my most relevant, useful posts on the subject that has been the biggest help to me over time and I have listed them all in one place for your surfing convenience.
How to maintain control when anxiety is triggered:
Related Posts:Discovering Your Triggers
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Do you ever have periods in your life where everything is just peachy? Almost too good for too long a time that you start to worry, and wonder when the next personal setback, family tragedy, or financial blow up will come?
Don’t get me wrong, my life is in no way perfect. Pregnancy brings its own share of headaches, backaches, etc. My dogs just escaped from home last weekend which brought on some worry that they were hurt and they were locked up all weekend which made us sad and lonely. You can read more about that here if interested. I've been up since 4 am this morning and am crazy tired. But overall my life isn’t half bad lately. My pregnancy is going so much better than I ever expected it to, money hasn’t been tight for a while, work is cruising along, etc. My anxiety tends to come and go in waves. When it’s around it can be constant, everyday, and then fade away for a couple of months. And I feel that I am in a recession right now where I don’t have to deal with it as often as I used to. I am not naive to think it won’t ever hit me again really hard, but I am trying to enjoy the down time right now.
However, deep in the back of my head I am worried about what is going to burst this peaceful bubble. I know something big has to be on the horizon and I don’t want it to come.
I know it has to eventually. Life has to have opposition in all things. If we never felt sadness we wouldn’t appreciate the times we are happy. If we were never sick it would be harder to be grateful for our good health. It is through opposition and adversity that we become stronger, deeper, and wiser individuals.
I should enjoy this time while I can; it really does me no good to worry about something that hasn’t even happened yet. Although worrying about something that hasn’t happened yet is my thing, its what I do. And therein lies one of the biggest adversities in my life.
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I recently had a conversation with a reader of the blog and it has prompted this post, I hope she doesn't mind. Sometimes I take for granted where I am in my process of figuring all this out that I don’t realize all the steps it takes to get there.
Specifically, I know what my triggers are. Performing for people via eating, driving, playing the piano, etc. all cause anxiety for me. Eating is enough anxiety to cause a panic attack. But it took me YEARS to realize that this was what it was. I struggled thinking maybe I was allergic to something, maybe I had a weird eating disorder, maybe I had IBS, and so on.
This reader was puzzled because she didn’t know what caused her panic attacks. They would come out of no where and so it was hard for her to prepare for them.
If you fall into this same category, all is not lost. Here is my suggestion. For the next while, any time you feel any anxiety at all, track it. Depending on how often you have panic attacks or bouts of anxiety this will fluctuate on the length of time you need to do this. Get out a sheet of paper that you keep somewhere (when I worked on this I had a journal that I dedicated to my anxiety that I carried around everywhere with me. I kept all the little thoughts and quotes and affirmations in it, so I would also track them in there). But a note card or sheet of paper will be just fine. Once you have the anxiety immediately or as soon as you can write it down. Write down the date and time you had the feelings, where you were when you felt them, what you were doing right before hand, what thoughts you were thinking, how strong the feelings/anxiety were on a scale from 1-10 and anything else you feel is important. After time goes by where you continue to track them consistently, you should start to see a pattern developing. It may be a location that is similar, maybe the time of day which could have to do with what you are eating beforehand, a certain scenario, a certain thought that reoccurs, all sorts of things that might be causing your panic.
If you want to take it a step further, you can look at the thoughts you wrote down that you were thinking and replace them with a positive one, so when you have that thought again, you can easily tell yourself the positive thought and slowly work on reprogramming your brain. I do this often and I will post them here. Instead of carrying my journal around I started blogging instead and now my life is a bit of an open book.
This was how I learned that I feared above all else being judged by others. I knew I got sick when I ate, but I didn’t really realize that my mind was screaming inside me with the fears of “What if this happens, what will they think of me then?!?” until I thought about it and wrote it down each time.
When you are able to figure out what your trigger situations are it comes with a price. Yes you are able to be more prepared before entering a trigger situation, but then you introduce the anticipatory anxiety, or worrying about worrying in a given situation. This can be extremely stressful. But if I had to do it all over again, I would rather be able to prepare the best that I can for an event with the additional stress, as opposed to not knowing and having a panic attack pop up out of no where and leave me sick and scared and worst of all, feeling helpless and powerless against it.Related Posts:
Here is what I did to help me this time. I printed out my last post that I had prepared ahead of time and kept it in my back pocket at all times. I read it every morning before I left the hotel room. On the first day we were eating in a food court environment at Gameworks and I started to feel nauseous. I am pretty sure it was anxiety provoked. I just stopped eating. When my friends asked me what was wrong I simply said I didn’t feel well. Then when I could feel the nausea subside a little, I just stuck with the simple rice that I had to get something down. The next morning I woke up panic stricken at 5:30 am. I used to feel this every morning when I would wake up. I am glad this happened when it did because I was able to lie there in bed and talk myself through it until I could fall back asleep and feel better about it. There were several other small instances where I could feel it creeping up but I was able to get distracted or simply rest until it passed. I sat a lot on the trip because we did a lot of walking and I got tired a lot. After a good two hours of walking I start to feel like I have a bag of weights strapped around my waist that I carry around now.
We had a lot of fun, saw a lot of things, gambled away lots of money, etc. But the coolest part of the trip I want to share with all of you in more detail.
It is called the Bodies Exhibit and it is in different cities all over the country. It’s about $30 a person but if you are cheap like us, we were able to sit at a Timeshare presentation for 2 hours and they fed us lunch and gave us the tickets for free. Well worth it. The exhibit is made up of real human cadavers that they have soaked in a solution to help preserve them. They are skinned so that you can see the muscles and bone and tendons and organs etc and placed in artistic poses to demonstrate how the body works. It sounds morbid or gross but it was really cool. It’s controversial in the media about whether it’s appropriate or not but I thought it was very informative and artistic. I wanted to take pictures but they wouldn’t allow any photography. They display a brain that has had a stroke and the inside is all black as if it had been burned. They display lungs with and without cancer, fetal development in every week of the first 16 weeks, the circulatory system with just the veins from your face, arms, legs, etc. and so much more. You walk away wanting to take better care of your body and realizing just what everything looks like. I recommend going if it is out near you or you have the opportunity presented to you.
Here is a quick video to give you an idea of what you can see:
This is something that I don’t want to stop happening because I love to hang out with my friends and family. However because of the timing, I was unable to really prepare myself for any panic that could arise. I told myself on the drive over a few things I thought might help, but I was already a little flustered. As I was waiting to meet my friends, I could feel the anxiety come and felt immediately nauseous. It has been so long since I had felt this high of anxiety that I wasn’t sure what to do at first. I thought, “I need to get distracted.” So I went into a store and looked at jewelry that I wouldn’t mind owning. When I peeked out I saw they were there. We decided where to eat and as I was ordering the food I thought “I am going to throw up right here in line.” I wasn’t even hungry because I had eaten a late breakfast. This makes sense because that is a perfect trigger scenario for me. Had I been starving I doubt there would have been an issue at all, but when I feel like I have to perform and I don’t think I can, that’s when I panic. So I ordered a light lunch knowing I probably wouldn’t be able to eat any of it. We sat down and I snacked on a bag of chips and a drink. Never touched my sandwich. I left it in the to go bag. I tried to focus on the conversation at hand and a few times I could feel myself lingering on panicky thoughts. So I refocused on the conversation. I kept thinking of what I would say if they asked me why I wasn’t eating. When it briefly came up, I mentioned I wasn’t feeling well and left it at that. After all it was the truth.
So what did I learn? If you don’t have time to prepare for a potential Trigger Situation, then do whatever makes you feel the most comfortable. I could have force fed myself the sandwich but then I really think I would have been sick. I decided to listen to my body and save the food for when I felt hungry. Sure enough two hours later I was pretty starving and had a yummy sandwich waiting for me in the fridge.
We are not perfect. I don’t think I will ever be “cured”. I don’t know if I will ever master my panic attacks. I don't always have hours beforehand to fully prepare myself for events. But the best I can do is manage them as best I can. But when we don’t have time to even manage them, then the next best thing is to be yourself and not what you think others think you should be, love yourself for it, and do what feels the most comfortable while still facing your fears. My fear is what people will think of me if I don’t perform the way I think I should, specifically around food. The most comfortable thing would have been to not go at all and catch a movie with them later on or something not food related. But I went, survived, and best of all, got to see my loved ones. And that’s a small step in the right direction.
Positive Affirmation of the Day: I can take as small a step forward as I choose.
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I am very proud of myself. Today I had a panic attack, but I rode it out and I overcame it. I haven’t had a panic attack, or anxiety at all for that matter, since Thanksgiving.
I got invited to a luncheon with my new department and the fear took a hold right away. It was that panic that I dread which only makes it worse once you recognize its there. So I pulled up some of my previous blogs posts that I refer to often to help myself and I did my mental exercise to prepare for the lunch. I felt a little bit better before we left. Once there the panic came rushing back again and I could tell I was going to be sick, so I went to the restroom. This nausea was definitely different than pregnancy nausea. My face and neck and were flushed and burning. I sat there ready and waiting to vomit, when I closed my eyes, took some deep breaths, and starting saying my positive affirmations over and over.
"There’s no need to push yourself. You can take as small a step forward as you choose."
"I believe in myself apart from other’s opinions."
"I am learning that I don’t need to eat to please others, I only need to eat to please myself."
I could feel the burning sensation leaving, and my body and mind starting to calm down. When I felt like maybe I wouldn’t throw up after all, I sat down and my legs started shaking like they always do after my panic attacks when the adrenaline is working itself out. I was amazed. Sure I had a panic attack, but I was able to keep myself calm enough to not throw up, and to ride it out for the few minutes it was there. I was able to go back out and eat comfortably after that knowing that the worst was over.
I was just so excited to know that even out of practice, I remembered the skills I need to make it through a panic attack, and to help it not be as severe as it could have been.
This is a little thing I live by whether its right or wrong. Don't get me wrong, I can sympathize, empathize, show compassion, and feel bad for someone if they are in a crappy situation. I am not a heart of stone. However, if after a certain amount of time of hearing the same complaints over and over and knowing the person has done nothing to change their predicament; I lose the sympathy and just get tired of listening. I have been known to tell people after years of the same problem that unless they do something about it, I don’t want to hear about it anymore.
Sometimes I have to take a look at myself and see if I am doing the same thing to others. I have been struggling with work lately and have even written a couple blog posts on it, because it really has been crappy and has been affecting my moods. A couple of you told me that maybe I should be looking for a change. That hit home to me, because really I wasn’t doing anything to improve the situation yet sulking and complaining was the natural release.
So I am pleased to announce that I did take steps to improve my work situation. At first I struggled because I didn’t think I had very many options being pregnant and all. But I posted my resume on Monster and was surprised of the response I got. I still didn’t think I would be a great candidate when they learned of my pregnancy so I didn’t pursue any of those too much. Plus the stress of starting a new job at a new company doesn’t sound like fun. But to know I had options really improved my self esteem and quieted some doubts. Luckily a position opened up at my work in a different department and although it will be a significant pay cut since it’s not a managerial position, it will allow me to work part time and at home after the baby is born at an hourly wage that is very good! I couldn’t be more excited or feel more blessed. Not only will I not have the stressors of management- meetings, confrontations, hiring, firings, dealing with senior management, etc. but I will be able to have the ideal setup and I won’t be working for my boss which has been the hardest thing.
It’s not completely official but it looks like it will be happening very soon. Thanks to everyone for your advice. I really do listen, promise. And now hopefully my complaints will go down as well which is better for everyone.
Moral of the story: Are you one of those people that when encountering a problem, take action to change your plight or do you thrive on the sympathy and attention you get from others, maybe from your anxiety or panic attacks?
That might sound like a silly question but it happens. We may not even realize it, but deep down we may be benefiting from having anxiety and don’t really want to give up that benefit. The question is what are we gaining? Is it really worth it? Do you thrive on the attention for example? Maybe your spouse picks up the slack in other areas of life that you don’t want to deal with such as housework, taking care of the kids, and the finances. There are so many possibilities. It’s interesting to think about, and to weigh whether the subtle benefits are worth the crippling effect of anxiety. If you decide to give them up, then change is the next step. Change can be a career change like me for example, a break in a relationship, a trip to the doctor, to the bookstore, out of your front door. It could be going out with a friend, taking a chance on a new relationship, etc.
So what kind of person are you?