Panic attacks in whatever form they come, can be terrifying and devastating. They can hit us out of the blue when we least expect it and paralyse us. Characterised often by a pounding heart, nausea, dizziness, disassociation and breathlessness, panic attacks can make us believe something terrible is happening to us and we may even feel that we are dying.
Panic disorder and social anxiety disorder exist along the same spectrum and share a common denominator, fear. Attempts to avoid and resist these conditions, may only serve to fuel them; facing up to what is happening and why it is happening, is the first step to freeing ourselves from panic attacks.
I work directively with these disorders and will help you to identify the source and triggers for your attacks/anxiety whilst also working with you to manage the anxiety on a daily basis. Our aim will be to gradually reduce the frequency and intensity of your attacks until you are in a place where you feel able to cope.
Some practical tips for dealing with a panic attack are:
When you are experiencing an attack, it is extremely important to breathe properly. This may seem impossible whilst in the throes of a panic attack but will really help to bring the episode to a swift end. When I say breathing properly, this means breathing from your stomach and not your chest and taking short breaths in and long breaths out. So often we breath from our chest which is not the natural way to breathe and can result in shallow breaths which may also lead to hyperventilation.
Visualisation is also a powerful tool. Using your imagination to take you out of the moment of panic and to a place of calm and serenity. Use music or a good book to help you if you need to.
Use rational thinking to bring yourself down from the runaway thoughts of panic in your head. "what is the worst that can happen?" "where is the evidence to say I am going to die?"
Instead of dwelling on "what if" statements, begin the sentence with "so"......."so what if I have a panic attack?" "so what if I forget what to say in this meeting?"
Another very important factor in the prevention of panic disorder is to do with good physical health, taking care of your diet and lifestyle. Whilst many may see this as irrelevant to their emotional/mental health, this could not be further from the truth. Keeping the body free from toxin overload, keeping active and ensuring hormonal balance are just some areas which can help with anxiety.
These are just some of the many tips to coping with panic attacks. What can be seen as insurmountable does not have to be, it's just a case of learning new and improved ways to deal with your body's reaction to fear or imbalance.
I am always struck by the large numbers of clients who come to see me with issues around low self-esteem. Presenting in many different forms and to different degrees, it is a problem that appears to pervade many people's lives and can leave you facing much deeper issues later on in life if it isn't dealt with at the time.
For many, low self-esteem or lack of confidence, is extremely common and something most people suffer from at some point or other throughout their lives. Very often, the problem can be dealt with at face value and may not worsen. For a lot of people however, the problem can present itself in a far greater and more debilitating form, serving to hold them back in the workplace or in forging meaningful relationships.
Facing up to the fears and emotions that constrict and hold you back, can alter your entire way of being and prevent what may be a minor issue around self-perception from becoming an all consuming negative personal and world view. Cognitive therapy is particularly useful in addressing problems with self-perception and can be employed to help change the way you perceive yourself and how other's perceive you.
It is so very often our own distorted beliefs about how other's see us that creates bigger problems than actually really exist. Cognitive therapy can help to dispel these misinterpretations and replace them with realistic and more helpful thoughts based on fact and not on what we simply want to believe.
Many people find the concept of 'self-harm' or 'cutting' very difficult to understand and it this view which causes many of us who do self-harm, to keep it a secret for fear of being labelled as 'weird' or 'insane'.
The fact is that self-harm in the UK is dramatically on the increase and is most prevelant amongst young people and to ignore its existence is very concerning.
Of course there are varying degrees and ways in which people choose to harm themselves. Many partake in superficial cutting or burning which may leave no permanent scarring whilst others cut much deeper and across a larger surface area. Some people may go as far as to stab themselves or pound their heads against hard surfaces whilst others may pull out their hair or pick their skin.
The term 'self-harm' can be any form of abuse to oneself be it through drug, alcohol or food abuse just to name a few.
So why do people self-harm?
For so many, self-harm is a desperate and last resort. They feel unable to cope with the feelings or pain they are carrying around and seek release for this pain through self-inflicted injury. Many testify to the powerful sense of relief they feel from hurting themselves. Self-harm tends to be the option of those who feel totally
overwhelmed with what they are experiencing and can see no other way out. Other forms of self-harm such as substance abuse serves to block out feelings which may be intolerable and need to be suppressed.
The intention of those who self-harm tends not to be to kill themselves although unfortunately for some this can be the end result. Self-harm is very often a bi-product of an earlier negative experience or trauma and help can be found by dealing with the source of the painful feelings.
Infertility, sub-fertility and secondary infertility can have a devastating impact on our lives. Being unable to conceive when it has always been your plan to have a family, can induce feelings of shock, anger, depression, grief and even isolation.
Relationships can suffer greatly as a result of an inability to conceive and can put a huge strain on you and your partner. Perhaps blame is being apportioned or sex has become clinical and a matter of 'having to'. The choice to undergo fertility treatment can be a very difficult one with the physical, financial and emotional burden compounding the pressure you are both under.
Infertility can also affect your friendships, you may feel you don't want to be around people who have children because you find it too hard and upsetting and it may seem easier to withdraw from situations which you find difficult. It can also be very hard for people who are not experiencing infertility to empathise with those who are, a feeling that noone understands. The pain of loss and disappointment can be overwhelming and leave us with a feeling of being stuck on a treadmill where everything becomes about having a baby, preventing us from getting on and living our lives.
Maybe you don't want to burden others with your feelings and as a result, keep these feelings inside. However, talking to someone about what you are going through will help you to cope with the myriad of emotions that arise from infertility, helping you to face every stage of your journey. Anxiety and stress can also have a negative impact on fertility and fertility treatment so keeping these out of your life as much as possible is vital.
Living with the uncertainties of infertility is painful and exhausting, being supported throughout the experience will not guarantee success but can help make the process more bearable.
Dissociation or Dissociative Identity Disorder (DID) at the more extreme end of dissociation, is a term used to describe a coping mechanism which we employ consciously or unconsciously (more often), to disconnect from an experience or particular aspect of an experience. This may be used frequently or infrequently, depending upon the need at hand.
There are degrees to which dissociation arises. On a more day to day basis, dissociation may be used to deal with everyday stresses or to allow us to focus on things in a more intensive way by tuning out external distraction. We may automatically 'dissociate' when we drift off into the far reaches of our imagination. An example of this may be when we lapse into a trance whilst cooking and allow the pan to boil over.
The varying degrees to which dissociation may present can determine whether it is considered normal or problematic. The more extreme end of dissociation or Dissociate Identity Disorder may involve a partial shutting off or entire blocking out of a difficult or traumatic experience we have had. Our natural ability to dissociate is automatic and should be employed as a short term survival strategy only, to allow us to process difficult experiences at a later time when we feel stronger to do so and more able to cope with what has happened.
Dissociation becomes a problem when we use it as a long term strategy, failing to address what has happened at the time. We may then find that the event we are blocking revisits us as we go about our everyday lives. This could be in the form of flashbacks or unexplained behaviours which we are unable to put down to anything in our conscious awareness. This can become a huge source of anxiety and may impact on our functioning and relationships. Recall of the event we are choosing to block out, should be addressed slowly and safely with methods other than dissociation.
There are conflicting theories around the causes of dissociation but some common themes suggest that it may be more prevelant in people with the following characteristics:
A person may deal with a dissociative disorder by coming to accept all parts of themselves, incuding the internal parts and/or events they have have chosen to block out. To accept oneself allows us to heal emotionally. Coming to recognise triggers for DID is key to dealing with the problem and preventing us from lapsing back into using this coping mechanism.