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Nov 11

Little Lessons About the Big Problems Caused By Anxiety, Social Anxiety, Panic Disorder and Agoraphobia | Ch. 1 – 10

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Welcome to my world. Welcome to Anxietyville. Unfortunately, it is very crowded these days. Anxiety and panic seem to be occurring at epidemic levels- especially among relatively young people. The people I meet are healthy, intelligent, attractive, and articulate. You wouldn’t know they have anxiety and panic looking at them. They think you would. I am sorry you are living in this city. My goal is to help you move out of it quickly and forever. I am confident we can achieve that.
But Not So Fast
Lesson 1: IT TAKES PATIENCE TO BE MY PATIENT, I OFTEN SAY.
It is the only time I use the word patient. The people who is it with me are just that- people-everyday people. They come from all walks of life. The people who visit me are angry, demoralized, and desperate to escape the prison of anxiety. They don’t understand what has happened to them and they don’t accept it. Thank goodness for that.
Despite you motivation for relief, it will take some time to untangle the web of events and experiences that have occurred to form the noose like grip of anxiety. It will also take some time for the underlying hurts to heal and neutralize to much less toxic levels. Often, current scenes mix with historical scenes to form a high wall that blocks your escape route. My job is to help you find a way to finally climb over the wall. A lifetime of experiences have contributed to your situation and it will take a while to sort all that out.
How long is a while you understandably ask? Typically months of time, I answer. It is not always easy to predict. Importantly, if you commit to our work and believe it will succeed, it will go faster. Time flies whether you’re having fun or not, I always say. Surely, in your case it is time to have some fun soon.
Lesson 2: NOT ALL OF YOU WANTS TO GET BETTER.
People in Anxietyville are a divided team. So are people outside this city, truth be known. All people are made up of different parts that tag along from their history. We are all little boys and girls, teens, young adults, and hopefully healthy adults. It is the latter part, which visits me and my colleagues. It is the former parts, which torment people with anxiety, depression, addiction, and other hurtful states of mind and body. Why, you ask, do our younger parts hurt us? Because they have been hurt, confused and given twisted pictures of life’s and their treasures while growing up. Our younger parts have been abused, abandoned, neglected, frightened, made to feel lesser than, angered to

the point of rebellion, overprotected to the point of submission, underprotected to the point of feeling unloved and unworthy of future love. And that’s not even all of it.
Given all this and more is it any wonder that people are hit with anxiety and panic in adulthood? Terrified, wounded, raging kids live just beneath our adult skin. Never underestimate the power of the kid within. S/he is very strong and very influential. In Anxietyville kids rule-at least temporarily. It is in this context that we can understand the tug-a-war. Our healthy adult self wants to get better. Our kid doesn’t. S/he is scared to give up the anxiety. To that part of us, “freedom’s just another word for nothing left to lose!” Freedom, mobility, an evaporation of all the rules by which Anxietyville residents live. (e.g. aisle seats, no planes, 10 mile driving radius, no bridges or overpasses, no traffic, no large crowds, nothing out of control!) is wanted by the adult and forbidden by the child/teen parts. The later wants you to never get better and never come back to my office again. S/he will look for any excuse to terminate our work.
Resistance to therapy and counseling is well known. That you have arrived in my office shows that your healthy adult voice has some say in the situation. Staying here and keeping the voice of doubt out (e.g. He doesn’t really know what he’s talking about, he’s a nice guy, but this is how he earns his living. I’m not getting better, nothing is happening, we’re just bsing, etc.) is very important. When this occurs let’s talk about it. Don’t be shy or awkward about this. It won’t hurt my feelings. It’s not about me. It’s about you learning to talk about sensitive issues and finally getting yours needs met. It’s also about fighting off the inner saboteurs that want to keep you stuck in the “safety” of Anxietyville. Your healthy adult self and I are in agreement. We both want you to leave this town and live in Tranquilityville for the rest of your life. I work to “put myself out of business” as quickly as possible with every person I meet. It is not as quick as I like, but it will have to do. There really is no magic cure in Anxietyville. A sound and proactive therapy with a guide who knows this town and the lay of its land is your only choice. Remember, I’ve lived in Anxietyville. It’s a hell of a town. I moved out in ’79 and have stayed out all these years. You can too!
Your Kid Is Not Alone
Lesson 3: THERE IS A JEWISH GRANDMOTHER LIVING INSIDE US ALL.
It doesn’t matter your religion or ethnic origin. Sarah, Bella, Bertha, Molly, or some old Jewish lady lives within. She works on our kid and fills his/her head with worry. She asks “what if” questions till we stop trying to be healthy, happy, calm, and adventurous. She is our Achilles mind and a royal pain in our effort to escape. Grandma whatever her name is, doesn’t trust us. She remembers times we went off track and behaved inappropriately and put ourselves at risk. She knows when we were tempted to even if we never, ever did it-not even once! She is afraid we will hurt ourselves or others, act out and embarrass ourselves, have an affair or even a fantasy of one, run away from home or drive our car off a bridge, jump off a balcony or otherwise do something hurtful. We won’t, but go convince her. In fact, that’s a part of what our therapy will do.

Clearly our grandma within is afraid we will lose control of ourselves in some hurtful way. Ergo, grandma uses anxiety to control us from losing control. Since grandma can sense out of controlness easily anything can push the panic button Anything that symbolizes “out of controlness” (e.g., a line in the supermarket, highways-I-95 worse than the turnpike, an overpass, failure, a middle movie seat, an elevator, airplane, cruise ship, other people, sleep, alcohol, medicine, death, you name it-is a trigger point for anxiety/panic and the ensuing retreat. Grandma scares the kid inside till s/he pulls the plug and gives up.
What do we do about grandma, you wonder? We empower your healthy adult voice of choice to talk to her and to your kid. You reassure them by word and by deed that you are truly in control and not inclined to do anything wild, dangerous, impulsive, or otherwise that will put you in jeopardy. You will reassure them that while you may have to make some adjustments in your present life to address difficulties, stressors, imbalances, and dysfunction, those changes will be made sensibly, self-protectively and with concern for those important others in your life. In another lesson your will learn that trusting yourself and the world and having confidence in your self and your convictions are very important in facilitating your move to Tranquilityville. Your kid needs your voice of reassurance to counter grandma’s voice of doom and gloom. It is likely that you need to learn a new language with which to talk to yourself.
It’s Not Really A New Language
Lesson 4: PEOPLE WHO LIVE IN ANXIETYVILLE ARE GOOD PEOPLE.
We may not have always done everything right and we may have erred or rebelled along the way, but fundamentally, we are a decent group. We are sensitive, caring, kind, helpful, compassionate, and supportive to others. Unfortunately, we are not typically that way to ourselves. We give others the benefit of the doubt; we give ourselves doubt. We give others reassurance; we give ourselves agida. We give others encouragement; we give ourselves discouragement I observe this over and over in people who live in Anxietyville.
My colleagues and I have described these tendencies by saying that we speak two languages. One, we call Objective Positivism. It is the language of the healthy and kind parts of us. The other is Subjective Negativism. It is the language of our youth. It is filled with “grandma’s speak,” along with much negativism. It is the language of self- doubt. Here are a few examples:
To others if they’ve gained some weight: “You will be fine. You are going to lose the weight. You are strong and disciplined. You’ll exercise and change your diet and lose the weight and more. You look great! (Objective Positivism).
To SELF if you’ve gained some weight. You are a fat pig, a whale, and an elephant. You have no control-LOSER! I’m disappointed in you-again. Just keep eating junk. Get a life. You look like crap. (Subjective Negativism)

To others if they’re lost their job: “ Don’t worry. You’ll find a new one and a better one. They didn’t appreciate you anyway. Your boss was a jerk. You are a good worker- committed, loyal, and motivated. It was their loss. (Objective positivism)
To self if you lost your job: Failure! Loser! Stupid Idiot! Can’t do anything right. Who wanted to hire you anyway? Probably be homeless soon. It was all your fault. You saw it coming and did nothing. Get a life (Subjective Negativism)
I could go on, but I think you get the drift. We browbeat ourselves unmercifully. We rage at ourselves like an abusive parent. We torment ourselves unforgivably. We show no compassion and seem to have zero tolerance. Self-hate is alive and we are not so well because of it. Yet, we don’t talk that way to others.
Subjective Negativism keeps us in Anxietyville. We are not losers and we need to lose this language. It is old, outdated, and wasn’t accurate to begin with. Objective positivism is the language of today. It is based in a realistic assessment of who we are. It offers a voice of optimism and reassurance during tough times and a voice of affirmation during good times. It can disappear in a flash under stressful conditions. Your challenge and our work in therapy is to have you speak the language of objective positivism to yourself on a reliable basis. You deserve it as much or more as others to whom you speak that very language. Work on it. Catch yourself in subjective negativism (as when I called myself a stupid idiot for dropping my keys in a hard to reach place in my car) and laughingly switch to positivism. It is a key part of your ticket to Tranquilityville. It will take you over the wall of terror once and for all.
It’s Dumb, But It’s Devastating
Lesson 5: ANXIETY AND PANIC ARE AN AFFRONT TO OUR INTELLIGENT, RATIONAL PARTS.
We know it is all silly and ridiculous to be afraid of this or that. We can present clear and cogent arguments as to why this or that is not really dangerous or anxiety provoking. The social phobic knows they can communicate at work or school. The agoraphobic knows they can leave their homes, go to malls or restaurants and navigate the world effectively. The panic driven person knows that their trigger points aren’t worthy of worry, let alone panic. Unfortunately, that knowledge does not help.
The anxiety/panic reaction is automatic like our knee jerk response. No thought is required or for that matter processed. All the rational arguments fall flat as anxiety mounts and panic erupts. Panic is like a volcano inside us. It erupts for no obvious reason or for an obvious reason that is not an obvious cause. It just happens at and to us, leaving us feeling helpless, overwhelmed and needing to flee.
By association, we rapidly learn to avoid the trigger points of our panic. Wherever of whatever caused it to blow, becomes something to avoid. Slowly, but surely our safe

space becomes less and less. Little by little, anxiety and panic rob us of our freedom to choose and to be mobile. The Jewish grandma wants us to live in limited and bounded space. Her thinking is that the more contained we are, the safer we are. It is also that the more we are distracted and in panic pain, the less likely we are to do something to put us in harms way. She’s got that right. Panic people are good little doobies.
If knowledge and wisdom don’t help, how do we get out of our panic based plight you must be asking? Via our healthy adult voice of choice is the answer. The current system is built on what my colleagues and I call the Trigger Point Habit point formula. It means that:
Trigger Point (TP) =Habit Point (HP) = Out of Control
This formula is always true. It applies to hurtful habits and behaviors (over eating, drinking, drugging, gambling, etc.) and to hurtful thoughts and feelings (anxiety, panic, depression, self-negation, etc.) In all cases some “out of control” issues occurs that is self-defeating and destructive. When I went through anxiety and panic in the ‘70’s my TP’s were people based. It ranges from having to teach a graduate level class to giving a talk at a PTA meeting to answering the door on a Saturday night to sitting and watching a football game at the Orange Bowl with my young sons! These and many, many other TP’s automatically led to HP’s of grand panicked proportion.
In a sense, the TP=HP formula summarizes the human dilemma-It is what get’s us stuck in our fears and our beer-often both. It is what gets us stuck in the blues of depression of the reds of whites of drug dependency. It is also what causes people in authoritative or public eye positions, to get caught with their pants down and their legal bills up. It is dam and Eve in the Garden all over again. Wherein lies hope for our panic or our protection from all that takes us to dark and hurtful spaces? It lies in our healthy choice points coming from our adult self. Here is the corrected formula:
CP In
TP = HP = Out of Control
When your adult voice can speak in objective positivism it can reassure your child and your Jewish grandma. Their thought patterns are habituated to override reason and rationality and just react. Choice points interrence and bring logic, reason and knowledge to bear in a powerful way. Eventually, choice points replace Habit Points and themselves become automatic and habituated.
During my panic years, anticipatory anxiety way very high. Anything new or different was a TP. Flying was freight with before, during and after anxieties and panic. Being in a plane felt stuck and out of control. The trip was a TP causing many HP’s of panic. Once I had vented stored up cess, understand the origins of my panic and anxiety and strengthened my adult voice of choice. I was able to “move freely around the cabin” and my life. Anticipatory anxieties eventually ceased and getting on a plane was just something you did. To get from point A to point B. This CP of healthy and rational

processing replaced a five plus year HP of discomfort, anxiety and panic. These transformations have lasted for more than twenty-five years.
The same is true for you. Once upon a time you enjoyed comfortable and healthy CP’s of all kinds. It may have been five, ten, or twenty plus years ago, but you can still reclaim them and move back to Tranquilityville. Believing that will help us get there.
Always Dard before Dawn
Lesson 6: ANXIETY AND PANIC FEEL LIKE THEY WILL NEVER GO AWAY.
This is a consistent and persistent feeling among panic people. The noose around their lives feels thick, tight and unyielding. That thought is a trick and a trap and makes these who can’t tolerate stuckness of any kind feel woefully stuck.
I am living proof that even in the “dark ages” of our understanding in the ‘70’s, healing, health, and happier times are available to all. I am living proof that meds are not necessary. My son is proof that for some, meds are very helpful. So too are countless numbers of people who we have helped to exit Anxietyville forever.
Anxiety, panic and phobia are not terminal conditions. They are treatable and resolvable. They do not last forever unless we allow them to. Our frightened child parts and worried grandma parts do try to hold on as long as they can. Ultimately, our healthy adult must rule so that we can escape and move on.
Cess Makes a Mess
Lesson 7: WE MUST DUMP EMOTIONAL CESS TO MAKE ROOM FOR THE REST OF OUR LIVES.
Those with anxiety and panic problems typically have stored a fair amount of not so pleasant experiences in what I have called the cesspool storage center in the back of our mind. Like a computer saving e-mails or other files, our brains store our experiences in some coded fashion. Not so pleasant ones go to the cess pool; more pleasant and positive ones go to our Dam. (See Chapter 3, Getting Back Up From An Emotional Down or Chapter 7, You Have Choices: Overcoming Anxiety, Panic, Phobia.
I created this simple, graphic model to explain my panic to myself. How, I asked, could ole and outdated aspects of my history infect my thirty-year-old self? Why were “old news” items, affecting my present life. Understanding the storage system and our minds less than ideal architecture helped me to understand why I felt as I did. With my Dam down, my pool was leaking and reeking from hurtful and overprotected experiences from my past. My little boy was running wile, while my adult self was struggling to hold on. I was a mess of cess! So are you.
This simple-minded model explains many complex issues. Outer and inner stresses agitate the pool while causing cracks and holes in the dam. SO does alcohol, PMS, or

menopausal hormones, money worries or just about any worries. Panic disorder itself fuels this, as we feel ashamed of our “weakened” state of mind and being. Old feelings of lesser than mingle with new ones in ways that tear at our dam and cause the emotional equivalent of a tsunami in our pools.
One of the problems with our mindly architecture is that it is not as efficient as our bodies. We ingest food. The nutrients are distributed for energy, while the wastes are delivered to elimination centers where urination and defecation keep us clean and healthy. Without them we would die. No such equivalents exist on a mental level. The closest we come to that are in our night dreams, but even that is a confusing dump. When we go to sleep, our dam is recharging after handling a days worth of complex activities. Our cess pool is freed to dance. We call that dance night dreams. That is why our dreams are filled with pieces of today combines with those of years ago.
I believe the primary role of night dreams is to dump cess. Research confirms that those deprived of sleep or of RCM (Rapid Eye Movement) sleep during which all dreams occur experience a synthetic psychotic breakdown which goes away immediately upon being allowed to sleep and dream. Dreams may protect us from total insanity, but are not sufficient to keep us from Anxietyville. Artificial elimination systems need to be established. Where you talk to me or someone like me you are dumping less. When I talk we are strengthening your dam. Unfortunately, it takes some time to get your mind in balance again. Fortunately, therapy works reliably to do just that. My work combines the power of cathartic release (Freud) with the break up of the TP=HP connection via choice (Cognitive-Behavioral).
Finally, beware that less isn’t only from our childhood experiences. It comes at us everyday. Learning to lessen the amount of less coming at you, while simultaneously adding dam grams is what keeps you out of Anxietyville for the rest of your life. A person I’ve assisted achieve that has given up toxic relationships and taken to swimming almost everyday. Being for the less pool of Anxietyville to the swimming pool (or whatever prideful and vomiting activity) of tranquil or reflects an adult voice of choice, instead of the child voice of fear.
Gotta Kick your Own Butt, But Gently
Lesson 8. THERAPY IS NOT ABOUT KICKING BUTT.
Some may practice that style and with some people it may work, but kicking butt is not my thing. Moreover, it typically ends up doing a great imitation of one or both parents, which feeds into hurt anger, which feeds into termination.
While in a psychiatric postgraduate training in New York I had such an experience and ultimately just the analysis. It wasn’t exactly the same as I was not my Anxietyville at the time. The schools self-serving rule was that you had to be in analysis with one of their professors. Talk about conflict of interest. My analyst badgered me to conform to his beliefs. I had to lie on the couch, free associate and listen to him and his

double standards. For example, when I accidentally knocked a pillow off the couch it was my hostility. When he spilled a soda over on the table above my head, it was an accident. It was transference from hell.
During my stay in Anxietyville I was also in analysis. While better, it was still a cold. (E.g. “your times up” mid sentence), sterile feeling with me doing 98% of the talking and he grunting, groaning, and unhappy Freudian style. I learned from that the importance of talking to the person talking to me. I learned the need for appropriate reassurance and encouragement. I learned better results occurred when the therapist was human, than when she/he was cold, indifferent or hostile. In your face, kick your butt confrontation is not, in my view, therapeutic except perhaps in addiction work. Gentle, sensitive souls live in Anxietyville. They need to confront reality, but slowly, supportively and with great sensitivity to their own sense of powerlessness.
Eventually, your healthy adult self will tire of the powerless feelings. Anger and resentment will turn to rage. You will channel that high-octane fuel and kick your own butt into shape. You will say, “I don’t care – I’m going. I’ll handle it. It won’t kill me. (It might hurt a bit, but it can’t be any worse, that’s how I feel now. “Let’s roll!” With courageous words flowing you embark upon the road learning Anxietyville. You will know when you are ready to move in that direction. If we push you prematurely, you will not succeed and you will be angry with us both. Even from that point it will take a while.
Do not underestimate the power of the resistance both to sabotage the best of your intentions. As I have said, parts of you want to keep you stuck. Signs, any signs of progress, are seen as a threat and those parts don’t up the one to keep you in your place. That is why even simple encouragements or basic reading often don’t get done until your healthy adult voice of choice can override them a push forward.
Keep On Moving On
Lesson 9: THAT IS NOT TO SAY THAT YOU SHOULD SIT ON YOUR BUTT WAITING FOR A SIGN FROM ON HIGH TO MOVE FORWARD.
Push yourself slowly and gently forward. Nudge not nudge yourself, read, do relaxation, go a little further in some area then last week, seek out a support group, go online to get information, take an online class till you can get to an ???? (page , find distracting activities that fill time and short circuit over time giving confide in a friend or relative, exercise moderately, put yourself in tranquil settings, in reality and in your mind, use affirmation (I call them vitaminds).
Work on healing old wounds too. Make peace within yourself. Depersonalize that which is not yours to own. Challenge historical hurts with a more realistic assessment of your healthy adult self. Do not tarnish that assessment with panic and anxiety issues. If you are a kind, caring, intelligent person then you are that in or out of

Anxietyville. The sooner you can acknowledge that, the sooner you’ll get the hell out of that Hell.
Talk to your parents or others who hurt you. If you can’t, write “not to be mailed” letters vomiting hurts and angers. Embrace yourself. Say, “I like me, I love me” in front of a mirror. Say it even if you don’t believe it until you finally do. You are worthy of love and self-acceptance despite your perfectionist strivings and hyper self- ironical nature. Work on being as compassionate toward yourself as you are toward others. You deserve it.
There are more things you can do for yourself. Keep a journal, which is really a healthy vent. Keep a dream diary as well; watch or listen to funny shows. Laughing is proven to heal mind and body ailments. Avoid reality TV and overdosing on the sad news of the day. Read light books that take you away from Anxietyville and self- analysis. Leave the latter mostly for therapy where it belongs. Otherwise you will wear yourself out. Listen to relaxing music or dance around your house when no one is around.
As you can see there is much you can do on your own to move yourself forward. It will help you to get further along on your journey. Funny enough I’ve met many people who chose “more of the above” and still left Anxietyville. Granted it took a little longer, but the end result was the same. So it is your choice, take action or be passive. Action potentialities therapy, but in the long run therapy potentialities you. Finally, the likelihood is you will do these things, as you are closer to leaving Anxietyville. The person who swims five plus times a week talked about doing that for a year. Finally, being able to swim reflected a healthy adult, self, able to choose healthy alternatives to anxiety, pushing the person closer to Tranquilityville and they’re being able to move permanently.
The Myth of Perfect Goodness
Lesson 10: IT IS TIME TO CHALLENGE THE HARD MARKING PERFECTIONS WITHIN YOUR SELF.
That part of you does much damage. It demands unreasonable performance standards. It frets and worries about that which is not worry worthy. It can make an otherwise capable, competent person feel woefully inadequate and inept.
People who live in Anxietyville can question the most basic issues. Can I walk into a meeting? Can I introduce myself by saying my name? Can I cook a meal, host my family, travel comfortably, drive, go outside, etc. The simplest of activities can become torturously challenged by a standard that is unreasonable in its demands. That we can walk and talk and do many other things does not quiet this voice of self-doubt. A helpless child in an adult body still feels easily overwhelmed and painfully inadequate. Just as I wrote that a toddler waddled out onto the beach. He tightly gripped Mommy and Daddy’s hands as he hesitantly moved along. Explaining a less than solid terrain. For

those of you in Anxietyville that’s “who you be.” Except the likelihood is Mommy and Daddy’s hands are not really visible hanging on to yourself! (See chapter 5, the Myth of Perfect Goodness, Getting Back Up from All Emotional Down.
Self-talk is a critical component of your recovery. Catch yourself dissing yourself and correct it with the language of objective positivism. Lower the hands just a bit in your personal perfectionistic marathon. Evaluate whether your demands on yourself are fair and reasonable. Ask if you would hold others to such high standards. It is likely you would not. In that event reduce the pressure. Cut yourself some slack. Look for areas in which you can simplify your life and the TP’s to stress and amidst. Be your own cheerleader, instead of a door leader. Catch yourself in perfection mode, chuckle and move to higher ground that will take your dream to higher ground as well closer to where it needs to be.
With a more affirming voice, chose to try to go to that meeting or host a few members of the family. Do some things to validate yourself when you can. Give yourself an A for effort and don’t rate yourself for how much anxiety you feel. Know that with repeated exposures fair, supportive reactions your anxiety will lessen and your confident voice will begin to reappear.
These are the basic lessons for those in Anxietyville read this over as often as you need. Important to know is that with time, patience and self-support you will emigrated to a more peaceful, confident, positive and tranquil state. I guarantee it! Truth be known I never believed it would happen to me. Reassuring voices were non-existent in the 70’s. If I could I merge whole and stay that way though all kinds of stressors during an age of ignorance, so can you in this much more informed and helpful time. Keep a bonding faith in yourself, even at a time when little exists within you. It’s really all you need along with a capable, caring therapist who knows what it’s like to live I Anxietyville and to know how to escape forever.


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