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Nov 11

Little Lessons About the Big Problems Caused By Anxiety, Social Anxiety, Panic Disorder and Agoraphobia | Ch. 11 – 20

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The language of Subjective Negativism is articulated by our Voice of Self Doubt (VSD). It is where all the “what if’ questions arise, commingled with our sense of inadequacy, inferiority, and helplessness. The VSD lacks power and is caught in a vicious spiral of negativity and child based thoughts and feelings. It is what keeps us stuck in our prison of fear, entrapping us with multiple maze-like labyrinths that block our path- TEMPORARIL Y!
The language of Objective Positivism is articulated by our Voice of Reassurance (VR), Voice of Affirmation (VA), and Voice of Determination (VD). These voices negate “what if’ questions and ultimately defuse them into nonexistence. As opposed to the VSD, these voices amp up our power. They come directly from our healthy adult voice ofchoice. It is our “get out ofjail free” card that takes us back to the comfortable person we used to be. As we reclaim these strong lion-like voices we reclaim our self, our identity and our esteem.
In the VR we are as supportive and understanding of ourselves as we are to others. We give ourselves the benefit of the doubt instead of self-doubt.
In the VA we validate oursclves and our adult abilities and capabilities. We acknowledge all we have learned in our journey. We remember all we have accomplished. We pay tribute to all the challenges we faced and overcame. The VA says, “You will be OK. You will get past this. You shall overcome.”
It is a realistic and credible voice based upon our qualities, characteristics, knowledge, and power. We accept our limitations, but we don’t see them as all we have. We are winners, not losers, achievers not failures, problem solvers not problems. Furthermore we are wOlihy of compassion, understanding, support and most importantly, acceptance. We are above all else eminently loveable. Ofthat there is no room for doubt.
The VOD awakens a force within us that has been asleep at the wheel. It simply says, “I’m tired of anxiety and panic running and ruining my life. It is enough already. I will do everything I can to escape. I will stay the course. I am determined to return to comfort.” In this voice we come to therapy, read or reread books, go to a support group, check out meds, find religion, and do whatever else we need to do to fight back to regain our identity and our sanity. This is a voice fueled by anger and fmstration. It is a Clark
Kent telephone booth moment of transfonnation into powerfulness. In that moment the exaggerated and distorted fears begin to melt.
Aisle seats, though more comfortable and comforting, are not as prized or as nccessary. Highways, airplanes, elevators, bridges, and overpasses become ways to get to our destination, rather than insunnowltable barriers that block our way and limit our behavior. Traffic jams return to being a pain in the butt, rather than the mind. Social
. engagements become fun instead of dreaded chores. Slowly but surely your VOD joins .with your VR and V A to override Self-Doubt and help you to retum to a more peaceful
and tranquil way oflife.
Pill Power
LESSON 12: TAKING MEDS WORKS FOR SOME, BUT ANXIETY PRONE PEOPLE TEND TO BE AVERSE TO TAKING PILLS OF ANY KIND. I vividly remember my Psychiatrist Anaylst offering me Valiwn to offset my anxiety. That’s all there was in 1973. Just the thought of taking one was enough to cause a Panic Attack. I was and to some extent remain pill phobic. I never read the lengthy medication wanlings of prescriptions for fear of immediately developing all the side effects. On rare occasion when I have a headache, I take one Tylenol, when my wife recommends three. “Are you trying to kill me for the insurance money?” I jokingly ask.
All that said, if I was to have a panic relapse (a very unlikely occurrence) I would definitely try an SSRI (Le.: Prozac, Effexor, Lexipro, etc.) and a benzodiazapine (i.e., Klonopin, Xanex). I recognize that I am saying this in my healthy adult voice of reason. If I was in panic city and Anxietyville, my frightened child voice might keep me from doing that again. The reason I hope I would try is that the Wlffiedicated pain ofanxiety is severe and paralyzing. Though the meds don’t work for everyone, as we all have a unique brain, when they work they work well. Ironically, many swear by meds that others swear at. It is important to try to find the one that works best for you.
IbelieveIwouldforcemyselftoatleasttry. IwoulddothatwithaPsychiatrist,expertin panic problems. I would seek one who was patient, compassionate and understanding of my pill phobic nature. I would at least give it a chance, doing my homework first via the web. I encourage you to do the same. The meds may not help you, but neither will they hurt you in any major way. By the way, watch our for distorted info on the web or elsewhere about these meds promoted by well meaning, but misguided religious zealots.
When meds work they speed up the therapy process. They facilitate your healthy voices and diminish the VSD. They help you to feel the way you are supposed to feel. ‘Tiley enable you to push yourself forward to overcome anxiety provoking Trigger Points. In many ways, a mind on SSRI’s is like a Teflon coated frying pan. The same things that bother you still do. However, they bounce off rather then staying put. They don’t drill down into the core of your mind or tum into obsessive ruminations. They dissipate
rapidly, leaving you to reengage your healthy adult voices and keep moving forward.
SSRI’s do not make you high or cause you to feel buzzed or stoned. In fact, people on SSRI’s consistently report that they don’t feel any different except for the relief they receive. Most SSRI’s take several weeks to build to therapeutic levels. Yet, I frequently observe that brains that have needed serotonin respond rapidly. Recently, a person I help had a positive effect from taking half the therapeutic dose for less than a week. My assumption, given the severity of her Anxietyville experience, is that her brain was
jonesing for the Serotonin.
My encouragement is that you explore this area and determine for yourself if you want to try meds. Truth is you have nothing to lose and everything to gain. Truth is the meds may not help, but they won’t make you crazy, worse or cause you to go out of control. Quite possibly, they can make a significant difference in how you feel and behave. If part of your problem is an inherited or a stress induced chemical imbalance, then having a chemical balancer might just be a very helpful and empowering thing.
Superstitious Behavior
LESSON 13: ALL SUPERSTITIONS ARE FALSE. People carry around many superstitious beliefs that influence their thoughts and actions. This lesson states that thirteen is not an unlucky number, despite the many buildings that go from the twelveth to the fourteenth floor. B.F. Skinner did much research to show that even animals could succurnb to superstitious beliefs based on associations that had no causal connections.
My first panic attack occurred in a Chinese Restaurant in Westchester County, NY. My brother-in-law still believes it was my way of avoiding paying the check. My attack hit after four bites of the pistachio ice cream. I went running out of the restaurant like a wild man, leaving him to pay. Superstition by association has caused me to avoid pistachio ice cream or pistachio anything and Chinese Restaurants all these years later. It’s OK,because none were high on my list of important experiences. My brother-in-law has
avoided having dinner with me all these years, still fearing he would have to pay again. We are all prone to superstitious associations.
What if your panic attack occurred on a plane, in a car, during a staff meeting, giving a presentation, riding in an elevator, or other important experience? We cannot allow the fearofan”instantreplay,”topreventyoufromreturningtothesceneoftheattack. Some associations like mine are irrelevant. Others are intolerable and far too limiting. We want you to have a full range of motion and emotion.
It is important to desensitize and separate the place panic attacks have occurred from the reason they occurred. Though some zones (i.e., supermarkets, malls, planes, highways, etc.) may be off limits for awhile, it is important, if not imperative, that you recertify them as “safe space” again- mostly because they are.
Truth is they were never “‘unsafe” to begin with, even though our minds created that feeling. Though these sites symbolize a sense of “out of controlness” and “stuckness” they were not and are not dangerous or truly scary. They just feel that way. Your
challenge is to see them for what they are, trust in them and focus on the positive benefits they offer. An airplane, for example, is one of the most efficient, cost effective and safe ways to travel long distances. No, we don’t get to pilot the plane. Nor can we exit if we feel nervous or have a panic attack. Thank goodness we don’t get to pilot, because most of us don’t know how. In trained and licensed pilots we trust! Thank goodness we can’t get off as that would become as annoying as riding a bus from Florida to New York, with too many stops along the way.
In sum, keep your superstitious behaviors that don’t cost you much in time, energy, or intrusions. Keep knocking on wood, po po poing, crossing yourself, or whatever else works for you. Like me, avoid egg rolls for eternity. But fight hard to undo those that limit your life. Leave no stone unturned until you can engage in important behaviors and activities that once were off limits. These are too important to be allowed to remain off your allowable list of experiences. Who knows? While you are turning over stones, you might just find a four leaf clover that will bring you good luck.
Adding To Your Confidence and Self-Esteem
LESSON 14: THERE IS A PRIDE BANK AND A SHAME AND BLAME ACCOUNT. Both are important parts of our mental apparatus. Our goal in life is tofi11 our pride bank with many deposits and limit our entries of shame and blame. We don’t always succeed in doing that. Nor do we always evaluate ourselves fairly. Those living in Anxietyville are great at ignoring prideful deposits and exaggerating shame and blame entries. If we kept our bank accounts like we do emotional accounts, we’d· all be
It is important to count all entries and use fair accounting principles. (See “A Self- Administered Self-Confidence Strengthening Program). Too many in Anxietyville see themselves through distorted filters. These promote shame, blame and doubt and limit pride. Anxiety and the limits it imposes make us feel inadequate. That is an understandable, but unacceptable self-evaluation. We are more than our anxiety. We are
friends, workers, partners, parents, uncles, aunts, grandparents, etc. We wear many hats. Despite our limitations, we plug along, do what we can, take our responsibilities seriously andpushtogetoutofAnxietyville. Wedeservecreditforallofthatandmore.
Too often I hear residents of A-ville say, “I just do what is expected. I don’t deserve credit for that.” “Yes you do,” I respond. “You gotta count it all!” Meeting expectations at work justifies a salary increase. It says, all goals have been met satisfactionly. The same is true when our life has become an obstacle course with barriers and detours at many turns. Soon you will be able to “exceed expectations” again. For now meeting them deserves pride bank credit.
Now is also a time to limit shame and blame entries. If you are over drinking or drugging to lessen fillxiety’s bite, now may be a good time to evaluate that and address it. The same with affairs, or other not so prideworthy behaviors. Typically, anxiety and panic attacks straighten people up quickly to rid themselves of hurtful habits. If that has
happened feel proud you contained your shame and blame contributions. If that hasn’t completely happened then it may be time to work on cleaning up your act even more. “Grandma’s” fears of your losing control are based in your potential to do just that. The more you can take charge of your behavior in healthy ways, the less she needs to use anxiety as an emergency brake. Granted her fears and worries may be ridiculously exaggerated and without merit, but they are strongly believed. Your little boy or girl is vulnerable and easily intimidated by these fears.
What is the relationship between the pride bank and the dam and the shame and blame account and tlle cess pool, you might wonder? They are significant contributors. The cess pool is composed of much more than the shame and blame account. The dam is composed of much more than the pride bank. These however, accOlrnt for more than halfofallpositiveandnotsopositiveentries. Theycontributeortakeawaysignificantly, from our sense of self, our confidence and esteem and how good we feel about ourselves. The likelihood is that we wandered into Anxietyville at a time we weren’t feeling so good about ourselves. We weren’t feeling all that adequate, successful, loved, worthy, appreciated, etc. Living there has only added to those not so positive feelings. Moving out demands a more positive view of yourself. Moving out gives you a more positivr view of yourself. That is precisely why, “YOU GOTTA COUNT IT ALL!”
Panic & Relationship Pain
LESSON 15: ANXIETYVILLE RESIDENTS OFTEN LIVE IN TROUBLED RELATIONSHIPS. This is not always true, but occurs often enough not to be coincidental. Anxiety and panic are often related to serious relationship problems. The panic person consciously or unconsciously feels stuck in anunfulfilling, abusive or otherwise unhealthy marriage or live-in partoership.That stuck feeling makes symbolically stuck situations anxiety provoking.
The purpose of the anxiety is to keep the person from leaving or acting out in some fashion. Often times, the romantic and intimate part of the relationship has eroded or evaporated. The quality of communications is low and there is an emotional disconnect. Anxiety sets in as flUstrations mount and fantasies run free.
Think “Jewish grandma” here. What better way to keep the frustrated partoer in the game than to zap them with thunderbolts of anxiety and panic. Not likely to “lUn away from home” or have a go with the pool man or neighbor lady when your mind is full of
junk and your heart flutters with palpitations for no reason. Can’t stray too far when you can’t comfortably go very far from home base. In these instances the prison of fear is unconsciously created to be just that- a jail cell.
If these comments apply, resolving relationship problems is key to your recovery. Couple work is, ifnot more, as important as your individual therapy. Both need to occur. What if there is no hope for the relationship? Perhaps t.here is too much water under the proverbial bridge. Or, too much damage done, no motivation for change in your partner
or other factors all make for un-resolvable situations. It is hard to generalize as each situation is unique, but here are some choices:
• Bite the un-tasty bullet of divorce. Strengthen your independence, pump up your dam, accept the harsh emotional, financial and familial consequences and deem yourself worthy of love and better times. Realize that even solo is better than
feeling so low.
• Accept that this is as good as it gets, reassure yourself that you won’t do anything wild or crazy, realize you are committed for better or worse, find meaningful friendships and/or activities to fill some of the void and accept that you don’t have to live in Anxietyville to trust yourself again.
• Beg the issue for the moment and put it on the back burner. For now you are staying put. What happens down the road nobody knows. Your primary goal is to “get out ofjail.” Convince grandma you don’t need it and don’t want it. Help her to see you will be fine no matter what. In your strengthened adult voice you will make wise, prideful, protective choices. You will also do everything you can to contribute positively to your present relationship, but you will work hard not to
let it drain your pride bank or add to your shame and blame account.
• Most important, if you live in Anxietyville and live in a problem relationship explore the connection. If it seems to be relevant find ways to address the problems. If those are blocked look for reframing the issues within your self so you can reclaim your freedom and mobility. Non criminally minded people do not need invisible bars to keep them in line or in unhealthy relationships. Wise
. and prudent choices will protect you far more comfortably than living in Anxietyville.
Neurosis vs. Reality
LESSON 16: THERE IS A SIGNIFICANT DIFFERENCE BETWEEN ANXIETY TIED TO REALISTIC ISSUES AND ANXIETY TIED TO NOT MUCH OF ANYTHING. Those of us prone to anxiety and panic tend to lump all of our reactions into the same unhealthy category. Actually, anxiety wears many hats and has many purposes. It can be motivational, (e.g. I have a test so I better study), inspirational (e.g. I’m worried about , so I’ll say a prayer), perspirational (e.g. I have to have surgery and I’m scared), or sensational (e.g. I am about to be indighted and the headlines will be ugly). As we who live or have lived in Anxietyville know, it can also be much ado about nothing much at all
Let’s all understand that we have reason and right to have fears, worries, gut grinding anxiety, and panicky feelings about real life drama and trauma. Anxiety is a natural reaction to all kinds of scary stuff from nightmares to horror flicks to horrible happenings to the anticipation of such. These reactions do not mean you are slipping, having a set back, returning to Anxietyville and panic street. They mean you are human, prone to
anxious responses to fearful situations, which in many instances will actually be a help instead ofa hindrance.
Anxiety and panic that have no basis or are based upon highly exaggerated and distorted reactions clearly fall into the neurotic category. Though this is a word I’m not fond of, it fits here quite well. Panic attacks occur primarily in pretty safe spaces. Supermarkets, malls, restaurants, stadiums, and the like do not a terrorist attack make. Tell that to our inner terrorist. S/he terrorizes us in pretty neutral places. Though we have developed highly influential anticipatory angst laced with enough “what if?” questions to sink a ship, it is all based upon an illusional, delusional system of our own design. The magical thinking of our child parts weaves a pretty tangled web.
It is that web that therapy takes aim at little by little. We bring reality and rationality to bear by strengthening the adult voice of choice. Preprogrammed, anticipatory anxieties give way to a clearer more accurate view of ourselves and our lives. A Voice of Reassurance replaces the Voice of Self-Doubt and eliminates all the “What if?” questions. As a lady used to say in a support group I facilitated to “what if?” questions,
“SO WHAT!” It took her awhile to get there, but once she did she never looked back. The same will be true for you.
A final note on this subject! I always say, give me a neurotic based anxiety problem any day, compared to a reality based one. The former is more easily modified than the latter. The neurotic problem isn’t what it appears to be and lends itselfto alteration. The reality problem is what it is, which often lends itself to ongoing anxiety. As a therapist I can be far more helpful with neurotic compared to reality based problems that bring people to see me. Like a Dentist, a therapist can extract the teeth of a neurotic problem. Often, very often in fact, reality bites and there’s not all that much one can do to lessen the pain.
Been There, Done That
LESSON 17: THE ONLY PEOPLE WHO CAN UNDERSTAND YOUR PANIC PAIN ARE PEOPLE WHO HAVE LIVED THROUGH IT THEMSELVES. Those who’ve never lived in Anxietyville can not relate to your experience. TypicaIly they equate it to stress, relate it back to themselves, process us as nuts and give dumb advice! Take Vitamins,” “Get more sleep,” “Slow down,” “Stop worrying so much,” “It’s all in your head,” Dah! Well meaning as they are you will be tempted to punch them out. Don’t do it. That will only bring reality based anxiety.
Stop expecting people to understand. It is almost, ifnot down right impossible, to do that if you haven’t lived that. Who can comprehend that waiting in line in a supermarket can be so upending that you have to abandon your cart and flee? They will equate it to,
“Y eah it’s frustrating and aggravating, especially when you’re in a rush, but you just have to be patient.” They don’t get that it has nothing to do with time and that it’s not about frustration and no amount of patience will prevail. It’s about sheer, unadulterated panic as if being chased by a cold blooded killer with a 12 inch knife.
Understand that those of us who have lived in the irrational, but powerful space of Anxictyville are part of a unique group. We have been given a special experience that demonstrates the absolute power of the human mind. We have been given an opportunity to learn some important lessons about ourselves, others, and the world in general. We have been given a taste of the mind’s ability to lose itself temporarily and an opportunity to regain our previous self in an even more positive way. As a result of this experience you will be stronger, wiser, and much more able to manage yourself and your life effectively. Upon leaving Anxietyville you will be taking with you treasures of understanding and insight that will positively influence you for the rest ofyour life.
Still Crazy After All These Years
LESSON 18: YOU ARE NOT NUTS AND WILL NOT GO NUTS. This is as bad as it gets. Many who live in Anxietyville fear they are crazy or will go crazy. Nothing could be further from the truth. First of all crazy and nuts are slang terms. They need to be eliminated from your vocabulary. Second, people in Anxietyville live too much in reality-so much so that they exaggerate it. They fear failing in some unlikely way and they fear fear for very understandable reasons. Fear hurts and creates painful experiences. It is healthy to want to avoid failure and pain.
More severely disturbed people have psychosis. These illnesses destroy reality to an unrecognizable level. They cause people to hallucinate and have delusions. Reality testing is limited Of absent. They may feel anxious and appear agitated, but not by supermarkets, malls or the like. They believe they are being persecuted by the CIA, hunted by aliens, running for president or Elvis himself. Their thoughts are absurdly twisted. They are not similar to people in Anxietyville. They are not self-conscious or inhibited. They will tell anyone their plight. They are not able to commlmicate in a rational or coherent fashion for very long. Much of their talk is not true, yet they believe it is. Most of the time they are beyond the reach of talk therapy. It is sad to see the
extent to which the mind can fall and fail. It is not going to happen to you. If it was it would have already happened.
Emotional illness is not progressive. We don’t deteriorate from neurosis to psychosis. We stay where we are till we get better. Though I often felt as if I were losing it and going off the deep end, I never did. Neither did anyone with whom I ever met. Neither
will you. Focus on getting better and don’t worry about getting worse. With time, persistence, and support you will exit Anxietyville, never to return. Unfortunately, the likelihood of leaving Psychosis is extremely low, although even there, modern meds and unique treatment can make significant differences.
Seeking Out Support
, … , .,
times even before anxiety overtly intruded into our lives. Anxiety and panic significantly add to those feelings.
In addition, we feel ridiculous, dumb, and a little crazy. Hard as people try they just don’t get it. They unintentionally say hurtful things and make us feel worse. Try explaining why you can’t comfortably walk in a mall or eat in a restaurant to Aunt Sue, Grandma, or Jim on your bowling team. How about your buddy with whom you go to football games or your friends at the gym. Fagettaboutit! But not so fast.
I told no one when I went through panic disorder, but my wife and mother. Again, how do you tell someone you have something that doesn’t yet have a name? In addition, as a new psychologist in town my stigma was squared. “Hi, I’m Bill Penzer. I’m the new shrink in town and I’m in psychoanalysis three times a week for Neurasthenia. Would you like to make an appointment so I can help you with your problems?” I don’t think so!
Today’s world is different. Everyone knows anxiety, panic, phobia. Many have been through it or know someone who has tllese problems. While it is still hard for people to understand, it is unlikely anyone who cares about you will truly think less of you. Realistically, many people will think more of you for being able to share personal issues. More importantly, it is a step toward caring a little less about what oilier people think.
This is an important modification that actually facilitates your escape from Anxietyville.
Yet another advantage to being more open about your situation is that it helps you to accept yourself despite your anxiety. When we go through anxiety it consumes our total identity. In the 70’s I was not a husband, failier, therapist, teacher, though I wore all of these hats. In my mind 1 was a panic attack in progress or waiting to happen. My whole selfwasfixatedonanxiety. Iobsessedaboutitcontinuously.
I wish someone encouraged me to sec myself as much more than just my problem. I wish the times were as they are now tor me to share my situation, so I didn’t add to my anxieties by having to hide iliem while being terrified someone would See them and “out me.” I lived in ilie closet of Anxietyville. I’d like to believe in today’s world 1 would come out. I could see myself saying, “I have high anxiety and panic attacks. It’s hard for me to do what I used to do and feel comfortable. I am fighting it in every way I can in therapy. 1 am confident I will get past it and get back to myself.” I can’t imagine
anyone having a negative reaction to that statement.
All this said, I can easily understand your reluctance to sharing any of this. I can think of a variety of situations where it would not be appropriate to open up. I leave it to you to sort it out for yourself. Talk about it in therapy. Experiment being more open in a nonthreatening situation. In either case, work to not allow your anxiety to blemish or overwhelm your sense of self In addition, you are much more than your anxiety. You
are, in all likelihood, a kind, intelligent, analytical, caring, hard working person. Feel pi’oud of all that and more. Feel upset, not inadequate about your TEMPORARY anxiety.
In the 70’s there were no support groups for panic and anxiety. How could there be? The only one who knew about it was Claire Weeks and she lived in Australia. I didn’t discover her books until much later. In reality, except for AA related groups, there were no support groups for anything in the 70’s. Ignorance and a “sounds of silence” mentality, does not make for an understanding of what or how to provide support.
The 80’s began a renaissance of information, understanding and communication which ushered in supports of all kinds. My counseling center offered many including a free support group for panic and anxit-i:y. My co author o f Y ou Have Choices and 1 facilitated that group on Monday nights for many years. It helped people “to have” a safe place to meet others similarly engaged in escaping from the prison of anxiety.
It was helpful because it offered help and hope. Practical suggestions filled the air. Other’s descriptions of their plight helped everyone see they were not alone. This is in stark contrast to how I felt in the 70’s. 1 was trapped on an island all by myself- a friggin’ freak! In support groups we lean we aren’t freaks at all. We are sagging soul mates, all sharing a syndrome that causes much suffering. We learn that it is a syndrome for which relief resolution strategies exist.
Support groups are also safe space. When just about everyone in the room has “been there and done that,” it eases our self perceived stigma. It enables the social phobics to sit calmly in a group and venture a comment now and then. It enables those who can feel “stuck” in a meeting to know they can get up and walk out for a few minutes. Armed with that knowledge they won’t have to leave. Knowing there is a back door takes away
the need to use one.
While being a fan of support groups, I realize, like with meds, they are not for everyone. That’s why we put an on going support group dialogue and cOlTelated exercises in every chapter of “You Have Choices..”. Readers can vicariously experience a group in the comfort o f their homes.
I do encourage you to try a meeting or two to see for yourself if it can be helpful for you. The only support group I am aware of meets in Plantation, every other Monday night at
the Central Park meeting rooms. Call Ronnie, a recovered anxiety/panic person who has been graciously facilitating these meetings. Her number is (954) 584-9540. Check to see if there are any in other locations by calling your local Mental Health Association. There are probably many on the Internet as well.
To Tell or Not To Tell That is The Answer
People vary, but most are reluctant to divulge their situation to family, co-workers, friends, etc. There is a stigmatizing feeling that accompanies anxiety and panic. We understandably feel embarrassed, weak, lesser than, and inadequate. We felt that way at

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