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Questions and Answers 2
Dissociation..everything
is unreal
Q. I
do have panic attacks, but before they start I get a feeling
that nothing is real, including myself. I sometimes feel as
if I am standing behind myself and it is really frightening.
I can also feel really dizzy which only makes everything
worse. I do panic, but I panic as a result of these
feelings. No one seems to understand what I am saying. They
think that it is all part of the attack, but it isn't. Stop
these unreal feelings and I won't panic.
A.
The research on Dissociation is now speculating that some
people with Panic Disorder, Dissociate first and then panic
or become anxious. A theory we, again, are in complete
agreement with.
Another word for Dissociation is
Self Hypnotic trance. When people Dissociate they get a
variety of symptoms, including 'out of body' experiences,
not feeling real, seeing their environment through a white
or a gray mist, stationary objects may appear to move,
tunnel vision, sometimes they may feel an electric shock
move through the body, or a 'whoosh' of intense energy. It
is quite easy to induce this state in people who are
vulnerable to them. One of the easiest ways to induce this
state is by staring.
When people are driving, they stare
at the road ahead or sit and stare at a red traffic light
and without warning they get a number of the above symptoms.
It can also happen watching TV., working on a computer,
reading and many people report fluorescent lights also help
to induce this state. The symptoms are not harmful in
|
themselves and once people can see how they
are doing it, they lose their fear of them and some people report
they now actually enjoy it when it happens!
If you are not eating properly and/or not
getting enough sleep you become more vulnerable to Dissociation. The
American research is showing that many of us can enter a Dissociate
state within a 'split second.' Recent research is showing that some
people can feel quite dizzy or lightheaded when they dissociate and
the fear of what is happening to them helps to hold them in that
state.
I have been working with this theory of
Dissociation with very successful results and I feel it is the major
cause for a large sub group of people with Panic Disorder.
Dissociation
is triggering the panic attacks
Q. I am
someone who suffers from panic disorder and generalized anxiety.
Your theories on dissociation and how these detached/spacey feelings
trigger panic attacks really struck a chord with me. Dissociation is
one of my biggest symptoms. I am currently taking a drug called
clonopin to control my panic attacks. In general I am more relaxed,
however, it does nothing to help the dissociation. In fact, I would
say the drug makes me feel more spacey/bewildered and detached. Now
that I realize this is a major panic trigger, is there anything I
can do or tell myself while in this state to halt my panic attacks?
A. We
have found over the years, dissociation is playing a major role in
spontaneous panic attacks. Those of us who do dissociate have had
this ability since we were children, although many of us have
forgotten we did it as children. It seems some of us 'grow' out of
it but when as adults we experience major stress and/or are not
eating or sleeping properly, this ability is activated once again.
The major way we do this during the day is by staring. Either out of
a window, at the wall, TV, computer, book etc. Staring can induce a
trance state and most of the dissociative 'symptoms' show the trance
states we can reach are quite deep. Fluorescent lighting also
appears to be a cause for the trance states. The research on
nocturnal panic attacks shows they happen on the change of
consciousness from dreaming sleep to deep sleep or deep sleep back
to dreaming. The same way as we can change consciousness during the
day when we induce the trance states.
The essence of all of this is to be (a) aware of how we can induce
these states during our normal daily activity and why they happen at
night, and (b) lose our fear of them so we don't panic.
I dissociate quite a bit, but now I don't panic. I am simply aware
of how easily I can do it. If I begin to get the sensations of
dissociation, depending on what I am doing, I'll either break my
stare/concentration or let it happen! Needless to say I don't let it
happen while driving, I simply break my stare. Sometimes I will say
to myself, 'Not a good time to do this' or words to that effect.
We teach people why there is nothing to be frightened of by this
ability and that they are not going insane. After all, we as
individuals are proof we don't go insane. If that was going to
happen it would have happened to us a along time ago!
We also teach people to become aware on a moment to moment basis if
they need to, of how it happens and how it can happen so easily.
When people can see this, we teach them to work with their thinking
and not buy into the panic/anxiety thoughts, 'What's happening to
me'...'I'm going insane' etc. We all put ourselves under more stress
by the way we think about our symptoms. This only makes us more
vulnerable to it happening. The harder we resist it, the worse it
becomes.
We teach people to break their stare by blinking, moving their head,
their gaze etc, let go of their thoughts and to get on with what
ever they are doing. If they are still anxious or feel as if they
may panic, we teach them to let it all happen and not buy into it
with their thinking. With practice people can get the dissociation
and the attacks down to about thirty seconds with no residual
anxiety or fear.
Meditation is also a great way to desensitize ourselves to the
various trance states plus a great way to practice non resistance
and working with thoughts.
Have you spoken to your doctor about your medication? The increase
in symptoms may be a side effect.
A
"problem" eating in Social Settings...
Q. I've
got this "problem" with eating in front of other people. I
have no problems dealing with people, but when it comes to a meal
(like a Christmas gathering at work/home) the symptoms starts. I may
feel hungry 30 minutes in advance of the meal, but when it closes up
to 5 minutes it starts. I lose my hunger and I get all dry in my
mouth, my stomach starts to become funny and just continues from
there. I don't want any food. I've overcome the problem with reading
in a magazine/comic or watching television, it's only when you sit
there, nothing to do but eat the symptoms appears. This is of course
a problem which isn't really funny to have. And the Christmas dinner
at work, will probably not go very well. You can't actually sit and
read a comic with your boss and everything. We're going out on a restaurant,
so it would be even more silly! What can I do?
A. I
would say you are experiencing a form of what is called Social
Anxiety (of course you would need to talk to a Health Professional
to get a diagnosis). It isn't a very funny "problem" to
have. It effects your life in a detrimental way. There are a few
strategies you can use to assist yourself (at least in the short
term). Ultimately, you may need to look at going to a Clinical
Psychologist who does Cognitive Behavior Therapy to sort out the
inner dynamics of the problem.
The first part is to practice what is
called relaxation techniques. This will reduce the amount of anxiety
that develops. We teach a form of meditation that is very effective
in reducing the anxiety levels and also aids in the cognitive
(thinking) aspect of the anxiety. It would be very beneficial for
you to contemplate starting a meditation practice. It will help in
all areas of your life. On the day, or even the lead up to the
dinner with other people, you can use the following techniques:
1. At the first signs of anxiety - hold
your breath (not a deep breath, just a normal breath) for 5-10
seconds. When you reach the 5-10 second mark, breathe out and say
the words "relax" or "let go" to yourself in a
calm and soothing manner (as if you were speaking to your best
friend or your own child ... very kind and caring). Then breathe in
for 3 seconds and out for 3 seconds and repeat this as much as you
wish. Say the word "let go" to yourself every time you
breathe out. Breath in smoothly, not forced but gently. At the end
of each 10 breaths in and out, hold your breath again for 5-10
seconds and then continue breathing. Continue in this way until you
want to stop. Breathing in this way will release and let the anxiety
to flow. The problem with the anxiety is that we tense up against it
and in effect hold it in our body. This leads to the increase of
"anxiety" symptoms and the spiral to what you were
describing. You can do this anywhere without anyone knowing you are
doing it. If you feel more comfortable, you can just excuse yourself
and go to the bathroom and do it in privacy. The important part of
this is to start to recognize when the anxiety starts to effect you.
To become aware of the initial signs of anxiety.
2. On the day I would recommend a
meditation session, in the morning as you wake up to release the
built up anticipatory anxiety that has accumulated. Anticipatory
anxiety is the anxiety we accumulate when we "think" about
the "Oh nos" and "what ifs". The thoughts that
say "I don't want to do this" and "Tomorrow is the
day" etc. You know what I mean. We sit and worry about the
event well before the event even occurs. Every day the anxiety
increases. You have perhaps a couple of weeks before the Christmas
dinner. Now is the time to start to reduce the anxiety. You may find
yourself continually thinking about the upcoming dinner and feeling
anxious about it. This is the power of our thinking. Meditation can
help to reduce this built up anxiety and also helps to learn to let
go of this thinking. If we can let go of the thinking pattern and
the thought train, it will not effect us. (Harder than it sounds)
Meditation gives you the power to do this. But it is your choice.
One way or another, you are going to have to start to work with your
thinking in the coming weeks. Instead if giving those thoughts so
much power, start to bring you awareness back to the present
moment... what are you doing right now and bring all of your
awareness back to that .. if you are driving the car, then drive the
car, observe the trees, the car in front. Whatever you are doing, do
it totally, not do it on automatic and having your mind thinking
about the dinner in two weeks time. If the thoughts come back, then
bring your awareness back to whatever you are doing right now. With
practice you will be able to do this very effectively. It demands
that you WANT to let go of the thinking. There is a lot I can say
here but time constrains.
3. On the day, you can do tension release
exercises. These involve a form of progressive relaxation. Take a
small breath and hold it from 5 seconds. At the same time gradually
tense a chosen muscle group eg. the stomach muscle group. Then
breathe out slowly and slowly say to yourself "relax".
Slowly release the tension from the muscle group as you breathe out.
Every time you breath out after that say the word "relax"
and let the tension flow out from the muscle group. Whenever you
feel a tension in your body, do this exercise and repeat as often as
you wish. Don't tense your muscles to the point of discomfort. It
can be done anywhere. Can use a variety such as - place hands palm
against palm, press down with the top hand while trying to lift the
lower hand; place hands under the sides of chair and pull into the
chair, place hands behind the head and interlock the fingers.. try
to pull hands apart while pushing head backwards into hands etc.
4. The most important aspect is going to be
your thinking. It is your thinking that is creating the situation,
it is your reaction to the anxiety that it is perpetuating it and it
is your specific fears that are the catalyst for the whole scenario.
Those fears can be the "what ifs". Only you know what
these are but many people have the fear of appearing foolish to
others, worry about what other people will think of them, worry that
they will commit a social error, are effected by the opinions of
others, are afraid of making a fool of themselves, are afraid they
will shake in front of others, worry about the kind of impression
they will make. These are common fears for many people, but your
specific anxiety about the dinners ... you will have to investigate
this for yourself. In the end, they are all JUST thoughts. It is
their effect on us that is the difference. Sometimes you need to
work backwards to find out what is the root fear or thinking
pattern. You start to feel the anxiety and then work backwards to
find out what was the thought that catapulted that .. the "Oh
no", the "what if", the fear thought. Sometimes it is
triggered by an image .. eg. people starting to take a seat at the
table is enough to trigger the thinking pattern .."Oh no, there
is no escape now, here we go again" etc. Whatever it is for
you. The thinking aspect is important. Look at the evidence and in
the end, the reality is that this is only going to last for say 2
hours and that is all. Compared to the sum total of your live, if
you know that the dinner will last for a limited time, it is easier
to work with. It is not endless, it is only a small time period. You
have the option of breaks during the dinner. The other thing is that
you say you will have nothing other to do but eat. As I remember
Xmas dinner with my work mates, it is more like a sitcom (TV
program) than TV. That is, you take the focus off the food and
eating and onto the talking, listening, laughing. You focus is to
become engaged in the lively conversation. You don't even have to
eat that much if you don't want to. There is no rule that says to
have to eat. You have control over this. The reality of the
situation is that you can eat when you want and how much. If YOU
give yourself permission to not have to eat, it takes the pressure
off. You don't have to eat. Most people aren't even aware of how
much you eat or don't eat, they are too wound up into their own
world.
5. The last suggestion I have is one that
has worked particularly well for many of my clients. A lady in a
situation similar to you found it worked fabulously. It will be time
limited, say for 10- 20 minutes and that will be that. It is called
imagination restructuring. What you do is create the Xmas party or
whatever in your mind. All the scenarios your mind is telling you.
You walk into the room and there are all your friends. To talk to
them and tell a joke etc. Then the food is brought out and you
imagine yourself through the whole dinner. The jokes or stories
you'll tell, etc. You see yourself pecking at your food between
conversations and it is all fine. You may even drop some food in you
lap and no one notices... you see yourself dealing with whatever
comes up. You have strategies up your sleeve before the day. At
least you in yourself feel that you can deal with whatever you fear
will happen. In imagination restructuring, you can see different
strategies you can use on the actual day, phrases that can offset
any fear you have and it makes it less of a fear of the unknown
situation.
In the end, I suggest if you feel this is
effecting your life in a detrimental way, then go and see a Clinical
Psychologist in your area. As I said, they will help you delve into
the hidden dynamics of the "problem". It is not something
that you will have to live with for the rest of your life. My
thoughts will be with you at Xmastime and hope that these strategies
help you.
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