By Daniel Hochman, MD and William Schroeder, LPC
Have you ever wondered what are panic attacks and why do people have them? Panic attack symptoms can be incredibly debilitating and embarrassing, and change the way people live. If they make you avoid grocery store and roads, it makes life pretty darn hard to navigate. You may have seen someone experience one, or even suffer from it yourself.
Let’s start with the basics. A panic attack is basically a sudden and unexpected feeling of terror that’s way out of proportion to the actual situation. About one in 20 U.S. adults has one at some point in their lives, with women being twice as likely to experience them. Here are the common signs and symptoms:
- Internal symptoms – Usually people sense a racing heart, sometimes with chest pain. It is not infrequent that we have a client come into therapy after they have had several emergency room visits because these symptoms can feel like a heart attack (in fact, most chest pain seen in the ER is due to anxiety and not heart attacks). As far as thoughts go, people feel a sense of doom, might even feel like they’re dying and feel totally out of control. To make it even more fun, people usually feel faint, woozy, tingly in their hands, and might sense a lump in their throat.
- External symptoms – On the outside, breaths are more rapid. You will notice the person looking quite uncomfortable, at a loss for what to do, and have a hard time making eye contact. Their skin can get sweaty and pale.
What’s the difference between anxiety and panic attacks?
As far at the timing, the major difference is that panic attacks are more intense and usually peak at around 10 minutes, and last less than an hour. Anxiety, on the other hand, can last many hours, or even years. When you ask someone to describe a panic attack, there’s usually a focus on the panic itself, with a fear of having another panic attack. And whatever fear they can describe will usually sound quite unnecessary. If you ask someone with anxiety to describe what’s going on their head, they can usually describe one or several things clearly on their mind about what’s bothering them.
The horrible positive feedback loop
With panic attacks, usually, it starts with just one small fear. Like a fear that people at the mall will be judging you. When you feel scared, your body reacts as if there’s a physical threat. And when your body reacts, it convinces your mind that there’s actually a major threat out there, which only makes the mind more scared, which only makes your body even more hyped up… and so on. What’s more, you start to notice you get scared of the mall during your drive over. And then you start to get worked up about thinking about leaving the house with your car at all. And then you get scared you’re having a heart attack or going to pass out, etc. This is the vicious positive feedback loop where now there is an entire cycle of fear, and the fear feeds itself. No longer is it the initial fear of a crowd, but it’s the drive, the road, the keys to the car, a friend’s invitation to go out, and the symptoms. They all compound. This is the idea behind how panic attacks hit so fast and hard. When I can help my patients explore their primary fear, say a fear about a crowd judging them, it helps reign in the rest. They can begin to emotionally process the underlying issue, and there’s no more fire for the rest of the feedback loop to feed.
If we can be of help, you might also want to read more about anxiety counseling or you can contact us to make a counseling appointment. We also have more information on dealing with panic attacks. If this article was of interest to you, you can also read our post on why do we get nervous.
Daniel Hochman, MD is the founder of Self Recovery, a private online addiction recovery program. It is ideal for those in therapy or post-discharge from rehab and need ongoing programming. The program will help to continue developing prior skills and teach new ones to create a more complete approach.
Photo by Fernando @cferdo on Unsplash
How EMDR Works in Treating Anxiety
/in Blog /by Kevin PatykBy Diana Schaefer, LCSW
Most people suffer from anxiety from time to time. I know I have. We all need some anxiety to function. If you had no anxiety you might not be motivated to do anything! However, too much anxiety can hinder us from being at our best. Whether it’s situational; such as having to do public speaking, taking a test, or having to drive after having had an accident, or more generalized where you feel anxious but are not sure why, EMDR works in treating anxiety.
How Does EMDR Work for Anxiety?
The first step is identifying what is triggering the anxiety. If it’s something like public speaking, one way I’ve used EMDR is to come up with a time when you did a good job speaking publicly and you felt successful. We would then touch on how you felt when you were successful, what positives thoughts you had about yourself, have you imagine how you sat or stood in front of the group and even think of a word or phrase to describe that feeling. We would then use bilateral stimulation, which is stimuli, either visual, auditory, or tactile, which occur in a rhythmic left-right pattern, while you experience those feelings, thoughts, body sensations, and images in your mind. Then, we would attach the word or phrase that helps you remember that feeling. This is called resourcing the positive experience.
The next step would be to have you concentrate on an upcoming event when you have to speak in public. Here again, we would have you imagine being in front of a group you’ll be speaking to identify the feelings that emerge, images, physical sensations, irrational negative thoughts you have about yourself and what you want to believe when we are done or the positive thought. I would also ask how upsetting this is on a scale of 0-10. We would then use the bilateral stimulation while you think about the situation. What usually happens is the negative feelings and irrational beliefs become more positive and the level of upset (or anxiety) goes down.
Another approach I’ve used is to have the person imagine that they are successfully speaking to a group. In this approach, we would run a movie in your head successfully speaking to the group using the bilateral stimulation, starting with the preparation of getting ready for the speech through to the end of the talk. We would stop when they feel the anxiety coming on and then we would process the anxiety until it went down.
Case Example: (all identifying information was removed and scenarios altered to maintain anonymity)
I worked with a young woman who suffered from anxiety which she felt intensely whenever she had to be the center of attention. She was getting married and the thought of everyone staring at her terrified her. She had suffered from panic attacks in the past and was very afraid she would have a panic attack at her own wedding and ruin the entire experience of her special day.
Obviously, sometimes the anxiety is based on traumatic experiences that also need to be addressed. This was also true in her case. She had a loss that left her feeling unprotected and vulnerable. We worked together for several weeks on having her imagine getting up that day, getting dressed and ready, walking with her father down the aisle of the church and doing this successfully without a panic attack. Her level of anxiety before we started the process was at a 10+. We were able to get the anxiety level down to about a 3 which was fine with her. She wanted to feel in control but the anxiety made her feel out of control. We also worked on the deeper reasons behind her anxiety. She ended up having a little anxiety during her wedding (who wouldn’t?) but it did not limit her or prevent her from having a wonderful experience.
If you feel that you or a loved one can benefit from either anxiety counseling or EMDR therapy, you can contact us to make a counseling appointment. If you would like a more general perspective on EMDR, you can read How EMDR Works.
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New Year, New Podcast to Listen To
/in Blog /by William SchroederBy Adam Maurer, LPC, LMFT
I always know when that new year begins because my gym fills with people, folks who have resolved that this year will be the year that they workout. And though I hope they reach their fitness goals, a part of me is bummed because I know my usual gym routine will be slowed way down. So, instead of getting frustrated with long waits for equipment, I decided that I could use that extended time at the gym to listen to podcasts. If you’re looking to expand your knowledge of love, sex, and relationships while you wait for your machine (or in endless Austin traffic) then give these ones a listen.
Sexting History
https://www.sexinghistory.com
This sex-positive podcast does a phenomenal job of mixing the perspectives of experts in different fields with the narratives of people who experienced events firsthand. The editing is wonderful, and the podcast is amazingly informative. I thoroughly enjoyed the episode “Touch Me! I’m Yours!” It explores how evangelical women in the United States created their own guide to marriage as a response to the free love movement and women’s rights movement of the 60’s and 70’s.
Where Should We Begin
https://www.estherperel.com/podcast
Esther Perel, famed therapist, and author of “Mating in Captivity” and “The State of Affairs” has the most incredible podcast for anyone interested in relationships. She uses audio from sessions with clients to explore and explain the complexities of human connection. As a relationship expert, I can tell you that the podcast is like free therapy, find it and love it!
The Science of Sex
https://www.stitcher.com/podcast/joe-pardavila/the-science-of-sex
Dr. Zhana Vrangalova, Ph.D. is the beautiful, sex-positive mind behind The Casual Sex Project where she archives people’s’ stories about casual sex and hooking up. Her podcast explores all areas of sexuality; from kinks and fetishes to sexting, being out and sex toys. There is always great insights from this top sex researcher.
Q Marriage Mentors
https://www.qmarriagementors.com
Jeff Lutes, LPC is an established relationship expert from right here in Austin. He invites LGBTQ+ couples to come onto his podcast and discuss how they met; how they manage the ups and downs of loving others. Now, to be fair, I know Jeff personally and he is an amazing human; he also had my husband and me on as guests. We talked about being more than monogamous, which you can listen to our episode, “Karaoke, The Golden Girls, & Radical Authenticity.” Learn about all the ways there are to love.
These interesting podcasts are a great way to start off the new year for your relationship and make the most of your time spent waiting. If you would like some additional resources regarding sex, you can read The Benefits of Getting Kinky and Why Sexting is Good for Relationships. If you’re looking to have some changes in 2019 therapy is a great place to start! It’s a safe, encouraging environment to explore how you can achieve your goals in life. Contact us today for a counseling appointment and we can pair you up with clinical who’d be a great fit or learn more about our marriage counseling services.
Photo by Siddharth Bhogra on Unsplash
How Much Does Counseling Cost in Austin?
/in Blog /by William SchroederCounseling prices vary a lot by the market, by the provider, number of years of experience, specialization, and by service. In Austin, counseling on average tends to cost between $100 – $200 per hour and the average being around $150. If you want to know more specifics on how much does counseling cost, check out some pointers below:
If you are curious about our counseling prices or if you are looking for affordable counseling in Austin, check out the provided links.
Photo by rawpixel on Unsplash
What Are Panic Attacks?
/in Blog /by William SchroederBy Daniel Hochman, MD and William Schroeder, LPC
Have you ever wondered what are panic attacks and why do people have them? Panic attack symptoms can be incredibly debilitating and embarrassing, and change the way people live. If they make you avoid grocery store and roads, it makes life pretty darn hard to navigate. You may have seen someone experience one, or even suffer from it yourself.
Let’s start with the basics. A panic attack is basically a sudden and unexpected feeling of terror that’s way out of proportion to the actual situation. About one in 20 U.S. adults has one at some point in their lives, with women being twice as likely to experience them. Here are the common signs and symptoms:
What’s the difference between anxiety and panic attacks?
As far at the timing, the major difference is that panic attacks are more intense and usually peak at around 10 minutes, and last less than an hour. Anxiety, on the other hand, can last many hours, or even years. When you ask someone to describe a panic attack, there’s usually a focus on the panic itself, with a fear of having another panic attack. And whatever fear they can describe will usually sound quite unnecessary. If you ask someone with anxiety to describe what’s going on their head, they can usually describe one or several things clearly on their mind about what’s bothering them.
The horrible positive feedback loop
With panic attacks, usually, it starts with just one small fear. Like a fear that people at the mall will be judging you. When you feel scared, your body reacts as if there’s a physical threat. And when your body reacts, it convinces your mind that there’s actually a major threat out there, which only makes the mind more scared, which only makes your body even more hyped up… and so on. What’s more, you start to notice you get scared of the mall during your drive over. And then you start to get worked up about thinking about leaving the house with your car at all. And then you get scared you’re having a heart attack or going to pass out, etc. This is the vicious positive feedback loop where now there is an entire cycle of fear, and the fear feeds itself. No longer is it the initial fear of a crowd, but it’s the drive, the road, the keys to the car, a friend’s invitation to go out, and the symptoms. They all compound. This is the idea behind how panic attacks hit so fast and hard. When I can help my patients explore their primary fear, say a fear about a crowd judging them, it helps reign in the rest. They can begin to emotionally process the underlying issue, and there’s no more fire for the rest of the feedback loop to feed.
If we can be of help, you might also want to read more about anxiety counseling or you can contact us to make a counseling appointment. We also have more information on dealing with panic attacks. If this article was of interest to you, you can also read our post on why do we get nervous.
Daniel Hochman, MD is the founder of Self Recovery, a private online addiction recovery program. It is ideal for those in therapy or post-discharge from rehab and need ongoing programming. The program will help to continue developing prior skills and teach new ones to create a more complete approach.
Photo by Fernando @cferdo on Unsplash