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If you have suffered from a panic attack you will know what a horrible experience it can be and if you suffer from regular attacks you will know how disabling and debilitating they can be.

The first attack can often occur out of the blue when undertaking a fairly ordinary and mundane task and is often a very traumatic experience. So what causes a panic attack and why does it happen when there is nothing to be worried or concerned about.

The cause of panic attacks

It is triggered by the body’s ‘alarm’ system; known as the ‘fight or flight response’  which is meant to be activated when a human being is faced with a life threatening situation. As soon as we become aware of a threat an immediate message is sent from the brain through the nervous system to the various systems in the body to mobilise all the body’s resources for dealing with the threat. The responses are immediate and are designed to counteract a danger by mobilising the body’s resources for immediate physical activity.

This ‘alarm’ reaction creates tremendous amounts of glucose and oxygen to the organs that are most active in warding off danger. These are the brain, which must become highly alert; the skeletal muscles, which may have to fight off a strong attacker; and the heart, which must work very hard to pump enough blood and oxygen to the brain and the muscles.

It also constricts the peripheral blood vessels near the surface of the body, raising the blood pressure and makes the skin appear pale; suspends digestive activity (including the flow of saliva) and in stopping this activity re-channels the blood used in this process to provide additional blood for the motor muscles; triggers the emptying of the bladder and bowels to free the body for strenuous activity.

Simultaneously, the ‘fight or flight response’ triggers the release of increased amounts of adrenaline (epinephrine) and related chemicals into the bloodstream. This provides additional strength, stamina and the ability to respond rapidly. These chemicals aid soldiers to survive in battle, athletes to perform better, and all individuals to respond more effectively when faced with danger.

So when faced with a threat the extra energy and strength produced is utilised in running away from or fighting the enemy and soon afterwards the body returns to its normal resting state. But what happens when you activate this response when there is no actual threat (this response can be activated by a perceived threat because the subconscious mind can’t tell the difference between what is real and what is imagined) and there is nothing to fight or runaway from. Whilst you remain inactive your body and mind goes into overdrive and the feelings and chemicals generated can overwhelm you.

When the heart starts pounding and breathing becomes constricted it can create a feeling of dread that something bad is going to happen. Some people think they might be having a heart attack. It is like your internal ‘alarm’ system has been activated in the same way a very sensitive smoke detector might be set off even if there is no smoke.

So what does a panic attack really feel like?

An essential feature of a panic attack is the unexpected nature of it. It often begins with the sudden onset of intense apprehension , fear or even terror. Usually there is a feeling of impending doom and the symptoms can include;

shortness of breath or smothering sensations/choking

dizziness, faintness or feeling unsteady

accelerated heart rate or palpitations

trembling or shaking

sweating

nausea or abdominal distress

depersonalisation or de-realisation

numbness or tingling sensations

hot flushes or chills

chest pain or discomfort

fear of dying or going crazy or losing control

The very first attack often comes completely ‘out of the blue’ and can occur whist someone is doing some ordinary activity like driving a car or at work or even whilst in bed at night. Suddenly you are struck by a barrage of frightening and uncomfortable symptoms which can last for a few seconds and may continue for several minutes. The symptoms usually fade within an hour. Clients usually describe their experience as extremely uncomfortable and that they feared they were being stricken with some terrible life threatening disease or were “going out of their mind.”

Why and when is a panic attack likely to happen?

The initial attacks may occur when people are under considerable stress, whether it be personal or work related, following bereavement, following surgery or after a serious accident, illness or childbirth. It could be triggered by a nightmare whilst aslle

asleep or as a result of ‘flashbacks’ to a previous traumatic experience.

Whatever the initial trigger the first attack takes the person completely by surprise and this unpredictability is one reason why they are so devastating. As a panic attack is so traumatic a fear of panic attacks often results and therefore thinking about the possibility of another attack can itself be a trigger resulting in a viscious circle.

Tip 6 for overcoming anxiety symptoms – How to regain control & stop a panic attack.

When you feel an attack coming on tell yourself that “there is nothing wrong with me, my body is doing what it is supposed to do when I am facing a threat, it is perfectly normal, it is just a false alarm.”

Let the feelings come and accept them, they do not mean you are sick or that you are going to die. Don’t run away from your panic; as you feel it increase, take a deep abdominal breath and as you let it out, imagine letting the emotions go out with your breath. Don’t allow the ‘what ifs’ to run away with your emotions; accept what is happening to you and observe yourself as if you were watching and advising someone else. Credit and marvel the fact that your body can respond in this way to your emotions.

Wait a few moments and the fear and uncomfortable sensations will dissolve and pass as they have before and as the panic subsides let your muscles relax, take a deep breath and each time you succeed in regaining control give yourself a pat on the back for being courageous.

If you need some professional help to regain control please contact us and we will provide you with a free initial assessment.

As I have explained in previous blogs fear and anxiety are both very normal responses to a perceived threat. Anxiety is experienced when we are anticipating that something unpleasant is about to happen and fear occurs when we realise there is a well defined threat.

Both anxiety and fear trigger a sense of helplessness and apprehension, which then triggers a range of physical symptoms which can range from simply becoming more alert to a pounding heart and uncontrollable trembling. Many people with anxiety symptoms sometimes feel that they alone suffer from such a problem.

Over the next few weeks I am going to be describing the most common anxiety disorders and providing tips on how to overcome them.One of the most common anxiety disorders is:

Generalised Anxiety Disorder (GAD)

Whereas many people have anxieties about very specific aspects of their life such as a fear of heights an individual with GAD tends to experience unrealistic or excessive anxiety and worry about 2 or more aspects of their life over a long period. For example you may be worried and anxious about money and the prospect of losing your home, the possibility of losing your job and/or worrying about your health and that of your family and so it goes on. For a child it may result from worrying about academic, athletic and social performance and whether or not they are liked by their peers.

The symptoms of GAD can be both physical and psychological:

Physical symptoms of GAD

Trembling/twitching/feeling shaky

Muscle tension/aches & pains

Loss of energy

Shortness of breath

Accelerated heart rate/palpitations

Sweating or cold clammy hands

Dry Mouth

Dizziness or light-headedness

Nausea and/or diarrhea and other symptoms related to the digestive system

Hot flushes or chills

Frequent need to empty the bladder

Difficulty in swallowing

Psychological symptoms

Feeling restless, keyed up or on edge

Exaggerated startle response

Problem with concentration or feeling of ‘mind going blank’

Difficulty in falling or staying asleep

Irritability

Loss of libido

Money worries

It is difficult not to be worried about money these days when we are being bombarded with messages of doom and gloom from the media regarding the state of the economy, unemployment, the slump in the housing market and public sector service cuts etc etc.

Whether you have plenty of money or not someone with GAD is likely to worry either way. They might worry about whether or not they can afford next months mortgage payment or if they have disposable income worry about what is the best way to invest for the future and then when they do invest worry about how their investment is going to perform. Will last weeks euro lottery winners who won a massive amount of money be able to enjoy spending, investing, allocating and giving their money to good causes or will they find it a burden?

Josh used to worry about money; he is one of our many success stories. You can listen to what Josh has to say here about how he overcame his money worries and other anxieties. Mike couldn’t sleep at night due to anxiety symptoms. You can also listen to Mike’s story about how he turned things round.

Tip 5 for overcoming anxiety symptoms as a result of Generalised Anxiety Disorder

Take control over your worries by organising them. Worry is very intrusive and tends to ‘gatecrash’ your mind when you are trying to concentrate on something or enjoy yourself. A good way to get round this is to prescribe ‘worry time’. Set yourself a specific time of day or evening to sit down and do nothing but worry for a specific period, say 20 minutes. This gives you permission to defer worrying so when a troublesome thought enters your mind outside this period you acknowledge it and tell yourself that you will worry about it in your ‘worry time,’ not now.

Setting up this fixed period (no longer than 20 minutes) soon creates a feeling of control over your thoughts and eventually it becomes a nuisance and is therefore no longer required.

In my last blog I explained that the cause of anxiety is usually worrying and that worrying often results from a negative internal self-talk and the use of our imagination or should I say the mis-use of our imagination.

Imagination is a powerful tool in the armoury of human beings and helps us to write books, invent technologies, develop, learn and speak languages and build empires. It may well be our best psychological tool.

Worrying has its place. For example; if your best friend insists on driving his car after drinking two bottles of wine then it is natural for you to worry. Your imagination would ‘kick-in’ and you would create mental scenarios of what could go wrong. For example; you might visualise your friend crashing his car and therefore take the appropriate action to stop him. In this case worrying is useful. Unfortunately, some people overuse this aspect of imagination. For instance; if you were sitting on an aeroplane and constantly worrying about whether it might crash you may well suffer from anxiety symptoms. So some people overuse this element of imagination to the extent that they drain themselves and others of energy, enjoyment and positivity.

If you are prone to chronic worrying; instead of worrying being helpful as an aid to avoiding what’s worth avoiding, it becomes a barrier preventing you from doing things that really would be worth doing. For example, if you suffer from social anxiety and you avoid social events because you worry about how other people perceive you or if you avoid travelling on planes and/or trains because you worry about not being able to get off when you want to.

There are other consequences of worrying. Your imagination also affects your physiology as well as your psychology. If you were to imagine your favourite food your mouth will water; an example of how your imagination can affect your salivary glands. Whilst in a state of hypnosis people can imagine what it would be like if their arm was encased in ice and the subsequent feeling of numbness; strong enough to be able to undergo an operation without anaesthetic.

Equally, you can imagine being in a beautiful place which might result in your breathing slowing down, your blood pressure may decrease and your muscles relax. In other words your imagination is having hypnotic effects on your mind and body. So, your imagination can affect how you feel mentally and physically, your motivation as well as the consequences of lost opportunities and wasted time.

If worrying always lead to problem solving and positive solutions it wouldn’t be such a bad thing. Unfortunately, most worrying is about the kind of thing that cannot be solved and being anxious about what may or may not happen in the future. For example; you can’t control whether people will like you or not. What someone thinks about you may have more to do with them than you.

If you are a worrier you need to learn to relax with uncertainty because, as Mark Twain famously said “there are only 2 certainties in life; death and taxes”. People who worry too much experience a kind of paralysis so instead of worries leading to solutions they just worry and don’t plan and act to solve the worry. It is a form of self-hypnosis whereby the worrier hypnotises him or her self into feeling what they imagine could happen, definately will happen and is usually focused on a negative outcome.

On the other hand, self-hypnosis used in a positive way to programme yourself for success, is a powerful tool to increase certainty and boost confidence.

Tip 4 for overcoming symptoms of anxiety

Learn to visualise successful outcomes

Practice visualising positive outcomes for your future whilst in a calm and relaxed hypnotic state. When you are deeply relaxed you open up the solution-focussed part of the brain enabling you to find solutions to what you may have perceived to be insurmountable problems.

Your subconscious mind can’t tell the difference between what is real and what is imagined, so you have a choice. You can continue to self-hypnotise yourself into worrying about things that could go wrong or you can hypnotise yourself to expect things to go well and be successful.

If you need professional help with this contact The Spence Practice now.

WHAT CAUSES ANXIETY?

One of my clients once said to me; “I was born a worrier”. Is that possible, that we human beings learnt to worry whilst in the womb? Persistent and chronic worrying can turn into a distressing habit that is hard to break and get rid of; just like an old pair of slippers that you have worn for so long you don’t want to get rid of them. I knew someone who seemed to worry about everything and even when there was nothing to worry about he would worry about that. The consequences were that he didn’t like flying because he was constantly worrying about what might happen to the plane. On the way to playing football he was worrying about whether or not he would play well or whether we would win and so on. He didn’t like to expect that things would go well in his life or look forward to future activities because that would only ‘tempt fate’ and lead to disappointment.

Anxiety is usually caused by looking into the future and anticipating/predicting that a future event will end in disaster. For example; “I am going to fail my driving test” – “I won’t remember anything and will fail my exams” - and these words are often preceded by the words “What if”. For example; “What if I make a fool of myself” or “What if I have a panic attack” etc. Maybe anxiety wouldn’t exist if we were not able to think about the future and could just concentrate on what is happening in the present. As a keen sportsman I know the importance of being in the present, sometimes referred to as ‘being in the zone’ and how distracting it can be when I start to think about what might happen in the future.

Worrying generally leads to anxiety symptoms as a result of 1 or 2 things or a combination of both. 1) The internal dialogue sometimes referred to as ‘self talk’ and/or 2) The imagination. I am going to focus on the internal dialogue today and explain the role of the imagination in my next blog.

Self-Talk

Are you an optimist or a pessimist? Perhaps you think of yourself as a realist. Maybe you are not sure what dominates your thinking and your internal conversation. You could ask your friends, family and colleagues how they would classify you and you might be surprised by the feedback you receive. Alternatively you can become more aware of your thoughts and internal conversation and gauge yourself whether you tend to think positively or negatively most of the time. It could be that there is a contradiction in that outwardly you appear positive and confident in which case your friends and family might classify you as being optimistic whereas internally you might be very self-critical and constantly doubt yourself.

Most people are having a conversation in their heads but some talk out loud to themselves which used to be referred to as a sign of madness. Recent research suggests that talking out loud to yourself can be beneficial. This is probably because when you communicate with someone else on a face to face basis your ability to communicate your message is achieved by a combination of 1) How you look 2) How you sound and 3) The words that you use. Research suggests that as much as 55% of your communication is based on how you are seen when talking, ie; your body language and that about 35% is made up of how you sound when you say it, ie; your tone of voice. That only leaves about 10% for the importance of the words you use to convey your message. Clearly there is nothing to see or hear when you have an internal conversation with yourself which means that the words you use to communicate with yourself are of paramount importance because they are, in effect, 100% of the message.

If you have a tendency to be very self-critical and constantly worry that things will go wrong for you then you are much more likely to suffer from anxiety or even an anxiety related disorder such as generalised anxiety or even panic attacks. If you are predominantly a negative thinker and have a pessimistic view of life, imagine for a moment, how different your life might be if you were always expecting the best to happen, if you were always thinking positively and had an optimistic outlook on life. This is clearly unrealistic because there are certain things that you should be worried about. However, life would be much more enjoyable if you didn’t worry about trivial aspects of your life, those aspects that are not life threatening and those which you have no control over.

So is worrying and anxiety down to nurture or nature. I don’t subscribe to the idea that we were born that way. From my own experience and of the thousands of clients I have worked with over the last 17 years I am convinced that the way we think about life is learnt from our environment and our life experiences. That means it must be possible to learn a new way of thinking in the same way that someone might learn a new language. As with any learning you can teach yourself or you can learn from a professional.

Tip 3 for overcoming symptoms of anxiety

Learn to talk to yourself in a positive way.

If you want to teach yourself you could read a self-help book called ‘Feel the fear and do it anyway.’ In this book there is a chapter devoted to what the author, Susan Jeffers, calls the ‘Pain to Power vocabulary.’ This is not a magic formula. It is like learning a new language. You have to engage with it and practice regularly. It is based on the idea of turning words that are associated with pain, such as problem and should, into powerful words such as, challenges and could. These words give you choice and motivation. If you find it difficult to help yourself with this concept you could seek professional help. In our treatment for anxiety at The Spence Practice we utilise hypnotherapy for anxiety along with other techniques and strategies for a more positive and optimistic view of life.

Anxiety & the Nervous system

Having explained, what is anxiety, in my last blog; to help with anxiety and provide a treatment for anxiety, it is important to understand how the nervous system works. When you understand the nervous system anxiety symptoms will make more sense.

The Nervous System

The two main divisions of the nervous system are the voluntary and the involuntary.

The voluntary system is made up of the brain and the spinal cord with a number of paired nerves arising from the spine and ending in a muscle. When you think a thought to direct your limbs, head and body you control the movement of these body parts voluntarily. For example, if you think to hold your hand still then your hand will lie motionless in your lap.

The Involuntary System

This part controls the operation of your heart, lungs, intestines and various other internal systems. You don’t have to think about it for your heart to continue beating and even if you try you can’t stop it from beating. It is under the control of your involuntary nerves which send out messages controlled by your endocrine glands and these glands respond to things you think are happening in your environment. Imagine a situation where you are amongst a group of unfamiliar people who are all laughing at a crude joke which makes you feel uncomfortable and embarrassed, you might find yourself blushing. This is because your glands have sent a chemical message to your involuntary system based on how you perceived the situation.

There are two parts to the involuntary system; the sympathetic and the parasympathetic.

Parasympathetic

The purpose of this division is to restore and conserve bodily energy. In order for energy supplying foods to be digested and absorbed by the body (under normal conditions) the parasympathetic impulses to the digestive glands; which control the smooth muscles of the digestive system, dominate over sympathetic impulses.

Sympathetic

In contrast with the parasympathetic, the sympathetic part is concerned with processes involving the expenditure of energy. In normal circumstances its main function is to counteract the parasympathetic effects; just enough to carry out normal processes that require energy. The balance between these two divisions is dramatically changed during a time of stress when the sympathetic dominates the parasympathetic.

When you are confronted with a dangerous situation (real or perceived) what is known as your ‘fight or flight response’ is activated. This response is triggered by your body’s ‘alarm’ system; the emotion known as fear. When your ‘fight or flight’ response is activated you become very alert as fear stimulates the sympathetic part causing the pupils of the eyes to dilate, the heart rate to increase, the blood vessels of the skin and the intestines to constrict, and the remainder of the blood vessels to dilate. This then results in a rise in blood pressure and a faster flow of blood into the dilated vessels of the skeletal muscles, cardiac muscle, the lungs and the organs of the brain that are involved in fighting off danger. Rapid breathing also occurs at this time as the bronchioles dilate to allow movement of air in and out of the lungs at a faster rate. Blood sugar levels rise as the liver converts glycogen to glucose in order to supply the additional energy needed. The adrenals produce epinephrine, a hormone that intensifies and prolongs these effects.

During this period of stress, the sympathetic effects inhibit other processes that are not essential for self-preservation. One example is that the muscular movements of the gastro-intestinal tract and digestive secretions are slowed down or even stopped which is why you might feel like you want to empty your bowels.

The sympathetic part of the nervous system reacts to stimuli very quickly and produces responses by instantaneous electrical conduction over its pathways whereas the parasympathetic system reacts more slowly and produces changes by releasing hormones into the blood-stream. In other words the parasympathetic system is governed by the endocrine glands, which produce hormones. These glands are the pituitary, thyroid, parathyroids, adrenals, pancreas, ovaries, testes, pineal and the thymus.

Conclusion

The involuntary part of the nervous system is responsible for activating the ‘fight or flight response.’ It is clear then that the response is an unconscious one and one way of accessing and communicating with the sub-conscious part of the mind is through the state known as ‘hypnosis.’ This is why hypnotherapy for anxiety is one of the most effective treatments for anxiety. Hypnosis is often likened to a deep state of relaxation. Relaxation stimulates the parasympathetic part of the nervous system and keeps the sympathetic part in check.

Tip 2 for overcoming symptoms of anxiety

You may not be able to control your heart rate but you can exert control over your breathing and by slowing your breathing down your heart rate will begin to slow automatically as will all the other systems of the body activated by the fight or flight response. There are a number of breathing techniques you can learn, the one we favour is known as the 7 in 11 out breathing technique, where you breathe in for a count of 7 and breathe out to the count of 11.

In our next blog we will be looking at the types of thinking that lead to anxiety.

What is Anxiety?

I have been treating clients with anxiety symptoms since 1994. Anxiety disorders include panic attacks, phobias and generalised anxiety disorder. Social anxiety is one of the most common conditions treated at The Spence Practice and often includes a fear of public speaking. In my opinion and based on my experience, the best treatment for anxiety is Hypnotherapy. However, hypnotherapy for anxiety is not the only treatment we use here. During the month of June I will be sharing with you my knowledge of this subject and providing you with some tips on how to reduce the negative effects of anxiety.

Anxiety is usually a feeling of apprehension and uncertainty resulting from anticipating a problem which may occur in the future and can be as mild as ‘butterflies in the tummy’ and muscle tension to the extreme symptoms experienced during a panic attack. It is normal to experience this when taking a test or exams or going for a job interview, for example, no matter how well prepared we are. You might feel anxious when driving on an unfamiliar road in a rainstorm no matter how good a driver you think you are. These are normal reactions to something that is unfamiliar and which might have an outcome that we don’t expect or won’t like. This kind of uncertainty can be helpful; it puts you in a state of alert by tuning up your muscles and brains to be prepared to handle the unexpected.

On the other hand this kind of anxiety is not helpful if it makes us so anxious that we are unable to take the test or remember the answers; if we can’t talk at the interview and perform badly; if we lose control of the car because we tighten up and over-steer. It is not possible to live without anxiety, yet it can be exhausting if we live with it all the time or it can be a stimulating tonic in short bursts in order to face a challenge. Most people see public speaking as so terrifying that they avoid it at all costs whereas a professional public speaker might see it as giving him or her an ‘edge’ to help entertain and hold the audience attention.

Is there a difference between fear and anxiety? A phobia is a form of anxiety and is usually defined as a ‘persistent or irrational fear’. You can be anxious in anticipation of a specific event, such as public speaking but you might say that you are terrified of public speaking. Anxiety is usually caused by worries and concerns that are external to the individual whereas a phobia is usually an extreme response to the sight of someone or something that feels like an immediate source of danger.

Anxiety describes an unpleasant state of mental tension often accompanied by physical or psychological symptoms, when the sufferer feels physically and mentally helpless, exhausted by always being on guard against the anticipated danger. Someone who suffers from ’generalised anxiety disorder’ may feel in a constant state of apprehension and continually feels worried, ruminates and is always anticipating that something unpleasant will happen; which can lead to feeling ‘on edge’, impatient and irritable.

Tip 1 for overcoming anxiety

Accept anxiety and avoid fighting it and make sure you don’t avoid situations that make you feel anxious. If you fight it you will make the symptoms worse, which will be explained in my next blog. Remember, it is not the situation or the environment that is frightening; it is your thoughts, feelings and emotions about the situation which frightens you. Anxiety is usually caused by thinking about a future event or imagining that a future event may go the same way as a past event so find ways to be in the ‘present’ instead of focusing on what might go wrong in the future.

Listen to what Mike did about the anxieties which were ruining his life http://www.thespencepractice.co.uk/anxiety

In my next blog I will be explaining what happens physically when you get anxious and what you can do about it.

Do you dread public speaking? Have you ever had a panic attack when making a speech or do you wish you could control your nerves in order to improve your performance when making a speech or a presentation at work? Fears, phobias and anxieties can be disabling but with professional help can be overcome.

Whether or not you have seen ‘The Kings Speech’ you will have heard of it unless you have been on another planet. The film is all about the relationship between the King and his Speech therapist who was also his Life Coach in many ways. This film highlighted 2 things for me:-

1) The need to accept that we can’t do everything on our own and that seeking help is not a sign of weakness, but actually a sign of strength and

2) That public speaking, with or without a stammer, is a daunting prospect for many people and it used to be a fear of mine, so here are my top 10 tips for speaking confidently in public.

Learning to speak confidently in public can do wonders for your career and/or business so don’t wait as long as I did to overcome your anxieties. Practice, practice and practice and if you want to become the King of speech making seek professional help if necessary.