Get the Support You Need

Learn from thousands of users who have made their way through our courses. Need help getting started? Watch this short video.

today's top discussions:

logo

Challenging Worry

Ashley -> Health Educator

2024-04-20 11:42 PM

Depression Community

logo

Hello

Linda Q

2024-04-11 5:06 AM

Anxiety Community

logo

Addiction

Ashley -> Health Educator

2024-04-08 3:54 PM

Managing Drinking Community

logo

New Year's Resolutions

Ashley -> Health Educator

2024-03-25 2:47 AM

Managing Drinking Community

This Month’s Leaders:

Most Supportive

Browse through 411.748 posts in 47.053 threads.

160,502 Members

Please welcome our newest members: Fwcl, anonymeLouise, RDANIELA NICOLE, Lfr, CPADUA

exposure to distressing thoughts - discuss Nov. Ask the expert question


13 years ago 0 118 logo logo logo logo logo logo logo logo logo logo 0
 

Hi, love trees

I am sorry I have not responded to your post that you left on my thread until now. One thing an educator said to me was to practice sleep hygiene. She mentioned a few suggestion about what I could do I think she realized like you I am not getting much sleep. So as usual, I looked up sleep hygiene to see what the various things I could do. One of the things mentioned (nothing to do with attacks) was to get out if bed when you are not sleeping. The reason given was that you begin you associate the bed with not sleeping when you stay there ruminating. After reading this, it occurred to me that this is how you and me could expose ourselves to lower anxiety and not have an attack. I have been getting up if I wake up at 2:00 am and I start writing all the things that I would be normally ruminating about. Alternatively, in your case the thing you dreamt about that are causing you to wake up with anxiety. By the way It is quite normal for people to experience bed time attacks it’s just that we are on a site dealing with agoraphobia and are less likely to come across people who have attacks in bed because they get them from going outside.

In here lies one of the clues if an agoraphobic can relate panic attacks to going outside then the same relation for you and I can happen in bed. If you were to get out of bed and have the thoughts about being alone would they cause an attack out of bed. Maybe a better question is does the thought of dying alone cause an attack in bed. If it does not then challenging this thought is useful but is not getting to the reason for panic attacks.

This is where you and me may be getting confused about core beliefs and there influence. A true core belief will come from being a child and having a parent tell you constantly you are stupid and no good. If the parent or someone close to you keeps saying this as a child, you do not have the ability to challenge it so you accept it as true because you do not know anything else.

I am not sure what Davit means by core belief does he mean the clinical meaning as mentioned above or does he mean a trait that you have developed in your life. If you have been reading the educators, writings about self-esteem this could be a trait you have without it being a core belief.

One of the traits the people with panic attacks and anxiety in the toolbox mentions relationships. This is where you could find help on the feeling of dying alone. Perhaps you do not have a social network to gain support from, so you view your life as empty. This belief was probably developed thought years of avoidance of social situation but I do not believe it is a core belief from child hood unless someone told you as a child that you are worthless and going to die alone. What I am trying to get at is that you can work on relationships, which will increase your self-esteem. Both these things may be the result of having attacks but are they the cause of the attacks. It is as if you were searching for the thing that caused us a 10 in emotional upset. The most distress brought up from my past and writing it down because we figured that there had to be a strong emotional reason for the state we are in.

You could see if expanding your social network would give you more self-esteem. The more self-esteem you have the more you are to look at life as a challenge that you can adapt rather than doomed to die alone. Both these things can be worked on without challenging negative belief. I now realize why I am the way I am and I do not need to know why all I need to do is start facing my fears about relationships. If you face your fear, the fear will go away. This is possible where Davit mentions core beliefs by changing the one (not having enough social support) impacts your self-esteem, your sense of purpose; bring some structure to your life. The list really goes on depending on who the person is.

There is nothing wrong with looking in you past and challenging negative thoughts that you still have or that apply to a new situation in life. To get to our goal is to stop the panic attacks and I think you have to concentrate on the thought when in bed that are causing the attacks. If the thought about dying alone is the one then expose yourself to it.  Perhaps instead of waiting in bed for the thought to cause, an attack you can out of bed before it the attack happens and do exposure yourself right then even if it causes you a 10 on the anxiety scale. If it does not cause an attack then I think you are reducing the effect the thought has on you. I have learned that exposure cannot always be the exact way you want it to be. So maybe exposing yourself to a 10 every morning you get up from bed before it causes an attack you will reduce it after weeks to a two. If you accomplish this then you have accomplished you goal of reducing anxiety towards the thought. Then if you want, you can try in reinforcing the lesser anxiety state by thinking about in bed the thought that caused you a 10 and see if you have an attack happens in bed. This would be another form of exposure to the thought once you have reduced it to a two.  This is what an agoraphobic does gradually expose himself or herself to a situation until it does not cause an attack.

Another place to look for an answer if the but statement, this statement is sure in me. I go to a support group where I live and the author says you ignore the initial improvement. Which was the case in me when I have an attack it is generally low in intensity “but the effect last the day”. Notice the “but” statement, I will give you another one I can stand the attack “but” it causes me to feel confused all-day and dizzy. Therefore, I cannot work because I will make mistakes. This is another place where traits that all of us in my group have some of them are perfectionism, being afraid of making a mistake, finding the right and wrong in everything and usually insisting we are right. This for lack of a better word could be a core belief. However, someone did not telling me that I am wrong all the time that I keep making mistake from childhood when I did not have the mental ability to see what the person was saying was incorrect.

You can see where the fear of making a mistake comes from if you are a perfectionist. Working on these traits by saying all I have to do is my average best not mediocre but my average best is in fact tackling a lot of myself talk during the day. Another one is I finding the right and wrong in my boss because she did not do thing the way I would have I have. I saying excuse her for the sake of my mental health and drop the right and wrong in many situations every day. These things cause me anxiety, or anger which simulated anxiety, by stopping them it leads to a more peaceful day. However, these thoughts do not cause an attack in me.

I think the “but” statement is causing me to have an attack, because the genesis of my attacks cause confusion and the way I dealt with it for 25 years was to tense my head up. There lies the danger for me I am still experiencing confusion only this time I do not want to deal with it by tensing up my head so that I can think for another 25 years. However, using the challenge sheet is tensing up my head temporarily such a bad think because what is different now is that I know where the confusion comes from and I do not have to be afraid of maintaining tension because I have tools to relax and abdominally breathe. Also with the tools that I mentioned above, I will not get as worked up as I did before about trivialities of making a mistake.

One final point is that you should look up the sleep hygiene because I also found in there that supposedly exposing yourself to sun light in the hours 6:00 to 8:30 in the morning you are resetting you sleep rhythm clock. This will give you a better night’s sleep. As with all things on the internet, I found another site that said this was unnecessary. However I did it for three days and on the forth I actually slept into to 6:00 am for the first time in a while. I do not expect you to try this I merely suggest you look in the sleep hygiene sites for things you can try. Guess what not getting up at the same time everyday is, “avoidance”. I have not felt well for a long time and have developed a poor sleeping habit by not getting up the same time every day.  

To sum up I believe an educator told you to go back to session 1 to 3 because this is where we find the thought causing an attack. This is where you can challenge the thought. You should stop looking for the most distressful emotion or thought as the cause of an attack. If it is not present in bed when whatever you are thinking at the time gives you the attack. I am not saying to disregard distressful emotions but first get rid of thoughts associated with the attacks. You may find that the distressful thought of 10 of dying alone will dissipate if you stop the attack. We tend to color everything we think of when were in an anxious or depressed state with that emotion. I am saying feelings are not always facts.

One last thing I think Davit is right on is that sometime exposing ourselves to the 10 of die alone will lead to an epiphany that never occurred to you before because it was being blocked by dying alone.

Your friend

dizzy

13 years ago 0 221 logo logo logo logo logo logo logo logo logo logo 0
Hi loves trees,
 
Section 1 , your homework is to write down the anxious thought. When you move to section 2 and 3, you start to challenge those anxious thoughts , by examining these thoughts. For a thought such as "I will die alone", section 2 homework involves 3 steps , and in Section 3, there is homework which involves asking 10 questions. You will become aware of the distressing thought, and then how to challenge it.
 
Overtime, challenging an anxious thought will become automatic.
 
Be kind and gentle with yourself. Keep telling yourself that you are a good person, worthy of love and affection of others.
 
 
Helena, Health Educator
13 years ago 0 6252 logo logo logo logo logo logo logo logo logo logo 0
loves trees.

My memory is not that good either. Core beliefs can be negative or positive depending on how you look at them. And some of them are inappropriate, because you don't know the answers. Remember the thing about the past and the future not counting because you have no control over them. You don't know if you will die alone or not. You don't know if you will go first or out live every one. So this thought is inappropriate. Not negative or positive. You would want to mark it as such. Remember that word perception. It is how you see and register things. Remember you can not change core beliefs but you can change how you see them. Like saying over and over this is not true to the negative ones to bury them. and putting a positive one in it's place and saying I really believe this to be true, or something to that effect. Of course you have to really believe it or they go negative. Same with the inappropriate ones. You have to believe that you have little or no say about them. Thinking about them is inappropriate, even negative.

Your friend probably finds most of life is out of her hands so thinking about it is inappropriate. A waste of time and she may not like to waste her time. So subconsciously she kills those thoughts by saying it is a waste of my precious time and thinking on some thing else. Of course you, like me have an anxiety disorder so our minds are conditioned to bring it up over and over again. All you can do is say, (or better yet write) each time, this is inappropriate and a waste of time, till you build a positive core belief to this affect and actually do believe it. 
Frustrating isn't it, knowing the truth but not being able to convince yourself.

Accepting you are doing something you don't want to is the first step to stopping it. I find myself being very critical of me to the extent of saying out loud "your doing it again". Exposing the fact and bringing it out in the open. Thinking out loud.

Spend as much time as you can controlling the things you can and there will be less time to think about the ones you can't. When you actually change a negative to a positive, celebrate it with a little reward. Start each day by reviewing every positive thing you have accomplished before you get a chance to start thinking negative. Do this all day long if you have to.
The mind is like a good computer, it will reach for what you used last or most often so if you can give it something positive to reach for it will till you go digging for something negative.
Hope this helped.

Here for you,
Your friend
Davit

Ps I still have days that are blue when I just can't find anything good in them. But they are blue days now not anxiety days because I know they just won't stick around.
13 years ago 0 538 logo logo logo logo logo logo logo logo logo logo 0
Hi lovetrees,
Its my  understanding that people who dont have anxiety and excess worry dont necesarily not have negative thougths like us....they just know how to ignore them better, and not make them into something bigger. We have taught ourselves by so much repition to dwell and give importance to our negative thoughts, where as "normal' people have the thought pop in their mind...like..."I'm going to die alone"...but their learnt behaviour is to brush it off or even make fun of it.
My new learnt behaviour... or it could be called "mind" exposure  is... when it comes to my negative thinking.... break the thought  down, either written, or in my head...for example "I will die alone"...I ask myself.."How to I know that?" I ask myself..."hmmm, do I really mean I will die alone, or do I mean I will be alone in my later years?" "Those are two separate questions"... "How do I know that? "I don't know when I'm going to die..no one does"..etc.... and after  many times the thought takes on no significance..just like " normal " people. I think its our reaction to our thoughts that makes us anxious, which in turn creates that vicious cycle of panic.
But, as Davit says..this is the hardest simplest thing we will ever do...even today, although I havent had any anxiety/panic in a store in months...I was at a long lineup in a store and the negative thought.."what if I have a panic attack"came into my mind...(I was hot, tired , and the woman behind me kept bumping into me)...I said exactly those things to myself..I'm hot, I'm tired , and the old lady behind me is annoying me...what does that have to do with panic? and then  the thought was gone...too bad the old lady wasnt...haha...and I was fine..
I dont think you want to walk around with negative thoughts in your head all day..youve just taught yourself to do that...but by using the challenging technique..that was the answer for me. Maybe you too!I dont worry about whether I'm doing it right...just that its working for me. I hope this helps a bit...you can do it!
Juanita
13 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
Hi Ashley,
 
Thanks, I think I will set aside some time soon to write out all the distressing thoughts that have led to panic attacks that i can think back and remember. I have a good memory for what some of the speicifc thoughts were especially for recent attacks. I will try to rate the level of fear they bring. 
 
 I have this friend who doesn't have an anxiety problem and i find it fasciinaiting that she just goes about life without panic attacks. I've been thinking a lot about the differences between us. this is what i have come up with:
 
For a while now I have realized that anyone who carries around a negative distressing thought like "I will die alone" would inevitably end up feelign anxious about it. how can you not? it is by nature a distressing thought, unless one is a buddhist who can accept being alone ( a goal i admit i would like someday  - to accept the truths about life without panicking about them). the difference between me and a friend who doesn't have panic attacks is that she doesn't think up distressing thoughts to torture herself with. She doesn't think "my husband might leave me someday" because she sees no point in thinking that. Who wants to walk around with negative thoughts all day long? I guess I do :) Because i do it, i have dozens of negative thoughts each and every day.
 
What info from the toolbox explains what I should do with the distressing thoughts once I find some to do exposure with? I mean just writing the list out tomorrow or whenever will be some level of exposure since i'll have to think of each one even momentarily while i write it down. I know in the past Davit has reminded me to write "not true" next to each one. but some people do end up alone in old age. so its not really untrue. its a reasonable fear to not want to die alone. for example. thoughts? actually I think Davit actually said something about for the ones that you can't write "not true" write something else but i cant' remember what it was. Maybe it was "oh well" i.e. accept it because what other choice do i have right? 
 
Davit I hope you can remind me what that whole suggestion was of yours. Sorry I only remembered half as you can see. :)
13 years ago 0 11213 logo logo logo logo logo logo logo logo logo logo 0
Hi Loves trees,
 
I am glad you found the ask the expert helpful.  
 
Im regards to your questions, what do you think would be helpful to you?  Everything you had mentioned you might find very therapeutic.  Challenging negativity is always good in regards to distressing thoughts but exposure work can be helpful as well.  Writing down potential trigger thoughts and rating these thoughts may also be helpful to you. 
 
Members, please give your in put and share your experiences.
 

 
 

Ashley, Health Educator
13 years ago 0 356 logo logo logo logo logo logo logo logo logo logo 0
I just read the November "ask the expert" post about how CBT can help people with GAD (generalized anxiety disorder?). 
 
I found the response really helpful because I have been confused about what my exposure would be but I think i have a better handle on it now. can someone weigh in:
 
I have been confused about how to plan exposure work because my distress and anxiety seemed to be triggered by what people do. however i am now thinking that the distress and attacks are triggered by certain thoughts. (i.e. the thought "she is upset with me" causes anxiety as does "she isn't really my friend" and so on...) there are thoughts that rate a 10 out of 10 on the fear scale for me. In the section on exposure planning on this site it says not to start out with something that triggers a full 10 / 10 level of fear. to expose myself to something that is a 5 or 6. Is that correct? 
 
Ok so a 10 / 10 thought for me is thinking that I'll end up alone in old age. When I really think about that and follow that train of thought I end up fully distressed. How do I back up and find thoughts that cause mild distress so I can practice exposure? Or am I still confusing exposure work with challenging negativity work? that is possible.
 
my understanding is that the goal of exposure work is to hold on to the thought for a while and see that it didn't have to cause panic. i am a long ways away from being able to hold my most distressing thoughts without panicking. i know that. 
 
what do i do during the exposure session once i identify a thought that will bring on moderate anxiety?  
 
anyone else do exposure work with thoughts? i feel like i am able to write out a list of distressing thoughts that i currently either avoid or react to with panic but should i do that and rate them in terms of level of fear they cause? would that be useful?
 
thanks in advance for any feedback anyone can offer. 

Reading this thread: