Why Am I Here? Where Am I Going? (Navigating the Therapy Process)

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“The purpose of psychotherapy is to set people free”. – Rollo May

Some clients know exactly what issues they want to address when entering therapy.  They know how they feel and that they want to change that feeling.  Still others struggle to identify the uncomfortable negative emotions weighing them down.  The latter of these will start their initial session with statements similar to “I’m not sure why I’m here”.  Even others know deep down that they need to “process” their story, yet run from the feelings behind the words.  When asked what progress will look like or how they’ll know when the therapy process is complete, they fumble with creating a clear picture of life as they’d desire it to be.  For the first few sessions, it may seem as if there’s no point in sitting down with a professional to talk things out.  In this grey area, without seemingly clear goals for healing or growth, there is a risk of clients dropping out of the process before realizing benefit.  If the process is effective in helping put their distress into words, and if this happens too suddenly, it’s not unusual for a client to “ghost” the therapist (discontinue therapy without closure). This risk intensifies if there is difficulty finding the words to tell their story.  Sometimes even therapy feels like too much.  And that’s okay.  The timing and necessity for therapy is unique for everyone.  While a person’s blind spots may prevent them from seeking help sooner than later, seasoned therapists give clients a respectful and safe space to make the decision for themselves, without judgement and blame.  Admittedly, many therapists feel a twinge of sadness when they watch a client prematurely deny the help for which they’d finally mustered strength and courage to ask.  For me, I always wonder if there was some conversation we might have had that would have helped them bond with the process that could be most helpful.

The timing and necessity for therapy is unique for everyone.

If you find yourself stranded in murky waters and can’t quite pinpoint your source of distress, or setting the course for positive change in therapy leaves you feeling lost, consider a look at your value system.  Quite possibly, you may see that a part of your unrest is caused by not living a life consistent with what’s truly important to you.  Being misaligned with your values can create an emotional disturbance, a sense of disorganized living, and an irritability toward life.  Left unattended this can lead to anxiety and/or depression.  Navigating the therapy process becomes easier when using your value system as a reference.  It’s about asking “Who Am I, Really?” and “Who do I want to be?”  Use this simple guide to locate your truest self and your therapeutic journey can begin and end with a clarified destination.

Consider your whole self – Bring structure to your search by recognizing the major ways in which you express yourself in life.  In addition to our physical self (our health), we have a relational, vocational, and even spiritual self that needs expression and our mindful attention.

Measure Your Spending – Make note of where you’re spending your time, money, focus, and energy.  What you find in this measure may include regrets, a need to forgive others or even yourself, and possibly lead to grief about losses (some uninvited and some necessary). Reflect on both positive and negative times in your life to recognize when you’ve been depleting yourself without good cause and when you’ve felt a greater sense of well-being and wholeness.

Be honest – When taking inventory of who you are and how you’re living this life, be totally transparent with yourself.  This honest consideration will include a look at what you belief about yourself, others in your life, and the world in general.  It will most certainly bring rise to any feelings about all you discover.  Don’t run from the emotions that surface.  Learn from them and use them to guide your efforts in change.

Shift with intention – Once you have a realistic view of where you’ve been, use your therapy space to proactively step into any readjustments needed.

Navigating the therapy process becomes easier when using your value system as a reference.  It’s about asking “Who am I, really?” and “Who do I want to be?” 

Therapy can be daunting.  Your therapist has the flashlight of her (his) training, experience, and intuition as a help on the journey.  It’s okay to ask your therapist to ensure you aren’t lost along the way, even if you feel lost.  I frequently ask my clients’ feedback on whether they believe we’re on the right path for them.  If not, we can consider changing directions.  You may enter therapy unsure of why you started.  Joining together with a trusted professional in the therapy space can ensure you are free to walk out your path toward a clear and positive destination.

Note: This information is not intended to replace the medical advice or treatment of a trained professional.  If you feel your needs are creating an unsafe situation for you or someone else, seek emergent care through your primary care physician or local emergency room.

 

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The Healing Agent of Talking

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As some people consider seeking a psychotherapist or counselor (often used interchangeably), they may question how “just talking” to a professional might be helpful. Many of my clients have told me that they believed talking with someone who was not closely connected to their personal situation, and who could remain non-biased, was what led them to make the call. Others are drawn to the therapy because of the confidentiality of that space. But what makes “just talking” helpful? If you’re considering therapy, though are unsure it would be any more helpful than venting to a friend, consider the following:

  1. A therapist is trained to listen. What is it about listening that would require a person be trained? Therapists are educated to manage their own biases in order to focus on the client’s needs. In fact, it is highly recommended that even seasoned therapists seek consultation from peers in the field so they can ensure they are listening and considering the client’s needs with complete objectivity.
  2. Therapists aren’t “just listening”. While a safe space to vent may feel great to the client, the therapist is doing more than just listening until the client has emptied themselves from distressing thoughts and emotions. A therapist can listen for any long-standing patterns of thinking that may be getting in the way of you living the life you want to live.
  3. Therapists aren’t afraid to lose your friendship. That’s because your relationship with a therapist isn’t a friendship. It is professional. The boundaries set in place for you by this professional connection protect you and allow the therapist to be honest with you about what they observe. Because of the safety in this well-structured relationship, the therapist can help you confront difficult aspects of your life and self in ways that foster healing and growth. Since it isn’t a friendship, there is no assumption that you are responsible for how your therapist feels. Having an entire hour in your life where the only person you are responsible for is you can be a powerful way to change.
  4. Therapists know the thought-feeling connection. Many therapists, especially those who practice cognitive therapies, understand how to help you change unwanted feelings by challenging certain thought patterns that may be keeping you stuck in an unwanted emotional place.
  5. Therapists understand how the mind and body work together. Some therapists are well-versed in somatic-based treatment. This means they can empower you by teaching you to better manage some aspects of your nervous system. By doing so, you can experience positive results in managing anxiety, the effects of traumatic events on your life, and a depressed mood. Although some of our body’s neurological and physiological responses may also require treatment by a medical doctor who can prescribe medications, having the support of a well-trained therapist can enhance your psychological healing.

Therapists typically aren’t finished with their training after graduate school. Throughout their careers, they are required to continue that education annually and some even begin to carve out specialty skill sets. This professional development doesn’t preclude them from sincerely caring about your well-being. Many therapists enter the field because they believe they are called to care for others while using specific gifts in helping people transform their lives. In fact, many therapists are well-trained in not only the science of psychotherapy, but also the art of it.  So while you are doing all this talking in their office, it can feel as comfortable and authentic as if you were just sitting down with that trusted friend. The exception is that you have the undivided attention a trained professional who is focused on only you.

If you suspect working with a therapist or counselor might be a good fit for you, I recommend you research those in your area. You have every right to make sure the one you choose is skilled in the area of your need and is trained to give you the best possible care. The healing agent of talking might be what you need.

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Considering Couples Therapy? 5 Things to Know

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“Vulnerability is our most accurate measurement of courage.” – Brene’ Brown
 
Couples who enter therapy to strengthen or repair their marriage are courageous by virtue of that choice. Relationships can be challenging. Factor in trust issues or attachment wounds pre-existing to the marriage and the relationship may be in for a difficult journey. Many couples withstand these challenges with little to no apparent scathing. For others, the time and energy each spouse uses to defend against the ensuing battles can create years of emotional pain leading each person to feel ultimately alone and helpless to change the situation. For those that find their way into a therapist’s office there is hope, and healing can be realized. The work that begins in that therapy space is, initially, uncomfortable for many. However, for those that withstand this beginning phase it is well worth the investment. Couples therapy is an investment of not only money, but also time and trust. The most expensive of these may be the trust. Trusting a therapist who will expect you to become transparent and forthcoming is one thing. Learning to trust your partner on new levels is a risk that makes some people squirm to retreat even further. The therapist will encourage you to become vulnerable. The healthier marriage you seek requires that vulnerability. **
 
If you and your partner long for a strong marriage and are thinking of entering couples therapy, consider the following:
 
1. Trust is a decision, not a feeling. Countless spouses have said to me, “I don’t feel like I can trust him (or her)”. They frequently believe they must hold out for some positive emotional experience that will signal it’s okay to move forward in working on a relationship. Trust is not an emotion. If you’ve made the choice to trust someone in your life and that person betrayed you, the decision to trust again will not initially be accompanied by warm, fuzzy feelings. In fact, making the decision to trust will often feel uncomfortable. You’ll feel vulnerable and may believe it’s intolerable.
 
2. Trust and vulnerability go hand in hand. They are really two sides of the same coin. If you want your partner to trust you, you must be comfortable showing all of you. This means your true self, not the self that has been cloaked in your defenses. Showing our true self happens with full disclosure of emotions, thoughts, fears, dreams, and so on. By your willingness to be vulnerable, you’re letting your partner know the relationship is a safe space for that level of openness. This, in turn, may encourage them to be more open and authentic with you.  Once this open exchange begins between you, you’ll find yourself trusting with more ease. It can soon become a dance of connection that seems effortless.
 
3. Healthy relationships require vulnerability. This is one of the reasons infidelity becomes a choice for some spouses. For certain people, it seems easier to enter a series of new relationships where we continue to show only our superficial selves rather than allow the opening up of true self that is required to build a life with just one person. Even in marriages where betrayal is not an issue, the fear of vulnerability can lead to a painful distance between two people and this emotional distance can last a lifetime.
 
4. You’ll be asked to lay aside your defenses. It’s natural to protect ourselves when we feel threatened. As humans, we have as many ways of shielding ourselves from perceived emotional threats as we do ways to defend from actual physical danger. However, these shields are often unhealthy and serve to separate us from our partner, keeping us from the safety of that secure attachment we crave. With the help of a couples’ therapist, it can take little time to identify these unhealthy coping tactics and create more adaptive ways to feel emotionally safe in your relationship.
 
5. Yep, it’s scary and there are no guarantees. The absence of guarantees is what makes vulnerability and trust such difficult steps. Not everyone is selfless and not everyone enters into marriage with the same goals. In any relationship, there is always the risk of putting ourselves out there, only to be left alone and without. But, if you and your spouse choose to trust a therapist to explore the landscape of your marriage and motivations, you’re one step closer to moving from that scary spot to the sweet spot of a meaningful bond.
 
** Vulnerability in a loving relationship does not include allowing oneself to be physically or emotionally abused. If you are being abused in any way, please search for a professional who can help you develop a safety plan for exiting the situation.
In the Tulsa County area, you can call the 24-hour Information and Crisis Line at 918.743.5763.
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The Resilience Resolution

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Resilience – The capacity to recover from difficult times; regaining our ability to thrive after having been through something.  

The holiday season is complete and I confess to a grief I feel at the end of each Christmas. While I have my share of melancholy during the season, I hold tight to any goodness I find in each year’s celebration. My faith (a focus of the season for me) is important, I treasure the extra time with family, and see extra portions of goodwill all around. After this surge of joy, there’s a sense of loss when it’s over. The grief is followed by a bracing for what’s to come. Another year. Even without a pessimistic outlook, reality dictates that life can have its ups and downs. That’s why resilience becomes a focal point in my efforts toward mindful living.

I am always briefly breathless from the roller coaster ride of thoughts and feelings that carry the end of one year into the next. As a therapist I have the inside track on emotion regulation, though am not insulated from the waves of feeling that come with being human. It also doesn’t stop life from happening. My only resolve is to remain resilient. In fact, I gave up setting other New Year’s resolutions long ago. It can be growth-stunting to hold positive change hostage to a calendar. To forego the burden of setting resolutions only at the New Year creates a relief. Bringing balance to the expectations for our life frees us up to strengthen our core self – the wellspring from which our resilience flows.

How do we develop a resilient self? While traits existing at birth make a contribution to resilience, we know it can be developed in most everyone. Cultivating such fortitude can seem a complicated task, but is certainly doable.

Bringing balance to the expectations for our life frees us up to strengthen our core self – the wellspring from which our resilience flows.

Try building a foundation with the following steps:

1): Develop the mindset: Decide that you want for yourself the strength and tenacity to overcome. Choose resilience. Intention can be the cornerstone of psychological survival. If you’re reading this, you’ve taken a step toward shaping your mindset for thriving on  life’s journey. Make it a daily habit to speak the intent of resilience each morning.

2): Forgive yourself: If you perceive failing at resilience, don’t hold a grudge. Have the crying spell, spend the Sunday afternoon wrapped up in a blanket doing absolutely nothing, allow yourself to feel all the painful emotions that arise from challenging events. None of this means you aren’t resilient. It just means you’re human. After such collapse as comes with a breaking point, pick yourself up and try again. One of the most important features of learning to walk when we were young was the developed skill of getting back up when we would fall.

3): Determination: Disallow the belief that you are forever defined or permanently damaged by any adversity or trauma you’ve experienced. Remind yourself that the positive traits you possessed before the struggles are not erased by the stress presented in the difficult situation. Look for reminders of your best self – a self that has been purposefully developed – one of hopefulness and determination. If this has been a challenge for you, begin now to identify those skills and principles you desire.

4): Seek examples: Make it a habit to seek out examples of others practicing the resilience you crave. Take time each week to seek out inspiring news stories, read about someone who has overcome the odds, or journal memories of your own victories (even the small ones) and recall them when tough times return.

5): Emotion Regulation: Keep it in check. Letting your emotions dictate the intensity of your actions can have both psychological and physical repercussions. Try calibrating your perspective. Use the “kitten or tiger” lens to view situations. If it’s a kitten, use only the amount of physical and emotional energy needed to rebuke its effects. If it is indeed a tiger of a situation, seek support from others to help you in the battle. Whenever possible, shift your focus to more positive connections (friends, church groups, community organizations that inspire positivity). Use perspective to temper emotions.

6): Value the stillness: There is power in the quiet times of our lives. Do your best to find a moment of stillness every day. Spend 15 minutes each day if you can, quiet and still. Be determined about this one valuable act of self-care. Find a place of solitary – under a tree, on the porch, anywhere you can – and close your eyes. Let the chaos of your life wash through you and float away. Imagine yourself being filled with the strength and determination you seek. Notice the quiet. Replenish.

My profession has allowed me to witness people overcome seemingly insurmountable odds. I’m convinced the human spirit is mostly veiled in the power to overcome. Give your spirit the chance to flex its strength. In the coming year, give yourself the gift of remaining resolute in your resilience.

This information is not intended to replace the medical advice or treatment of a trained professional.  If you find yourself struggling to manage challenging thoughts or moods during this time of year, contact your primary care physician or seek the support of a licensed mental health professional.

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‘Tis the Season for Joy and Gratitude – Using Gratitude to Unlock Joy

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If only feelings of joy and gratitude were synced to a calendar. That would certainly make the holiday season an easier experience, at least for some. Constant messages all around us suggesting we must feel joy and be grateful can seem pressured, leaving us feeling inauthentic in our efforts to make our lives look like a Norman Rockwell picture.
It might help to consider that any feelings (even joy) stem from our thought-life. We can change how we feel by changing the way we think!  Re-training our brain to think differently can take some time. The good news is we can move closer to a healthy thought-life by practicing the behaviors that are associated with feelings like joy.  In fact, there is evidence that practicing gratitude can unlock our joy!  No prerequisite feeling needed! The feeling will follow the intent and action.
So how do we practice gratitude? Consider the following actions you can take. Begin during this holiday season and carry these new rituals into the new year!
  1. Begin a gratitude journal – I know it may sound cliche’, but the research is showing us that significant positive changes in our brain chemistry take place when we just think about what we might be grateful for! Try it for a month. At the end of each day, spend 15 minutes thinking about 3 things for which you are truly grateful.
  2. Voice your appreciation for something – Even the smallest of compliments to someone else, or voicing how grateful you are that a much needed rain fell last night can begin to re-shape how we think and shifts our perspective about our world.
  3. Eliminate complaining – What a challenge! I encourage you to try it! Commit to going one day, or even a whole week, without voicing complaints and see how you feel!
  4. Look for the lesson in an otherwise annoying situation – Since we can’t control what situations or toxic people come our way, we can strive to change how we experience that event or person. Always look for what you can learn in any given scenario. It shifts your thoughts from the negative to the positive.
  5. Make gratitude a habit – Because gratitude is a choice of thought and not an emotion, we can make the practice of it a daily routine in our lives. Creating a healthy habit of practicing grateful thoughts can sustain us through difficult times.  Because it’s not a feeling, we don’t have to wait for it to rise up in us randomly or spontaneously. We can summon the habit of gratitude by practicing some form of it each day.

Remember that gratitude is an attitude rather than an emotion. Stressful events can certainly steal our joy for a time, though an intentional shift of our attitude back to gratefulness can help us regain or retain that joy, despite our circumstances. Victor Frankl, a well-known psychiatrist and Holocaust survivor thrived during one of the most egregious seasons of his life (and in our world’s history) by realizing that the Nazis could take away everything from him – including his life – everything but one thing. That one thing was his attitude.  Our attitude is our way of thinking about a situation. Regardless of what’s happening around us, we get to choose it. This awareness helped Dr. Frankl hold on when there was no concrete hope on which to hold. We can do the same.

“Everything can be taken from a man but one thing: the last of the human freedoms — to choose one’s attitude in any given set of circumstances, to choose one’s own way.”    ― Viktor E. FranklMan’s Search for Meaning

Finding joy is a unique journey for each of us since a person’s joy is created by very personal experience. However, there are common steps we can each take on our journey that can help us reach the desired destination of feeling more joy. While joy is never a permanent state of being, taking these steps can ensure it comes more than it goes. I certainly wish you peace and strength on your journey – and of course, joy and gratitude in this season and for many seasons to come!

 

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6 Tips for Managing Difficult Emotions During the Holidays

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There is no shortage of information written about coping with the holiday season.  That’s because there’s no shortage of people feeling extra stress this time of year.  Yet many people will cower in the darkness of an emotional corner before reaching out for support.  Following all the tips on the Internet for coping with the holidays won’t guarantee a stress-free season. Yet, there are some simple ways to manage the more distressing emotions that come during this time.  Consider these 5 steps for managing holiday woes.

1. Eliminate untrue self-talkCommon statements we tell ourselves that create isolation are:

“No one would understand how I’m feeling”This is simply untrue. There are universal experiences that connect us as human beings. Periods of deep sorrow, loneliness, depression, or anxiety are some, to name a few. While it might be true that your life includes uncaring persons, you can also find a number of people who are gifted to show compassion when you’re in need. Counselors, pastors, and chaplains feel truly called to listen. If you’ve not shared these isolating thoughts and feelings with your family or friends, try that first. You might be surprised to know they’ve been down that road themselves.

“I don’t deserve someone to care about me”This is a ‘shaming’ thought and may be a symptom of depression. It’s also untrue. Shame can isolate people. The first thing that shrinks shame is disclosing it to someone. Connection shrinks shame. So, battle that thought by stopping it in its tracks.

2. Find a support group – Many local chapters of mental health associations sponsor support groups for people with various concerns. Your local hospitals or certain churches may also offer the same type of connections. It can be scary to connect with new people, though research shows group support is an effective way to cope with many life issues!

3. Do something! Starting a new hobby or lifestyle choice can shift our thoughts and build our emotional immune system. A few possibilities include:

  • Reading a new book – can’t afford one? It’s okay – your local library will let you borrow them for free!
  • Take walks – walking is known to relieve stress, lower blood pressure, and can clear your mind of negativity! Got a park or small forest nearby? Even better! Research shows being around nature has great healing power!
  • Learn something new – Whether it’s speaking a new language, learning how to garden or play the piano, learning new things keeps us mentally fit and adds to our overall emotional wellbeing!

4. Commit random acts of kindness – Giving of ourselves benefits us just as much as the person we’re giving to! Even a simple gesture of kind words to someone who might be having a bad day can make a difference. Remember to be equally kind to yourself!

5. Search for the spiritual meaningFor many, the holiday season, especially Christmas, is a time to reflect on and celebrate valued spiritual beliefs. Some studies show that connecting with one’s spiritual self can bring a sense of peace and help a person find purpose in life. There is evidence that exercising one’s spirituality helps to build resilience and overcome the effects of a traumatic event.  If you find yourself feeling negative about connecting with spirituality because of bad experiences with religion, consider that spirituality and religion are not necessarily the same thing.  While religion is a particular system of beliefs, spirituality is more personal and without the dogma that often leaves people feeling guilty and shamed.

6. Gain perspective – The holiday season is temporary. Its value comes from the meaning we assign to it. For some, it’s a time of spiritual celebration. For others, the focus is on family and friends. For you, it might be a time for reflection and personal growth without getting caught in the trap of commercialized mayhem. You get to decide what the season means to you.

I hope you find these tips helpful. I wish you a peaceful Christmas and restful holiday season.

This information is not intended to replace the medical advice or treatment of a trained professional.  If you find yourself struggling to manage challenging thoughts or moods during this time of year, contact your primary care physician or seek the support of a licensed mental health professional.

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From Panic to Peace

COPING WITH A PANIC ATTACK

During a panic attack you are likely to breathe more quickly or more deeply (or both) than you usually do.  This will have the effect of reducing the amount of carbon dioxide you have in your lungs, which in turn will give you a bunch of unpleasant feelings in your body** and may make you feel strange. These feelings can make you feel more frightened because if you don’t know what is causing them you will tend to think the worst – that something awful is going to happen to you. That type of thought makes you more frightened, which will probably make you breathe more, which will increase the unpleasant sensations, making the frightening thoughts seem more real, and so on. The vicious circle of fear leading to over-breathing, leading to frightening physical sensations will cause more fear and so on.  The process looks much like the diagram below:

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It is possible to get control over this process. To do this, you have to increase the amount of carbon dioxide in your lungs. The best way to do this is to change both your breathing and the way you react to the body sensations when they occur. This involves breathing less air at times when you start to get the physical sensations that go with an attack.

These steps can also be helpful in situations where you expect to get frightened or have these feelings. Then you can possibly stop the panic attack altogether.

It is usually best to start with small steps. Try the sequence below. You may need a slightly different sequence, but it will be similar.

  1. Take the steps slowly. First, notice carefully just what it is you are feeling, what happened just before the feelings started. What were you doing? Where were you? What symptoms do you have now? Rather than being fearful of the panic attack itself, accept that it is has happened.

Every time you panic it is an opportunity to learn more about what happens and how to gain control over your anxiety.

  1. Notice your breathing. Is it fast? Is it deep? Are you sighing a lot?
  2. Try to breathe smoothly, regularly, slowly, and gently in the pattern you learned with your therapist.
  3. Notice what’s going through your mind. What do you think is the worst thing that could happen right now?
  4. Remind yourself that breathing quickly has almost always resulted in similar physical sensations and frightening thoughts.
  5. Continue to breathe as gently as you can at the sort of speed you learned from your therapist. You may find it helpful to remember the calm voice your therapist used when teaching you the deep breathing exercise; focus on this memory as you control your breathing.
  6. As you slow down your breathing, you will notice that you will want to breathe more deeply. Try not to let this happen too much. Remember, the ideal pattern you are aiming for is smooth, slow, regular breathing in a way that doesn’t allow you to over-breathe.
  7. If you have managed to slow down for a few seconds but feel out of breath you will often want to take big gulp of air….try not to. Resist it by swallowing several times. If you find you have taken a gulp, hold it for 5-10 seconds and then let it out slowly. Then go back to breathing as before. This may help prevent taking a gulp, increasing your anxiety.
  8. As the breathing is reduced, notice what happens to the body sensations.   As they get less because of your breathing control, think about what this tells you. Does it mean that the sensations were caused by the things which you were more afraid of, or is it more likely that what is happening is the vicious circle of body sensations → frightening thoughts → over-breathing → more body sensations → more frightening thoughts → and so on? Would you expect to control your thinking and breathing to stop the symptoms if you were seriously ill and in danger? To sum up, breathe in and out as slowly and evenly as you can and avoid any big increase in depth as you do.

Notice the thoughts of disaster that happen when panic starts and which add fear to the symptoms, then remind yourself that the symptoms are, in fact, signs of a harmless but frightening change in breathing. Reducing your breathing is both useful and harmless and will start to give you some control over the panic attacks.

You may want to work on preventing the most severe attacks before they happen, but until then, take heart and know that a panic attack is temporary. While it has its own set of symptoms, you’ll want to confirm with a qualified medical professional that they are not indications of a medical issue that needs attention from a doctor.

** Most common symptoms include some combination of the following:

  1. Tight chest and shortness of breath
  2. Sweating
  3. Heart racing and/or palpitations
  4. Dizziness/feeling faint
  5. Hot or cold flushes
  6. Numbness or tingling
  7. Weak legs
  8. Feeling shaky

If the doctor has ruled out medical issues, consider contacting a therapist who can help you uncover the root cause to your panic and offer solutions that work for you!

Note: The information in this article is not meant to replace a full assessment by a qualified medical or mental health professional.  Please always see your doctor to rule out the need for further medical treatment.

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