Dear Dick
articles about wide ranging psychological issues
from "The Local Bulletin" (Brisbane Australia)
by Dick Rigby
©all articles are copyright 2006

April 2005
 “That was so dumb.  I can’t believe you did it”. Peter said to his good friend Lucy.  “I just panicked.  I lost the plot”, Lucy replied.  It’s not the first time that Lucy panicked in a difficult situation and made the wrong move.
When we panic, we lose some of our ability to make rational decisions.  Panic is a version of the “flight or fight response” where our bodies gear up to deal with a serious crisis.  When the flight or fight response works well, it can be very helpful in providing the physical strength and focus to deal with an emergency.
But a panic attack is where something goes wrong. The body goes into emergency fear response without a good reason.  A person can shake, perspire and feel as if they really are in danger.  Often a panic attack goes unreported because the person feels too embarrassed. 
Lucy used the toilets at a large shopping complex.  When she went to exit the cubicle, the lock wouldn’t work.  She felt trapped and claustrophobic.  She panicked and started banging on the closed door and yelling for someone to let her out.
Help came, but it took 20 minutes for her to be let out.  Someone pointed out that the lock just needed a bit of a firm twist to open it.  This didn’t help how Lucy was feeling.  Humiliation added to embarrassment which added to trauma.
She was so embarrassed that she didn’t tell anyone for a week.  Peter’s response didn’t help either.  Technically, Peter was right, Lucy’s response was “dumb”.  It’s true; anxiety does lower your IQ at the time.
That was the last straw for Lucy, she decided to get help.  She visited a psychologist, Anne.  Anne taught Lucy how to manage her panic attack.  Lucy learned how to find out what beliefs were behind the attack.  A most important step, because if you don’t know what your subconscious part is saying about the danger you are in, then you can’t communicate with this part.
To her surprise, Lucy found out that this part had been saying, that she would be trapped in the toilet for a long time and something very dangerous was about to happen.
Anne gave Lucy the tools to communicate with this part and reassure it that it was not in any danger at all.  There was a protocol to go through on these occasions.  It worked.  Lucy has been in similar claustrophobic situations since then and she has dealt with them with her IQ intact.
 

Panic Attacks

March 2000
I am 24 years old and I have a good job.  Nearly every morning when I am getting ready to go to work, I get really frightened and start shaking.  My doctor tells me that this is a panic attack.  He has given me some pills for it and they help, but when I take them I feel dull in my head for the rest of the morning.  Is there a better way of managing these feelings?
Shelly
Dear Shelly
Yes Shelly, there is a better way of managing panic attacks than just using medication.  Panic attacks (also known as anxiety attacks) are surprisingly common.  They usually take the form that a person starts to feel feelings of dread and foreboding in a particular situation.  Often the person is not sure what is causing the fear.  In other cases, the cause is known.  For example a client of mine would have a panic attack in a crowded shopping centre.  She would feel trapped and feel that something dreadful was about to happen.
Medication, such as Valium can help under certain circumstances, but medication doesn’t do anything to cure the condition.  There are techniques that you can learn that will help you regain control.  When I treat people suffering from panic attacks, I use a combination of two methods.  The first is the control of breathing and the second is self comforting.   When you have a panic attack, you will hypervetilate (take in too much air).  This results in a reduction of the amount of carbon dioxide in the lungs and bloodstream.  This increases the feelings of fear.
When you feel a panic attack starting, breath slowly and take shallow breaths.  Breath from the diaphragm (tummy) not the chest.  Maintain this slow shallow breathing for at least 5 minutes and preferably 10 minutes.
The second technique is talking to yourself in a reassuring way.  It may help to visualize yourself as a young child.  You (the adult) reassure this child that it is safe and nothing bad is going to happen.  This technique is only to be used where you are sure that there is no real danger.
These techniques work, but they are not easy to do.  It takes practice and perseverance to unlearn the habit of a panic attack.
 

Anxiety and how to beat it

September 2001
Anxiety, worry, apprehension, nerves, and so on.  They all come down to one word.  Fear.  Fear rules many people’s lives.  Fear can stop them from living life to the full. 
We need some fear otherwise we would take unreasonable risks.  Reasonable fear is healthy.  But a fear that is out of control creates problems for people.  You know that fear is out of control  when you are frightened of something, yet, at the same time, know that something is not dangerous.   This is often called a phobia.  A phobia is, by definition an unreasonable fear.
Amanda was frightened of being in a crowded shopping centre.  She would become very distressed.  She would start to have a panic attack and have to leave immediately.  She knew that her fear was unreasonable, because she was not in any danger.  She just felt that she was.
Amanda has a subconscious part in charge of this fear.  This part is an intelligent subsystem within her.  We all have them.  This part believes that the shopping centre is dangerous and acts accordingly to protect Amanda.
To fix the problem, Amanda must learn how to communicate with this subconscious part.  There are lots of techniques that help do this.  Techniques such as “Voice dialogue”, “Gestalt therapy”, and “NLP”.  When I work with someone like Amanda, my starting point is to get her to appreciate that this subconscious part is trying to look after her.  Once she believes this, she can thank the part for doing it’s best. 
It sounds strange, but it really does work.  Unless one makes a connection with this part, nothing changes.  Establishing trust and dialogue between the conscious mind and a troublesome subconscious part is the best way that I know to overcome an unreasonable fear.
Using voice dialogue, we can learn what that part is really afraid of.  Sometimes it isn’t the obvious.  Once we have that information, we can better reassure that part that it is safe.
It turned out that Amanda’s subconscious part was afraid that she would get lost in the shopping centre and not be able to find a toilet when she urgently needed one.  With this knowledge, Amanda was able to plan her visits to the local shopping centre better so that she made herself aware of where all the toilets were before she went shopping.
 

Don’t’ be afraid

 October 2002
“Don’t be afraid of those things that are not dangerous!”  A good motto for life, but so hard for some people to live by.  Claire had a fear of frogs.  Not just a fear.  She was terrified.  In her adult mind, she knew that a green frog couldn’t harm her, but she couldn’t shake her overwhelming fear.
How could this be?  Well it’s all in the way that we learn how to be frightened.  Claire learned her fear of frogs in primary school when a couple of older boys teased her with a frog. They held the frog against her face and she couldn’t get away.  She was terrified.
Our brain lays down the memory of such events using the limbic system.  The limbic system sits in the centre of the brain.  Ordinary rational discussion doesn’t seem to reach this part.  So Claire could reason with herself ‘till the cows came home, but she just couldn’t get rid of the fear.
Different techniques have to be used to overcome this sort of fear or phobia.  These techniques involve making emotional connection by way of the limbic system.  One technique that I have talked before is “Systematic desensitization”.  This worked for Claire using a model  of a frog to help make it realistic.  After a couple of sessions, she was able to touch a real frog without any fear at all.  Too easy.  If people really want to put in the effort, they can learn to overcome fear of things that are not dangerous.
As part of my practice I help people overcome a fear of singing or public speaking.  Larry was absolutely petrified of singing in front of other people.  He was terrified to sing even in front of his trusted friends.  He knew his friends were supportive and would not rubbish him.
I was able to help him retrain the limbic system to know that he was safe to sing in front of these people.  Eventually he got the confidence to do this.  He now enjoys singing in a choir.  Larry learned that, even if people were to rubbish him, he is still not in any real danger. 
Many of us have unreasonable fears that prevent us doing what we want to do.  For me, it is always a great pleasure to see someone let go of unfounded fears that have been cluttering their lives for years. 

Running from fear

December 2006
WARNING:  Readers should be warned that this story does not have a happy ending.
Josh (not his real name) had a happy life, or so he said.  His wife Jannette was not happy because she had to deal with Josh’s chronic anxiety and depression.
He came to see me at Jannette’s insistance.  She brought him because she was at the end of her tether.  She was sick of making excuses.  Sometimes he was so anxious that he couldn’t even go to work.  She would ring up his boss and make some excuse.
Eventually his boss fired him.  Josh had been out of work for 3 months before he saw me and Jannette was having to work extra shifts just to keep enough money coming in.
He was such a nice man when I met him.  He was so pleasant and cooperative.  He genuinely wanted my  help to fix his anxiety.  So far so good.
The first session went well.  I had some suggestions about anxiety management and he was more than willing to give these a go.  He and Jannette left the session feeling optimistic.
His anxiety had improved by the second session and he had done some job hunting.  We did more on anxiety reduction and coping strategies.  We talked about his family of origin and how his mother had been such a worrier.  We talked about his father’s suicide when he was just 11 years old.
He understood how he learned to be frightened and how things that he loved would be snatched away from him.
By the third session he had started getting anxiety attacks again and he felt more pessimistic.  He appeared to have closed down.  He said that he was just going through a bad patch and he would be fine.
He didn’t keep his fourth appointment.  When I rang him to find out what had happened, he said that he had forgotten and he would ring me to make another appointment.  That call never came.
At some deep level it just became too scarey.  He chose the easy way out which was to retreat back into his fear.   If he had kept coming, Josh would have broken through the fear barrier.  So sad because he had so much potential.