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cbt and panic attacks

1102 Views 9 Replies 6 Participants Last post by  terri*
I have a question that I've asked a few times on here before but I I'm having the same conundrum again. I have textbook panic disorder. I'm scared of having panic attacks and going crazy and usually what causes my panic attacks now is derealization. Originally I guess stress caused them. Now the cycle is stress, then derealization, then panic. So, I've started cbt. And it is helping a LOT. I'm learning to quit obsessing and how to deal with my worries.
The problem is, my therapist wants the next time I have a panic attack for me to just find a chair or something, sit there and let the panic happen. Don't try to distract myself. He wants me to feel the fear and realize that nothing terrible is going to happen as a result of my panic attack. But this goes against everything I have learned on this board. Everyone here seems to say distraction is the key to dealing with derealization. Don't think about it. But if I keep distracting myself, I'm never gonna get over my fear of panic attacks. The derealization is better but I still live a life scared of the next incident. So basically I have no idea what I should do. Fight or flight? It's driving me crazy because I don't know which direction to go in. ANY responses would be greatly appreciated. Thanks everyone.
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What your therapist is talking about is "exposure therapy," in which you gradually confront the feared thing. It's the same therapy they use for phobia.

It is also the theory behind Claire Weekes' famous and oft-recommended book, Hope and Help for Your Nerves, which has been used and highly praised for the last half-century.

Let's put it this way. You're not a toddler; a toddler you can distract from something, and when you're "learning" to not be anxious or whatnot, you can successfully do the same for yourself. But eventually you have to face the fact that you often will not be able to distract yourself.

The truth is that panic will wash over you if you stop fighting it. The fighting of the panic is what causes it to not leave.

So your therapist is using Dr. Weekes' method, which today is called "exposure therapy." Whether you are ready for it is another question.
Like you, apparently, my DP was a product/coexistent of a panic attack. So, if I still had panic attacks, I would definitely work on seeing if I could learn to let the fear wash over me and then leave me.

If you can learn this in your therapy, it would be a skill that will serve you well for the rest of your life!

Once the DP sets in, that's the time for distraction, but if we can nip the panic attack in the bud, we will never see DP at all.

Go for it! If you like your therapist and you're doing well in other aspects of CBT, there's every reason to believe you can do this. If not, there will be another way -- and you can always try this again down the road. But I have a feeling this is going to work for you because of the very positive vibes I get about your feelings about your therapist and CBT so far.

Additional thought added a minute after I wrote the above: Before you sit yourself in that chair, get a large glass of water and drink it down right away -- all at once. This trick comes highly recommended by my sister the doctor.
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