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Ask KansasTherapist Your Own Question

KansasTherapist
KansasTherapist, LSCSW
Category: Mental Health
Satisfied Customers: 565
Experience:  17 years experience with depression, abuse, and borderline.
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Hey can you please open a chat window

Customer Question

Hey can you please open a chat window
Submitted: 2 years ago.
Category: Mental Health
Expert:  KansasTherapist replied 2 years ago.

KansasTherapist :

Hello

KansasTherapist :

I will be on line to chat for at least an hour. If you come back on line while I'm here, I'd be glad to help you.

Customer:

hello

KansasTherapist :

hi

KansasTherapist :

What can I help you with?

Customer:

well i have panic/anxiety disorder and freak out a lot and have trouble relaxing

KansasTherapist :

Anxiety disorder is a big problem. Lots of people really struggle with it. Are you taking any medication for it?

Customer:

but recently for some reason i worry that i will try and harm myself or family and friends but i know i never would

Customer:

my head just trys to make me freak out over stuff that i would never do

KansasTherapist :

When a person has anxiety, their body is sending all kinds of signals that something bad is about to happen. In that situation it's natural to search for where the bad might be coming from. Often people will come up with fears that are unrealistic but fit what their body is telling them. Do you think this could be the case with you?

Customer:

how do i get rid of these like fake thoughts

Customer:

yes that sounds familiar

KansasTherapist :

One of the ways to get rid of them is with a technique called thought stopping.

Customer:

its like im afraid my head might make me do something harmful

Customer:

but i know i wouldn

KansasTherapist :

First you come up with a list of positive things. For example, I love and care about my family, I would never do anything to hurt them.

KansasTherapist :

There should be several things on your list. When you notice you're thinking this thought about hurting someone, in your head you tell yourself, STOP! Then substitute the positive thoughts you want to have.

Customer:

ok

KansasTherapist :

It takes some work to get it going but the more you do it, the more effective it is.

KansasTherapist :

Are you taking any meds for anxiety?

Customer:

no not really

KansasTherapist :

That's another possibility if you'd consider it.

Customer:

ok

Customer:

i just always feel like my heart is racing and stuff so i just need to relax

KansasTherapist :

You can go to you're regular doctor and talk about the symptoms you're having. Antidepressants are often prescribed for anxiety.

KansasTherapist :

Some people don't like to take meds. That's okay but then they really have to work hard at techniques like this to get things calmed down.

KansasTherapist :

Yoga and meditation is also helpful if you want to try it.

Customer:

ok ill try that

KansasTherapist :

There is a meditation web site I really like, wildmind.org

Customer:

ok

KansasTherapist :

I hope these ideas work for you.

Customer:

are these problems im having normal?

KansasTherapist :

They are very common.

Customer:

ok thanks

KansasTherapist :

You're very welcome.

KansasTherapist, LSCSW
Category: Mental Health
Satisfied Customers: 565
Experience: 17 years experience with depression, abuse, and borderline.
KansasTherapist and 2 other Mental Health Specialists are ready to help you
Customer: replied 2 years ago.
hello--im still having some trouble. i feel like my head is afraid im going to develop something where i do something bad to me or someone i know like friends or family but deep down i know i never would. how do i get rid of it?
Customer: replied 2 years ago.
Relist: Incomplete answer.
Expert:  Dr. Mark replied 2 years ago.

Hi, You have relisted the question, which means you would like to get further help from a different expert. However, you have rated the previous answer. The question, then, is if you want further help, which the experts would be glad to offer, but only if you are prepared to start over. And the other experts would expect that you would give them a rating as well for their answers if the answer is helpful. This would mean you would be paying again. I am a psychologist in private practice and would be glad to help here. But I would need to know if you realize that you will be starting over again and want to do that and pay for your answer. Let me know, okay?


Thanks, Dr. Mark

Customer: replied 2 years ago.
ok--i will pay
Expert:  Dr. Mark replied 2 years ago.

Hi! You know, I read carefully your exchange with Kansas Therapist and I think that to give you the best answer, I should ask you a few questions first that will help define the problem and the situation.


There are two stages to your experience. The first stage was feeling anxiety. How long have you had anxiety? When did it start? Was there a triggering event in your life?

But now you're also starting to have intrusive thoughts that are scary. When did these start? Was there a triggering event?

Are the anxiety and/or the intrusive thoughts coming in cycles? Meaning, do you go through periods of time where you're feeling a lot of anxiety energy and intrusive thoughts, then it will sort of crash and you'll feel depressed for a while, and then maybe okay for a little while, then the anxiety will come back? And it goes back and forth like that?

Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?

Are you interested in medications to help? Or self help techniques? Or psychotherapy?

Are you getting any treatment right now? If so, what type? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Any extra information that will help, feel free to share.


Dr. Mark

Customer: replied 2 years ago.
basically, ive had it for prob a couple years but the past 6 months its gotten worse and i freak out very easily. If i feel a minor pain in heart i start panicing maybe its heart attack or if i feel something i always think its something minor. Also, if i have a big day coming up or something really fun--i worry that if i dont get enough sleep i cant enjoy the acitivies. So its like my head trys to keep me from having fun or relaxing and looks for things to panic about. I know i would never do anything to harm myself or friends/family--its more my head worrying that what if i develop something that causes that so i panic and cant relax. It's kind of confusing. I have a great life ahead of me and am fortunate to be in a very wealthy family and i feel maybe my head is trying to keep me from enjoying that. No trauma or abuse in childhood--no medication or treatment. I know my dad has anxiety disorder also.
Expert:  Dr. Mark replied 2 years ago.

Thank you for the replies to the questions and the added information. It helps a lot. I believe I can now be of help with this issue.


First let me say that I can imagine how distressing and worrisome and even scary this situation must be for you. You are at an age where a number of different mood disorders can become visible and diagnosable. That your father has had anxiety disorder is important history here. You are not reporting that the anxiety cycles, so it is most likely that you have an anxiety disorder with panic reactions (the intrusive thoughts). Let's work from that premise, then.

This is definitely a problem that you need to address effectively. There are two ways of doing this: medications and psychotherapy. The research shows both together are the most effective form of treatment. Psychotherapy is important because anxiety and panic and phobic reactions do not come out of nowhere and they are rarely only physiological events in your body. So therapy is an important way to manage the emotions and worries and intrusive thoughts. Medications can give an important boost to your confidence as you work on learning management skills and what is going on in therapy. So this is your decision: consider if you want to use medications with psychotherapy; or if you want to try psychotherapy on its own at first to learn skills.

I will also at the end of the posting give you a technique you can use on your own as well for when you are in the throes of anxiety and phobic fear and worries.

Let's work on five ways you can begin to build a behavioral program for yourself: diet, exercise, spiritual life, motivational reading and psychotherapy. The first four are to help you feel more involved and in control of yourself and what's going on inside. The psychotherapy can actually teach you skills and give you tools for managing your symptoms. This is serious for you as you need to reprogram your thinking about yourself. Spiritual life, diet and exercise are great ways to begin such a reprogramming.

Diet: cut out coffee, sugar, white flour. That may be tough. But you will see results as some of the newer research shows. And lean meats only. No fast food restaurants, no fatty foods. See what I mean about getting involved in controlling what's happening? With diet changes you are treating your problem with respect: you are acknowledging you need to make changes to get your body feeling better.

Vitamins can be useful for moods. A good quality daily vitamin, for example. One of the most important supplements is Omega 3 fatty acids, either in fish oil or capsules or in flax seed oil. Buy good quality. The clinical dosage is 1,600-3,000 mg daily. All these things you should get at the biggest and most frequented health food store and ask them for the best brands they trust in terms of quality.

Exercise: 5 days a week moderate exercise, to include 3 days of strength training as you get more used to it. Pretty amazing isn't it? I told you it would require work, but what you put in to it you will get out of it. Your doctor will verify the research results showing the benefit. You are young person and you may need to up the intensity of the program.

Spiritual life: the medical literature is now rather overwhelming about the benefits to so many different areas of physical health of regular religious and spiritual practice. Going to church, meditation, etc. are all shown to produce benefits to the physical body. What about our mental health? Well, you will see that meditation is now a regular part of psychotherapy interventions. I don't know if you're a religious person or not. But if not, this may be a good time in your life to tune up your spiritual life. If you do not believe in G-d, that's not a barrier to your own spiritual life. Just thinking about the meaning of your life, of life in general, and studying spiritual texts and practices will help with the anxiety. And that will help with the panic reactions/intrusive thoughts.

Then along with exploring the spiritual part of life, I want you to get really into motivational videos and books. Here's a simple YouTube search I put together for you on "motivational speakers":

http://www.youtube.com/results?search_query=motivational+speakers&aq=f

Some like Tony Robbins are the classic big guys. Some are newer. Watch them all. Get inspired. Buy a book or two. Here are some possibilities, but they are only suggestions as there are so many good ones.

The first book is the father of all these type of books. How to Win Friends and Influence People by Dale Carnegie. There are classes in these books now! It was written in the 1930s and still has something to say to us today that is very worthwhile.

I think very highly of the second book on my list, which is a real classic: The Seven Habits of Highly Effective People by Stephen Covey. It is the book that has helped more people than probably any other.

The third book is by Anthony Robbins. He's one of those speakers who fills up huge auditoriums. For a reason. He's a terrific speaker and writer. The particular book (if you like it, try his others): Awaken the Giant Within.


Which brings us to psychotherapy. This is the heart of the program. You need to find a psychologist or psychotherapist to help you manage the anxiety. This is for the phobic/panic reaction you are having to the possibility of your own medical problems as well. Fortunately, anxiety and phobias are among the most researched disorders in terms of effective treatments. And the therapies today are very effective. The preferred form of treatment today is Cognitive Behavioral Therapy to learn skills.

If your doctor isn't able to refer to anyone, here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list CBT therapy in their orientations and anxiety disorders as one of the areas they work with.

http://therapists.psychologytoday.com/rms/


If you want someone who isn't as structured as a pure CBT therapist, consider seeing if the therapist also lists humanistic and/or psychodynamic therapy in their orientation. The idea here isn't that these types of therapy are magic. It's that you may want to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and social phobia.

Okay, that should help you get working on these symptoms and get some relief. I wish you the very best!

Now, I want to give you a tool to use for when the intrusive thoughts and anxiety is overwhelming. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety states is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark

Customer: replied 2 years ago.
ok that seems like some good ideas--i feel like when im relaxed i dont get these thoughts. The only reason i have them is because it gets my heart racing and worrying about what if my head just makes me do it when i know i never would
Expert:  Dr. Mark replied 2 years ago.

You sense in yourself that you are CONVICING yourself of something that has no reality other than your inability to stop thinking about it and obsessing about it. It's a vicious cycle that is caused by anxiety and increases anxiety. You originally started feeling anxiety because of some triggering event that is now long forgotten and may have been not a big deal even then, but now the anxiety has settled in to become itself the problem rather than a reaction to a problem. You no longer even know what internal triggers are causing your heart to race, or what external triggers are causing this. That needs to really be worked on in therapy and that's why I called it the heart of the program for you. But you seem to be asking me for self help tools, so I'll try to help with those. But know that therapy may be needed here as the symptoms are severe, okay?


You need to know that this is not as uncommon as you think. Intelligent people, both male and female, tend to have these obsessive thoughts. And there is no way to predict or know why each person's subconscious mind chooses one thing to obsess about instead of another. Your mind fastened on these negative actions. These are not anything profoundly true, they are just what your mind fastened on. Other people fasten on other things. We can theorize about fears driving the subconscious choice of subject, but it's only theorizing at this time. Therefore, I need you to reorient your view of what is going on.


EVERYONE has strange thoughts come into our minds! So what's the difference between all of us and those who have a psychological problem? What we DO with those strange thoughts!



Here's what I mean:


It is very common to have a thought about jumping or falling off a subway platform or onto the tracks of a train. Why? Because we've all seen images of this in movies, etc. Same with jumping off balconies or falling. And other such calamities. BUT, most of us let these thoughts just go. We don't hold on to them. We treat them like all the other type of fleeting thoughts we have throughout the day about whole sorts of things. We just let them go and don't attach any importance to them. When someone CAN'T let the thought go, then that could be part of Obsessive Compulsive Disorder for example, or some other anxiety disorder.


Do you see the difference here? It's not in the thought. It's in what we do with it. So for some reason you don't know about, the obsessive thoughts of people's suffering and your lack of worth are now habitually coming into your mind. But that's all they are: habit.


By the way, you may be interested: about 8 months ago I treated in my private practice someone with stray thoughts problems. His tended toward being very sad about possible hidden motives in his thoughts. He was obsessed that if he thought about a relative in a fond way that really he must have had a malevolent intent: that somehow by thinking a pleasant thought about his mom, dad, or someone else, he was actually hoping they would get cancer or something like that. It was very debilitating to him. What did we work on? What I'm telling you. We worked on changing his view from being so scared of these thoughts to just letting these stray strange thoughts go the way of any other fleeting thought.

So, that is the key and I hope you will be able to apply it on your own or with help in therapy. Apply the strategy. Every time you have the thought, consciously tell yourself that it is just a stray thought, a strange thought. This is just a stray thought. If it persists, use the technique below and remind yourself it's just a stray thought like everyone has because you still have residual anxiety. Got the technique?

Good. Here's the other part:

We're going to create an acronym. An acronym in case you don't know is when you take the first letters of something. Like EU stands for European Union, right? But whenever you hear or read EU, you know what it means. That's an acronym. So what's our acronym?

This is just a stray thought = TIJAST


When a thought of others' suffering or your own lack of deserving happiness wanders in you're going to remember TIJAST. But you also are going to remember what TIJAST stands for, okay?

And whenever you get nervous about it and start to worry, you're going to smile and say TIJAST! Because it is a funny word isn't it? TIJAST...this is just a stray thought...

Because we ALL get stray thoughts. The thoughts of suffering themselves have no power and are not a problem. It's the nervousness and fear you feel about having them that causes you a problem. So use the technique: It's only fear, it's not anything else. It's just fear of stray thoughts. It's..........TIJAST.

Again, don't be afraid to work on this in therapy also. I wish you the very best.

My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons. If I can be of further help with any issue now or in the future, just put "For Dr. Mark" in the front of your new question, and I'll be the one to answer it. All the best, Dr. Mark

Expert:  Dr. Mark replied 1 year ago.

Hi. I see you've viewed but haven't responded yet to my answer. I would be very interested in hearing back from you on whether you thought my response was on target or if we need to continue with further clarification. My goal is for you to feel like you've gotten Great Service from me and the site. If we need to continue the discussion for that to happen, then please feel free to reply and we'll continue working on this. If the answer has given you the help you need, please remember to give a rating of 5 (Great Service) or 4 (Informative and helpful), or even 3 (Got the job done) button. This will make sure that I am credited for the answer and you are not charged anything more than the deposit you already made by pressing any of these buttons.

Let me know,

Dr. Mark

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