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Hello, I have been going through some anxiety over the past year that has manifested itself in my fear of having a heart attack. Idid go through a trauma before this started that I was basically fired (illegally) by a firm. One day I was doing great work and the next day they were doing a back end deal trying to force me to resign so my boss could make more money by taking my salary. Once I got a new job five months later I started to have horrible panic attacks. I have a horrible fear of dying or being out of control. I had a horrible day today with anxiety and it's starting to wear on me and make me sad. I have been in CBT for a year and it has been helping but lately in the past week this has gotten worse.
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Answered in 1 hour by:
9/16/2013
Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5,334
Experience: Dr. Mark is a PhD in psychology in private practice
Verified

Hi! I'll be glad to help you with this issue.

I can imagine how distressing and overwhelming this situation must be for you. The archives is giving a message right now from the system that it is unavailable; you're asking for someone to reply who hasn't before, so I assume you've asked about your anxiety and panic attacks previously. I don't recall your question, so unless it was a while ago I haven't replied yet. But I also don't have access to the archives to see what was recommended to you previously. Okay?

As I said, this clearly seems overwhelming. The anxiety has built after 1 year of CBT. The phobia that developed hasn't abated. That's a clear indication of a deeper problem. You've given here what you believe is that deeper problem:

You were fired from a firm. And not a normal case of being fired but a trauma, as you termed it. And it sounds like it would have been a trauma the way you describe it: one day you're a valued employee, the very next day you're being forced out. I wish this was very rare, but it is not so rare. But it is still a true trauma for the person experiencing it. I've seen one person who truly was traumatized to the point that his marriage collapsed.

And this is actually the key to my answer to you that you need to consider and think about. I would recommend after we've seen that CBT didn't help enough that you consider now treatment for PTSD. I know that you don't have true PTSD in the sense of a full blown disorder. But we are looking at the anxiety and panic symptoms and the resultant phobia of a heart attack as produced by the trauma. And so treating the trauma is perhaps the next step to explore. I'd like to recommend two possibilities: one is EMDR or other exposure therapy and then hypnotherapy.


I have found EMDR can be very useful especially for trauma that had been treated and now reappears with anxiety and panic. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/


On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. However, I have found that you need to combine these types of therapy with a more introspective, humanistic approach. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. So ask for referrals for individual therapy as well.

Two: I rarely recommend hypnotherapy. But here I'm going to. Why? Because there is no other symptom of a life problem that is debilitating going on. Please note I am talking about only hypnotherapy, which is a recognized form of psychotherapy used by psychologists and psychotherapists. So I'm not talking about people who put in ads in newspapers for hypnosis. Maybe those are useful or maybe not, I can't say. But a psychologist trained in hypnotherapy is a real licensed therapist. Even so, here's the important statement about hypnotherapy: hypnotherapy can help with a specific problem and that's why I'm thinking of it. HOWEVER, there are good and honest hypnotherapists and there are other types. Your only way of assessing is two ways: first, make sure he or she is a licensed psychologist. Don't let anyone tell you they are a licensed hypnotherapist. There is no licensure in most states that I know of. It's all a "self-licensing" which is not good enough. So you want to know his or her license number as a psychologist and call the state licensing board to make sure there have been no complaints filed. Please do not skip this step.

Okay, 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. Bonuses are always appreciated! 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, ***** *****

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Customer reply replied 4 years ago

Dr. Mark,

thank you for these suggestions.I don't know if my self diagnosis is correct but I was trying to give you an idea of what has happened to me in the past couple of years.

Why would this manifest in my nervousness of having a heart attack? Are we sure this is even connected? I do have a little history of mild hypochondria and rumination. I just can't get the thoughts to stop so that's really what's wearing on me. If I'm distracted enough they do tend to dissipate a bit but once done the thoughts come back.

no.

No, we don't know for sure that they're connected. But yes, there is a connection.

We just don't know if the connection is as straight as I'm saying: that the trauma, which is an anxiety disorder (PTSD is classified as an anxiety disorder) and prone to panic attacks and phobic reactions would be a straight linear correlation between your events of 2 years or so and the rise of these symptoms as serious manifestations rather than a mild predilection toward them.

Otherwise, there is a psychodynamic correlation, something much deeper in your psychological makeup. This is because when it comes to panic and phobia, CBT by a competent therapist is in most studies as effective as medications. That's impressive, agreed?

Yet we see that it didn't help, rather it made it worse, so to speak. That's an indication of a correlation between the life events and your symptoms that needs to be addressed. That's why my suggestions focused on the trauma:

Let's first rule out a straight correlation before we start discussing deeper psychodynamic forces of your whole life, youth, etc.

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. Bonuses are always appreciated! 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
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5,334
Experience: Dr. Mark is a PhD in psychology in private practice
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Hi! I'm very glad that I was able to help you with this and thank you for your positive rating. If I can help you in the future in any way, please don't hesitate to let me know.
All the best,
Dr. Mark
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Dr. Mark
Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5,334
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