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- Anxiety Disorders
Confronting Phobias: How to Change Your Mindset
When anxiety turns to panic, it feels like the world is falling down on top of you. The pressure is instantly physical, squeezing the heart in your chest and the air in your lungs. A litany of thoughts run in a cycle through your head, one replacing the other in the forefront of your mind without pause, feeding each other into a frenzy and snowballing out of control. Some time after the panic attack has ended, you may be able to see that the way your thoughts developed was irrational. Whatever thought triggered the feeling that the world would end was wrong, because here you stand with the world intact around you.
Because of the exacerbated nature of a panic attack, it can be easier to see in retrospect that the thoughts that led to the attack were flawed. What is not easy to see, however, is that the same thoughts are the cause of more commonplace anxiety as well. The cognitive aspect of Cognitive Behavior Therapy focuses on the identification and eradication of these flawed thoughts. Even someone who does not suffer from an anxiety disorder can benefit from identifying these types of thoughts when they occur, a process which can improve one's mood and outlook on life.
DSM-IV Diagnostic Criteria for Panic Attack
A discrete period of intense fear or discomfort, in which four (or more) of the following symptoms developed abruptly and reached a peak within 10 minutes:
- palpitations, pounding heart, or accelerated heart rate
- sweating, trembling, or shaking
- shortness of breath, feeling of choking, or chest pain
- nausea, dizziness, or lightheadedness
- feelings of unreality or being detached from oneself
- fear of losing control or going crazy or dying
- numbness, tingling, chills, or hot flashes
Breaking the Cycle: Identifying "Distorted Thoughts"
The breakdown I will be providing is based on the work and publications of David D. Burns, MD. I highly recommend picking up his works if you are suffering from anxiety. They will give you a new outlook and a new way of thinking about your own successes and failures. That being said, here is the breakdown.
Dr. Burns identifies ten types of "distorted thoughts" that can lead to anxiety and panic. For simplifying purposes, I have divided these ten types into three categories.
Failing to See the Big Picture
These types of thoughts narrow your focus. You concentrate on the negative, ignore or minimize the positive, and fail to see any middle ground.
Distorted Thought Types:
1. All-or-nothing thinking
You are either a failure or a success. There is no possibility in-between.
2. Mental filter
You see only the negative in a given situation or yourself. Your filter blocks the positive from becoming conscious thought.
3. Discounting positives
Even when you see the positive in yourself or the situation, you minimize its worth, thinking that it does not matter in the long run like the negatives do.
These three types of distorted thinking actively block out other, more positive ways of thinking. It is like looking at the Sistine Chapel ceiling and not being able to perceive some of the frescoes. Using such selective ways of looking at the world limits your ability to see reality clearly. Without all of the information, how are you able to make rational decisions?
Making a Mountain of a Molehill
These are the types of thoughts that easily contribute to the snowball effect I described earlier. You take one event as an indication of future events, or you simply know what will happen even without any evidence.
Distorted Thought Types:
A single piece of evidence becomes indicative of an entire pattern. For example, you see a white rabbit and conclude that all rabbits must be white.
2. Jumping to conclusions (mind-reading and fortune-telling)
You really cannot predict what other people are thinking or what the future will hold, but that does not stop us from thinking that way. If you are talking to someone and make a mistake and instantly the thought, "She thinks I'm an idiot," runs through your head, even though she has not told you that, then you are attempting to be a mind-reader.
3. Magnification (and/or minimization)
This involves taking the negative about yourself (or the positive about others) and blowing it out of proportion with reality.
All of these distorted thoughts presume more than can be evidenced. Reality has little to do with these types of thoughts, which take negatives and enhance them or create them from nothing.
Making It Personal
Rene Descartes' famous statement "I think, therefore I am," concludes that the ability to ponder existence proves existence. One conclusion that should not be drawn from this statement is that what one thinks defines who they are.
With this group of distorted thoughts, the actions of others, the way you feel, and the way you perceive others think you should act and feel attributes negatively to your feelings of self worth.
Distorted Thought Types:
A single mistake leads you to conclude that you are a "loser," "idiot," or "failure." This type is similar to overgeneralization, except that this thought type adds negatively to your own self image.
2. Emotional reasoning
Just because you feel fat or useless or boring does not mean that you are any of those things. With this type of distortion, anything you feel instantly becomes reality.
3. “Should” statements
Everyone has goals, and not reaching those goals can negatively affect one's ability to keep trying. It is good to have goals, but they are not necessities. Just because your situation is not what you think it should be does not mean that you are in a bad place.
Not all aspects of life are in our control, but it is tempting to blame ourselves for certain outcomes nonetheless. Even when other people are clearly responsible, a person with this type of distorted thinking may assume the blame.
The bottom line to take away from these distortions is that your internal life does not dictate your external reality and vice versa.
How to "Untwist" Your Distortions
Once you have identified your distorted thought patterns, the next step is to work to "untwist" them. You must find the flawed thinking and negate or replace those thoughts. Dr. Burns identifies fifteen ways in which you can turn your thoughts toward a more positive and realistic direction. For the purposes of this piece, I will not be detailing all fifteen methods. I urge you to pick up a copy of Ten Days to Self-Esteem that you can work through your own particular thought processes and find the solutions that work best for you. I will, however, highlight the methods that have worked best for me.
1. Identify distortions
This is the process to which the bulk of this article is dedicated. The very act of identifying the flaws in your thinking can make it easier to stop them from forming in the future.
2. Straightforward approach
This is essentially using self-affirmations. Replace your flawed thoughts with the exact opposite. The more you think these positive thoughts, the more likely you will internalize them. It is even better if you can replace you flawed thoughts with positive thoughts that you can accept as true.
3. Examine the evidence
All flawed thoughts break from the reality of a given situation. That is what makes them flawed. As someone once told me "follow your thoughts to their logical conclusion." By doing so, you can see that since the conclusion is flawed, the thought that led to it must be flawed as well.
Useful for those who are likely to take blame for situations out of their control, reattribution is the process of assessing a situation and identifying the real cause so as to take the pressure from yourself.
5. Acceptance paradox
The most useful of the coping techniques that I have found is the acceptance paradox. By simply accepting that you do have negative qualities, but they are normal and not all-encompassing, it becomes easier to move past the cycle of flawed thinking into which one may fall.
Whichever technique you choose to employ, the very act of attempting to gain insight into your thought processes can give you more control over how you react to an anxiety-provoking situation, stopping a panic attack before it can even start.
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