Hello brothers and sisters of the panic disorder set. I’ve written a goodly number of articles on this site pertaining to recovery from agoraphobic and panic attacks, which I’m sure you’ll find helpful. I have stopped posting to this blog, however, and now make regular posts on panic disorder on my unagoraphobic facebook page. I hope you’ll become followers in your quest to become free forever as I did more than 20 years ago. Best wishes and see you on facebook.
Mindfulness is, I think, a rather lovely word , pleasant to pronounce and has been in the air more and more the past few years. It begins with the Mmmm sound that is sort of like ommmmm, creating a syllable that is our favorite subject, followed by the word “full”, and who doesn’t like that notion? And it’s finished off with “ness,” a satisfying release of air that indicates “quality of being.” Who could say anything bad about a word like mindfulness?
Well, some people don’t care for fancy words. What it really means is “paying attention.” So, pay attention to this: in order to be mentally healthy, you need to spend a good portion of your day paying attention to every little thing you do and see and engage. My Un-Agoraphobic recovery plan is built on focus and action, and creates many ways for the panic disorder victim to engage in mindful activities.
I advise lots of research and writing, and purposeful activities that require full focus. One of the recovery steps is to learn a new skill that requires all your attention. My healing mindful activity that helped me recover from 30 years of agoraphobia was to teach myself to draw, and then to draw regularly. Learning a musical instrument such as a recorder or penny whistle is another mindful activity that actually builds gray matter in the brain and defuses the flight or fight apparatus. Learning a new language does the same; music is a new language.
The anxiety of traveling outside one’s safety zone can be eliminated by fully engaging with everything in your environment as you travel. Read all the signs, look closely at clothing those around you are wearing, count blue cars and so forth. Take pictures and write about what you see. Getting outside your head and into what is around you will help you recover totally from chronic panic attacks and anxiety.
A recovery plan should also include sitting meditation as the practice is scientifically proven to make positive changes in the brain. Your way, way over-staffed alarm system needs to lay off a few neurons, and the way to do that is to let your amygdala know that you feel safe. If you practice regular activities that give you a calming feeling, the amygdala will get the message and re-assign some soldiers to more peaceful duties. The peace and serenity gained through meditation and meditative activities gives you a safe place to go when anxiety creeps in.
Here’s a link to a brilliant article that de-mystifies and explains “mindfulness” by an expert on the subject:
Writing is an important part of overcoming panic disorder and agoraphobia, and I’ll tell you why. As you’re working on your recovery program, you’re doing a lot of research and thinking and then writing about it in your journal. The hour of the day you dedicate to reading about brain science and panic attacks will produce an abundance of material to comprehend and digest. Your job as a journal writer is to select what is of best use to you and condense the information to fit in your journal. Think of writing in such a way that the essence of what you learned is now on the page in your hand in a style that will be easy to read and learn from months later.
As a journalist I sometimes faced hundreds of pages of material related to a story I was working on, and had to learn to find the good stuff quickly. Decide on some buzz words of specific things you want to learn about and then you’ll soon spot whether a particular article or book will be helpful to you. Getting things right when you’re reading and interpreting someone else’s point of view is not easy. Your job as a writer is to take the time to understand what you’re reading or hearing. As a journalist you can, believe me, be deeply embarrassed when something you wrote turns out to be wrong and it’s your fault. As a personal journal writer you don’t face that kind of pressure of course, but that doesn’t eliminate the moral need to seek the truth in everything you read and hear.
Your amygdala creates firestorms based on apparently flimsy and even false information, and that is your basic problem. You have panic attacks because your alarm system no longer knows how to interpret data and must be reprogrammed. This time you’ll want to do it right, so make sure you comprehend what you’re finding in your daily research projects and passing along to your subconscious.
I never fully understand something until I write about it. Writing is a process and that’s what’s good for you about writing. When you read things they pass on by and you remember particulars here and there, but when you write about what you read, you read in a different way; you kind of process the information . When I’m reading about something in order to write about it, I become inclined to see the big picture more clearly because I want to produce a story (blog) that will hit the mark. Write clearly and thoughtfully and you will be served by what you write – as may others if you publish in some way.
I recommend you start your recovery program by writing a piece in your journal explaining what you think caused you to become ruled by the fear of having a panic attack. Recall any early fearful feelings and talk about what your environment was like then. This can be the “before” of you and you’ll get to compare that with “after” when you recover and write about it.
Once you get your recovery project underway and are writing regularly, I have an assignment for you. I want you to read aloud everything you write. Does it sound just like you? It should because your journal is your voice and your voice should sound like you – otherwise it won’t seem real. If your writing doesn’t sound conversational or like you, it’s probably because you have the dreaded fear of writing. Even I, who loved language and reading from early on and spoke and wrote well, hated English class as it was taught all too often. Conjugating sentences should not be allowed under the Geneva Convention rules on torture. Learning that way promotes stiff and formal writing in my humble opinion.
I believe the best way to teach “English” or any language is to treat it as a spoken as well as written language, so that students hear what they write. The best way to learn to write is to write (and read read read). Shortening of the language for technological reasons may be doing harm to the written word and the future of literature. More about that in a later post, but for now I’d like you to focus on creating a clear, conversational writing voice if you don’t already have one. Your overall communication skills will be improved immensely when you write in the vernacular, meaning the common voice – the sort of language you would hear in your particular society every day.
To be blunt, I’m reading things online written by obviously English speaking people that make them sound barely literate. I’m sure they are well-spoken people who are losing the skill of writing in a flowing, descriptive, conversation like manner. If paper disappears, clear writing will become even more important with so many online voices misinterpreted perhaps because of fractured syntax. Just a theory… I’d love to hear what others have to say about the future of written language.
All of this is to emphasize that your writing will help save you – if you write clearly, with passion and compassion.
I’d like to de-mystify agoraphobia a bit by discussing the various manifestations of classic panic disorder. I think most civilians equate agoraphobia with hiding in the house, but that’s not true all the time or even at all for everyone who suffers from this mental illness. My personal experience as well as what I learned from mental health clients and peer support group members led me to rate agoraphobia by severity:
– Level 1. Housebound or mostly so.
– Level 2. Partially mobile.
– Level 3. Mobile with a wall.
Many people who suffer panic attacks when they venture beyond their safe perimeter have experienced all three levels at one time or another. I ran the gamut more than once during my 30 years with agoraphobia. The housebound stage is usually the result of extra stressors; the increase in fear level that drives someone into a corner is demoralizing. Being inside can feel safe, although terror-stricken people will resort to hiding in small spaces to reduce the fear level. A great day for someone at Level 1 is a trip all the way to the end of the block. The victim’s fight or flight system is on such a high stage of self-imposed alertness that unending anxiety is the result. Someone at this high level of anxiety feels that a panic attack is so nearby that one dare not rock the boat.
When agoraphobes are at Level 2 they are able to work and go to school, though with great difficulty. Going to and from is likely the most difficult of every day’s difficult tasks. Those periods of vulnerability bring out an agoraphobe’s talent for catastrophic thinking. Anything and everything can be a threat, but bridges, railroad crossings and long lines of streetlights are particularly troublesome for someone at this anxiety level. Work may be the easiest part of the day; a job that requires total focus on the work is good for the agoraphobe who wants to shut out anxious thoughts.
Many people with long-term agoraphobia spent a lot of time at Level 1. I did. When you are able to work and have relationships and feel free from heavy anxiety, you can become complacent. Eventually, though, being stuck at this level is heartbreaking because you are so near yet so far from complete freedom. You’re still a prisoner even if you have a good job and relationships.
So… the truth is out: No one is safe from agoraphobes because not all of them are locked up in their houses. Some of them are moving about you, working with you, touching you, and even…. Yes! Agoraphobes can appear to be nearly normal, if not more so.
Start increasing your functioning level by decreasing your fear level with the help of “Un-agoraphobic.”
I write extensively in Un-Agoraphobic about your amygdala’s role in your panic attacks and how you can re-train the #%#!&@&!#! traitorous false alarm-creating organ. (Now, now Hal – remember: every month is “Be Kind to Your Amygdala Month” from now on.) Sorry. I forgot for a second there that I’m not mad at my amygdala like I was when trying to survive the daily lightning storms caused by I knew not what. I never even heard the word “amygdala” until many many years after I started having panic attacks – age 10.
I’ve done a lot of reading about the amygdala’s role in our misfortune and have written about it in blogs and in my book. I like to think I provide information to people like a journalist who doesn’t have to follow all the grammar and order rules, just the truth rule. I hope you are able to understand more about brain science as it relates to you as I’ve written about it in the book. I do, however, write in kind of easy going, casual Hal language – sort of the opposite of scientific writing.
I came across some scientific writing recently about studies done on the amygdala’s role in panic attacks.
You might occasionally come across a string of words that might cause you to rupture a synapse if you try to wade through them. Stop and breathe. They’re only words and the people who wrote them aren’t necessarily all that much smarter than us – they just have specific knowledge and know bigger, cooler words and how to use them. Here are some links:
I recall having a paradoxical relationship to the four seasons back in the bad old days with agoraphobia when my anxiety level was particularly high. I started feeling better in the late Fall when leaves reign and days grow shorter. Some people experience a downturn in their emotions – a feeling of weight from lack of sunlight. “SAD” is its accurate acronym – seasonal affective disorder. Many others are somewhat depressed by shorter days. I, on the other hand, welcomed the comfort of a world closed in rather than wide open. I started to cheer up in mid-September
I don’t know if this is true for all agoraphobes – it was for some I talked to in peer support groups. I felt more anxiety on long, clear, blue sky days than when clouds were low and dark and days were short. I loved darkish, cloudy days when I was most anxious because I felt somewhat sheltered or protected or contained. Wide open spaces were terrifying for me. I never looked up at the night sky when I was anxious. Give me a smaller space please. A darkish, cloudy day feels like a smaller space.
So that covers two seasons: I dreaded Summer‘s constant wide open sky and embraced Autumn‘s clouds and shorter days. Winter’s tale was long and complicated. On one hand, I felt the comfort of often cloudy skies and less time in wide open space that I could see. I never ever looked up at stars after doing so once set me off on a terrible period of panic attacks as a teen. Darkness was also my friend. The downside to Winter for me had to do with crowds and transportation. Stores and travel about town are difficult enough for anxiety ridden folks but when Christmas crowds and all that traffic begins, going to a store or trying to make a quick auto trip can be a horror story. Spring had dual effects on me as well. I joined many others in the relief from cold temperatures that March brings, but I also felt my anxiety level rise – always in late March. I think the increased light was too much stimulus for me and I hated coming to this part of the year. After the Equinox period, I would get a wonderful break from constant anxiety by the joy of Spring.
After that period of relative elation, the greening and flowering and sex of the world, I would begin to get the long, clear-day yips again, longing for a return to the comfort of less light. If I hadn’t been agoraphobic I would have moved to a cloudy climate area, but if I hadn’t been agoraphobic I wouldn’t have needed or wanted to. See how that works? The four season of agoraphobia.
Meditation is an integral part of recovery from agoraphobia, but meditation can take many forms. I just read a recent article by one of my brother/sister bloggers at Psychology Today pointing that out. Emma Sepalla advises her readers to find a form of meditation that works for them. In her words, “You just have to find the shoe that fits.”
In the Un-Agoraphobic recovery program I recommend both sitting meditation and the meditation that comes while learning and practicing a new skill. I emphasize employing some form of meditation as a means to get out of your own head. Practicing loving kindness was the Buddha’s means of learning and teaching compassion as a way to attain a peaceful mind.
PhD Sepalla, a TED speaker on the subject, elaborates on the virtues of meditation and suggests learning to meditate by starting with something that comes easily to most: kindness. “Loving kindness” meditation, she says, can be a powerful healer because it brings out healing feelings such as empathy, compassion and love.
Her blog, “18 Science-Backed Reasons to Try Loving Kindness Meditation,”talks about the healing aspects of this basic tenet of Buddhism. The Buddha Dharma Education Association website says this about loving kindness meditation: “It acts, as it were, as a form of self psycho-therapy, healing the troubled mind, to free it from its pain and confusion.”
When you can begin focusing on loving compassion toward others you can begin practicing it on yourself – part of healing the whole you which will free you from panic disorder and agoraphobia forever. Un-Agoraphobic is available in bookstores and other places to purchase books on Oct. 1.
You will be writing your recovery program in your journal day by day as you begin work on the Un-Agoraphobic plan. Writing is a vital part of your recovery: you write your goals, your accomplishments, your insights, your passions. What you write based on what you learn through the book is what will set you free from agoraphobia.
One of my brother/sister bloggers at Psychology Today has written a nice little piece about the therapeutic values of writing that I know you’ll enjoy reading. PhD Harriet Lerner’s article, “Five Ways Writing Can Make You Braver and Happier,” gives us several avenues for improving our lot by writing about it. Included in her humorous look at writing is the advice to write yourself a love letter. Who else, she asks, knows better what a lovable person you are?
I advise saying those 3 little words to yourself every day in the mirror, so that self love becomes a driving force in your healing process. Writing a love letter to yourself as Ms. Lerner recommends would give added value to your self love endowment. She also suggests writing as a means of self discovery. I know I often don’t know how I truly feel about a subject until I begin writing about it. That’s why I have you writing about your passions as part of the assignment in Un-Agoraphobic, appearing in bookstores Oct. 1.
Look for Ms. Lerner’s blog on writing at psychologytoday.com/posts in the topic stream “Creativity.” She is author of the book The Dance of Anger. My blogs on agoraphobia appear at the same Psychology Today site in the category “Personal Perspectives.”
When people ask me how I recovered from agoraphobia, I usually avoid a very long story by saying such things as “It was a process,” or “It’s a very long story,” or “I had a lot of help,” but one thing I always say is “I had to learn to become blase’.” You know, that French word meaning a sort of satisfied boredom. When I was in the grip of chronic panic attacks I was trying to control everything I could, probably out of desperation to be in control of something, since I couldn’t control my anxiety or fears. As I came more in contact with others suffering from panic disorder through peer support groups I started or helped organize and my social work job at the Mental Health Center I discovered a lot of anxious people with perfectionist traits. I’m not referring now to “obsessive compulsive disorder,” but rather to the controlling behavior exhibited by those who suffer chronic panic attacks for no apparent reason.
I somehow knew my perfectionist, controlling habits were interfering with recovery from agoraphobia. Learning to become blase’, wasn’t that much of a stretch for me. A lot of my habits are of a casual nature, so I just had to extrapolate from not making my bed to not making a big deal out of speeded up breathing or heart rate or other kinds of false warning signs that can trigger panic attacks. I had to learn to stop caring about the outcomes of many many things I used to think were necessary to my well being. The whole business of letting go and letting down my guard didn’t happen quickly… but once I could see positive results from forced lack of concern about this or that, I allowed myself to become kind of casual. The whole process over several years affected everything about me – the way I walk and talk and write and listen. I can listen a lot better now that I’ve become less self-concerned.
Folks who suffer with agoraphobia will help their recovery efforts by learning to let go – a lot. The question of whether anxiety creates perfectionism or perfectionism creates anxiety is a circular one – worth pondering though. I’m thinking of how perfectionism and anxiety disorders co-occur because of an article written by Psychology Today blogger Max Belkin. His nicely written piece, “5 Steps to Taming Perfectionism,” appeared in late July and links the obsession of perfect to both low self esteem and procrastination. I’m not saying that agoraphobes are necessarily perfectionists; just that there’s a trait toward controlling one’s surroundings that actually creates more anxiety.
Dr. Bilker advises those who have let perfectionism ruin their dreams to learn to accept themselves just as they are and to acknowledge that they are good enough just as they are. Self love is at the core of recovering from panic disorder and agoraphobia. Healthy self love always radiates out, so once you obtain it, walk it around and shine on some folks in the shadows.
I’ve noted a phenomena common to many agoraphobic people I’ve connected with over the years. I’m trying to think of a nice name for it. What would you call it when someone exaggerates and distorts reality in order to make someone think something is way more complicated than it actually is? Practicing deceit is I guess what I used to do when explaining my craziness to someone who had never heard of agoraphobia before. And so have some of you, admit it.
Here’s the problem: we’re afraid of panic attacks. That’s all. It’s not like we’re delusional, or have a “”thought disorder” type of mental illness. We’re not psychotic, but we are disabled because of this one very strong fear. If your business partner or spouse is waiting on the other side of town for you to show up for a very important reason and you can’t make it, somehow “I’m afraid I’ll have a panic attack” doesn’t carry much weight. I found myself engaging in a lot of psycho babble to make whatever it was I had sound medically complex and almost dangerous whenever I was really blowing something by not showing up. My grandmother’s funeral was painful for the whole family, made harder by my not being able to show up.
I can understand the phenomena. Someone who’d never had a panic attack would think I was a sissy or faking it; that’s how I justified my elaborate and mystifying explanations of my peculiar condition. I was trying to make certain people believe I really was crazy, but in a nice way. I wanted my disability to seem significant to the few people I had to explain myself to. I guess there are times when you might want to use clinical language to obfuscate the reality of your condition. The one person you don’t want to deceive is yourself.
Keep it simple. If you suffer from panic disorder, what you are working on is a way to stop being afraid of panic attacks. Once you accomplish that, your problem is solved. Once you change the messaging in your “fight or flight” system you’ll no longer have false alarms like the ones your amygdala has been triggering because you gave it too many things to be fearful of. Every day that you work on your recovery program you are creating new neural pathways that will lead you to freedom. Keep it simple: all you’re doing is re-training a clumsy elephant