Can someone tell me why I keep getting pains in the top of my head? (Like someone is stabbing me burning my head I can't explain it?) Is it because Of the Paxil and if so has anyone ever had this or has anyone gone crazy blot clots anything because of this and what should I do? Should I go get a MRI or a cat scan???

Hi, Marianne. Nice going! It sounds like you and your therapist are doing some good work together, such as identifying some important fears like responsibility, and challenging them like you would any other anxious thoughts. By doing this, you might have a few new ideas and you should probably talk to your therapist about where to go from here. Keep up the good work! -- Anne-Marie, Site Administrator

Hi Anne-Marie, Many thanks for your reply! I'll try seeing the 'pictures' just as intrusive thoughts. That's certainly a new perspective on them. I have done the 'following through' exercise with my therapist and found that the underlying fear is having to do something, being responsible. It's not so much a fear of dying but a fear that if I was in danger/having a heart attack I would have to do something to save myself, and that it's all my fault if I can't. So if I'm in a situation where I'm stuck and can't do anything to save myself, eg in a plane or on top of a mountain, I panic. So far so good. Now what do I do with this knowledge? I'll try writing the thought/pictures down in detail, although it sounds very scary, but it must be better to look the things in the face rather than trying to repress them! Many thanks again, Marianne

Hi, Marianne. You asked an interesting question. "Thoughts" maybe often more like brief intrusive thoughts or images. These are indeed sometimes very difficult to "challenge." There are several cognitive behavioural techniques that may apply. First, rather than challenge intrusive thoughts and images, it sometimes helps to simply identify them as "intrusive" or "obsessive" thoughts that don't "mean" anything at all. Intrusive thoughts are common. Most people have them. What makes an important difference is whether or not you attach any importance to them. So, for example, most people experience intrusive aggressive and sexual images. Such intrusive thoughts are "normal". But most people do not attach "meaning" or "importance" to them. They are "just a thought". Its like when you have a dream that doesn't make sense. You can say "It was just a dream and dreams don't make much sense sometimes" or you can start to worry about what it "means" about you. Sometimes our thoughts don't "mean" anything. So , one strategy is to label intrusive thoughts and images as "intrusive" or "obsessive" thoughts and see if that takes some of their power away. "its just an obsessive thought". Sometimes people have trouble challenging their anxious thoughts because they haven't followed their fear far enough to find the "real deal". So, a second strategy is to "follow the fear" as outlined in the panic program to see where it leads. If you are having intrusive thoughts or images, is there an underlying fear that you haven't identified yet, such as a fear that you will be responsible for something terrible happening to somebody else or some other horrible consequence? Try doing a thought record "on paper" and really following your fear to see where it leads. Challenging thoughts on paper and really "following the fear" to discover all of your underlying fears and assumptions isn't easy but is often worth trying, even if you have been doing it on your own and "in your head" for a long time. Finally, a third CBT strategy to challenge intrusive thoughts and images is to expose yourself to them. So, for example, one thing you can do is make a tape in which you describe the intrusive thought or image in as much detail as you can and "follow the fear" by describing what happen

Hi Everybody! I was wondering if I'm the only one who is having problems with the concept of challenging anxious thoughts. My problem is that the 'anxious' thoughts are very brief and aren't really thoughts with words at all, more like pictures that flash up very very briefly. They come and go in a split second and the panic reaction starts. Within seconds the conscious 'reasonable' thoughts start and challenge the anxious picture, but by then it's too late. They somehow just don't seem to get through. I can tell myself a hundered times I'm not going to die, and my brain knows it's very unlikely, but somehow this knowledge doesn't stop me from being scared to death. I'd love to hear if anyone else is having the same problem and how they deal with it. Anne-Marie, do you have any advice? Marianne