Sorry for the extremely long post but I needed to unburden myself, as I was taught that a man does not complain and talk about his feeling or fears. I have not talked with any clarity about my fears and problems until a year ago. I find it now somehow cathartic in that when I lay everything out I usually gain insight that I had not had before.

I have questions that will help me to decide on what exposure work I should do. To start a bit of background I developed Labyrinthitis a loss of hearing and had extreme positional vertigo, this is when I developed my panic attacks. Every time I would turn slightly to my left I would experience vertigo and panic attack associated with the vertigo. The way I dealt with this was to tense up my head and left side of face and neck. After awhile I stopped having panic attacks but kept the tension in my head. At this time I did not know what anxiety attacks were or anxiety I was emotionally immature. So as I went through school as you can imagine I developed anxiety to a lot of things. However I did not realize I was developing anxiety to this thing because my fear would manifest itself in physical symptom. As you wrote in your sessions I Google every physical alliment and justified it with known medical illnesses. I did not look for anything exotic justification my main justification was allergies, since I had headaches all the time particularly in my sinuses (and yes I did go to an allergist and prove that I had them). As I went through school and university I developed anxiety toward more and more situations (I am told that when you have anxiety and panic attack you tend to color everything you do with a sense of anxiety). Through high school and university I would prepare (or do home work less and less) because I order to concentrate I would have to tense up my head even more to get rid of the inability to concentrate. I have to add a little piece of information hear when I started school I was diagnosed with a learning disability for reading, writing, grammar and especially spelling. So my excuse for my in ability to concentrate through high school and university was my learning disability. I developed anxiety towards reading and writing and spelling and an assortment of other things.

 Then I graduated and went to work in a CA firm where I passed the professional exams and worked for a year and a half. When I worked at the CA firm I developed a burning sensation in my face every time I went to work and it would stop when I left work at this time I self-diagnoses that I had chemical sensitivity to my environment and that’s what caused the burning in face and sinuses. I was so on edge from this situation that I developed agoraphobia to the building all day all I wanted was to get out of there and get some relief. But I did not quit my job I kept working until I got laid off. As you can imagine this was very distressful to me, but on the other hand I was able to not go to work anymore (which gave relief “avoidance”) where I now know I was experiencing anxiety. Then I started to see a therapist after being checked out by an psychiatrist and they believed that had chemical sensitive and deduced that I was an perfectionist and not in touch with my emotions. So I spent years talking to the therapist and I ended up talking about my fear to go back to work because this is where I experienced most of my distress at the same time I realized that I was running out of money and how was I going to live. This continued examination of my anxieties caused me to end up in the hospital where a new psychiatrist diagnosed my disorder, that all the tension and pain in my body was just in my mind (in other word I was delusional). Yes I have been re-diagnosed with a mood problem and not delusional by a professional. You can imagine what that diagnoses of delusional did to me, on the up side of things I was able to get disability from the government and I decided that doing nothing for the rest of my life (not working) was what I was going to do.  I applied for social housing and stayed home with my father pretty much doing nothing all day. The drug the psychiatrist gave me got rid of the pain from my body but it did not get rid of the anxiety and depression. I then developed irritable bowel where I would spend 5 hours a day going to the bathroom about 5 to 6 days a week. If you look up irritable bowel you will find that having anxiety and panic attack can certainly make it worse. You can imagine what fun I was having now and I still had anxiety an inability to concentrate and would not engage my mind with anything meaningful (except that I became a board member of a mental health agency and did some part time work). But every time I sat down at the computer to do work I would develop irritable bowel and not know why (the reason I have in my mind now was the anxieties that I had built up from my learning disability from school and university and at work). This is when I developed a serious complication to my medication that was prescribed to me and I decided, against my psychiatrist wishes to go off it. Then all the tension came back into my body and I had an epiphany that I was suffering from panic attacks an anxiety (I read somewhere that its easier to face fear my creating physical manifestations rather than dealing with the emotion, but as they also said if you continue to do this eventually you will explode like I did and end up in the hospital). This is the time my I decided that I had anxiety and panic attacks that resulted in tension and pain in my body. So I spent a year meditating and I gradually got rid of all the pain and tension. But know I am faced with having to deal with panic attacks and anxiety and all the negative maladaptive connections I made in my past. I no longer think that allergies cause me headaches or sinus problem I fact I drive around with my car windows down during allergy season, I am not entirely sure just how much learning disabilities I have and how much can be explained by anxiety. (The proof there is when my anxieties subside at night all of a sudden I can spell better and write more fluently). I do not think that I have chemical sensitivity anymore. One last thing I have also been diagnosed with Dysthymia a constant state of depression, but to be entirely truthful I really don’t notice it as much as I notice the anxiety. So know that I have got rid of all the tension in my head I have started to have panic attacks in bed just like I was having when I lost my hearing.

Two question here did I learn the panic attack from my Labyrinthitis as you have mentioned the way we learn panic attacks is by association. Evidence for it is attacks generally happen when I turn in bed (as when I had Labyrinthitis); evidence against this is the attacks do not 100 % of the time happen when I turn in bed. Evidence for is Labyrinthitis the attacks are always in the morning time, that is when I have my most vivid memories of attacks from Labyrinthitis.  I also have considered the possibility that they come from the time when I went into the hospital because I was worried about getting a job at that time because to do so I would  having to face my chemical sensitivity of an office. Evidence for this is that I would wake up in bed and lay there for quite awhile then I would start to feel my muscles tensing up and causing pain. It is also possible that the pain was from a MDD episode made worse by anxiety. Trying to diagnose the problem myself does help me solve the problem since I can’t go back in time and be properly diagnosed. In CBT you teach us that the problem we should focus on is now but how do you reconcile that with learning to panic in a certain situation from the past. So forward looking I still have the same danger (of worrying about going to work again), only this time the danger is not being able to concentrate and realizing that I have anxiety towards everything I would have to do read, write, spell and function in an stressful situation and have time pressure to perform. Basically I have just switched one problem for another the old chemical sensitivity, with new panic attacks and anxiety. The difference is that this time I know what my problem is and I can work on it where in the past I felt like a victim of sensation from chemical sensitives. I know that anxiety problems are often co-morbid with depression and I wondered about how much my depression could contribute to my panic attack. To me I think I am challenging my depression because I stopped the medication and am now facing my fear and have tools to do it with, I no longer have a sense of hopelessness because for the first time I am doing self help. I think the main source of my depression was the negative thinking I had, blaming my loss of hearing and allergies for all the pain I had in my head. And losing my job was a result not being good enough because of my learning disability. This learning disability thought does not come out of nowhere I have been stigmatized with it all my life. (I will give one example I wrote a paper on environmental accounting at the time it was an emerging issue, I got my paperback and my professor wrote on it this would have been an excellent paper if it was not for the grammar, now I will tell you the mark I got perfect in every category but got 1 out of 10 for grammar). All my professors knew I had a learning disability, why did he not say this is a great paper and if you would like I can show you where your grammar mistakes are. I know the saying people do things that annoy use not to annoy us; I doubt that he said those comments to annoy me it’s just how I perceive them. I have challenged all these thoughts that I have expressed here but I keep having panic attacks. From reading other people’s posts it is probably too early to expect the panic attacks to go away. But I was wondering how I expose myself to panic attacks in bed I could go right now a lay in bed and turn as much as I wanted to and not produce any anxiety attack. A more recent thought I have considered, is do I know that all my confusion is related to anxiety, I go to a support group and there is a member there who is always depressed and he tells me that he often finds it hard to concentrate. I have spent at least 3 decades in this state I do not know what it it's like to have a clear mind, however on the side of anxiety my thinking becomes more clear as the day goes on or perhaps the farther I get away from the panic attack of the morning. So my other though was don’t wait to get well to do something do something to get well. I have been exploring doing some volunteer work or helping people that can’t afford an accountant to stop them from going into bankruptcy. So if my panic attacks come from Labyrinthitis memory I don’t know how to gradually expose myself to them, but to simply go to bed every night and challenge the negative thinking I have towards them. On the other hand if my attacks are from the perception that I have an in ability to work because of my confusion I have devised a plan for that.

 Another question I have I read one of the councilors post and they said how much do you get out of worrying about the same thing. My problem with thoughts are that I keep analyzing the same things to death, not really worrying but I keep looking for the best solution for a client problem and often when I continue to analyze the same thing I come up with a better solution to the problem. I have tried brain storming but it doesn’t work for me sometimes the best solution will come when in bed trying to go asleep and then the answer just pops into my mind. I think that this is a sense of trying having the perfect answer. But I also notice when I go for a walk and am not thinking about a client my thoughts will go to the future or past and then I challenge them right away. I am trying to practice mindfulness and am taking yoga where I try to concentrate through the whole session about my breathing and what a particular position feels like. This has taught me how maladaptive my behavior has become because when I do a particular stretch that is supposed to be stress relieving my head tenses up immediately. So the things I notice about my thought specifically are they are not in the present is mindfulness useful or am I perceiving a problem where this none. I think I may be trying too hard to find everything that is documented as anxiety related. Is it possible that I notice the self talk more now because I am always looking for maladaptive thoughts?

So to sum up I went from Labyrinthitis and allergies as the sum of my entire problem to learning disability as the cause of me developing more anxiety to panic attacks and depression as the source of my confusion and as a danger to returning to work. This is all or nothing thinking isn’t it. I have defiantly developed a propensity towards negative thinking and all ways trying to find the reason for everything. Perhaps my confused state is just something that I going o have to live with and has no answer.