Unless your medication is making you too sleepy or to nauseous to concentrate I would not reduce it. The fact that you are thinking about exposure and it is not causing attacks is a good thing. If you stop or reduce the medication in this state where you are not positive about your fears they will come back for sure. Instead of lowering the dose so the attack come natural, the final stage of exposure is to be able to force an attack and have it not happen or have it be only normal panic, the type that goes on it's own because there is no reason for it to be there. Like having something momentarily scare you.

The fact that you are concerned about exposing yourself to your thoughts tells me the thoughts are still there and you are being successful at blocking them. Do you know what your triggers are. Can you open yourself to them enough to have an attack, if not then maybe you are right and it is time to lower the medication. Believe me when you do, if you are wrong, the rebound will be horrible. Even when you have got controls from doing the exposure it will still be a fight as you taper off the meds. It just will not be an attack, it will be something noticeable you have to deal with. Which is no problem if The CBT has been successful and you now have the tools to do this. Think on this and what ever you decide, post your reaction so others know what to expect. 

Here for you,

Davit.

There are definitely two kinds of anger, you are right there, and you can use one to get rid of the other. By beating the stuffing out of a pillow you can release the anger you would normally turn on yourself. But still you need to get rid of the reason to beat yourself up.

Remember me saying negative core beliefs are not always what they seem. Some times they are a reaction to a root belief you can't see. In your case it is the past. Or more appropriately basing the future on the past. So you manage to tell panic to go away a few times but then you go back to the past and say because this is how it was this is how it has to be. See the core belief is not that you will have an attack but that you have to have an attack. So question that or those instead of "my life would be better without attacks" because you know it would be but going to the past and past experiences won't let you believe it. But you have been able to tell them to go away so this must be true, They don't have to be there and yes life will be better without them. The Past is in the past, you can not change it you can only learn by it. Changing how you look at the past is not changing the past it is changing the present and only the present counts. Change the present and the future will follow it. 

Accepting an attack once it happens is all you can do. Accepting there will be more because you still believe they have to be there is all you can do. Accepting you will have emotions over this is all you can do. Working on telling yourself they do not have to be there is what you need to do. Try to catch yourself when you start relating the present to the past. You can change the present, it doesn't have to follow the past.

Your last sentence, yes you have to accept the last thirty years, but you do not have to use it for a template for the future. Think of this time as a recovery time to get over it and build a new now and a new future. A rebirth so to speak. And it will take time, because you have a lot of past influencing the now.

So if you think I am on the right track here chain this dragon where you can look at it and know it is wrong and can no longer influence your future.

Here for you,

Davit.

Hi Dizzy,

It sounds to me like I have what you have. I am having a heck of a time with my exposure work, because I am not actually avoiding anything really. So I am in a tough spot. I've been trying to expose myself to thoughts, but I guess my meds are working so well that I really don't even know how to do that. A little bit discouraging.

 But after reading your last post, my ultimate fear is 'I am never going to get better', 'what's wrong with me', 'I am having an attack', 'I am going to have an attack'.

So how do I expose myself to that? Lower my dose and wait for the attacks to start again? What now?

 

Ocean

Davit

 

You hit the nail on the head, when you said that fear of an attack or thinking about one comming is exactly my trigger. I have CBT all trigers away but it always come back to the same underlieng thought would'nt life be a little bit better if they stopped. There lies the trap I have learned that you take a beating self-esteem wise when you picture a life after not living in the moment (exp no attacks). In terms of anger the group I go to (and this is just jargin) but here are two types of anger one against soemone and one against yourself. The one against yourself is called fearfull anger becuase you are beating yourself up for everything you did wrong. This is where I have to change or accept my thinking and let it pass. I have any number of ways of continueing to beat up on myself and CBT contrubuted to this by showing me that what I was thinking was false or negative. Do not missunderstand me I needed to know where the drangons lie, but before I started anything about CBT or therapist I had some days where I just decided that I was not going to have an attack and I did not. Unfortunatley it lasted a few days (ingnorance is bliss). I would imagine they came back becuase of the way I was thinking althought I cannot remmeber becuase I was not watching my thoughts at the time. I do not know how to ten question myself out of "my life would be a bit better if the attack stopped". I do not know if it is true that it would be better nore do I have any evidence that it would not. What is the worst thing that can happen, a far as I am concerned I am living it. That is why I believe that acceptance of all emotions and attacks and everything else is my way out. I think I said it before my way in was denial of everything relating to emotions. So to get what I want I have to accept everything I rejected that started me in this 30 year of attacks.

 

Dizzy

I think you are on the right track with acceptance. I hate change too but have accepted that it is pretty much out of my hands. I do though have an unchanging place to go and just escape.

Not all thing change, some things coast along living besides the changes without being effected.

Acceptance is one of those things. It takes change and makes it "is". Doesn't mean I have to like it but makes it more acceptable and less problematic.

Fighting panic just puts the focus on it and makes it stick around longer. Accepting it and doing something to cope lessens it and keeps it below the level of a panic attack allowing it to fade. 

It is like this if you had a wooden leg you would have to accept it and in time you would get used to it and forget for the most part that it is there. But when you did remember you would say okay this is normal for a person with no leg to have a wooden one and go about your business as best as you can. 

In your case you have a lot of panic which is normal for you because you can not have panic. By accepting it is there, you can stop it from becoming an attack. The difference is that by accepting it you can live with it and eventually learn with coping skills to ignore it. Much like the wooden leg. Only difference is that over time you can forget why you ever had panic attacks, not something you can do with a wooden leg.

You realize though that you are going to have to accept more than just the panic. You have to either accept every thing that disturbs you or learn to work around it. A sort of acceptance. You don't have to like it but you can live with it. Like spelling, let the computer do it, we all do.

I doubt your life will ever be panic free, I doubt anyone's is. Mine isn't but my panic doesn't turn into attacks and is actually lessening over time as I learn to accept more and more things. You might say I'm mellowing. One thing I do not do is fight my feelings. I let them happen and fade away if they are negative. The positive ones I try to hang on to. Unfortunately they fade too.

Take anger, I look at why it is there and accept it and let it fade. A lot of anger is directed at not being able to do anything about a situation. Better to be mad for a short period of time than to dwell on the fact you can not do anything about it and turn it to panic. The only time I find anger unacceptable is when it is aimed at someone or some thing of value. Splitting fire wood is okay. 

I really want to know how you do with this and if you find any modifications to make it work better. I'm sure others will also because fear of an attack and trying not to have one is pretty common. I know I used to be able to have one just because I was thinking one might be just around the corner and the more I tried not to think about it the more it happened.

Here for you.

Davit.

Davit

 

I have one trigger and that is not wanting to have an attack in the first place. I have self-diagnosed that I am in a state of hyper arousal most of the day. I know that every thing I do unless I do nothing I have some sort of stress response to it. This comes from my early years as you may remember. I have tried all sorts of thing like you suggested before and, during an attack. Anything I try just brings me to the fact that I am striving not to have an attack. Along ago post from you, basically gave me the answer I think I need and that is just acceptance of what is going on. I have denied my inner felling for to long that is what got me in a state of hyper arousal. As you know felling are not true nor are thoughts or sensations this is the realm I have been working on. It is easier and quicker for me that if a negative thought comes into my mind (I can know identify them) to let them pass just as an event just as panic passes and pain ebbs and flows. I think one of my main discoveries is that I do not like change but life is never the same from one moment to the next. Even if I were to say I had the same attack and rated it on the same scale of 1 to 10 it would not be the same attack. why because I am one day older and my body is one day older and I know what the previous attack was like even if I think it is the same as the next. I am working on dealing with stress in my life more so then an attack. i know the attack is stressful and produces symptoms for awhile but as is said before when I was trying to control them through breathing I was still having the same symptoms all day even if I had a small attack, from just tying to work. This would cause me to try and change the way I was feeling right at that moment, I have been thinking that if you can not accept where you are know you cannot heal and move forward. So I think I have to accept that things that bother me and cause stress. Like writing I have challengend it to death both with CBT and other methods I have basiclly given up on trying to spell things correctly becuase as I told you before I am learning disable and spelling is a chalange for me. So I let the computer correct the spelling, but my body has not caught up with my new veiw of wrinting it still produces symptoms and I think they are learned and have to be unlearned.

 

Dizzy

What you are doing, learning to live with panic is a step towards getting rid of them. Like you said you are conditioned to have them. Next comes conditioning yourself to live with them. See, if you can do that then they have no power and you will soon stop having them. It goes back to that core belief thing. Box breathing is a relaxation technique. A step on the road to a cure. A coping mechanism to help you cope with the attacks. Use it to tolerate the panic. So you are doing exposure to the attacks by contributing to them! Have you been able to ignore any of the triggers? Is there any one that is stronger than the rest that you could focus on? Since you are still with us you must be capable of ignoring them to some extent. If you find there is one that you can ignore, use it when you have one you can't. What I mean here is when you are real agitated because you are focusing on something that makes you panic bad can you move the focus to something that makes you panic but you can tolerate. By doing this you kill two birds with the same stone. You reinforce the tolerance of the one you can tolerate. 

At the same time by taking the focus elsewhere you lessen the impact of the one that is more difficult. This is part distracting part coping but mostly it builds positive attitude. 

Have you tried the muscle relaxation technique? If nothing it would give you a safe focus.

Here for you.

Davit

Hi Dizzy:  Just wanted to say "hello".  Good to hear from you.

 

Sunny

Hi David

 

Thank you for asking how I am doing. Although the focus of this site is to get rid of attacks I have not made much progress in that situation. However, where I have made progress is in living with symptoms all day. I have been tense for a good 30 years and my muscles have not been re-educated to the way I think now. This is where I believe the source of my attacks and the ending of them will come from. To give you some idea last year when I was in CBT in the winter he had me box breathing to stop an attack. I was successful for awhile until more stress's came in my life. So I did as this site suggested and stopped trying to stop attack by breathing and living with the symptoms they produced. I think I can safely say that I am on the same scale of when the CBT was measuring my anxiety symptoms with breathing (to stop them) as compared to not breathing and living with them. Do not get me wrong I also contribute to the attacks all day, but I have been lessing there impact of this and working more.

 

Dizzy

Hi Dizzy,

 

Your right everyone can experience a panic attack differently.  Check out the Education section for more information on what to expect.