This is the fifth video in my series on panic attacks.
If you have missed the first four, click on the link at the top of the screen now. This video
will show you how to reduce safety behaviors which is an important step in overcoming panic attacks.
You learnt in video 3 that safety behaviors prime a part of the brain called the amygdala
to be constantly ready to respond to danger.
This lowers your panic threshold making you very prone to frequent panic attacks
that seem to come out of the blue. So to reduce panic attacks you have to reduce safety behaviors.
The first step is to make a list of all your safety behaviors, Here is the list of Amanda's
safety behaviors that we saw in video 3. If you are struggling to know what your safety behaviors
are, ask a loved one or close friend what they notice you avoid or do to prevent a panic attack.
Common categories of safety behaviors are those related to escape or rescue,
those to suppress or check for symptoms that you associate with panic attacks
and avoidance of places and situations you fear a panic attack will occur.
When you have made your list put them in order of importance.
At the top put the safety behaviors that you believe are essential.
At the bottom put the safety behaviors that you think would be the easiest to give up
Amanda has at the top of her list avoiding busy places and supermarkets as she believes these
are certain to cause panic attacks. At the bottom she has carrying a water spray that
she uses to keep herself cool which she feels she could give up albeit slightly reluctantly.
It is important to give up safety behaviors slowly and gradually. It takes time to retrain an anxious
brain. If you try to stop all safety behaviors immediately it will overwhelm the anxious brain
which will not help. Giving up one to two safety behaviors a month is a sensible target but do it
at a speed that is right for you. As you manage to give up safety behaviors cross them off your list.
Many of your safety behaviors you may have had for years and the constant repetition reinforces
the belief that they are essential. A useful tool in CBT for challenging these beliefs is
the behavioral experiment. A behavioral experiment consists of the belief you want to test which you
rate from one to ten, an experiment to test that belief a prediction of what you fear will happen
and then reflecting on what actually happened followed by a rewriting of your belief.
For example Amanda believed that if she did not tense her legs and hold something tightly
she would faint or collapse. Her belief in this was ten out of ten. The experiment was instead
of tension her legs and hold on tightly she would use the technique taught in video four.
Amanda predicted that she will faint after doing the experiment. She reflected,
although I still felt dizzy I did not faint so tension makes no difference.
The panic attack was also shorter than usual. She re-rated her belief to a six.
You may have to perform the experiment a few times before long-held beliefs reduce to a two or
three. Here is another example of a common belief in panic disorder.
I must get in and out of a shop as quick as possible to prevent a panic attack.
I must check that the exit is clear at all times. Amanda's belief in this was ten. The
experiment was to walk around the local store slowly without looking at the exit.
She predicted that she would have a severe panic attack and someone would call an ambulance.
After the experiment she wrote I found it hard not to rush and I did feel very anxious but i did not
have a full-blown panic attack. Her belief in the need to rush and check exits was reduced to seven
and after repeating the experiment a few more times reduced to a four.
Here are a few other ideas for experiments related to safety behaviors.
For the belief if I feel a lump in my throat I must keep swallowing so that I don't choke,
try not swallowing or reducing swallowing. For the belief if I don't monitor my heart rate or
blood pressure it will get out of control, give your monitor to someone to look after
for a week and see what happens. For the belief if I don't control my breathing I will faint,
when anxious just let your body control your breathing naturally and see what happens.
Experiments like these will give you a different perspective on your safety behaviors
and will make them easier to give up. Make sure you write down your behavioral experiment results
as it helps the new positive belief sink in. As your safety behaviors reduce so will the frequency
of your panic attacks. If in doubt consider this. People who have no panic attack related safety
behaviors don't have panic attacks. People who have lots of panic attack related safety behaviors
have lots of panic attacks. One of the things that makes giving up safety behaviors difficult
is negative thoughts so in the next video Im going to show you a tool to deal with negative thoughts.