Do Panic Attacks Really “Come Out of the Blue?”

Many panic attack sufferers report that panic hits them with no warning at all; others do have a sense of building panic leading up to a full-blown attack.

According to a recent study reported at Science Daily (, there appears to measurable physiological changes occurring for at least an hour preceding a panic attack.  This would suggest that attacks do not “come out of the blue,” but that sufferers are not aware of the internal changes taking place prior to a panic attack.

From the article:

“A study based on 24-hour monitoring of panic sufferers while they went about their daily activities captured panic attacks as they happened and discovered waves of significant physiological instability for at least 60 minutes before patients’ awareness of the panic attacks, said psychologist Alicia E. Meuret at Southern Methodist University in Dallas.”

To read more, you can follow this link:

Bibliotherapy for Anxiety Disorders

Hello, everyone!

I must confess, I’m a “bookaholic!”  I have loved to read all of my life.  LOVE it!

Have you heard the term “bibliotherapy?”  It actually has a few slightly different meanings, but I find it to be a fantastic form of therapy, no matter how defined.

Which is why you’ll see a lot of book recommendations from me (thus the Amazon widgets and book marketplace you’ll notice on this site).  I’ll mention specific books or helpful products from time to time.  (Note: Your purchases do help us maintain our site, so many thanks to you if you should ever buy from these links.)

Having had panic disorder/anxiety, I found–as many do–that reading and re-reading those things that assist us in our healing process can be a godsend.  It is sometimes like having a personal therapist in your hands.  I know I’ve had a lot of “Aha!” moments, while reading, as I gained a better understanding of my experience. So many amazing insights arise….

Additionally, as a publisher of a newsletter on this subject, I was sent gobs of review copies of books in the field of anxiety disorders.  It was great to read each one, and often write about them in the newsletter.

Of course, reading is not enough.  Acting upon that newfound knowledge is what it really takes to see progress.  That knowledge truly is power when put to use.

I should add:  Don’t let seemingly conflicting information confuse and paralyze you!  Just take what feels right to you, and discard the rest—-or even save that other info for a time in the future. There will always be differences in opinions, but only you know what is best for you at any given moment.   Your own discernment is all that is needed.

Be Encouraged!

Our Genes, Our Chemistry, Our Thoughts …

Over the many years of keeping up with treatment trends and scientific discoveries in the field of anxiety disorders, I’ve found it especially interesting to see all the “newer” attention on the brain.

Initially, when people were told that emotional and/or mental issues were “all in the head,” it was inferred that we could or SHOULD think or feel differently;  there was little basis to assume that physiology or biochemistry was at fault.  There was shame and blame felt.

SO, when science started pointing a finger at faulty chemistry in the brain, many were downright relieved.  “Aha! See?  It is not my fault!  It’s just like DIABETES!”

Is it that simple?

I don’t think so.  A chunk of info has been left out:  Every thought we think affects our brain chemistry!

We DO have some “control” or some responsibility for what is seen going on in our brains.

Of course, that is oversimplified.  A brain injury, for example, isn’t changed with a simple thought, per se.

However, mood and emotion, and choice in response, is still the mandate of the conscious mind.

I won’t go into more detail here, except to say that I bring this up to point out a new way to think about our situations with anxiety.  We are more than our brain chemistry, and pharmaceuticals are simply NOT the ONLY route to affecting change in it.   Perhaps I can find some interesting links to share in the future, that better explain just how brain chemistry is modulated by our thinking and actions (as opposed to simply assuming pharmaceuticals are the only way).  Just think about a sucking on a lemon slice for a while, and you’ll soon see how your brain just sent a message to your salivary glands to turn on, even though you have no lemon at all….

Of course, medication can be helpful.  I know because I take some myself!

But, in my humble opinion, I must continue to oversee and witness my thoughts and to take great responsibility for my reactions, decisions and even mood.  I can take responsibility for my brain health, too, with proper exercise and very specific nutritional choices. I can make a huge difference in my brain’s activity AND I can override any genetic predisposition.  Genetic expression is not a given.

In any case, what good is shame or blame?  There isn’t a person on the planet who will not come face to face with challenges, insecurities or “issues.”  We are on equal footing, and there is no shame in being anxious, any more than there is shame in having diabetes.

And, to me, it isn’t because of supposed faulty biochemistry that I am off the hook.  It is because I am a human being, experiencing a chance to grow and better myself—–just like everybody else.

Be Encouraged!

Waiting and Procrastinating?

With so many years behind me now, of being in touch with the community of people experiencing anxiety disorders, I can say with some certainty that most of us prefer an easy route.  So we wait to find one…

And who wouldn’t?

You have every right to decide when, where and how you will approach your dealings with anxiety.

Yet I would humbly suggest:  Don’t wait endlessly, in fear, for the perfect answer or a magic pill.

So many of us have complained that this or that program didn’t “cure” us.

Or we procrastinate, fearing to try ANYTHING!  I understand. It’s scary!

But every step we take–no matter how tiny, no matter how imperfect–brings us closer to healing.

And do we have to be “perfectly cured, perfectly normal” to have a worthwhile life?  After much contemplation, I believe it’s simply not the only goal. You can live a valued life no matter what.

We have to start somewhere.  There are all SORTS of competing products, competing ideas, and possibly confusing data.  It can feel overwhelming and paralyzing.  But I urge you:  START SOMEWHERE!

If money is an issue, then choose wisely.  For example, there are great books and workbooks that can get us going in a wonderful direction (if we are willing to DO the exercises and so forth).  These books, of course, are very cost-effective compared to weekly therapy.

No matter how much money you have to spend, though, remember that you are making an important and worthwhile investment–in YOU.

Give something a try.  Fail, if that should happen.  It’s all learning. Be willing to make mistakes.  Be willing to make progress.  Simply be willing.  Keep trying new things until you find what feels right to you!

Moving forward, if only an inch, feels better than standing still, frozen in fear.  What shall we wait for?

Be Encouraged!

“I Truly Admire My Dog!”

With him, there are no good nor bad days, there are just “right now” days. Whatever that “right now” is, he’s fully in it. One can view him as simplistic, but life is quite simple, it’s us humans who complicate things. For instance, he is not overly optimistic, nor daft, he just has no clue he is incapable of flying. Evidence of this, each and every single time he spies an evil squirrel up a tree, he will try and fly up that tree. Dogs don’t climb trees. He’s such a toad. He’s being silly right? Except that time he defied gravity, pulled a Keanu move straight from the Matrix, and by goddess, flew up that impossible, no lower branched tree. The tail less squirrel, as we now refer to it, is still a bit peeved bite into more joy. Pun absolutely intended.

Well there missus, we are not dogs so what does this have to do with the price of panicky potatoes? Panic attacks make me believe I cannot fly. They slow me down, they make me stop trying, they never ever live in the present moment. They are running days, weeks, months ahead and focussing on every possible negative scenario from the past. Even positive, wonderful moments from my memory will be portrayed as awful dramas unworthy of even the worst soap opera award.

My dog doesn’t identify with painful memories, nor lack of wings, nor does he worry one whit what tomorrow will bring. He sees things quite clearly. I am here, I am in the now, I am love. Ta da!

In fact he doesn’t identify with egoic thoughts such as: “What if that squirrel comes back next week? What if we run out of treats? You know, I really ought to stop jumping like that, I might break a toe, I remember that time I hurt my paw, I had to spend days in the crate and visited the Poke and Stick doctor…” Nope, none of that.  With him, It’s 1-2-3 FLING in the air. 1-2-3 FLING even higher. Fail? Try again. Fun! Ouch! Get back up. Yay! Unbridled enthusiasm lesson 101.

Short of mastering the Art of Zen Whippetry, I practice taming the present moment, for it is, in fact, all I have. Past is gone, future doesn’t exist, it’s been said a million times, but we don’t adhere to it or else we could easily chuck the panic suit no problem. And, an ugly sweaty orange lycra spandex suit, no less. Identifying with a panic filled thought, making it mine, and adding its repertoire to my inner being, is, quite frankly, fraudulent. It doesn’t belong there, it is not who I am. It lies.

It is not who you are. Repeat it after me. Panic is not who I am.

Yes, I truly admire my dog. He knows who he is, where he is and what he wants. He has wings, he can fly, never a bad hair day and he never ever wears a suit. A cape, perhaps, but never a suit.

Carry on,

Kate is a guest blogger and proud whippet mom.

The Medical Viewpoint on Panic

The Medical Viewpoint on Panic

Is panic disorder a physical or mental problem… or both?

by William D. Kernodle, M.D

The following article is excerpted by permission from the book, Panic Disorder: The Medical Point of View, by William D. Kernodle, M.D. This section pertains to “Key Points About Panic Disorder.”

A panic attack is a normal physical reaction occurring at an inappropriate time. Panic disorder may affect 5% of the population. By diagnosing panic disorder early, effective treatment can begin which should control or eliminate panic disorder, as well as prevent any possible complications. Panic attacks are benign; the complications of panic disorder can be malignant. Possible complications are anticipatory anxiety, demoralization, depression, agoraphobia, alcoholism and even suicide.

The best way to prevent complications of panic disorder is to diagnose it early. Panic disorder should be a rule-in diagnosis, not a rule-out diagnosis.

There is strong evidence that panic disorder has a biological core. Its complications are primarily psychological. Panic disorder is believed to have a strong biological core because of its strong familial and genetic tendencies: because panic attacks can be reproduced by physical means in the majority of patients vulnerable to panic attacks; and because medication is highly effective in blocking panic attacks. This same medication can prevent panic attacks from being caused by physical agents such as sodium lactate. PET scan data have established brain abnormalities in panic disorder. More evidence for the biological core of panic disorder should be seen in the future.

Panic disorder fits well into the medical model, including diagnosis, treatment and prognosis. It is analogous to ulcer disease. There are different stages: mild, moderate and severe. It is often chronic. Stress is contributory but not a sufficient cause for panic disorder, just as in ulcer disease.

In motivated patients, treatment using medication, education and cognitive-behavioral techniques is 90% effective. While this treatment combination has been scientifically verified, it is not standard treatment in this area. Supportive psychotherapy may be helpful, but is not as specific in treating panic disorder. Long-term exploratory psychotherapy used to find the cause of panic disorder has been ineffective and cannot be verified scientifically. Psychological and social factors should certainly be addressed if other treatment methods have failed or are not bringing the desired results.

Multiple factors are involved in panic disorder. Even though we have not yet pinpointed the exact cause, or causes, of panic disorder, we now have extremely effective treatment to help patients live normal, productive lives.

Ed. note: We have had numerous inquiries as to the medical viewpoint versus a more psychologically-based causation stance. In an effort to share more of such information with our readers, we are pleased to provide this article. ENcourage Connection is committed to disseminating information supplying a broad spectrum of ideas, and we trust that our readers will benefit as a result of having a well-rounded “education” in furthering each person’s efforts toward wellness.

Image Credit: smokedsalmon /

(This posted article was originally published in our ENcourage Connection Newsletter, print version.)

Social Phobia

Expert advice on dealing with social phobia…

by Thomas A. Richards, Ph.D.

What would it be like to sit in front of the telephone and agonize for hours because you’re afraid to pick up the phone and make a call?

You’re even afraid to call some unknown person’s office although you know that the person will never know who you are. Still, you just can’t seem to lift the receiver and make the call. If you were to make it, you’re certain that your voice will falter, you will begin stammering, and you will sound weak or silly. You don’t want to sound weak or afraid, so you don’t make the call.

You want to go to parties and other social events–indeed, you are lonely–but you don’t go because you’re nervous about meeting new people. Too many people will be there and crowds bother you anyway. If you went, you know you’d be afraid and embarrassed, so you don’t go to the party.

You dread meetings at work because you know you’ll be “on the spot,” tense, and anxious. You’re intelligent, but you won’t be able to discuss matters freely in front of other people because you’re so worried about what they will think about you. You stare at the ground or fix your eyes on the table. When you have to speak, your voice sounds hesitant. You know you sound weak and sometimes you even stammer. Other people are probably thinking you’re dumb or just plain weird. The tension, anxiety, and fear continue to mount. It’s humiliating to feel this way, but the fear in the pit of your stomach won’t go away.

Finally, the meeting is over. A big wave of relief spills over you and you begin to relax. But the memory of the meeting is still with you. You are convinced you made a fool of yourself and that everyone else in the room saw how afraid you were and how stupid you acted in their presence.

In public places, such as work, meetings, or shopping, you feel that everyone is watching and staring at you. You can’t relax and enjoy yourself. In fact, you can never relax when other people are around. It feels like they are evaluating you, criticizing you, or making fun of you. They don’t do this openly, of course, but you still feel the judgment in their presence. So you avoid other people.

Many times you simply must be alone–closeted–with the door shut behind you. Even when you’re around familiar people, you feel overwhelmed and have the feeling that they are noticing your every movement, critiquing your every thought. You feel like they stare at you and that they’re making negative judgments.

What seems to be the very worst circumstance, though, is meeting new people who you think are “authority figures”–people such as bosses, supervisors, principals, and doctors. You feel that these people are more important than you are. You get a lump in your throat and your facial muscles just won’t work up into a smile when you meet them.

A job interview is pure torture; you know your anxiety will give you away. You’ll look funny, maybe you’ll even blush, and you won’t be able to find the right words to answer their questions. It is especially infuriating because you know you could do the job well if you could only get past the interview.

Welcome to the world of the social phobic.

Social phobia is a relatively common problem that affects millions of people–men and women almost equally. Unlike some other psychological problems, social phobia is not well understood by the general public or even among practitioners. Because few social phobics have heard of their problem and have never seen it discussed on the television talk shows, they think they are the only ones who have these symptoms. Unfortunately, without some kind of knowledge and treatment, social phobia continues to wreak havoc on their lives. Adding to the dilemma, social phobia does not come and go like other psychological problems. If you have it, you have it every day.

The feelings I described to you at the beginning of the article are those of people with “generalized” social phobia. That is, their symptoms apply to most social events and functions in almost every area of life. I suffered from social phobia myself for eighteen years before I ever saw the term or read about its symptoms in a textbook.

Luckily, my social phobia has, for the most part, been under control since I learned how to deal with it. I do not say that I’m “cured”–that term is too strong. I do say, though, that life is much easier, more bearable, and even enjoyable compared to how it used to be.

As with all problems, everyone with social phobia has slightly different symptoms. Some people, for example, cannot write in public because they fear people are watching and their hand will shake. Others are so introverted that they lack normal social skills, thus making it impossible to “fit in” with any social group. Still others have a severe phobia about eating or drinking in the presence of other people.

One thing that all social phobics share is the knowledge that their thoughts and fears are basically irrational. That is, social phobics know that people are really not critically judging or evaluating them all the time. They understand that people are not trying to embarrass or humiliate them. Yet, despite this head knowledge, they still continue to feel that way.

It is the automatic “feeling” and thoughts that occur in social situations that must be met and conquered in therapy. Usually, these feelings are tied to thoughts that are entwined in a vicious cycle in the person’s head.

What can be done about social phobia? Many therapeutic treatments have been tried, but cognitive-behavioral techniques have been shown to work best. Some of these techniques are the ones used for panic attacks, agoraphobia, generalized anxiety, and post-traumatic stress problems. Other techniques are entirely different.

Attacking irrational thoughts, role-playing real-life events that will occur, and imagining problems and learning to cope with them are therapeutic techniques that work for some anxiety problems. However, many social phobics benefit from shame-attacking exercises, role-playing and learning new social skills, realistic assertion-skill development, and an all-out campaign to ferret out the inaccurate thinking that is tied to anxiety.

Many times the results are dramatic. If therapy is structured toward teaching the patient to be responsible for thoughts and feelings, then progress generally continues after treatment. This is not to say that social phobics become anxiety-free after treatment. But quality of life is greatly enhanced, and people often find they can do things that they never would have considered before treatment.

Social phobia responds to relatively short term treatment, depending on the severity of the condition. I have seen significant progress in just six sessions, although most people respond better with ten to twelve meetings.

What social phobics do not need is years and years of therapy. In fact, social phobics who learn to “analyze” and “ruminate” over their problems usually make their social phobia worse.

There is hope for a better life for all social phobics. Without treatment, social phobia is a torturous emotional problem; with treatment, its bark is worse than its bite. Many of us have been through the crippling fears and constant anxiety that social phobia produces–and have come out healthier on the other side.

Thomas Richards, Ph.D. is a psychologist in private practice in Phoenix, Arizona and specializes in the treatment of anxiety disorders.


(This posted article was originally published in our ENcourage Connection Newsletter, print version.)

There Is Life After Letting Go Of Perfectionism

Why dropping our unrealistic perfectionism provides anxiety relief…

by Susan Turner

This article is going to be different from past ones as I will not be the only person writing it! Yep, you are getting a break from me! I asked a few of my friends to contribute to this topic as it is a very important one. If you are anything like me, you love to hear from as many people as possible on ways to overcome some traits which most definitely need modifying. And yes, I confess, perfectionism is a trait I continue to work on. Letting go of perfectionism is a process just like our agoraphobic/panic disorder recovery is. Wouldn’t it be fantastic if those of us who suffer with “having to be perfect” could wake up one day ….and poof…that aspect of ourselves was no longer with us? But alas, just like many of us wish we could open our eyes one sunny morning and panic would be no more, it just “ain’t” so. It “ain’t” going to happen! Work, yes, work is involved in ridding ourselves of a trait which can reek havoc in our lives and be extremely debilitating.

My striving for perfectionism came from feeling totally imperfect on the inside. Okay, I knew I was way imperfect, but I decided if I put on this “perfect” front I could fool everyone. Unlike many perfectionist people, though, I did not strive to be the perfect mother, wife or house keeper! Ah, if you could see my house(my kids, my husband!), you would know I am speaking the truth! My family knew I was far from perfect so it was the outside world’s eyes I was attempting to pull the wool over.

Perhaps, I mused, if the world thought I was perfect, then in some magical turn of events, their praise would enter my body and mind, making me less and less imperfect. As you probably already figured out, it didn’t work. No matter how much praise I received, the fuzzy warm feelings were fleeting. I was left empty and off to find something else I could be perfect at.

How have I gone about changing? How have I been able to begin letting go of perfectionism?

The first step actually occurred years and years ago. Way before I had my first panic attack. I may have related this little bit of folklore to you before, but I feel it bears repeating.

I use to do a million different arts, crafts and hobbies. For those of you who knit and crochet, you know it is not fun to have to ” rip back” your work. There you are happily crocheting or knitting away and all of a sudden a few rows down from the row you are you working you spot a MISTAKE! Of course, in reality, you would probably be the only one to notice it…but still….it HAS TO be fixed. YOU CAN NOT HAVE A MISTAKE IN YOUR WORK and that is that! Ripping back( pulling out the stitches) while crocheting is not too bad…but ripping back while knitting is a royal pain. But I did it! There could be no mistakes in my work. So a hobby which was suppose to be creative, relaxing and fun turned into utter frustration for me.

After I complained to a friend( I complain well (and a lot!) about having to rip back to fix my mistakes, she shared this little story with me.

There is a tribe of Indians who weave blankets and make money doing so. These Indians INTENTIONALLY make a mistake in each of their blankets! Why, you ask? I sure did! They make a mistake on purpose and leave it in their weavings to prove they are not perfect–only God is. What a concept! I was blown away by the tale.

I am not a religious nor spiritual person but for some reason, I understood why the Indians did what they did. Who knows? Maybe I needed an excuse! Whatever the reason was, from then on I was able to let a mistake or two( not real noticeable ones, mind you) in my crocheting or knitting go. It was hard, believe me…but after awhile I was okay with it. Unfortunately, unlike panic which generalized by the speed of light to every place outside my house after experiencing my first major attack at work…the Indian- intentionally- made- mistake did not generalize into any other part of my life!

I had gained a small victory in my fight against perfectionism, but the rest of my life was steeped in going for the gold!

As I mentioned above, I experienced my first panic attack at my job. I was working as a teacher’s assistant. One of my duties was to check the students’ spelling tests. The teachers I worked with gave practice tests Tuesday, Wednesday and Thursday. Friday was the main test. Okay, so here I am Miss Perfectionism having to check over fifty tests four times a week. I went nuts going over and over each test. I COULD NOT MISS a word spelled incorrectly. Well, of course, on occasion no matter how diligent I was, I did miss a word. When the teacher pointed my mistake out to me, I was devastated. She was not in the least bit upset. She just wanted me to know. For me, the world had crashed down around me. The secret was out…SUSAN WAS NOT PERFECT!

I could recount instance upon instance where striving for perfection made me extremely anxious and caused me much distress. But I think you get the picture. None of us want to be slouchers…but… it is not healthy to forever chase after perfectionism. It can not be run down!

Can a middle ground be found? I think it can be.

I would now like to share with you what some of my friends( in recovery from panic <and perfectionism>) had to say when I asked them to help me out with this topic. Ah….I will be back, though, at the end of the article to tell you how I am doing at present on my quest to rid myself of “needing” to be perfect.

Everything had to look its best or I’d stress out trying to get it there. I would wrap a Christmas present with fancy paper and just the right shade of color for the bow or ribbon. Of course, they have to match…now, don’t they? My son’s socks had to go with his shorts. His cowlick had to have just the right amount of gel to keep it under control. When I took my car to the garage, of course, it had to clean on the inside and out. I didn’t want the people at the garage to think less of me, now did I? Just writing this out is exhausting me….ahhhhhhhhhhhhhhhhh! It didn’t take a day but in time I have changed my perfectionist habits. I still like things clean and neat, but the difference now is I don’t let my house define who I am nor does it control my life. My time is more enjoyable now. I, also, feel much differently about myself. I have lost those negative “SHOULDS” which go along with the need to have everything ” perfect.” Two little words have helped me so much…I say them over and over again…WHO CARES? Who cares if the mechanic sees my messy car? ( like they would even care anyhow) Who cares if my son’s cowlick decides to do what it does best! Who cares if the gifts I give aren’t wrapped neatly and color coordinated with ribbon and just the right bow? ( I know my kids don’t when they are ripping them open!) I still have more work to do, but I ‘m on my way to a much more relaxed life…and it feels good, too :-) Just ask my family.



I’ve never been much of a perfectionist. My husband will attest to that…but… I do like to keep a neat as a pin house. Closets are my biggies. Everything has to be lined up. I would never leave my house without everything being just so. I am not sure if this was a perfectionist behavior or more of a phobia. I had visions of something happening to me when I was out and… I didn’t want anyone coming into my house thinking I was less than a perfect housekeeper.

I have really come a long way where my house is concerned. Now I can leave with beds unmade and dishes in the sink. I could never have been able to do this before. I’ve changed my “what if” thinking revolving around my agoraphobic recovery. I, also, have changed my ” what if they see my house like this” negative talk to “Too bad if they don’t like how my house looks, they can clean it themselves! ”



When I was a child, I lived with parents who were perfect in their cleanliness…and also obsessed with helping the ” universe.” I grew up demeaned for what my parents perceived to be a lack of neatness on my part. I was, also, ridiculed if I did not stop to help every street person or someone who had been in an accident. These rules were stringently observed and religiously obeyed. I did take on some of my parents’ ways.

My family ran to every poor home and helped strangers on the street. I, too, helped others because of my upbringing. I volunteered in hospitals. When in college I volunteered in the department studying brain patterning. Everyone came before me. My parents died when I was in my twenties. My older relatives assumed I would take their place. They expected me to travel across the country running to help every relative and to entertain all the time. I did my share of entertaining but due to my panic attacks, I could not travel to help all of those who felt I should. I lied to my relatives for years giving them a multitude of excuses as to why I could not come to them. In time I realized that I had to let go of my parents’ ways. I had to be myself. So…I told my relatives the truth. I told them I had panic attacks. I could not always be there for them. When relatives visited me, my home was not in the ultimate state of cleanliness my mother’s house had been. For many years, I suffered shame due to my lack of neatness. But now, I am happy with me. My house is not dirty, it is warm and lived in. I do help those that I CAN AND WANT TO help. I can’t travel to the ends of the earth as my parents did nor do I want to anymore. At this stage in my recovery from agoraphobia I do want to travel more, to be there for those I love, but only for those who accept me for who and what I am. I still live with my mother on my shoulder at times. When she is with me, I take a magazine or book and read it in the tub. This is my symbol of freedom from her after thirty years!!



My area of perfectionism lies in not making mistakes. Having a low self-esteem to begin with, making a mistake made me think even less of myself. I had to boost my self-esteem some way and the only thing I could think of was to be “perfect.” Study hard, get good grades, say the right things at the right time, wear the right clothes, please all of the people all of the time…the list goes on and on. Needless to say, it’s a lot of work being “perfect.” Changing wasn’t easy. It meant letting go of a lot of negative self-talk that had become the norm for me. It got easier when I had kids because a lot of the positive reinforcement I gave them, I also gave myself. When they made a mistake, I helped them to learn from it, and consequently, I began to realize that sometimes it’s good to make mistakes, because we learn from them.



“Would you like to come over for dinner?”

“You and the children can spend the weekend. It will be fun!”

These are some of the things I avoided saying for many years. I always had an excuse: the house is too small, I don’t have time to make dinner for company, I’m not interesting enough to entertain. But the reality is that I am a perfectionist and the thought of people around for extended periods of time bothers me. I’m afraid I won’t have enough time for myself, afraid that people won’t like my cooking, afraid I’ll be boring, afraid I won’t be able sleep while other people are in the house. and afraid my life will be scrutinized. In short…I am afraid I won’t be perfect.

I’m making an effort to change. I ‘ve found a few techniques which help with dinner guests. First, I force myself to invite someone over. Then I make only tried and true recipes and tell them it’s going to be a causal dinner. I accept their offer to bring something( it takes the pressure and focus off me). I have my husband and children help with cleaning the house.

The situation is similar with overnight guests. I only invite close friends and relatives….and even then I have to force the words out of my mouth! I give them lots of privacy. I go into my room early enough at night to have time to myself.

I’m still not an easy-going person who can joyfully entertain day after day. I have to gear up for it. But I have noticed that after a couple of years of having my children’s’ friends spend the night occasionally, I no longer worry about that type of guest.

I know that it gets easier as I force myself to do the things which make me uncomfortable. I’m always very proud once I invite someone over and even more proud once I have pulled it off!



I hope you enjoyed reading what some of my friends had to say about there dealings with perfectionism. See…you are not alone! There are many many just like you out in the world.

Okay…so how am I doing on my quest to overcome perfectionism? Well…not too badly! Not sure what is up with me but over the last year or so, I have learned to laugh at myself more. This is not to say that if I was still working at school and I didn’t find a spelling error on a child’s paper I would be thrilled and make a joke out of it…but…I am lightening up. The word ” DUH” has become a big part of my vocabulary…and I use it often to make fun of the some of the mistakes I make. Once I realized my friends did not think less of me( and probably were grateful I was not the robot I appeared to be!) when I made a mistake, I felt as if a gigantic weight had been lifted off my shoulders. This is not to say I run around happily making mistake after mistake because that just is not in my personality. But I have learned that mistakes can be fixed, mistakes can be forgiven, and mistakes will not bring my world crashing down around me. Well, not little mistakes, anyway! HA. And interestingly enough, once I lightened up about my mistakes(because no matter how perfect I tried to be… unfortunately…I still made them), I developed a sense of humor! Surprise! I had been pretty humorless before. I laugh at me and my friends laugh with me. Many times I don’t mind being the butt of a joke which I had created by making a mistake.

Today, I feel so much “lighter!” It is a very heavy burden striving for unattainable


Until next issue…

have a great fall…
and lighten up…
life is way too short…
to carry around our perfectionist baggage

day after day after day…


(This posted article was originally published in our ENcourage Connection Newsletter, print version.)

Panic Disorder and Pregnancy

How one women dealt with panic attacks during pregnancy…

-  One Woman’s Experience . . . and Joy

by Beth Watson

Like most women, when I found out I was pregnant, my thoughts were filled with questions: Will the baby be healthy? What sex will the baby be? What kind of mother will I be?

Having panic disorder raised some different concerns for me, as well. I worried about my medication; would I be able to continue to take it, and what about side effects to the baby? I worried about the delivery; how would I ever manage the normal anxiety associated with labor and delivery compounded with my heightened level of anxiety because of the panic? And the question, “what kind of mother would I be,” included questions about whether or not I could handle the daily care that a child requires. Could I take the baby to the doctor even though I was having a bad day? What if there was an emergency; could I handle it or would I panic?

When the nurse told me that the pregnancy test was positive, I was shocked, overjoyed, and scared to death–all at the same time.

The first trimester of my pregnancy was very easy for me. I went to my ob/gyn and together we researched the medication I was on (an antidepressant and a tranquilizer). After doing some reading, we both felt it would be safe to stay on the medication during the pregnancy. I then began reading every baby and parent book I could get my hands on. I was still very nervous about the delivery, so I decided that having a Cesarean section was the answer. I convinced myself that if I had a C-section, I would be able to set the date of the delivery, and I wouldn’t feel much pain because of the epidural. I would be in total control! Now all I had to do was convince the doctor, but I had plenty of time for that. (Hormones do wild things to your perception of reality!)

I moved to another state during the second trimester, which meant changing doctors. When my new doctor learned of the medication I was taking, he became very concerned and started talking about possible birth defects and how my baby would have to be put on drugs after delivery to deal with the withdrawal. He then rushed me to a hospital to begin getting me off medication.

Needless to say, this was all pretty frightening. They proceeded very cautiously because I was pregnant, but within four weeks, I as off all my medication. The withdrawal from the medication wasn’t fun, but I still don’t know how much of that was withdrawal, how much was pregnancy, and how much was panic.

Now here I was in a new city, with no friends or family, pregnant, with no medication. If I could have crawled under the covers and stayed there, I would have, but luckily life doesn’t work that way. And, to my surprise, I was able to handle many new and possibly difficult situations with ease. I’ve heard that the hormones your body produces while you are pregnant can block panic, and that may account for some of it. I also discovered that people are extra friendly and forgiving to a pregnant woman, which gave me a great deal of security. I knew that if I was in a line and began to feel panic, I could simply ask someone to hold my place while I went to the bathroom or ask if I could go ahead of them because I wasn’t feeling well.

By my seventh month, I was feeling great. I was experiencing no anxiety, other than the “normal” new-mother concerns. The doctor had ordered two ultrasounds because I had been on the medication, and our little boy looked just fine. And although I realized at this point that I couldn’t just decide to have a C-section, I was relaxing more and more about the idea of going through labor. After all, the doctors will let you labor for only twenty-four hours, and I could handle anything for twenty-four hours.

I began using the same tools I use to deal with anxiety to prepare for the upcoming event. I used a lot of visualization and rational self-talk, along with relaxation techniques which I planned to use during labor.

My husband and I took a Lamaze course which I highly recommend for all new parents. The fear of the unknown is hard for me, and this course answered a lot of my questions, dispelled a lot of myths, and gave me tools to practice so that I felt more in control of the situation.

Being the typical “high anxiety personality,” I had my Lamaze bag packed six weeks before my due date. My husband and I practiced our breathing techniques regularly, and we even made up a computerized chart to use during the contractions. (The nurses loved it!) At this point, I was pretty confident about my ability to handle labor, but I was still trying to figure out how to get out of going through the delivery.

By my ninth month, I was more than ready to have this baby. I had gone over my list of final questions with my doctor. I must say I was a little disappointed with some of the responses I got. I had been told that there was a mild tranquilizer that could be given early in labor if the mother was very anxious. As my doctor knew of my panic disorder, I asked that this be made available to me if I needed it; I was told, “Don’t worry, honey, everyone’s a little nervous before they have a baby.” I explained my circumstances again, thinking: the doctor sees a lot of patients, maybe he forgot. He then told me I could go back on my medication if I thought it was necessary. It was lucky for him that I was too big to move quickly, or I might have strangled him. After all we had gone through five months earlier–and now he had changed his mind. I know doctors differ on whether the antidepressants and tranquilizers are safe for pregnant women, but I assumed my doctor only had one opinion.

Finally, the big day arrived. My contractions started after breakfast, on my due date, five minutes apart. We called the doctor and he told us to go on to the hospital. We then called the hospital and asked if there was a nurse on duty familiar with panic disorder. They checked on it, and she was waiting for us when we arrived. I was calmer than I had thought I would be. In fact, my husband still teases me that I had to get that last load of laundry done before we left for the hospital.

After twelve hours of labor, I had an epidural. I didn’t like the idea of being confined to bed (I was more comfortable walking than lying down), but once the epidural kicked in, I didn’t mind. When I reached 10 centimeters dilation, the nurse told me I could push when I felt the urge. She came back a half hour later and seemed surprised to find me still lying there watching TV. (Believe it or not, I was still trying to figure out how to get out of delivering this baby!)

After a little coaching from the nurse, I began to push. In less than fifteen minutes, my son was born. Labor and delivery were not as bad as I had thought they were going to be. I had heard so many horror stories. But I found that if I relaxed and went with the contractions, time just seemed to slip by; before I knew it, T.J. was in my arms and I was officially a Mom.

We brought him home two days later. I had spent so much time preparing for the birth, but no one had prepared me for the first few weeks at home. Between the hormones, the lack of sleep, and the new person who literally depended on me for his life . . . I was overwhelmed and had a lot of anxiety. My mom stayed with me for the first week, and when she left I thought I was going to fall apart. To no one’s surprise but mine, I didn’t.

Today T.J. is a healthy, happy nine-month-old. I’m lucky enough to be able to stay home with him. Nothing in my life is the same as it was since the day the nurse told me I was pregnant. I’ve pushed myself at times because my son needed me, when in the past I might have let things slide. I’m stronger and happier (and more tired) than I was then. And I’m even thinking about baby number two.

I worry about what kind of example I will set for T.J. Will panic disorder affect his life, either through me or because he develops it? These are questions I can’t answer now, but my husband and I joke that we aren’t just saving for his college education, we’re saving for his therapy. I know that along with some of the “high anxiety personality” traits that he may pick up from me, I will also teach him how to deal with stress and anger and give him the tools to manage the anxiety if it becomes part of his life.

Having a baby has also helped me to reach a long-term goal that I had set years ago when panic first came into my life. I wanted to learn how to have fun again. Now, when my son giggles, or shows wonderment at a new toy, I feel a joy and playfulness I haven’t known in years. Oh, to see life through the eyes of a child!

Reprinted by permission, ABIL Newsletter, December 1993. ABIL Inc. (Agoraphobics Building Independent Lives) is located at 1418 Lorraine Avenue, Richmond, Virginia 23227.

(This posted article was originally published in our ENcourage Connection Newsletter, print version.)

Helping Herself, Helping Others

Helping Herself Helping OthersAnother inspirational story of agoraphobia recovery…

an interview with Linda Hyman by Pat Merrill

On March 2, 1995, I watched Linda Hyman with great respect. I had never met her, yet I knew I would want to. She appeared on the “Leeza” show, sharing her experiences in recovering from agoraphobia. I’m glad that we did meet by phone and that she graciously allowed me to conduct this candid interview with her. I learned a great deal from her, and I suspect you will too.

One of the first things I wanted to ask Linda Hyman was, “Why did you go on national television?” I suspected I knew the reason, and I was right. She is one of those special people who wants to help others who are struggling or simply need more help.

It is not easy for the average person to walk onto a Hollywood studio set in front of an audience of strangers, let alone a sensitive person prone to experiencing an intense variety of anxiety. Yet there she sat, an attractive young woman, appearing amazingly poised. She answered Leeza’s questions with candor and conviction.

How did she feel about being on the show? Was she as calm as she appeared? Linda reported that she really was pretty tense, but she knew how to deal with those anxious feelings. “It was exciting,” she revealed. “The fun part of it was when they came to my house to make tapes. What caused me a lot of anxiety was that, knowing the most important things they taped and that we talked about, never would show because they weren’t ‘exploitative’ enough.” All of the tape that was shot showing Linda working with a field worker, showing how one is worked through things such as going to the market, was not aired. Additionally, the O.J. Simpson trial preempted that particular “Leeza” program at least in Southern California where Linda lives and works.

Having had panic disorder off and on for about a dozen years, Linda knew the pain and struggle well. During that time, she additionally went through some immense stresses and personal tragedies–a major accident, painful losses, a stalker.

For a period of time, she managed to–despite panic attacks–continue in her strenuous and stressful career in the Los Angeles area as a salesperson and designer. “I would have to have meetings in front of groups of people to sell a project, and I would go in . . . without remembering a word I said. But nobody knew.”

She tried various forms of therapy including psychotherapy. But she quickly worsened and eventually became very agoraphobic, completely housebound. Deciding to admit herself into a hospital program for treatment, she risked leaving the “safety” of her home for the help she hoped to receive. Linda recounted the difficulty she experienced. “I had to go with a pillow over my face just to get there.” Despite the severity of her symptoms, the evaluating psychiatrist said she wasn’t “bad enough” to be admitted. “All of that trouble and all of that heartache was for nothing,” she lamented.

Another attempt to be treated at a well-known hospital proved equally disappointing. It became clear the first day when she was locked in her nearly empty room by the staff that they did not understand agoraphobia. She left.

But on her way out, she saw a sign that mentioned a treatment program called TERRAP (which stands for Territorial Apprehension, the term coined by its founder, Dr. Arthur Hardy).

She discovered that it was a specialized program for those with panic and anxiety. “We ended up making it there and went to the orientation, and I sat outside on the steps and cried, and my mom went inside. I listened and could kind of hear what was said and I thought, ‘This is me! Wait a minute!’ ” All the staff had experienced the same things Linda had. “The woman that came outside to talk to me is now one of my co-workers.”

Being so phobic, it was difficult for Linda to begin attending the program. She recalled that “the first week I sat outside in the hallway, the next week I went into the door a little ways, the third week I was inside.”

Linda started working as a volunteer for the TERRAP office after she had been part of the program for a relatively brief time. Not driving yet, her mother drove her there to work four days each week. Next, she began driving there herself, with her mother in the car. Later, she began driving in her own car, having her mother follow her in another car. Eventually, she was able to get there on her own.

Does she consider herself recovered? “I call myself recovered, but as you know, ‘recovered’ is a funky word. This is something that I’m born with. It’s never going to go completely away. Everybody gets anxious. I have a lot more chemical imbalance as far as my adrenaline than most people do. . . . To me recovery is knowing when I’m getting anxious, knowing what’s happening, being able to figure out a way to circumvent it and not get into panic.”

On the television program, viewer’s saw Linda’s loving and supportive parents in the audience. But she mentioned that her best friend of twelve years did not understand her panic and phobia; subsequently their friendship ended. “What I tell people is that if others love you, honestly love you, they will try to understand. And if they’re not going to, then you need to find another avenue to make yourself better. If you can’t rely on them, maybe they’re not the people you need to have in your life, maybe that’s why you’re having anxiety. If they’re not going to be supportive, then evidently they don’t love you enough.”

What is the most important thing that she thinks is key to recovery? “It’s hard to do without support,” Linda answered. “But the most important thing is to know is that this is a terrible thing and it’s a terrible feeling, but thank God this is all you have. It could be a lot worse. Even when you’re in the middle of the worst panic attack and feel like you could die this minute . . . if you work hard enough, and you care about yourself enough, building up your self-esteem again, you can get through it. But you have to do it yourself. That’s the most important thing. No one can do it for you.”

Today Linda is able to “do everything.” “I travel, I go everywhere, I can even go to Las Vegas–the most anxiety-provoking city! I can drive, fly, do restaurants and malls.

“The most important message, I think, is for people who have this is to not be scared, to tell someone, to go to their doctor and get the proper care . . . to not be ashamed of it, to have enough love of yourself and you can get better.

“I’m not embarrassed by panic attacks any more. I still hate the feeling, I’m not going to lie about that. They still scare me, but I’m not ashamed.

“A couple of weeks ago, I had a panic attack in the store, and I just sat down on the floor. I sat there for a minute, did my breathing, thought about what was going on. . . . I realized I had [tried to get too much accomplished and was rushing too much]. I don’t think I was exactly doing it the proper way! So, I calmed myself down, went to the phone and [changed some plans] so I could get things done that I needed to.

“Not one person looked at me when I was down on that floor. . . . It helps you to get over this when you know that people aren’t going to just look at you thinking, ‘What a weirdo!’ ”

Linda shared the fact that she had had to work to get past the embarrassment issue. During her treatment, she went to a major department store while with her mother, and had a panic attack in the children’s department. Rather than fleeing, Linda got on the floor and acted out a little temper tantrum just like one of the little children that was fussing in the same area. To her surprise, despite several other shoppers being present, not one person seemed to notice! “Everybody is too busy. . . . I was at the point where I was tired of worrying about it,” she declared. This was a real breakthrough in her progress.

Linda is also no longer embarrassed to request help when necessary, even from strangers. She simply explains matter-of-factly that she is not feeling well and has an anxiety disorder; if she feels the need for some assistance, she has found that someone is always willing to help.

But even more significant, Linda explained how important it was in her recovery when she realized that she could handle her anxiety alone if need be. “The reason before that I wouldn’t drive is because if I had a panic attack and had to stop, I would think, ‘What if I can’t go again? What if I’m stuck here?’

“Well, I cured myself of that by making myself stop without one [a panic attack]. I’d pull over on the side of the freeway; you can pull off and get back in the traffic if you need to.” She added humorously yet with all seriousness, “You could pull over into a shopping center, run around the car 50 times and scream, do whatever you want to do, get back in the car and you can still go!”

Linda’s coping skills and strategies no doubt additionally helped her with a very scary, life-disrupting situation not long ago. She was able to respond well during and after the serious Northridge earthquake that severely damaged her home.

It seems obvious that Linda’s recovery had much to do with her perseverance and willingness to change. Having worked hard to help herself, she is now more than willing and able to help others.

(This posted article was originally published in our ENcourage Connection Newsletter, print version.)