treating generalised anxiety disorder and panic attacks · painful long-term health conditions,...
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www.mindbodybreakthrough.co.uk 1Wale Oladipo
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Treating Generalised Anxiety Disorder and Panic Attacks
Course Outline• Introduction
• The Amygdala Paradox and the Biochemistry of GAD and Panic
• Region of the Brain Implicated in GAD and Panic
• Managing GAD and Panic
• The FEAR Cycle, Brain Activities and Recovery
• Moderate Intervention: The F.E.A.R. Model Recovery Steps
• Common Denominators for Transformation2
Introduction
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GAD is a condition that causes people to feel anxious about a wide range of situations and issues, rather than one specific event.
What is Generalised Anxiety Disorder?
What Causes GAD?
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GAD is understood to be caused by a combination of many factors which may include any one or more of the following:
- A history of stressful or traumatic experiences, such as domestic violence, painful long-term health conditions, child abuse, bullying, etc.
- A history of drug or alcohol abuse
-Overactivity in the brain areas involved in emotions and behaviour.
- An imbalance of the brain chemicals which are involved in the control and regulation of mood
- Genetic predisposition
- Head injury
Session 1
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The Amygdala Paradox and the Biochemistry of GAD and Panic
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The Triune Brain in Evolution: Maclean P. D. (1990)
The Emotional Brain; LeDoux J. (1998)
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Hypo-activation of the PFC and insufficient top-down control found in GAD and Panic Disorders:
Ball, T.M. et al., 2012; Goldin et al., 2009; Etkin et al., 2006; Lee et al., 2012
Session 2
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Treating Generalised Anxiety & Panic Attacks
Implicated Region of the Brain for GAD and Panic
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Treating Generalised Anxiety & Panic Attacks
The Basal Ganglia: Functions, Issues and Recovery Tips
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Basal Ganglia Functions1.It helps set the body’s anxiety level
2.It integrates thought, feeling and movement
3.It modulates motivation and drive
4.It moderates pleasure and ecstasy
5.It involves in habit forming
6.It suppresses unwanted motor behaviours
7.It shifts and steadies fine motor behaviourswww.amenclinics.com
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Basal Ganglia Overactivity Symptoms1. Nervousness and anxiety
2.Physical sensation of anxiety
3. Excessive risk aversion
4. High tendency to predict the worst
5. Conflict avoidance
6.Tourette syndrome (involuntary body movement and vocal tics such as head jerking, eye blinking, arm and leg jerking, puffing, barking, and sometimes swearing, etc)
7. Fine motor problems (such as handwriting issues)
8. Excessive motivation
9. Social anxiety
10.Over-sensitivity to rejection
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Treating Generalised Anxiety & Panic Attacks
SPECT Brain Imaging Study on GAD and Panic
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Treating Generalised Anxiety & Panic Attacks
SPECT Brain Imaging Study on Anxiety and Depression
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The Basal Ganglia Checklist
0=never 1=rarely 2=occasionally 3=frequently 4=very frequently
***5 or more symptoms below rated 3 or 4 signify a high likelihood of the BG issues.***
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The Basal Ganglia Checklist
•Feeling on edge •Easily frightened •Tendency to freeze in anxiety-provoking situations
•Feelings of nervousness and anxiety •Heightened muscle tension (such as headaches, sore muscles, hand tremor)
•Excessive fear of being judged
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The Basal Ganglia Checklist
•Lacking confidence •Conflict avoidance •Sensitivity to criticism •Picking own skin or biting fingernails •Excessive motivation •Tics •Poor handwriting •Always watching for bad things to happen
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The Basal Ganglia Recovery Tips1.Diaphragmatic breathing: Breath slowly and deeply with your
belly. Take 5 seconds to inhale, then hold it for 2 seconds. Then 5 seconds to exhale, and 2 seconds to hold your exhalation. Repeat for 10 breathes. Do this several times a day.
2.Learn to warm your hands with your brain. Use the power of imagery to warm your hands by imagining activities that warm your hands (such as putting your hands in front of a warm fire, holding a cup of hot green tea, sitting in a hot tub, putting your hands in the warm sand etc)
3.Write down your worrying thoughts, challenge them, play with them and kill them.
4.Learn effective skills to deal with conflicts
5.Find purpose and passion or deep spiritual belief
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The Basal Ganglia Recovery Tips
6. Eat small meals through out the day to stabilise insulin
7. Quit smoking and reduce alcohol and caffeine intake
8. Glucose tolerance test (GTT) to see if you have hypoglycaemia (low blood sugar level). Symptoms include, feeling confused, dizzy, light headed, irritable, sweating, feeling faint, panicky or shaky
9. Exercise regularly (aerobic (4 times a week), anaerobic (once a week))
10. Helpful supplements. Supplements for high basal ganglia and anxiety include, magnesium, theanine from green tea, B complex vitamins, calming scents from essential oils of lavender and chamomile, and fish oil/omega 3 fatty acids
11. Guided meditation
First Aid Treatment During a Panic Attack Episode
❖Reassure the sufferer
❖Regulate the breathing
❖Reach out and hold hands
❖Resist struggling
❖Ride out the attack
❖For hyperventilation, reduce the oxygen intake by increasing the amount of carbon dioxide in the lungs. Breathe into cupped hands if no paper bag is available (avoid plastic bag)
Session 3
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The FEAR CycleThe 5 Building-Blocks of Anxiety
Disorder
The FEAR Cycle 5 Building-Blocks of GAD & Panic Attacks❖#1:Your life experience
❖#2:Your pattern of thoughts
❖#3:Your feelings❖#4:Your physical symptoms❖#5:Your avoidance mechanisms
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The FEAR Cycle5 Building Blocks for Anxiety-Related Disorders
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Life Experience
Pattern of Thoughts
FeelingsPhysical
Symptoms
Avoidance Mechanism
Unpleasant life experiences generate negative emotions
including the 5 major negative emotions: Fear,
Guilt, Sadness, Hurt, Anger
Catastrophic thinking, Habitual negative thinking,
Rumination, Worrying
Anxious, Panicky, Nervous, Ashamed, Depressed,
Scared
Panic attacks, Faintness, Shortness of breath, Heart
palpitations, Sweating, Dizziness, Nausea
Denial, Social Withdrawal, Repression, Alcohol, Drugs
Intellectualisation, Aggression, Regression
Brain Activity & the Hebbian Law
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‘The neurones that fire together wire together.’ Donald Hebb (1949): Kevin Fox and Michael Stryker (2017)
Session 4
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Treating Generalised Anxiety & Panic Attacks
The F.E.A.R. Model: Step-By-Step Guide to Self-Regulation
from GAD and Panic
The F.E.A.R Model1. F……….for……Flip2. E……….for……Envision3. A……….for……Advance4. R……….for……Relax (Resilience)
The F.E.A.R Model1. F……for…….Flip
1. Dominant Negative Word (DNW)
What do you flip or turn over?
2. Dominant Negative Thought (DNT)
The F.E.A.R Model
1. F….for…..FlipSteps for effective Flipping:
• From the above lists, identify your dominant negative word (DNW) and your dominant negative thought (DNT).
• Allow your deeper mind to flip the identified DNW into a positive Word, and the DNT into a positive statement.
• Identify and write down three negative thoughts that often come to mind in connection with your anxiety situation.
• Identify and write down three negative words that best describe your total experience with your anxiety condition.
• Your positive word and statement do not have to make sense now or be the exact opposite of your DNT and DNW.
The Conscious & Subconscious Mind
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The F.E.A.R Model
• Sit comfortably, close your eyes, relax your mind and body.
• Allow your deeper mind to flip your dominant Word. What positive word comes to your conscious mind from within? This is now your new Dominant Positive Word.
• Likewise, allow your deeper mind to flip your dominant worry. What positive statement comes to your conscious mind naturally from within? This is your new Dominant Positive Thought.
• Observe your breathing. Breathe in deeply and breathe out very slowly, while imagining your entire mind and body relaxing.
• Now, write down your new Dominant Positive Thought as though you are already experiencing it.
The F.E.A.R. Model
Step#2: E…..for…. Envision
• By constantly visualising your new positive statement, you authorise the brain and the subconscious to start a positive restructuring process.
Start to build a mental picture of your flip statement, picture or feeling as though it is already your reality.
• The brain reconstructs itself in accordance to our dominant imagination.
• Repetition is the code for reconditioning the brain and the subconscious.
Envisioning is re-living and building a positive story around your new flip to create a new reality. A sustained feeling creates reality.
Imagine yourself expressing your flip feeling, word and statement. Connect fully with the experience. Feel the feeling as though it is your reality.
If possible, repeat this activity twice for at least 21 days.
The F.E.A.R ModelStep#3: A…..for…. Advance
Steps to Advancing:
For transformation to complete, at least one avoidance mechanism must be identified and progressively challenged.
• Identify one avoidance you want to start advancing toward (we recommend a less severe avoidance to start with).
• Use the Imaginary Desensitisation Technique to transform your avoidance one day at a time. Do it for at least 21 days.
• Once comfortable with the imaginary desensitisation, then attempt Direct Desensitisation.
We will need to advance instead of avoiding.
The F.E.A.R Model
4. R…..for…. Relax (Resilience)
• Resilience is the ability to bounce back from adversity.
• Regular relaxation exercise equips the entire cells in the body with higher resilience levels.
Relaxation breeds resilience.
• The gap between intervention and transformation is resilience. This is why constant relaxation exercise is recommended.
• If done regularly, the brain and the nervous system will eventually bypass the old anxiety pathways and build new ones for calm, courage and confidence.
Daily Exercise (at least once a day)
• Sit or lie down comfortably and close your eyes.• Breathe in and out 5 times deeply and slowly, while imagining your entire
mind and body relaxing.
• Now, envision your new positive word and statement. Imagine yourself expressing your positive word and statement using a real life scenario.
• Countdown from 3 to 1 to open your eyes.
• Next, imagine yourself moving towards your fear with confidence and calm. Imagine yourself living life without depending on your negative defence mechanisms.
• Repeat this activity twice a day for 21 days consecutively (preferably 66 days). It takes at least 21 days for the brain to rewire itself to reinforce your new positive word and statement.
• As you breathe in and out, visualising yourself being enfolded with elevated emotions; gratitude, compassion, appreciation, love, optimisms, hope, happiness etc.
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The F.E.A.R. Model for Treating GAD and Panic@copyright - www.mindbodybreakthrough.co.uk
Flip
Envision
Advance
Relax
• Identify your Dominant Negative Word and Thought.
• Flip your Dominant Negative Word & Dominant Negative Thought with your deeper mind.
• Envision your new Positive Word & Thought.
• Do this at least twice a day; before getting up in the morning and before falling asleep at night.
• Advance toward your fear first in your IMAGINATION.
• Once comfortable, approach the object of your fear in REALITY.
• Relax means “Do Not Respond to any Developing Negative thought.”
• Instead take it through the F.E.A.R. Model.
• Make the F.E.A.R Model your daily mind practice.
F.E.A.R Model
8 Common Denominators for Transformation• Believe that transformation is possible.
• Let go of past anger.
• Resolve not to blame, complain or give excuses for your current circumstances.
• Accept that your personal transformation is your responsibility.
• Acknowledge that your way of thinking is shaping your state of being. Flip negative thoughts.
• Embrace daily positive visualisation of your desired reality.• Connect with life; stay in gratitude, and do what you love.
• Be patient. Don’t give up.
Saturday 2nd May, 10 am - 4:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events London
We are running this workshop here again…London Workshop:
Treating Generalised Anxiety Disorder and Panic Attacks
@ Regent’s University London
Sunday 26th April, 10 am - 4:30 pmSaturday 6th June, 10 am - 4:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events London
Other workshops in London…
London Workshop: Trauma, the Brain & Recovery
@ Regent’s University London
Saturday 25th April, 10 am - 4:30 pmFriday 10th July, 10 am - 4:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events Dartford
Other workshops in this region…Dartford Workshop: Treating Complex PTSD
- the Brain Science of Recovery
@ DoubleTree by Hilton Hotel
Thursday 14th May, 1 pm - 6:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events Croydon
Other workshops in this region…
Croydon Workshop: Trauma, the Brain & Recovery
@ Jurys Inn Croydon
Friday 24th April10 am - 12:30 pm or 4 pm - 6:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events Bracknell
Other workshops in this region…Workshop Bracknell:
Treating Obsessive Compulsive Disorder
@ Hilton Bracknell
Saturday 6th June10 am - 4:30 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events Maidstone
Other workshops in this region…Workshop Maidstone:
Trauma, the Brain and Recovery
@ Hilton Maidstone
Sunday 7th June, 10 am to 5 pm
To register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events Maidstone
Professional WorkshopGrow Your Private Practice
- from Start-up to Profit Satisfaction
@ Mercure Maidstone Great Danes Hotel
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To Register: • Register on FACEBOOK: MindBody Breakthrough: Click ‘EVENT’ • Visit: www.mindbodybreakthrough.net • Click the links of our previous emails to you • Search: mindbodybreakthrough events webinar
WEBINARS
Treating Intrusive Thoughts & the Inner Critical VoiceThursday 2nd July, 7 to 9 pm
ADHD, Anxiety Disorder and RecoveryTuesday 12th May, 7 - 9 pm
Treating Generalised Anxiety and Panic AttacksWednesday 29th April, 7 - 9 pm
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For Online Anxiety Recovery Courses & Materials
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