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Panic & Anxiety (part 2)

Learn to change Unhelpful thinking styles

In the previous article we saw how physical factors such as low levels of fitness and poor health can make symptoms of stress and anxiety, worse. We also looked at various techniques to help deal with panic attacks or extreme anxiety and now will examine the negative thinking styles or thoughts that can make you more vulnerable to these problems.

Identifying Negative Thinking

How we interpret experiences and situations will influence how we feel about them and hence our emotional responses. For example, if you think you are going to have a panic attack in a crowded shopping centre, you may find yourself very nervous and anticipating the attack, every time you go shopping. By predicting anxiety, you increase the risk of a panic attack happening. Then once the attack happens, it strengthens the belief that you will always have a panic attack in that situation and that it is inevitable. Thus you have given yourself a negative message!

Another unhelpful aspect of these interpretations is that they are over-generalisations. For example, after having a panic attack on a train, you may assume that you will have similar attacks on all forms of public transport, thus creating a vicious cycle of avoidance of all situations that you predict will lead to anxiety but never testing them out to see if they are false. Before too long, you may become locked into a restricted and fearful life.

Here are some examples of negative thinking styles:

Black & white thinking - all or nothing, whereby an event is either a success or a failure with no graduations in between.
Generalising - as explained above, where if one situation is a problem it is generalised to all similar situations.
Focusing on negatives and exaggerating - by magnifying the unpleasant part of an experience and ignoring the positive aspects.
Setting unrealistic expectations - and not allowing yourself to make mistakes, for example, after practicing the techniques, I will be cured of panic attacks in a week.
Taking responsibility for others feelings - e.g. 'it is my fault that my partner was so upset, because I am so anxious.'
Trying to mind read other people's thought - assuming certain outcomes without checking facts, such as an assumption that people think you are stupid because you have panic attacks.

Challenging Negative Thoughts:

Having identified your negative thinking styles, the next step is to change those to more appropriate and positive ones. There are three ways of challenging your negative thoughts:

Question the evidence for the negative thought. What evidence do you have that a panic attack will be the result if you travel on all means of public transport. Recall the times you did not have an attack or only minor symptoms.
Check out other possibilities before jumping to a conclusion. For example, if you feel sensations such as dizziness or weakness, are there other factors which may have influenced those feelings, other than anxiety? Where you overheated, did you stand up too quickly, or maybe have a viral illness?
Ask others for their interpretation of a situation. This can be very useful if you have friend or family member that you can trust to provide an accurate account of the situation. They may help you to see it from a different perspective.

To practice challenging negative thoughts, it is often helpful to keep a record of them for a period of time, as shown below.

List Your Negative thoughts in various stressful situations;

Situation	Negative Thought	Challenging Thought

Changing Negative Thoughts to Positive Thoughts:

The next stage is to substitute more positive thoughts for the unhelpful negative ones. Taking your situations from the last example, substitute a positive thought for the negative one listed. At first this may seem difficult but will become easier with practice. It is often helpful to have someone else help you with ideas, at this stage.

Situation	Positive Thought

Further Ways to help Change Negative Thoughts:
1. Cue cards - small cards you can easily carry that each have a single positive thought on them. Read them when required.
2. Imagine you are someone you know who always looks on the bright side - how would they handle the situation differently.

Next; examining ways of dealing with the physical sensations of anxiety and panic.

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