The Panic Information Page
To meet the Criteria of a Panic Attack one must have at least 4 of the following 13 symptoms occurring at the same time *From Panic Disorder- The Medical Point of View By William D. Kernodle,M.D.
DO'S & DON'TS
Your family and friends may sometimes contribute to your stress. They may often have to deal with the consequences of your fear, just as you do, and they can lapse into feelings of frustration, helplessness, resentment, irritation, and even anger.
Often, however, all that family and friends really want to know is, "What can I do to help?" Therefor, we recommend the following list of helpful suggestions, as a result of listening and learning from our clients. So, here's a list of do's and don'ts for those who are closest to you.
1- DON'T criticize. Sufferers of panic attacks have real physical symptoms. They are probably more critical of themselves than you are. Remember that negative comments can contribute to slowing down their progress by adding stress and making them feel guilty for their feelings!
2- DO encourage rather than shame or embarrass them. They are already tackling a difficult situation, so positive support will pay off for everyone in the end.
3- DON'T induce guilt when the anxious person is unable to do certain things. It is hard for them to deal with their limitations anyway, and adding guilt will only alienate you from the person you most want to help.
4- DON'T express disappointment, anger, or frustration if a setback occurs. When trying to overcome a problem like this, every effort is an accomplishment, with the potential for other, greater accomplishments in the future.
5- DO notice and compliment their efforts to conquer their fear, as well as their actual successes. Your affirmation will help build their confidence.
6- DO be empathic. Try to understand the problem from their point of view. They don't need your pity, but your help, your encouragement, and your support.
7- DO be willing to accompany them on practice sessions if they ask you to. This means going along because you want to help, not because you feel obligated.
8- DO be quick to point out their positive qualities. Give them the same consideration you would want for yourself.
9- DO listen when they need to talk. It can be a great relief for them to share their distress. Also, listening becomes an opportunity to gently encourage their attempts to cope.
10-DO allow them to be in charge whenever you can. The ability to make decisions and take action is a real aid to self-confidence and helps them realize that control is possible.
11-DO avoid surprises. Let them know what is going to happen and when, so they can make plans to deal with any panic that may arise.
12-DO help them identify their successes. Change can be so gradual that improvements amy go unnoticed and a sense of progress is very important
13-DO work with them to identify family patterns, situations, or concerns that may contribute to the problem. Try to notice and improve any interactions between you that are detrimental to their growth and independence.
14-DO be consistent. Recognize that there will probably be changes as they are better able to handle anxiety and stress. Try not to be threatened by the prospect of their increased self-confidence or potential changes in your relationship. Seek family therapy or marital counseling if necessary.
15-DO be patient! Maybe more than anything, it will help if your loved ones know that, when they finally overcome these attacks, you will be there for them.
(Adapted with permission from an article in the Greater Boston Phobia Society Newsletter)
"Have you tried?"For The Support Person: Helping Your Partner Do IN-Vivo Exposure
Edmund J. Bourne,Ph.D.
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The most important characteristic of an effective support person include: a caring and supportive attitude, the ability to be nonjudgmental, and a willingness to encourage the phobic to confront fearful situations with patience and persistence. The following are guidelines intended for support persons who may work with phobics during in-vivo exposure.
1- Before beginning a practice session, ask your phobic partner exactly what they would like from you during the practice. Do they want you to talk a lot to them? Stay right with them? Follow behind them (walking or driving)? Wait outside? Hold their hand?
2- It's always up to the phobic -- not the support person-to define the goals of a given practice session. Let the phobic tell you exactly what they would like to try and not try. Do not pressure them to do more than they're ready to!
3- Be familiar with the phobic's early warning signs of anxiety. Encourage them to verbalize when they are beginning to feel anxious. Don't be afraid to ask them from time to time how they are doing. When they reach the point where they're wondering whether they might panic, it's time to stop, pull back and continue practice only after the anxiety has subsided.
4- Create with you phobic partner a list of coping statements and / or brief relaxation procedures that you can remind them to do during exposure sessions.
5- Don't allow your partner's distress to rattle you, but don't fail to take it seriously. Remember that anxiety isn't necessarily rational. If the phobic "overshoots" and starts to panic, quietly lead them away from the difficult situation, end the practice session for the day, and take them home. Above all, stay close by until the panic completely subsides.
6- Be reliable. Be where you say you're going to be during the practice session. Don't move to another location because you want to "test" your partner. It can be very frightening for the phobic to return to a prearranged meeting place and find you gone.
7- Don't push a person with phobias! Phobics know what's going on in their body and may panic if pushed further than they're ready to go at a particular point in their recovery.
8- On the other hand, encourage your partner to make the most out of practice. It's better to attempt to enter a frightening situation and have to retreat than not to try at all. If your partner seems stalled or unmotivated, ask them what is getting in the way of proceeding. Assist, if you can, in exploring and identifying the reasons for the resistance.
9- Try to see things from the phobic's point of view. Things which seem insignificant to you -- such as walking down a street or eating in a restaurant-may involve a great deal of work and courage for the phobic to achieve, even for a short period of time. These accomplishments and the efforts leading tot hem should be recognized.
10- Phobics generally are very sensitive and need a great deal of praise for every step they take. Be sure to give them recognition for small achievements.
11- Accept the phobic's "bad" days and reinforce the idea that they can't have a perfect day every time. Remind them that backsliding or setbacks are part of the normal course of exposure therapy.
12- It may be necessary to readjust your own schedule to facilitate your partner's practice. Be sure you're willing to make a commitment to work with your partner regularly over the sustained period of time before offering to be a support person. If you're unable to see them through the full recovery period (typically six months to two years), let them know specifically how long a commitment you can make.
13- In spite of your desire to help, phobics must have responsibility for their own recovery. Be supportive and encouraging but avoid trying to step in and do it all for them. This will only undermine their confidence.
14- Know your own limits. Be forgiving of yourself when you are a less-than-perfect partner. If your capacity to be supportive has been stretched to the limit, take a break.
©1998 KB DK