Just a quick thought for people who are trying to overcome anxiety disorders, panic disorder and agoraphobia. When tackling situations which have been known to lead to panic attacks and anxiety attacks it may be best to work in a microcosm.
For some people the situations that can lead to anxiety and panic will be physical (a shopping centre or subway underground train) or emotional (having to confront someone, make a complaint, end a relationship). One core trait of CBT (Cognitive Behaviour Therapy) is creating a hierarchy with the most difficult at the top and starting with the easiest at the bottom. This is all well and good for some sufferers but, depending on exactly what kind of anxiety or panic you are experiencing, and what is triggering it, it may well be that the CBT approach is much too simplistic.
What might be more appropriate is to find a weak example of the situation that causes fear, and treat it like an inoculation. Your body learns to fight viruses by examining weak versions given in vaccines. By examining a lesser version you can do something similar.
How is this different from CBT?
Well, with CBT you enter a situation, prove your negative thoughts wrong (ie you prove to yourself that you don’t die, faint, vomit, go crazy) and when the fear subsides in that situation you move to what you perceive to be a more difficult situation. The problem with this is that in many cases the anxiety or panic disorder is complex and therefore to desensitize yourself from one situation does not necessarily mean you have progressed, as the old anxiety can reappear in either the same situation or a new situation at a later date. CBT neglects to tackle the underlying problems which can and do exist in complex anxiety and panic disorder. Going back to the inoculation metaphor, when given a vaccine your body does NOT desensitize itself to the symptoms, it learns from them.
So, in order to recover we need to inoculate ourselves against the root emotions. If we fear wide open spaces and shopping centres because we lack control in those places, then we should find a place where we lack a little control and expose ourselves to it not with the intention of desensitizing ourselves so we can move up a linear hierarchy, but with the intention of gaining further insight.
When we start to feel uncomfortable, a little anxiety or panicky feelings, this is the time to question ourselves and to try to understand why. When we do this we can move on to deal with the underlying causes.
For example: if I fear public transport due to feeling out of control on vehicles from which there is no ready means of escape, then by sitting on a local bus and traveling round my local neighbourhood (much easier than flying say) I can start to gain insight into what control actually means to me, and why it is important. I may also get insight into how I can regain a feeling of control or relinquish a need for it.
This is likely to be a far more comprehensive way of understanding and changing my emotions than CBT alone.
