What is a panic attack?  Here is a link to an article we ran on this site that answers this question.  Do you know the difference between an anxiety attack and a panic attack?  You may want to check out this article we ran about this issue.  Finally, here is a list of the symptoms of a panic attack.


Stage fright and performance anxiety are part of performing music, but they can be overcome. Adequate practice, rehearsals and experience help musicians cope with nerves.

Read this article:
Coping With Stage Fright and Performance Anxiety: Overcoming the …



ADHD and Anxiety – Which One is the Primary Condition?
By Robert D Hawkins

ADHD and anxiety regularly coexist and there is some question as to whether ADHD drives anxiety, anxiety drives ADHD, or whether they are they separate overlapping conditions caused by a biological imbalance of brain neurotransmitter chemicals. To add to the confusion symptoms and proportion of ADHD and anxiety may vary greatly from person to person.

Nevertheless, in this article we will delve into the quandary which is ADHD and anxiety seeking to find some answers.

Most agree that arriving at a definitive diagnosis for attention deficit hyperactivity disorder is no easy task with no definitive test currently available to either rule in, or rule out, the condition. When comorbid conditions exist such as ADHD and anxiety the plot thickens even more.

Research tells us that between 50 and 70 percent of individuals with attention deficit hyperactivity disorder suffer from overlapping (comorbid) conditions such as anxiety, clinical anxiety, depression, learning disorders, bipolar disorder, and substance abuse. Of these approximately 60 percent are dealing with anxiety on a regular and persistent basis.

Additionally, in a test group of teens and adults with overlapping conditions a whopping seven out of every ten had at least some history of substance abuse and dependence.

Let’s take a moment to quickly refresh our memory by looking at how the American Medical Association defines ADHD, anxiety, and anxiety disorders in our quest to find answers.

ADHD: A mental illness characterized by difficulty paying attention and a high degree of restlessness and impulsive behavior that begins before the age of seven, lasts for at least six months, and can cause the individual substantial difficulty in at least two settings, usually family and school.

Anxiety: A general feeling of uneasiness, dread, uncertainty, and fear in response to, or in anticipation of, a real or imagined threat.

Anxiety disorder: A group of mental illnesses characterized by overpowering and long lasting fear, dread, unease, apprehension, obsession, compulsions, and unpleasant physical symptoms, such as sweating, elevated heartbeat, shaking, and trembling.

Could ADHD actually cause mild or generalized anxiety?

The three primary symptoms attributed to ADHD are inattention/distractibility, impulsivity, and hyperactivity/restlessness. Those with the condition tend to underachieve academically, have trouble socially, are forgetful and/or absentminded, be worry warts, have a negative outlook on life, have disciplinary problems, and have low self esteem.

In looking at this list it becomes pretty clear that if in fact and ADHD child or adult didn’t have some anxiety it would be miraculous. Add into the mix the chance that they may be under a great deal of pressure to do such things as improve their grades or unruly behavior and all of the sudden we are looking at a person who is under so much pressure in all aspects of their lives that they might simply raise the white flag of surrender, figuring what’s the use in trying since I am going to fail anyway.

Of course this isn’t the reality since many great names throughout history (Einstein, Franklin, Edison, Lincoln) have had ADHD but one could sure understand how the ADHD child or adult could end up so riddled with high and persistent anxiety that struggling to find the confidence and willpower to forge on might be prove challenging.

From my point of view it appears, that at least most of the time, it is attention deficit hyperactivity disorder that is driving the bus when it comes to ADHD and anxiety, but as with so many things ADHD their seems to be no firm evidence to definitively prove or disprove this hypothesis.

Robert D. Hawkins is an enthusiastic advocate for the use of natural health and natural living with over 10 years experience in the field. To learn more about ADHD, along with safe and effective natural remedies for improving problematic ADHD symptoms Click Here

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Stymied in the search for genes underlying human neuropsychiatric diseases, some researchers are looking to dogs instead. David Cyranoski meets the geneticist’s new best friend.

See the article here:
Genetics: Pet project


YOUR health can be seriously affected by your personality. Depending on whether or not you are shy, ambitious or a worrier. They all mean something.

The rest is here:

How your personallity will affect your health


For Giselle Gerolami, anxiety meant asthma-like attacks whenever she spent a long time alone.For Richard Kozieja, anxiety meant family gatherings talking to only one or two people for fear of being judged.For Jack Benton, anxiety meant an overwhelming feeling he was going to die whenever he drove his car outside his comfort zone.Each found help — and now they’re helping others as the leaders of …

Originally posted here:
Support group helping people with anxiety help each other


One in 10 will have a panic attack caused by the body’s natural `fright or flight’ response.

Visit link:
How to beat anxiety ‘butterflies’



Therapy and Counseling – Five Basic Things You Should and Should Not Get
By Christopher O Michael

These are just the very basics–this does not get into any given therapist’s methods or theory. We are talking simple therapeutic courtesy and bare-bones requirements. If your therapist or counselor is not offering you the basics or is offering things that should not be happening, then they might consider a new profession and certainly you might consider a new therapist or counselor. They either have not themselves been on the client end of the therapy interaction, have not been with a respectful therapist, or did not learn despite training and example, which would be the worst possibility.

I wrote this article after having heard one of the most pathetic stories about a doctoral-level therapy / counseling practitioner I have ever heard–short of actual abuse or other illegal behavior. I am not including most things that should be in the practitioner’s code of ethics or the law. Those things, however, are sometimes violated too.

In therapy or counseling you should get:

1. The absolute, undivided attention of the therapist or counselor on YOU (with some occasional and minor lapses being acceptable and probably expected…). Furthermore, you should be unconditionally prized and supported (within reason) and the therapist or counselor–again, within reason–should not ‘judge’ you or your behavior so much as he or she should explore and call your attention to things he or she notices.

2. A relatively quiet and private atmosphere that remains consistent in terms of location is usually very important. Some therapists may take you to locations specific to your problems in order to work on them, but the majority of contact should be private and consistent. For example, a therapist or counselor might occasionally take you onto a bridge in order to address your bridge phobia or fear of heights.

3. Informed consent to therapy so that you know what therapy involves and does not involve and are still willing to participate. The therapist or counselor’s office policies and usual procedures should be outlined, as well as the times that he or she can or must break confidentiality. Informed consent can, to some degree, also help you to know when the therapist has truly violated a boundary.

4. Clear discussion of fees and fee arrangements, including what happens when sessions are missed, any insurance arrangements, and so on.

5. Although depending upon the type of problem being treated this may actually become a repeating and important part of the therapy, in nearly all cases the therapist should apologize or otherwise make things right–or at least productively explore what happened–if something has led to negative feelings.

Things you should not get–please note that even wonderful therapists and counselors occasionally slip up on these, but if it occurs too frequently there are problems that need to be dealt with–perhaps starting with your departure…:

1. A therapist or counselor whose main focus in the session is his or her self. There are many therapists out there who talk amazingly frequently and constantly about themselves! If there is a lot of this, it is NOT normal. Run away. Unless there is some therapeutic reason, more than brief and social personal sharing about the counselor or counselor’s acquaintances, friends, or family should be a red flag about a possibly self-centered or temporarily stressed practitioner who uses paying clients as social time-fillers, friends, or ego-supports. Even ‘gossiping’ and getting the client’s ‘oh my’ reaction is a sign of this if there is no good clinical reason for the disclosure. Finally, such persons may basically use paying clients as therapists / counselors!

One good reason for therapist self-sharing might be to give limited and appropriate information about how someone else–including the therapist–learned from and coped with something very similar to what the client is going through. Also, late in a long-term treatment a bit more revealing from the therapist is perhaps more acceptable, but not a constant focus. Another acceptable time for a therapist or counselor to share about him or herself is when they use their own inner feelings about you or your situation to help you learn something about yourself or your situation. However, a good counselor will be cautious and sensitive in how they use such information.

2. Changes in the conditions or fees unless discussed with and agreed to by you. I have seen it done by excellent therapists in terms of raising fees or changing the financial rules in the middle of a course of therapy or training, but I do not agree with the practice. Especially if work has been going on for some time, the client is now more likely to agree to the change even if he or she does not really want to–because an intimate and valued process has started. Therapists who need to raise fees should do so with new clients. Fees and other financially related rules are a surprisingly sensitive area for both therapists and clients, and once set should usually be left alone. If you are having serious financial trouble, however, the therapist should offer a lower fee or other temporary arrangement rather than simply terminating therapy or counseling only because of the financial issue.

3. Therapists who answer the phone, text, email, etc. during a session–unless it is for a purpose that will immediately help the client, or unless the therapist or counselor is literally ‘on call’ for a birth or a death. I cannot even come up with the words for this one. Rude does not suffice. It is enough that we have to endure loud (and personal!) conversations in beautiful surroundings, movie theatres, and fancy restaurants, but in a process in which the client pays for calm, undivided, intimate attention to his or her deepest concerns? My jaw hurts from dropping open whenever I hear this one.

4. Therapists who take care of delay-able personal needs during the session. Filing nails, looking in a compact or mirror, constantly fixing his or her hair, checking their schedule, eating, using the restroom (like a 5-year-old on a car trip…he / she should have done that beforehand–unless the therapist is so sick that he/she probably should not be at work anyway), and on and on. Drinking water or drinks is usually less disruptive, but if done it is nice of the therapist or counselor to ask you if you would like something.

5. Therapists who are frequently quite late and do not make up the time, or who otherwise do not respect the therapy hour and overall process of the therapy as a whole. Your therapist or counselor should be taking regular vacations or he or she will not be as effective. However, that does not mean that he or she should be vacationing every two months for 2 weeks at a time if you are having serious problems at that time.

Hopefully, you do not run into these last 5 ‘should nots’ on your journey, but if you do I wish for you the strength and savvy to find yourself a better treatment situation. The first 5 ‘shoulds’ are moderately common to find in most therapists, which is the good news. However, given the outrageousness of some of them, the last 5 ‘shouldn’ts’ are surprisingly common! Here’s to avoiding them if possible.

Dr. Chris Michael is a licensed clinical psychologist practicing privately in Laguna Hills, California. He specializes in therapy with the gifted, talented, and creative, and with those dealing with serious mental illness, and also performs clinical and forensic psychological evaluations.

Dr. Michael graduated with his Ph.D. from the University of Tulsa, a respected APA-accredited institution. He took his internship in clinical psychology and post-doctoral fellowship in forensic psychology at Patton State Hospital, a large high-security mental health facility. For more information about mental health, Dr. Michael’s practice, or to consult Dr. Michael, please feel free to visit his website http://www.michaelpsychological.com

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This is an interesting slant from a non practitioner who is coming from her own perspective.

Cognitive Behavioural Therapy – The Approaches and Techniques Used by Therapists

By Emily Cheyne

There are a number of cognitive behavioural techniques used in by professional therapists. These approaches are chosen to suit the needs and issues of the client.

Cognitive Behavioural Therapy: an overview

Cognitive behavioural therapy is an approach that looks at both behavioural therapy and cognitive therapy. It looks at why people think and behave the way they do and then provides them knowledge and choice.

In simple terms, (C) cognition is the way we perceive and think, (B) behaviour is the way we react and behave and (T) therapy or change is the method for changing the perception and behaviour.

Common CBT techniques include:

  • Exploring a client’s irrational thoughts and replacing them with rational healthy ones
  • Stopping unhelpful irrational thoughts altogether
  • Gradual exposure to situations and social skills training
  • Assertiveness training

Cognitive behavioural therapy is often the main model and approach for therapists dealing with the following issues with their clients:

  • Anxiety and panic attacks
  • Depression
  • Eating disorders, predominately bulimia nervosa
  • Phobias

The above areas and issues respond well to CBT as it is widely accepted that perception is the key to lasting change and unnatural or irrational perceptions are the root of these conditions occurring.

Rational Emotive Behaviour Therapy (REBT)

Developed by Albert Ellis in the 1950s, rational emotive behaviour therapy (REBT) is a form of cognitive behavioural therapy. It is a psychotherapy approach that focuses on resolving emotional and behavioural problems and disturbances.

REBT assumes that individuals are hedonistic in that they strive to remain alive and achieve happiness. It also assumes that individuals are also prone to irrational beliefs, thoughts and behaviours that then affect them achieving their wants and goals.

The core belief is that individuals are disturbed by things, but not by the views that we take of them. This means that it is how we feel about something that bothers us, not the “something” itself. Therefore, if the individual can reframe the event, then it is an entirely different emotional effect.

Ellis believes that a client needs to change their belief system in order to deal with and manage an emotional issue or problem. He created the ABC model: this looks at a disputing belief system that questions and challenges the existing belief system.

A – activating event

B – the belief system

C – the consequence, cognitive, emotional or behavioural reaction

For example:

A – person is asked to have a one to one with their boss without any prior warning

B – person is afraid of the manager and person with power, as they believe they are nasty and unfair

C – person panics and acts out of character and behaves irrationally

If the boss is actually a threatening individual who regularly reprimands staff then this consequence could be appropriate. However, if the boss is actually very fair and agreeable then the system has malfunctioned and a faulty belief exists.

The main error is usually generalisation. For example, in this case people such as managers in power are all intimidating and unreasonable. This means that the fault is often the mind over-grouping on the basis on one category.

You can then introduce D – the disputed belief system. This allows choices and reflection in the mind to occur. The disputed belief system will usually take the initial form of questions. So:

D – is my manager actually unfair. Am I perhaps scared because I have had a bed experience with a manager in the past that bullied me?

Cognitive restructuring therapy (CRT)

Cognitive restructuring therapy (CRT) was developed by Aaron Beck in the 1960s. Like Ellis, Beck believed that irrational beliefs were the cause of a problem.

The key philosophy of CRT is that an individual’s emotional response to an event or experience is determined by the conscious meaning placed on it. This means that the interpretation of what we perceive is the key to our personal outcome. So, if we see, hear or notice something, then we try and gain an understanding of that thing we have noticed. This means we place a meaning or an interpretation on that thing.

Beck believed that faulty and irrational beliefs spread in a specific manner. He believed that these beliefs could spread threefold and form a triad representative of the entire belief system. The three areas are:

  • The self
  • The world
  • The future

The self represents how the individual feels about himself or herself. This includes self-esteem, feelings of self-worth and self-image. The world is then the way the individual interacts with the rest of their experiences. So this is when the individual applies their feelings of self to the rest of the world around them. The individual then applies their belief to the future. This means if they have feelings of inadequacies or other such issues, then they portray this into the image of their future.

Beck suggested that these three areas of the triad had negative effects and worsened each other as each one undermines the next in a vicious circle.

For example: an individual may feel they are not good at anything they do. They may think that as they are not perfect at everything, then they are not good at anything. This is their self-belief. They will then believe that world thinks that are not worth or any good at anything. They will portray this image onto the world around them. They will fear their future and believe that nothing will change.

Beck addresses this negative triad by developing adaptive metacognition. This is the process of teaching clients how to think about their feelings. This process teaches clients to notice when their thoughts are distorted and irrational and therefore monitor their negative automatic thoughts and make conscious choices rather than allowing their inappropriate thoughts to dominate.

Cognitive restructuring therapy has developed two major goals as it has matured. These include:

  • The client learns to spot negative and inappropriate thinking whenever possible. The client will then monitor this and make the choice to substitute this thinking with more realistic and appropriate interpretations of the situation
  • When the pattern or stimulus is too powerful, the client will monitor the impulses and accept their presence but not give in to them. For example, the client suffering from sever depression will accept that they are depressed and that they have little control over that, but will choose to cope the best they can and not give into despair

The first point is most usual, as for many clients their issues are psychological in cause and therefore changes can be made.

The second point is about managing the condition rather that curing it. Monitoring, awareness and self-management are all useful approaches to help the client suffer less.

For both categories, the key point is for the client to learn to identify and alter their negative beliefs that lead to distortion. The therapist will help the client spot his or her own thought patterns. The realisation of this patterns empowers the client to monitor and self-manage their response and behaviour.

There are a number of confronting approaches used in CRT as a practical technique. Some of these include:

  • Specific
  • Realism of outcome
  • Context

Attributional therapy

Attribution therapy is a recent development in cognitive behavioural therapy and considers the meaning we place on things, specifically what meaning or relevance the individual attributes to an event or situation.

For example: the client experiences a situation when their think they have failed. As a result of this they assume that they are useless in everything they do and that their failure must have happened because of a specific fault, like they are not intelligent enough. Therefore they link the event and situation to their intelligence.

These individuals will also explain success and personal achievement as a fluke or luck, or suggest that the task was so easy anyone could achieve it. This means they continue to reinforce their key belief that they have now formed that they are not intelligent enough.

There are two classic tools used in attributional therapy. These include:

  • Hand out and log sheets for clients to fill in with their thoughts. This allows them to log the patterns and analyse them
  • Personal journals and diaries for the client to record their thoughts and related subjects. Again this allows the client to analyse and recognise certain patterns.

The self-instructing training (SIT) model

Within the self-instructing training (SIT) model, inoculation works by the client building up immunity to the old stresses and negative reactions and instead applying and favouring new behaviours.

The client will practice using change techniques such as self-hypnosis and visualisation to help them become comfortable changing their old belief into their new positive belief. This will be done in steps to ensure that the client’s confidence increases, with each step becoming more and more challenging.

As a client succeeds at each of this stage, then their confidence will increase and their progress will accelerate.

The SIT model is important to our understanding of what techniques are naturally used by CBT therapists as it sets the precedent that change techniques are a natural and appropriate part of a CBT therapist’s practice. These change techniques and models include self-hypnosis, visualisation and affirmations.

emily@knowhowlife.com
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There is a morbid fascination with hoarding, but Americans have been slow to recognize it as a social problem.

Read more:

Hoarding disorder can consume households