Betrayal Of The Body. Panic Attack Therapy

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

Betrayal of the body. PANIC ATTACK THERAPY

Through my anxiety attacks I regain myself

the figure of the need for the Other, I recognize its importance and value for me

Continuation of the article. Start here

Therapeutic Reflections

I will try to outline both the immediate, primary and further, strategic tasks in the case of psychotherapy for panic attacks.

For a client with anxiety attacks, their symptoms are daunting and it is not surprising that they are eager to get rid of them. It is with this request that he turns to a psychotherapist. And the therapist here can fall into Symptom trap following the client in a desire to rid him of him. This approach is doomed to failure, since in this case the client's symptoms and his problems do not coincide. Therefore, getting rid of the symptom will be temporary and will not solve the problem.

I note right away that I will rely not on a symptomatic approach to solving this problem, but on a system-phenomenological one. Its essence is that:

1. Hear the symptom, give it the opportunity to “tell” what it is about?

(phenomenological stage);

2. Determine its essence, its meaning, understand "why" is it? What need does he express? (system stage);

3. Find another, asymptomatic way to satisfy this need.

Earthing

One of the first goals of therapy in dealing with clients with an anxiety spectrum disorder will be to alleviate the client's anxiety. The phrase uttered by Heidegger in the last century: “Perhaps the best thing we can do for a person is to make him anxious” for a person of this century is definitely not suitable. Anxiety disorders, as I wrote in the first article, are becoming a hallmark of the present time. And here the therapist should be himself as stable as possible and by all means (verbal and non-verbal) demonstrate this stability to the client, thereby becoming for him the only stable object in this world.

How can this be possible?

The therapist himself must have a creative type of identity, be stable in a situation of extreme instability of the client. The therapist contrasts the fragmentation and disintegration of the client's personality with the integrity and integrativity of his own personality.

Another way to calm the client down is to contain his anxiety. The client's anxiety will manifest itself both in the desire to control the therapy process ("What are we going to do ???"), and in his intolerance, the desire to quickly get rid of the disturbing symptoms ("When will this all end? How long will the therapy last?") … It is important to understand that behind these questions the client is his anxiety and you do not need to accurately answer these questions. When a client asks me how long it will take for therapy, I usually say, “I don’t know, but I’ll try to do as little as possible.” The main thing here is not WHAT you say, but HOW you say it.

If you are calm, the patient will feel this at the level of his mirror neurons and will also calm down.

A client in a state of panic does not “test reality” well. And one of the first tasks of the therapist is to bring him back to reality. We return the client from his “panicky picture of the world” to his usual one. It goes through a process grounding … Read more about this in Boris Drobyshevsky's article "Borrowing in Life and Therapy". To do this, we transfer the client's consciousness from his frightening state (figure) to the environment (background). The client's new figures can be the therapist himself ("Look at me. What do you notice?"), And any elements of the outside world ("Pay attention around. What do you see?"). The emergence of new figures in the client's mind is necessary so that he can rely on them, since his I ceases to perform the function of support. This is background support. It is important for the client to have a sense of reality, the density of the world on which to rely.

For the same reason, therapeutic intervention such as “You have to take responsibility and decide what to do” in this situation is at best useless, and at worst it can be retraumatic - the client has nothing to rely on. His Self is weak and unstable and needs to be supported from the outside.

The person does not know why this happened to him. This is a powerful symptom that is cut off from life, and because of its incomprehensibility is terrifying. It is important to give (expand, redefine, recreate) a background to make an incomprehensible symptom understandable.

It is very important for the therapist himself to keep track of his "points of support" in the state of work with such a client. In each case, when a patient with PA comes, we can lose the feeling of support: breathing badly, sitting badly, ceasing to feel our body, "going headlong" into the client's symptoms. These are signs that you yourself have lost your footing and will not be effective in dealing with such problems.

Meeting fears and loneliness

In therapy, it is important to follow the symptom, that is, to try to understand what is behind the symptom, what supports it, why is it? A step-by-step immersion in the problem is necessary here. Important steps in therapy for a client with anxiety attacks will be the awareness that anxiety is behind their symptoms, fears behind anxiety, unconscious loneliness behind fears and identity problems. The highlighted stages are consistently worked out with the client in therapy.

So, for example, converting anxiety into fear reduces the client's degree of stress. Anxiety is known to be a diffuse state that has no object. In this regard, it is difficult for a person to stay in anxiety for a long time. Fear, unlike anxiety, is defined and objective. The emergence of fear instead of anxiety is a big step, when the client can say that I am afraid of a heart attack, and not I have a heart attack.

The next step in therapy will be the client's awareness of their loneliness. The value of individualism in the modern world, among other things, leads a person to loneliness, which is difficult to meet, realize and experience.

Francesseti writes that PA is a sharp breakthrough of unconscious loneliness … It is the loneliness of someone who suddenly finds himself too visible in front of the vast world. It is the loneliness of someone who suddenly feels very small in front of a huge world. However, this loneliness is unconscious and unacceptable for a person suffering from anxiety attacks. And this type of experience is forbidden for a person, otherwise there would be no PA.

Loneliness cannot be recognized and lived, since in a narcissistically organized world one must be strong and independent. Affection, closeness is considered here as weakness. It turns out to be impossible for a person to turn to another, to ask for help - this contradicts his identity, the idea of himself as a strong, independent person. Satisfying your need for closeness and affection becomes impossible. So he falls into the trap - the trap of individualism and alienation from the other.

And then, through the attacks of panic, I regain the figure of the need for the Other, I recognize its importance and value for I.

Formation of involvement

In view of the above, one of the therapeutic challenges with these types of clients will be to work on creating feelings in them. involvement.

With PA, the fear of death and the fear of insanity arise - these are the fears in which we drop out of the community. This suffering becomes weaker when I am with someone, trust someone. In the modern world, where the former social institutions have ceased to fulfill the function of support for a person, it becomes important to be included in various communities: professional, according to interests, etc. They create a sense of support - both due to the existence of certain rules, norms, boundaries in them, and due to the appearance of an experience in a person involvement, compatibility.

This work begins initially in contact with the therapist. The client gradually takes root in the therapeutic relationship. The therapist becomes for him that Other with whom he can be weak, ask for help, talk about his experiences, in general , be in a relationship … This new experience can become invaluable for the client, over time the client will be able to "take the therapist with him", even when he is not with him - to communicate internally with him, to consult, while maintaining involvement. This leads to the appearance in the picture of the world of a person other than-I. Narcissistic loneliness is overcome due to the appearance of the Other in the psychic reality.

Working with identity

One of the strategic and long-term goals of therapy with a client with anxiety attacks is to work with their identity. In the first article I wrote that the I of a modern person is identified mostly with his mind, gradually alienating his emotional part and corporeality from himself. As a result, along with the loss of these “territories”, the I loses a number of its functions. It functions well in the field of control, analysis, comparison, evaluation, but it turns out to be impotent in the field of establishing relationships. As a result, such human phenomena as participation, affection, intimacy become inaccessible to him.

Through therapy, there is a return of trust in the body, feelings, a return to the I of emotionality and physicality. This is the return of previously alienated territories. As a result, I become more holistic and integrated. When the former self, identified with the mind, “gives up” its positions, ceases to control, becomes more tolerant of its feelings, desires, bodily phenomena - the panic goes away.

This work is technically carried out through the discovery of the client's emotional and bodily phenomena and the possibility of access to them through the organization of a dialogue with them. The path to integration lies through dialogue and the ability to negotiate.

Practical advice for those who are not in therapy

Your Self is not only your mind. It is also your feelings and your physicality.

• Assume that emotionality, sensitivity is not weakness, and try to find the resources they contain;
• Discover the world of your senses. It will make your life brighter and tastier;
• Listen to your body, to its sensations: it has many signals, and pain is only one of them - the strongest;
• Explore your body: where do pleasant sensations live in your body, where are tension, clamps?
• Please your body, arrange a holiday for it: go to the bath-sauna, soak up the bathroom, sign up for a massage …;

The following simple exercise will help you better understand what your body wants?

Letter of the Body to I

Write on behalf of the body a letter to your I according to the following scheme:

• How is he with me?
• What kind of relationship exists with the self?
• What are the needs of the body?
• Are you managing to accommodate your needs?
• How strict am I in relation to these needs?
• What needs are forbidden by the Self?
• What feelings does the body have for the Self?
• What claims does he have, requests to Me?
• What would the body want to change in this relationship?
• How would I react to these changes?
• How would the body feel if this relationship could be changed?

Organize a dialogue between your self and your body. Try to hear your body and negotiate with it.

Concerning development of emotional sensitivity, then here you can do the following:

- Search the internet for a list of feelings and emotions; print them out. Have them at your fingertips;

- In situations of contact with other people and objects of this world - natural and cultural phenomena - stop yourself and ask yourself the question “What do I feel now?”;

- Refer initially to your cheat sheet - the list of feelings. Try them on to your state of mind. Try to find a resonance in your soul with some feeling from the prepared list.