breathing exercise in Part One you should now feel confident enough to use it to reduce Anxiety levels. Before you start an exposure session, steady yourself with calm slow breathing, counting in your head to make the Out breath longer than the In breath.
If you feel the first flutterings of panic at any time, use the calm breathing technique to dampen them down.
More about breathing
Now you can learn a little more about breathing. Sit comfortably, or lie down. Put one hand flat on your stomach, and the other on your chest, just below your neck. Sit quietly and feel how the hands move as you breathe. Which hand is moving the most? If it is the upper hand, the one on your chest, then you are breathing in a shallow way that isn’t helpful for Anxiety.
It should be the lower hand that moves as you breathe, with the upper hand nearly still while you’re at rest (it will move more when you’re active) Here’s an exercise to help you practise good breathing.
• Lie down flat on your back.
• Place your hands on your stomach with the fingertips just touching.
• Breathe through your nose.
• Breathe in and allow your stomach to expand like a balloon as you fill your lungs with air. Your fingertips will move apart as you do this.
• Breathe out and allow your stomach to shrink as you push the air out of your lungs. Your fingertips will move back together as you do this.
You can count in your head as you do this exercise. Once you’ve got the hang of it, try it sitting, and then standing. When you feel confident that you’ve mastered it, you can also use this kind of breathing during exposure sessions.
GROUP MEMBERS TALK ABOUT PANIC
‘A little thought was dawning that this might be a panic attack – I never knew what people meant when they talked about panic, I thought it was what you felt if, say, a car swerved towards you.’
B RIDGET
‘… at the Eurostar terminus, that Huge open space by a very steep escalator proved to be too much for me and Anxiety started to play havoc with my nerves, flooding me with negative thoughts. I then was very close to panicking and giving up.’
J ULIE
23
Planning Your Exposure
The next stage is to take the easiest one of your goals and plan how you will achieve it. It may be that the lifestyle changes you have already made have created enough improvement that you feel able to tackle the goal straight away. By all means try it, but don’t push yourself too hard.
Probably you will feel that the goal is beyond you, in which case you can break it down into a series of smaller goals. Remember to make each one SMART, and remember that you need to be able to repeat it. Use your notebook to write down the goal, and the steps that you will take to achieve it.
Exposure ladders
Working through your goals is like climbing a ladder, where each rung takes you closer to your ultimate goal at the top of the ladder. When you first write out the steps you may feel that you will never reach the top of the ladder – it’s out of sight, lost in the clouds. Never mind. Write out the steps anyway, and start climbing the first few rungs. Don’t think too much about the higher rungs – eventually they will come into sight and you will be able to tackle them.
Do bear in mind that you need to feel some Anxiety while you are doing your exposure. If you don’t feel any, you won’t have learnt anything, and if you feel too much you’ll feel disheartened. In practice, most people will need to do many repetitions of the first few steps while they are regaining their confidence, and they may have to do fewer repetitions as they get further up the ladder.
Visualisation
If you can’t see a way on to the ladder, then start with visualisation. Lie or sit comfortably, close your eyes, and imagine yourself doing the goal. Try to create a complete picture, including not only a visual picture of the event, but also the noises and other sensations associated with it. Put yourself in the picture
If you feel the first flutterings of panic at any time, use the calm breathing technique to dampen them down.
More about breathing
Now you can learn a little more about breathing. Sit comfortably, or lie down. Put one hand flat on your stomach, and the other on your chest, just below your neck. Sit quietly and feel how the hands move as you breathe. Which hand is moving the most? If it is the upper hand, the one on your chest, then you are breathing in a shallow way that isn’t helpful for Anxiety.
It should be the lower hand that moves as you breathe, with the upper hand nearly still while you’re at rest (it will move more when you’re active) Here’s an exercise to help you practise good breathing.
• Lie down flat on your back.
• Place your hands on your stomach with the fingertips just touching.
• Breathe through your nose.
• Breathe in and allow your stomach to expand like a balloon as you fill your lungs with air. Your fingertips will move apart as you do this.
• Breathe out and allow your stomach to shrink as you push the air out of your lungs. Your fingertips will move back together as you do this.
You can count in your head as you do this exercise. Once you’ve got the hang of it, try it sitting, and then standing. When you feel confident that you’ve mastered it, you can also use this kind of breathing during exposure sessions.
GROUP MEMBERS TALK ABOUT PANIC
‘A little thought was dawning that this might be a panic attack – I never knew what people meant when they talked about panic, I thought it was what you felt if, say, a car swerved towards you.’
B RIDGET
‘… at the Eurostar terminus, that Huge open space by a very steep escalator proved to be too much for me and Anxiety started to play havoc with my nerves, flooding me with negative thoughts. I then was very close to panicking and giving up.’
J ULIE
23
Planning Your Exposure
The next stage is to take the easiest one of your goals and plan how you will achieve it. It may be that the lifestyle changes you have already made have created enough improvement that you feel able to tackle the goal straight away. By all means try it, but don’t push yourself too hard.
Probably you will feel that the goal is beyond you, in which case you can break it down into a series of smaller goals. Remember to make each one SMART, and remember that you need to be able to repeat it. Use your notebook to write down the goal, and the steps that you will take to achieve it.
Exposure ladders
Working through your goals is like climbing a ladder, where each rung takes you closer to your ultimate goal at the top of the ladder. When you first write out the steps you may feel that you will never reach the top of the ladder – it’s out of sight, lost in the clouds. Never mind. Write out the steps anyway, and start climbing the first few rungs. Don’t think too much about the higher rungs – eventually they will come into sight and you will be able to tackle them.
Do bear in mind that you need to feel some Anxiety while you are doing your exposure. If you don’t feel any, you won’t have learnt anything, and if you feel too much you’ll feel disheartened. In practice, most people will need to do many repetitions of the first few steps while they are regaining their confidence, and they may have to do fewer repetitions as they get further up the ladder.
Visualisation
If you can’t see a way on to the ladder, then start with visualisation. Lie or sit comfortably, close your eyes, and imagine yourself doing the goal. Try to create a complete picture, including not only a visual picture of the event, but also the noises and other sensations associated with it. Put yourself in the picture
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