The issues presented deal with how to reduce stress and anxiety within our lives. The underlying message in all of this is that each of us were born to live. A simple statement on the surface and quite obvious. However, there is so much power contained within this statement. We were born to LIVE. If we are caught in the webs of anger, inner critic, guilt cycle, anxiety cycle, low self-esteem, then our ability to truly live is limited. We are the wild birds caught in a cage. Sure we go through the motions of living, but we are not really alive. We are not free. We are looking at life through the bars of the cage. If there is one goal, one wish we would want for ourselves and for others, it is that we experience being fully alive. That we live.

This gift of life is limited in a time perspective and so makes the goal of living even more pronounced. This life we are given will end somewhere down the road. We can cherish every step we take on that road. The other point about our life is that it was given to us. It is our life ... not our parent's, not our friend's, not our enemy's, not our family's, not our boss's, not everyone else's ... it is ours. It is for us, and us alone, to decide the path that our life will take.

If we subdivide our life up and give responsibility for it to others, we, in effect, lose our life. If we take responsibility for our life, we open ourselves to a wonderful, often painful, often joyful journey. Number one on the resistance list is take responsibility for our lives. Sure it is easier to give up that responsibility to others. The easy path is sometimes the most destructive to us. We often like others making decisions for us, telling us what to do and when and how to do it. This is giving up power though. To live as fully as we can, we need to take on and feel our own power. A power that roars like thunder.

Once we do decide to take the reins on our own life, then we need to go in search of the dragon that stands between us and life. That dragon is known by the name of ... the mind. The mind can be a very powerful tool when it is under our control. When we are under it's control ... then it becomes the dragon. It becomes the cage, it becomes the web that traps us.

The mind is infinitely fascinating when we start to learn about it and how it works in our perception of what life is. There are many aspects that exist within all of us. The mind is also the greatest game player. It works out tricks and plans to achieve what it wants to achieve. If we are unaware of our true relationship with the mind, we may carry on business associating ourselves as the mind.

The mind says to us "You are so lazy" or "You can never get it right" and we nod our heads agreeing with these statements as if they were the ultimate truth. Unconsciously we agree with every thing the mind states and assume we are saying it to ourselves.

If we have meditated, it is clear that once the thoughts have died down - we still exist. We become awareness. When we are aware, the separation between us and thoughts is quite apparent. We are not our thoughts. We can chose which of the millions of thoughts that the mind throws out that we will take on board. Also, the mind is very limited. That is, it is a basic memory storage system. It contains all the experiences of the past, all the things that have been said to us, all the painful outcomes of events, all our reactions and emotions to certain events. Basically, it records our state of being on the physical, emotional and thought levels to external and internal stimuli.

When the external world mirrors a past event, it pulls up that past record and reminds us how we reacted the last million times. The mind will tell us: "You got angry" in this situation last time so here we go - the anger tape is pulled out.

Haven't we often wondered why people seem to repeat the same behaviour time-after-time and never seem to change. It is because we are all programmed to react and act certain ways to certain situations. We clean the house a certain way, we shop a certain way, we act a certain way with different people, we dress a certain way, we have our daily routine, we react to life the way we are programmed. When we are not aware of this process, the mind is free to tell us how we will act or react to certain situations. And we will. The mind says, "we wash the cutlery first and that's what we do." We never question. That's how we have done it time-and time-again and that is that.

We replay the past over-and-over again in the present. The programming can get nasty if we are programmed to repeat very negative ways of being. The person that is trapped in one abusive relationship after another. The person that is a perfectionist (well the mind tells them they must be) and is driven to perform "perfectly" efficient tasks. The person that can't seem to stop for one minute to relax but needs to be busy all the time. It is the mind driving the car. We are the passengers.

The mind will drive endlessly around the one known area, but fears to venture onto unknown roads and countryside. Pretty boring really. It's like we decide to go on a family outing and drive around the one circuit continually. This is the mind. It doesn't care if it is boring or limited or lifeless ... it is known. That is all that matters.

The mind, also being in essence a product of the past, will throw up past events for us to ponder over. While we exist physically in the present moment, the mind is back in the past. As we associate ourselves with the mind we are dragged back with it and so we go over and over some irritating event. He said, she said and then they did .... We can spent a full day going over-and-over one past event. We react again-and-again to that too. We get angry remembering the injustice or disrespect. We get guilty over that event. The event is past, but the mind throws it up on the TV screen of our mind and see relive it blow-by-blow, over-and-over. We add in a few "If only's.." and there goes the present moment down the drain.

Plus, the mind is always judging the current moment from past information. If it is a totally new and unknown situation it will either stall and freeze or it will pull up a number of scenarios to threaten us with. It can't sit comfortably and totally in the present moment. That is a contradiction in terms. The mind is all past recordings.

Whenever we find a moment of peace from our mind, it will jump in telling us "how wonderful this is." We may be struck by the beauty of a sunset or the expanse of the ocean, the calm of the beach or forest. We sit with wonder and awe at what we see. Then the mind has to tell us how red the sunset is, how green the forest is, "just listen to the sound of those waves as they come in and go out..", "Isn't the ocean incredible..". The moment is lost. As much as we try to regain that feeling, that experience, the mind won't allow it.

We think that this self-talk will get us back to that openness, but we are only going out the other way. We leave the spot thinking about how great that moment was, but is is gone. The moment is of total absorption in the present and the mind needs to be in control. It is not in control in the present moment. Actually, it is peace that we seek. The mind will not allow us that peace.

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Many people listen in rapt attention to someone who recounts that experience of absorption. When we try to experience that ourselves, we can't because we are trying too hard. We are trying to use the mind to create the experience. We talk to ourselves incessantly. "Look at how blue the ocean is. Look how calm the ocean is. Look at the waves that crash in on the sand..." But the moment is allusive. It is frustrating.

Has anyone had the experience of going out with a friend? You walk to the top of a hill and are overcome by the scenery and expanse you feel there. You sit on a rock, totally in awe. Suddenly, the stillness and peace is interrupted by the friend telling you how magnificent the scenery is. And how high do you think this hill is? And do you see the car on the road way down there. The moment is lost. You feel like telling the person to just shut up. All that is left to do is pack up and go home. That annoying disturber of the peace is the mind that we carry around with us continually.

A funny thing about the mind judging the present moment is that we never question the need for all this constant commentary. Heck, the ocean has been called the colour blue since the dawn of time, yet our mind feels it needs to tell us that, "Yes, indeed it is blue."

Not only is it judging the obvious, but it is judging the subtle as well. A friend comes over for a visit and seems quiet. The mind takes in the person's facial expression, the way they talk, and the general feel of the person and will tell you ..."Yep, they are angry at you. What haven't you done? What did you forget? Was it their birthday? Did you say something terrible or insensitive? .... Blah! Blah! Blah!"

We react to this judgement and change our behaviour. We may apologise profusely for God only knows what. In the end, we find out they are merely tired from staying up all night while reading a great book. The mind's judgement of the present moment is not as accurate as we credit it. We get tangled up in reactions to it's judgement and it all ends up an illusion. We are living our life in a fantasy made up by the mind. The mind seems to think it can "mind read" and we obviously believe that it can too. Otherwise, we wouldn't be reacting to all these false situations. "Oh, they don't like you," states the mind. We bend over backwards to earn that person's approval. Ends up, they are just shy and retiring people that don't think one way or the other about us. This is the illusion of the mind.

The other side of the mind is it's projection into the future. The mind actually has a problem with the future. You see the future is actually unknown. Sure it will tell us that we go to work tomorrow; and then, Saturday, we don't have to go to work. There are all sorts of schedules and routines that have been set up and it feels comfortable about this. However, the future is not truly known. Anything is possible.

The mind has to limit this, and state only those on the list that are possible. It will also tell us how we feel about those future events. We either enjoy the event, then usually there is a scenario invented by the mind to worry us, or we dread the event - based on past information. So, as we wake up in the morning, the mind has already in effect lived the whole day. We have gone to work and sorted through all these imaginary scenarios, we have returned home and watched the TV shows for the night. That is that - all before we even get to work.

In the car driving to work, we have reacted to the boss telling us we haven't got the report finished yet or we have made all those phone calls. We have contemplated how we are going to watch this or that TV show tonight. We have gone through the dilemma of peak hour traffic after work. We may have even fitted time in to contemplate shopping and how we will go by a different route to pick up the groceries. Phew! We have already lived the day in our mind before it has even happened. No wonder going through the process of actually doing it is so boring. Not only is the future planned - based on past experience, but unknown situations are thrown in for that extra jab of fear.

The mind is continually thinking up new future events to scare the pants off us. It tells us "it is for your own good," so that we can plan how to deal with the scenario. Just in case...then we'll be ready for it. We usually end up dreading the actual event. It seems so real when we are imagining the scenario. We can even feel ourselves being there. Walking into the room. What we will say. We can see the people there. It is the master illusion of the mind. Not only unknown scenarios are pondered over, but actual future events. Have we ever caught ourselves contemplating some future event. We are invited to Christmas dinner at the in-laws. We have two weeks between then and now. Yet, the mind can't give it a rest. It goes over all the bad experiences we have had at Christmas dinner with the in-laws. It goes over what they said that riled us.

It says "What if they say that again?" and we respond with all the things we will say or not say or just get angry. And what if they get you a horrid gift once again ... and what if, what if ...." So it goes. We live that Christmas dinner a million times before the actual event. When the time comes to go, we often feel like just cancelling out, saying we are sick. The mind has lived the present moment already. That is the bottom line. So we are actually not living, but going through the motions. The mind has been there, done that, and now we physically have to do it. Where is the spark or spontaneity in that. It is a drudgery.

We have a list of chores to do. While our body is going through the mechanics of doing one chore, the mind is already going over the next chore. Does this sound familiar? We have to go shopping, then pick up the children from school, then go home and cook dinner. Simple on the surface. While we are in the car driving to the shops, the mind is walking down the aisles of the super market. Mustn't forget this or that and you must buy coffee this time. It might fill in with a past event of how our spouse went off the hammer about not having coffee in the cupboard and the ensuing fight. We get angry at the memory of this and mumble, "They can get it themselves if they want it so much."

We are actually physically driving the car - on auto-pilot. We get to the shops and are actually walking down the aisles now, but the mind is at the school picking up the children. It is getting angry because the children are not waiting out the front ... again. It is considering how it is not going to get caught talking to Mrs so-and-so again. It is trying to avoid the PTA president who will ask a favour- again.

We are in the shops physically, but we are at the school in our mind. No wonder we forget things we need. So we are at the school picking up the children, but we are worrying about getting back to make dinner. We are peeling the potatoes and looking in the refrigerator for that sauce. On and on. Get the idea of how it works. The killer is--with all these imaginary scenarios that the mind creates, we are copping the reactions. We get angry or fearful or guilty or sad or whatever reaction to the mind's venture into the future. People quite honestly look at their life and say they are not stressed. Take a look at the imaginary life we live and see if we can say the same thing. So the mind projects into the future it's own creation. Then we have to walk into this set up. If it projects fear onto a future event, then we will feel that fear as we have to go into it. It puts a wall of fear around the event and we have to walk through it. The what ifs sound in our ears.

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So we react with one, or many of the "bad" emotions, when our belief system has been proven to be insubstantial or not totally accurate. It is at this point that we have two paths to walk down. One is we react and we never question why we are reacting. Why am I reacting like this? We just assume that it is someone else's fault or that the world is cruel or whatever justification we may use - which are thoughts. We hook into the reaction, unconsciously. So we are angry, and we either go straight into repression that uses another number of fears to hold the emotion down, or project it out onto someone else - saying they caused the emotion to arise in us. We are feeling something RIGHT NOW, but we never look at why and if we don't like the feel of it, how can we let go of this feeling. We go instantly into--resistance. We don't want to feel like this, so like everything we do, we try to push the experience away from us. The resistance can be seen on various levels.

Mental / thought resistance. An external or internal situation occurs that conflicts with one or more of our set of beliefs. Basically, what is happening is not as we wish it to be. The actual situation is reality (that has occurred, and only asks to be experienced now, and let go of for the next experience in the next moment) but we don't want this version of reality. So we try to resist actual reality and this resistance is reflected in our reactions - emotional, etc.

Have you ever observed a little child when they resist something that is actually happening. Sometimes they go into this mode of pretending that it is not happening. They hold their breath and shut their eyes tight. They clench their hands. It is as if they think that if they resist hard enough, it won't happen. If they don't see it, it isn't happening. Sometimes they put their hands over their ears, so that if they don't hear it, it won't exist. The child pushes away and resists things that it doesn't like. It hasn't learned the tools to deal with the situation.

We have to admit it, sometimes we act just like the child that resists. We still seem to think that if we push and resist the experience hard enough that it won't happen. The egocentric view. The fact is that we actually resist alot of reality - one level or another. From the moment we wake up, to the moment we fall to sleep, we are taking in the present moments and judging it according to how we would like it to be. Not only external reality, but also our internal living state. It is like we each have our own lists of "good" and "bad" (and grey zone of not really caring one way or the other).

Each present moment is weighed up against these lists. If it falls into the "bad" or "I don't want" category we will resist. So we wake up and we may even resist this fact. We want to sleep in and so this colours how we start the day. We go to have a shower and the water is too cold or hot. Another resistance. Breakfast time arrives and there isn't any cereal left in the cupboard. Another resistance- we only want cereal and not just fruit. We go outside and it is too hot already. The drive to work is full of people in cars not driving as we would like them to. They cut us off or travel too slow or in general get in our way. Work may be full of jobs that we have left to the last minute because they are not interesting.

So we resist this. Get the idea. Plus we have social interactions on top of that. People may not be in the mood we would like them to be in. There may be too many people crowding our space, or rude people, or strangely dressed people. The children may be fighting when we get home. Dinner is the leftovers from two nights ago and is boring. On a given day, we may go from one resistance to another. Not only external reality, but also internal. We may wake up sick or in a bad mood or depressed. We don't want to experience these realities, so we resist them. We may feel tired. Bored. Anxious. Life feels like one treadmill after another. The spark of life is missing. We don't like these internal states of being, so we try and resist. This is resistance with the cognition or mind to stimuli perceived.

Emotional resistance: We experience the emotional reaction as a result of our resistance to a situation. Then we resist the emotional reaction due to another set of beliefs and rules or conditioning. So if we experience an emotion that is in our "bad" emotion list, then we will resist actually experiencing that emotion. We are feeling one or more of these emotions right now but we resist that actual fact. We don't want to feel this way and so try to shut down that emotion. That's called repression.

Body / physical resistance: Our body reacts physically to the emotional reaction. Our body is the only ground that our emotions can be released. We resist this experience also. We tense the muscles or we may hold our breath. We push the emotional reaction in our body away to not allow it to flow through us. But like all good balancing mechanisms of the body, the more we resist against the feeling/ emotion, the more we dam it up.

Emotional energy is like a river of energy flowing in the body. If we resist it, tense the muscles to stop the flow / feeling, we dam it up and it stays. We also resist certain sensations that occur in the body. The fact is that many people describe a feeling as if their body is numb. They have dissociated themselves out of their body and live almost totally in their head. Some people can actually bump themselves and not feel pain. They may observe bruises on their body, but they have no idea as to how they got there.

We can actually resist living in our body to certain degrees. We recoil from the experience of pain and instantly go into resistance to stop the pain from being sensed by the nervous system. Ever noticed what happens when we stub our toe or burn our hand on something. We feel the initial triggering in the nervous system that signals pain. Then we try to shut that part of the body off from the rest to stop feeling that pain. We tense the muscles. We can almost tell the nervous system in that part of the body to switch off. So physically, we resist also.

When we take the opportunity to relax, or maybe have a massage, we can really see just how tense our body always is. Some of us are just one big tight muscle. Those muscles are tight for a reason. After a massage, we come out feeling loose and relaxed. How long does it take for us to tighten those muscles up again? Probably as soon as we get home.

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Let's try another example that we have all experienced. What happens when someone sits TOO close to us. We all have our own personal space around us. If someone gets inside that personal boundary, we feel very uncomfortable. The personal space varies according to how comfortable we are with the person. Say someone stands right in our face. We recoil from the situation. We have this impulse to step back or move away to a distance that feels comfortable. This is resistance also - but healthy to maintain. The example shows resistance clearly though. It feels uncomfortable, and we don't wish to remain in the situation, so we try with all our might to remove ourselves from the unpleasant experience. So resistance occurs on the physical level also.

The resistance that occurs from the first initial trigger is like throwing a pebble in a still pond. It sets up a ripple effect. We resist the situation that sets up resistance in our mind which creates a reaction within us. The reaction sets up the emotion and we resist that emotional reaction. The emotional reaction sets up a reaction within our body and we resist this physical experience. The cognition monitors the bodily reaction and resists, on the cognition level, the experience in the body. That sets up a reaction that creates another emotional reaction that we resist that creates a reaction in the body. The ripples go out-and-out until finally the cycle loses energy or another cycle is set up with resistance to another situation.

The other path we can take is to accept what we are feeling right now, allow the reactive emotional energy to flow out of the body naturally, and to investigate what it was that we were reacting against. What was the catalyst? What was the "I don't like .." "I'm afraid of .." "It should be like this ..." "It shouldn't be like this ..." etc. Having allowed this to arise, see what the action is to finalise the drama. So we say something to someone, we don't say something to someone, we let go of an outdated belief or rule, we vow to be more aware next time, we find a way to meet our own needs and fulfil them (because we are not getting what we need externally). And when we have done this - we let go of the whole ordeal - the whole lot. From this very moment, it is finished. We go onto the next moment.

It takes a great deal of honesty with ourselves to take this path. It means pulling right back from the external catalyst and only looking at what is occurring within and why. After awhile, with practice, we need not go through this on a conscious level. It is then the new habit. It occurs spontaneously - we have dealt with the issues / beliefs - they no longer return. We accept whatever comes our way with the feeling of adventure and learning. Every new moment is a moment full of infinite possibilities and challenges. And we can deal with them - with all confidence. For your information, there are various emotional reactions to look for. Things we don't particularly want and resist against:

• boredom: of varying degrees - from plain disinterest to the intense boredom that permeates every part of our life, even bored with being bored. Every activity that we once enjoyed no longer is enjoyed
• fear : may be felt as an unknown source or as projected onto an external situation
• anger: as discussed before
• depression: although we become the depression feeling, we fight being depressed by bodily and emotional resistance. By trying to snap ourselves out of depression also.
• sadness: many people do not feel comfortable sitting with sadness or grief and will do anything to avoid expressing and feeling this emotion within themselves or in others. Have you heard the following statement "Don't be sad ...." The same is for that generic feeling of "unhappiness". We are not happy or joyful but not sad either. "Be happy.." rings in our ears.
• pain: Physical, emotional and psychological pain are resisted by us all. Notice what we do when we feel pain in part our body - do we tense our muscles against the pain to try and stop the pain. We try to avoid it at all costs. Emotional and psychological pain are harder to define but in these cases the pain may be more acute than physical pain.
• guilt: as mentioned before
• shame: as mentioned before
• envy / jealousy : another of the "bad" emotions we feel we should stomp on as soon as it raises it's head.

So we see resistance in this area very clearly. It is something we can work with and let go of. But here we go onto the next layer of resistance. That is the resistance to change / action / growth.

DOUBT

We make the commitment to growth and investigation and yet - it is not all roses and sunshine. Once again, there seems to be a force that is trying to prevent us from moving in a new direction. The resistance to change manifests itself in many different guises.

One is self-doubt. We may have seen that there are certain ways that we operate in the world that need changing. We may have also seen how those ways are creating a negative effect in our life. We are filled with the first glimpses of awareness and resolve to change those ways. We set out full of motivation and set exercises for ourselves to achieve our goal.

Gradually, we start to become lapse in our practice. We see that there is actually more work than we anticipated. Face it, we all want to have that change instantaneously. Unfortunately, the initial stages of change are hard work. The mind will play it's games with us to actually prevent us from making that change. Remember, it wants us to stay in these behaviours and ways. These are known for it.

To change the way we operate in the world can be a very unknown thing for the mind. It's control over us has been supreme and now we want to take control of the reins? The mind says "I don't think so!" Say we are trying to increase our awareness and letting go skills by practising meditation. The mind will not like this overt attack on it's ruler ship of the dominion. We may have some great meditation sessions. The mind will sneak in though and then judge every meditation session. It compares our current meditation with the great meditations of the past. "Not meditating well today.." it starts out. "This is definitely not working". So, from then on, if we don't see the game the mind is playing, we are trapped into replicating the past "good" meditations. Anything else is classified as "this meditation is not working".

The same with all our efforts to change. We may make headway and have some great successes - but it needs us to keep at the practice until this is "the new way of being". In-between, there is the mind. Most people hit a hard spot where nothing seems to be happening. The change is very slow. Everything we do seems to be thrown back into our faces by the mind. Enter stage left the incredibly effective resistance that the mind uses .... Doubt. The mind says to us (usually after a lapse or setback) - this is not working.

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Sure, the mind says this to us in a tone that implies that it only has our best interests at heart. It is the same with every new activity we try that needs considerable practice - be it learning a new musical instrument to learning new ways of dealing with anger. The mind tries to covertly whisper in our ear about how this is not working. The old way was considerably easier. Maybe this is not the technique for us. Perhaps we can find a technique that is more suited to us. It fills our mind with statements like:

"You just can't do it"

"This is just too hard"

"Everyone else can do this. Why can't I. I'm useless"

"It's the wrong time to sit for meditation"

"Maybe I should try some other method"

We're bombarded with thoughts of doubt. It is a very effective way actually to resist change and growth. With every self-doubt, the reaction to the thoughts are a drain on our energy. Our body energy drains away until we are dragging our slumped body around the house. Our inner-drive to change is drained away - our motivation is attacked. Our sense of direction and goals are attacked and drain away. So on all levels, we drain away our energy needed for change. These are all primary parts we need for change. Without one or all of them, it is a tough uphill climb. Sometimes we keep going on sheer willpower. The doubts knock this around, and soon we find ourselves reading about chakra alignments and the latest advances in past life regressions. We will find ourselves hop around from one technique to another. One way of growing to another.

All techniques actually require working with them, practising them and so requires action. Sometimes, we have to face the inner wish for change right now, without having to do the work. Most of us want that magical pill that gives us instantaneous transformation. Unfortunately, all real changes need us to do the slow, painstaking process of learning new ways.

When we hop around from one technique to another, we never reach any depth in any one technique. It is like digging many shallow holes in the ground to make a well - but what is required is to dig just one deep one. So it can be seen that doubt sits on the next layer of resistance. It is very subtle, but very effective. Doubt causes the mind to run around, opening the door in effect to many thoughts - each with their resultant reaction. We become confused and muddled and sink back into the quagmire of reacting and unconsciousness. We find ourselves on level one again. It is like a game of snakes and ladders really. Alot of fun when we see all this. We can start to chuckle to ourselves and say - yep - "I did it again." When we don't understand the growth process, we tend to chastise ourselves and call ourselves ridiculous names. Yep, back to level one again to deal with self-esteem hits and reaction. We need to develop compassion for ourselves. A little bit of humour.

So doubt sits very quietly niggling away at our motivation, drive for growth and change. Once again, we see that it is just thoughts. We are reacting to the thoughts with the doubt reaction. We give the doubt-thoughts more energy than they should have. We hook in. So, in this way, we need to observe the doubt-thoughts and see what they are really doing to us.

Identify the main culprit. Understand that this is resistance, a fear of change. When we have been operating a certain way for so long, there is going to be a hell of alot of energy that wants to stay that way. Fears of retribution, fears of the unknown. It is important to see, at this stage, the need of one (or more) of the aspects within us to remain the same - no change. Through very tricky self-investigations, we may even be able to understand why those aspects are fearful of change. Why the doubt is thrown up. When we see this, the more powerful part of ourselves - the one that is moving towards growth and change and completion - can move with compassion for the suffering part. We understand that growth is absolutely necessary for a feeling of wholeness and centring, but there are parts that are scared. With every step that we take, we cradle the fearful part of ourselves in our arms and reassure it. We don't drag it along screaming and kicking - it then becomes the powerful part - and we end up at stage one again. So become aware of the doubt thoughts and let go of them. The effect they can have on our journey is quite significant.

RESISTANCE TO ACTION

Go to the edge', the voice said.

'No!' they said. 'We will fall.'

'Go to the edge,' the voice said.

'No!' they said. 'We will be pushed over.'

'Go to the edge,' the voice said.

So they went

and they were pushed

and they flew

The complement part of this is the resistance to action. Action is a prime part of growth. If we don't do any actions to achieve our goal, then how are we going to achieve our goal?

The problem comes with us living totally in our mind. We think about it. We contemplate what we are going to do. We are not saying that we should leave the mind behind and just totally jump into action. Some contemplation may be necessary. The unfortunate thing is that we remain in the contemplation stage and never venture onto the doing stage.

The other point is, that when we are venturing into unknown territory, we have really no idea what it is going to be like. We have never experienced this before. It is a totally new experience. The mind will choke on this fact. Fear. How can we possibly use the known experiences of the past to give us confidence to proceed into the unknown. It is like a brick wall suddenly materialises and bars us from movement. The longer we contemplate the resistance, the less chance we have to break through. The brick wall is once again fear. And we often feel it as such. We get hooked into the fearfulness of doing the action, we are at level one again.

We can experience this resistance to change by the inability to let go of an old way of dealing with something. No matter how much we want to, we just can't let go. It is like we are standing on the edge of a precipice looking over - will we be able to fly or not. Fear of the unknown. We operate in a certain way for so long that it is known. I know that if I act this way, this will happen. It is known - or so we think. Even if it means suffering, we choose the known path because it seems much easier. So if we are guilt bound and chose to let go of the guilty feeling (thoughts), what is left? We don't know. We have never tried it before. There is a hole in the game plan.

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What comes in to fill that gap? It is a shock. Aren't we supposed to be feeling "bad" right now, and be racked with guilt thoughts and the inner critic for a couple of days ( at least a couple of days if I am going to get value for money)? Staying in the cycle, we know that we are not growing and are suffering, certainly - but it is known. Now, we decide to let go of the cycle and give what we really need to our self. What is left? There is resistance to stopping playing the game. It is the same with letting go of the other "bad" feelings. We get this eerie feeling that something is not right. Aren't we supposed to feel "bad" at this point? Aren't we supposed to be ripping ourselves into strips with the inner critic?

The point is that we have done this time-and-time again. When we are guilty, this happens, then this happens, then this and then the cycle is finished. Usually, in the middle, we get into the "I'm a terrible person" as well, so we have all of this. It is the same every time.

The way we go through guilt (as an example) is exactly the same every time. We have our guilt thoughts saved up for the event, we have our "I'm a terrible person" outlook saved up for the event - the whole box and dice. It is the same every time. So if we let go of the guilt, at say a third of the way through the suffering, there is a whole 2/3 of the process waiting to jump in and have it's go. We sit back and say, but wait - aren't I supposed to get onto the "I'm a terrible person" part now. The cycle is cut and a huge fear rushes in. We stand on the precipice of the unknown. We are launched head first into the reality of being here right now, because we are no longer in the middle of a veil of rolling cycles.

Most of us roll in cycles. We go from our anger cycle to our guilt cycle to our anxiety cycle to our fear cycle to our worry cycle to our depression cycle and then it all starts again.

To let go, means letting go of the veil of unconsciousness reaction and the expectation and knowledge that this follows this reaction. And what waits for us in the letting go - fear. Either, before the action, we can experience the fear (a wall), or immediately after (with our toe nails clawing desperately to the cliff edge as we drop).

Also, when we actually go to do the activity, our mind will inevitably have set us up with it's own interpretation of the actual experience. So this colours the actual experience. Usually the mind will prevent us from taking the actual step. It says: " Wait a minute. Let's think about this a little longer. Wouldn't you prefer to do something else? What about all those chores you have to do?"

If we allow the mind to halt us in our tracks, we will remain standing in the one spot for ever. Imagine the choice to change in the following way. Many have climbed a nearby mountain and have returned to tell the tale of the magnitude and wonder of the experience. They had actually experienced life. We stand at the base of the mountain pondering how we would like to experience this also. We look at the height of the mountain. We see the craggy rocks and the vertical rocks we would need to climb. The mind will tell us we need more preparation to do the climb. It will tell us that we will never make it, that we are not as good as those others that had made it, that we haven't the time to allocate out for such a trip.

Now, if we allow the mind to interfere at this point, we will stand at the base of that mountain looking up, pondering "what if" for the rest of our lives. Once we actually set foot on the mountain, it is easier to keep the momentum going. We have gone this far, lets just go a little further. Once we start to experience the unknown, then we see there is so much life contained there.

Everything is new and infinitely interesting. The rock formations are different, the view of the surrounding countryside is more-and-more expansive. But, it is hard work. We need to walk upwards and this requires consistent work. If we don't get past the initial resistance to actually taking the first step, we will lose the opportunity to experience something new. Once we let go of this resistance, we are free to move forward. Sometimes we need to just bite the bullet and go for it - we have nothing to lose.

As Anthony de Mello says so beautifully "People who deliberate fully before they take a step will spend their lives on one leg." A very uncomfortable position in deed. Henry Ford also states succinctly: "Whether you think you can or whether you think you can't - you are right."

The power of the mind to create reality. What stands between us and the first step to take action is the mind, with it's infinite scenarios and games and tricks. If the mind tells us we can't do it - chances are we believe it, never questioning or taking the risk to try anyway. This is how our lives go many times. An exciting new door of opportunity opens for us and we sit there contemplating the wheres, hows and whys of the open door.

Many times we turn our back on that because in the end it seems all too hard. To go through that open door just seems like too much work or may be surrounded by fear of "What ifs". The mind has so much power, doesn't it?

Imagine if we were the ones that called the shots and told the mind what we were going to listen to and what we weren't. Our life would be so much freer. In all probability, it would be more exciting and fulfilling. The simple fact is that the mind and thoughts can limit us if we allow it to. Once we take the reins of control over our mind, then there are limitless possibilities. The mind is transformed into a very powerful tool for our use. The limiting is the resistance to action. The resistance to taking new roads and ways within our life.

Sometimes, action takes on a symbolic form within us to let go of old ways. An action within the very psyche - not necessarily on an external basis. But action, it can be seen is primary to growth. The choice of action. Action finalises a moment and opens us up to a new moment. It is like tying a string around a garbage bag and leaving it at the side of the road for the garbage truck to pick up. We leave it behind. We no longer need to carry it around with us.

Action can take many forms - increasing awareness, letting go, meditation, reading, letting go into an unknown situation, going to a group or therapist / counsellor - all symbolic ways of telling the Self, yes - I am open to change.

The resistance to action is a biggie. If we don't do it now, it is harder next time. All we can do is push through the resistance and open ourselves to experience. The fact is, we never REALLY know what will happen in the next moment. It is unknown. But we believe we know, due to our rolling cycles and projections.

Living on the edge

is perilous,

but the view more

than compensates.

---

RESISTANCE BY OLD SELF

Another resistance to change and growth is the mind / old-self using dazzling lures to the old ways. They are those frustrating parts of ourself that like to react - thank you very much. The old memory kicks in and says remember how much twisted joy you got out of being this way. It holds the golden carrot in front of your face. Isn't it fun to project your anger onto someone else - just one more time

OK. Why do we always have to be the one's that change? Can't we be left alone to our suffering. There's less fear involved in it. You know they said this and this and this about you. Come on, let's react. And so the story goes. The lure to go back to the old ways of being may persist until the new way has been established. It still has a hold over us until it's energy has been let go of. In this way, we have to keep our resolution in tact.

It is a very glittering carrot indeed to return to unconscious reactive behaviour. The pain of finding out aspects of ourselves is not present. It takes no energy of awareness. We just roll in our reactions. But it is not growth. And our stress and anxiety levels will increase again. And we can never really return to our previous way of being. But the carrot is still there. It is a resistance to letting go of the old and obsolete ways. A tricky device of the mind that has had so much control for so long. Just become aware of this aspect, and keep the resolution to grow strong.

RESISTANCE TO ACCEPTANCE

We have another resistance at this level - and that is the resistance to acceptance. We need to accept where we are at right now before we can move forward. If we are continually saying that we don't like where we are at right now, we want to be somewhere else, we are not accepting ourselves and acknowledging our journey to this point. We are not saying don't have goals or that we resign ourselves to being this way forever. All we are saying is that we need to look within and truly see that where we are right now is perfect on the road to transformation. We can not be anywhere else but here.

We accept that we need some work in certain areas and that we have to let go of alot of old ways. We accept that we are not perfect, but the way we are right now is the best place we can be in our journey. We are at a certain point in our recovery and what we are experiencing right now is exactly what we should be experiencing.

Everything we feel is just part of the journey and we know that we are exactly at the right place. We are healing, we are letting go of built-up emotions (eg. fear, anger, sadness etc.) and we accept where we are, and see that we have come a long way.

A little verbose, but it is very important, because our growth can be stunted by the resistance to accepting where we are at right now. If we don't accept where we are right now, how in hell are we going to grow from this point. Our minds will be full of where we want to be and why we aren't there right now.

Well, there may be a lot of letting go between where we are right now and the place we want to be. So acceptance is big. It is to resist growth when we chastise ourselves or get impatient at where we are right now.

next: Famous People Who Have Experienced an Anxiety Disorder
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The letter raised some interesting issues. Issues we have been researching for a number of years. This article is written in response to a letter querying the difference between panic attacks and menopause.

Firstly, the issue of the role that hormones play in anxiety and panic. From what we have seen over the last ten years, there is no doubt that a large group of women across all age groups experience an increase in anxiety and/or panic either in conjunction with PMS, pre menopausal or during menopause.

Besides noting that pre-menopausal clients experience their worst symptoms while in bed at night, the article describes a number of sensations such as sudden tingling surges, adrenaline rushes, skin irritation and itching like 'worms under the skin'.

As the article states, this last symptom is rarely mentioned in the literature of panic disorder, but can be a very common one during pre-menopause.

Our research over the last six years is showing that this, and other 'symptoms' not detailed in the literature, are experienced not only in pre, or menopausal women, but from across all age groups by both male and female. Our research and our ongoing contact with large numbers of clients shows a definite pattern to this type of attack which can vary considerably to the symptoms categorised in the literature. Yet these sensations appear to be the 'core' of the spontaneous panic attack.

Our second study of these particular symptoms conducted in 1994 surveyed 72 people with an Anxiety Disorder, 36 with Panic Disorder and 36 with other Anxiety Disorders. (1)

Besides a list of the most common symptoms experienced such as racing heart beat, breathing difficulties etc, participants were asked to indicate if they experienced other sensations prior to, during or after their panic attack.

A condensed summary of the sensations and client answers is as follows:

Sensations Moving through the Body	Panic Disorder Participants	Other Anxiety Disorder Participants
Unusual intense energy	69%	9%
Rushes of energy	47%	12%
Electric current	67%	5.6%
Hot prickly sensation	50%	11%
Intense heat or burning pain	42%	8.3%
Wave-like motion of energy	50%	8.3%
Vibration	50%	5.6%
Ice cold sensation	44%	11%
Tingly sensation	44%	42%

• 71% of panic disorder participants compared to 14% of other anxiety disorder participants found it difficult to relate the above sensations to adrenalin.
• These sensations occurred while going to sleep in 69% of panic disorder participants compared to 22% of other participants
• 86% of panic disorder participants were waken from sleep by these sensations compared to 19% of other anxiety disorder participants.

The study also showed people who experience these sensations as part of their attack scored significantly higher on a 'Dissociative' scale than people with other Anxiety Disorders. This provides a very important link to what is now known about nocturnal attacks. Researchers have found that the nocturnal attack occurs during the transition stage from REM sleep to deep sleep or from deep sleep back to REM sleep. (2) The research shows this attack is not precipitated by dreams or nightmares, but happens during the change of consciousness from one state to another. Similar to the changes in consciousness experienced during dissociative episodes. Recent research, which links dizziness to depersonalisation states: 'it is the magnitude of the change (of consciousness) ..which is significant.' (3)

Our experience with clients over the the last ten years is somewhat different compared to the article's in so far as it appears a large sub-group of women with these sensations, ( including two of our staff members), do not or did not get long term relief from these 'symptoms' with HRT.

In regards to the issue of educational and CBT approaches, there are two distinct factors which come into play. Firstly, people who are experiencing these symptoms do not have the language to describe it. As one sleep study says it is felt as an ' upward surge of an indescribable nature, an electric sort of feeling...' While people will speak of the usual symptoms, racing heart, breathing difficulties, etc., the subjective experience of these sensations and/or the dissociative phenomena is difficult to put into words. Even if people can articulate what is happening to them, many hold back because they are frightened of what the therapist will think, and perhaps do, as a result. Secondly, as our studies show, it is difficult for people who have this type of attack to relate it to an adrenalin response and so it is extremely difficult for people to accept this explanation. Combined with this, the various in-vivo components of CBT rarely precipitate the above sensations or those of a dissociative episode.

Our Panic Anxiety Management Programs/Workshops are run by facilitators who have had the Disorder. We have been describing these sensations, and the Dissociative phenomena, in detail during the education component of our Programs and Workshops for over six years. We teach people how they are Dissociating and how these sensations appear to arise as a result of the Dissociation. Once people have an understanding of these sensations, and of the dissociative symptoms, Cognitive techniques are extremely effective. This has been demonstrated in the Evaluation of our Workshops conducted during our recent Project for the Commonwealth Dept of Human Services and Health.

We realise our research is viewed as being controversial, but from a subjective point of view it describes the experience of the many of people with spontaneous panic attacks. While hormonal factors can complicate the Attacks and/or the Disorder, the Dissociative component and the above sensations are playing a much greater role in Panic Disorder than is currently recognised.

Sources:

Arthur-Jones J & Fox B, 1994 , 'Cross Cultural Comparisons of Panic Disorder'.
Uhde TW, 1994, 'Principles and Practice of Sleep Medicine', 2nd edn, ch 84 WB Saunders & Co

Fewtrell WD & O'Connor KP,' Dizziness & Depersonalisation', Adv Behav Res Ther, vol 10 pp201-18

Oswald I, 1962, 'Sleeping & Waking: Physiology & Psychology', Elsevier Publishing Company, Amsterdam

next: Panic Attacks at Traffic Lights
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The diagnosis of depression and anxiety can run along similar lines. In this article, we will look at the conundrum - where is the line drawn between depression and anxiety?

One of the hardest things for people with an anxiety disorder is to describe exactly what is actually happening to them. When they go to the doctor, it is hard to put in words, sometimes, the full experience (Using Sports to Explain Anxiety). When people experience panic attacks and dissociative symptoms, this can be increased a hundredfold. How do you transmit across to another person the full experience of what is happening? Obviously, it is very hard for someone who has never experienced the full impact of an anxiety disorder to understand. Ultimately, people relate to each other according to their own experiences.

"Oh, anxiety. We all get anxious sometimes. What's your problem?"

As for the doctor, it is difficult for a doctor to truly get to the depths of what is happening. The physical symptoms of anxiety are one thing, but the emotional and psychological effects run very deep indeed.

So when we visit a doctor, they are trying to listen carefully to what we say. They see our general demeanor. They hear the physical symptoms and from that they try to ascertain what is ailing us. After running the numerous tests to check out the cause of our suffering, they usually find that nothing is physically wrong. An anxiety disorders diagnosis is usually at the end of a long range of tests to ensure there are no other causes for the symptoms.

The diagnosis of depression and anxiety can run along similar lines. In this article, we will look at that the conundrum - where is the line drawn between depression and anxiety?

What's the Difference Between Anxiety and Depression?

Recently, there has been an incredible amount of media on depression and how prevalent it is in society. It is named as the most prevalent mental health problem in the Western world. If we take a look at our society today, we can certainly see the root causes of why this would be so. But what is the underlying issue of depression? Does anxiety have some contributing factor to the depression people are being diagnosed with? In particular, are the diagnoses of "anxiety" and "depression" distinguishable?

People who experience an anxiety disorder often experience depression as a secondary condition. That is, if you are experiencing panic attacks, for instance, then it would be logical that the huge physical and emotional impact of this ongoing experience is going to affect you, and you may develop depression. When we live in a cramped cage of fear and anxiety, our system will react to the loss of personal freedom. In our research on Treatment Needs for Anxiety Disorders, 53.7% of people reported they also experienced major depression as a secondary condition. When asked whether they felt this depression was a result of having an anxiety disorder, they all responded "Yes."

The other side of the coin is that the researchers also state people who are severely depressed do become anxious. Depression can be the primary cause and people then react to the depression with anxiety. This is true of people diagnosed with bipolar disorder. Certainly, the constant roller coaster, from deep depression to manic high, can create anxiety in a person's life.

Other theories believe they are different parts of a single disorder. Still, others believe they are distinct disorders, but overlapping. The DSM-V includes a formal definition of "Mixed Features" specifiers for patients with depression who have at least three symptoms of mania but do not meet the criteria for bipolar disorder and severity ratings for anxiety.

So when a person presents to a doctor with symptoms of depression and anxiety, what is the diagnosis? The coin can flip either way. In the case of panic disorder (the root cause is spontaneous panic attacks), obsessive compulsive disorder (OCD), social anxiety, and posttraumatic stress disorder - the diagnosis seems clear. It is the anxiety disorder that is primary.

The grey line comes in with generalized anxiety disorder. There is overwhelming anxiety - certainly, but with depression being present, the doctor may diagnose major depression rather than an anxiety disorder. The root cause may be anxiety, but it is the secondary condition that is treated. It must be said, however, some people have a diagnosis of major depression but also experience spontaneous panic attacks. Surely the diagnosis should be a panic disorder or anxiety disorder. Perhaps when the person presented to the doctor, they spoke of their symptoms and the doctor decided they were experiencing depression. Some ask for assistance in managing the panic attacks, but seem resolved to the fact they have been diagnosed with major depression and that is that. They seem to think the two are unrelated and accept they have a "chemical imbalance in the brain" theory.

So when we present to a doctor and speak of our experience, our physical symptoms, and our general sense of wellbeing, what are we telling the doctor?

What are the defining symptoms of anxiety and depression? The tables on the next page show the differences and the similarities.

---

Differences Between Anxiety and Depression

Anxiety & Anxiety Disorder	Depression
Feeling of fear, apprehension and excessive anxiety energy	Feeling of emptiness, deep sadness or misery, loss of hope
Physical feelings of agitation, muscle tension and symptoms of anxiety eg. heart symptoms, nausea, dissociation, diarrhoea, breathing difficulties etc	Slowing down of physical movement and lack of physical energy
General sense of being tense and rigid	Physical body slumped
May be a perfectionist and is concerned about the results of activities (can lead to poor performance)	Loss of interest and ambition (can lead to poor performance)
May fear death but not focused on suicide (Suicide thoughts come only when Depression is a secondary effect of anxiety disorder)	Suicidal thoughts present in deep depression

Similarities Between Anxiety and Depression

Anxiety & Anxiety Disorder	Depression
Fatigue - related to the overwhelming experience of the anxiety and fear energy, tension and extra energy used to continue regardless, loss of sleep etc	Fatigue - related to the energy drop associated with depressed mood
Difficulty concentrating (related to anxiety cycle thinking and monitoring of symptoms)	Difficulty concentrating - related to energy drop of depression, slowing of the mind)
Difficulty sleeping - related to thoughts, symptoms, anxiety cycle, nocturnal panic attacks	Difficulty sleeping (may oversleep)
Headaches, muscle tension and pain	Headaches, muscle tension and pain
Loss of appetite (or overeating)	Loss of appetite
Loss of libido or sexual desire/enjoyment	Loss of libido or sexual desire/enjoyment
Loss of interest/pleasure in normal activities - related to constant need to monitor symptoms and inability to let go of negative thought patterns	Loss of interest/ pleasure in normal activities - related to loss of physical/emotional/cognitive energy
Significant weight loss or weight gain (in some)- related to anxiety energy	Significant weight loss or weight gain
Feelings of excessive or inappropriate guilt - related to person's desperate fight to overcome the anxiety disorder for an extended period of time; feelings of guilt about how it effects their family and guilt that they haven't gotten better yet	Feelings of excessive or inappropriate guilt
Drop in Self esteem and sense of self confidence - due to effects of anxiety disorder	Drop in self esteem and sense of self confidence
Feelings of unworthiness, guilt, self-blame and self depreciation	Feelings of unworthiness, guilt, self-blame and self depreciation

 

It Is Difficult to Draw a Line Between Depression and Anxiety

Looking at the list above, you can see why it can be difficult for a doctor to ascertain the cause of a person's distress. If a person goes to a doctor and reports they are feeling fatigue, loss of appetite, can't get to sleep, are having constant headaches and can't concentrate, then the doctor has to ascertain which of these is the primary cause.

The other problem is the person may report all the various symptoms they are experiencing with the anxiety eg. heart palpitations, racing heart etc and this is now effecting sleep, concentration and energy levels and also are feeling "down" as a result of this, the doctor may feel the diagnosis is depression. The diagnosis of depression, and the subsequent treatment, may help the depression but will do nothing to solve the underlying problem - that is, the anxiety or anxiety disorder. The depression will only return again-and-again because the root cause of the distress was not addressed. This may verify to the person that, yes, they do in fact have a chemical imbalance in the brain causing the recurrent depression episodes. It is really a catch 22.

DSM-V states the following associated feature of major depression:

"Individuals with a major depressive episode frequently present with tearfulness, irritability, brooding, obsessive ruminations, anxiety, phobias, excessive worry over physical health, and complaints of pain."

The description above is almost identical to people who present with an anxiety disorder. Surely the major components of anxiety disorders are the major fears of physical health ("What if ..."), anxiety, phobias, obsessive ruminations, pain, and irritability, tearfulness. This is the problem. How many people with an anxiety disorder have been diagnosed with major depression?

The overlap between anxiety and depression become more confusing when we look at an important diagnostic tool, the Hamilton Rating Scale for Depression (Hamilton, 1967). This scale, still the most widely used to screen patients entering clinical trials, includes many questions about anxiety. Many people who have anxiety as the primary cause for their distress, rather than depression, will identify with these indicators and may be incorrectly diagnosed as Depressed.

The distinction between depression and anxiety is not too clear from one of the long dominant theories about the biological basis of depression, and the role of serotonin (5-HT). The "chemical imbalance of the brain" theory has been cited often as the root cause of not only anxiety and panic attacks but also depression. The theory is the same for both. "Chemical imbalance theory" is specifically identified as one of the keys to depression, but now serotonin is closely linked to the feeling of anxiousness too.

" ... a great number of new compounds, with relatively specific actions on the 5-HT system have begun to appear on the market. Are they [working on anxiety] or antidepressant or both ?... however, is an issue that is likely to be confounded greatly by the efforts of drug companies to market their products" (Healy,1991).

It is hard to sift through the data available to designate a defining line that states this is anxiety with depression as the secondary effect, or this is depression with anxiety as a secondary effect. With depression being the latest promoted "disorder for the 90's" it will be hard for all concerned to define. Anxiety is placed in the background as a ground swell of depression diagnoses arise.

The important point for all people who are experiencing anxiety or depression is to note that treatment for the condition is possible and that recovery is possible. We need to stay with our own individual experience. 53.7% of people with an anxiety disorder experienced depression as a secondary condition (Treatment Needs Research). They all agreed that the depression was as a result of experiencing an anxiety disorder. Your experience will tell you which came first - the anxiety disorder or the depression.

next: Alcohol and Anxiety
~ all articles on insights into anxiety
~ anxiety-panic library articles
~ all anxiety disorders articles

Over the years, we have found that relaxation methods such as progressive muscle relaxation doesn't work for a large sub-group of people. Part of the reasons why include, people are already focused on their bodies, albeit in a negative sense, and it is so easy to simply divert our attention back to our symptoms. Also, progressive muscle relaxation requires us to tense our muscles and then to relax them. Many of us are so tense, all we do is let go back to our normal state of tension!

It seems many people find the basic meditation techniques to be easier. The practice of meditation not only helps us relax by relaxing the mind first, but it also teaches us about our thinking patterns and how we can control them. For those of us who dissociate, meditation can also be a great technique to help us become familiar with different states of consciousness and how we can control them!!

next: Resistance
~ all articles on insights into anxiety
~ anxiety-panic library articles
~ all anxiety disorders articles

In contrast to the high prevalence, degree of disability, and cost to the community, depression and anxiety, once correctly diagnosed, can be treated. Over the past decade, effective treatments have been developed for many anxiety disorders and depressive disorders. The most effective treatments are cognitive behavioral therapy (2,3,4,5,6). These treatments for anxiety disorders are time-limited, self-directed, produce high rates of end state functioning, and are cost-effective.

Cognitive behavioral therapy is a series of strategies specifically targeted to an individual's disorder. These can include cognitive therapy, relaxation, breathing techniques for anxiety and exposure therapy.

We are what we think. And the way we think when we have an anxiety disorder only perpetuates the disorder. Cognitive therapy assists us in seeing the damage our negative thoughts cause and it enables us to have a choice in how and what we think. We all 'What if....'. What if this is causing much of the problem. It is! Recovery is a matter of altering our perception of what is happening to us and/or what will people think of us and changing our thought patterns to our new perception.

Working with a CBT therapist can be extremely empowering as we learn to take control over our negative thinking traps, instead of our thought patterns controlling us. Armed with our cognitive skills, we can then go back to situations and/or places we have avoided and practice our cognitive skills. Remember though, it will take practice and more practice! We are learning new skills and we need to allow time for these skills to develop.

If you feel you are not making any progress with CBT, don't simply give up. Speak to your therapist and work through any problems you are encountering. CBT does mean we need to do the work involved. It is up to us to learn and see how our thoughts are creating so many of our difficulties. CBT will not work if we don't do the work needed.

As a matter of interest we have listed below excerpts from a number of studies.

'Studies comparing the relative efficacy of pharmacologic and cognitive behavioral interventions report panic-free rates above 80% for cognitive behavioral interventions and between 50% and 60% for pharmacotherapy' (3)

A Spanish study assessed the cost before and after diagnosis and treatment of 61 people with Panic Disorder. The treatment involved psychotropic drugs including 'Alprazolam (Xanax) tricyclic anti depressants also MOAI' Direct costsprior to diagnosis were $US 29,158; After diagnosis, $US 46,256; Indirect cost prior to diagnosis were $US 65,643; after diagnosis, $13, 883. The increase in Direct costs were associated to the number of psychiatrist consultations which grew from 40 prior to diagnosis to 793 after diagnosis. (7)

In comparison, a German study looked at the cost-effectiveness of Cognitive Behavioral Therapy involving 66 people with Panic Disorder. At a three year follow up, anxiety-related health care costs, direct and indirect, decreased by 81%. 'Taking the cost of Cognitive Behavioral Therapy into account the cost-benefit ratio for the first two years was 1:5.6. Thus one dollar spent for Cognitive behavioral treatment yielded a saving of 5.6 dollars in anxiety-related costs'.(6)

Cognitive Behavioral Therapy and the Red Herrings

Cognitive Behavioral Therapy can be classified as a 'talking therapy' and in a few instances it has been implied that it is not as successful as some other therapies offered. Cognitive Behavioral Therapy is very proactive. It is not so much as just talking with your therapist, CBT encourages you to take a direct personal approach to work through the negative cycles of thinking.

There is also perception that those of us who have recovered from Panic Disorder by using CBT:

(a) didn't have 'Real' Panic Disorder in the first place. (How one distinguishes between 'Real and Unreal' Panic Disorder is something we have yet to discover! It apparently means that although we meet all the criteria for 'Real' Panic Disorder the fact we have recovered means it was Unreal!);
(b) are in remission (except we don't know it!)

We need to remember, CBT is a relatively new therapy. In the past, many health professionals did not see people recover from their disorder and some therapists are still not aware that people can recover.

If you are told your particular therapist has used CBT with little success, it may be your therapist doesn't have the skills required to teach their patients!

If we are prepared to do the work involved, CBT can give us back our lives, not just in the short-term, but in the long-term.

next: Cued Panic Attacks
~ all articles on insights into anxiety
~ anxiety-panic library articles
~ all anxiety disorders articles

The research has now shown that despite the severe disabilities, once the Disorders have been correctly diagnosed, they can be easily treated. While medication can be necessary for some people in the short-term, the most effective form of treatment which has shown long-term results is Cognitive Behavioral Therapy. Cognitive Behavioral treatment is a number of specific treatments designed for each separate Anxiety Disorder. One of the main features of this therapy is teaching people to understand and correct their anxiety-producing thoughts. With these skills people can then begin to work with their avoidance behavior.

How many times have we said 'What If?' 'What if I have an attack, What if I can't do it? What if people see me?' What if this is causing most of our problems? It is! Many of us have no awareness of what we are thinking about. Our thinking is so much a part of us, we don't pay attention to the process. Without realizing it, our thoughts dictate and control our life. When we have an Anxiety Disorder, the way we think creates so much of the fear we feel, which in turn increases the symptoms; which creates further fear and around-and-around we go!

It is difficult for people who don't have an Anxiety Disorder to realize why it is so difficult to break our negative thought patterns. It is not a matter of replacing negative thoughts with positive ones. Positive thinking doesn't work for many people in the early stages of recovery. Basically, because we don't believe what we are saying to ourselves. If it was that easy, no one would have a problem in the first place! It can seem pointless telling ourselves we'll feel better tomorrow when we have seen so many 'tomorrows' go by and there has been little or no change.

Instead of positive thinking, we need to change our whole perception of what is happening to us. We need to see how our thoughts create so much of our fear, which in turn creates many of the symptoms. Once we can see this, we can see how the anxiety and/or panic are actually reactions to our thoughts and that our thoughts are not a reaction to the anxiety and/or panic. Once we can see this, we can reverse our thinking from 'What if'...to 'So what!. This is the way to Power and Freedom.

We react to our thoughts and feelings never realizing our thoughts and feelings are fleeting moments. We don't see each thought as being separate. Instead, we see the continual progression of our thoughts and the feelings caused by them as something solid. Not seeing the progression from one thought to another, not seeing the progression from one feeling to another, creates the fear. The overwhelming force of the anxiety and panic can be quite violent and it does feel as if something terrible is happening to us. But if we can learn to see behind its seemingly solid appearance, we will see how it is happening and why there is nothing to fear. Seeing why there is nothing to fear, we can begin to take our Power back! Power over our thoughts, power over the Disorder and power over our lives!

Power means freedom!

next: The Line between Anxiety and Depression
~ all articles on insights into anxiety
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Anxiety Disorders were only recognized in 1980 by the American Psychiatric Association. Before this recognition people experiencing one of these Disorders usually received a generic diagnosis of 'stress' or 'nerves'. As there was no understanding of the Disorders by the health professionals, very few people received effective treatment. Since 1980, international research has shown the severe disabilities associated with these Disorders. Most of these disabilities can be prevented with early diagnosis and effective treatment.

These disabilities include agoraphobia, drug and/or alcohol abuse and major depression.

Recently, there has been more media on the prevalence of Anxiety, panic attacks and Anxiety Disorders. As more people become aware of the presence of anxiety disorders, there is more interest in the appropriate treatment of these disorders. Anxiety Disorders carry less stigma now as more-and-more people from all walks of life report to their health professionals for treatment.

It was often thought that Anxiety Disorders and panic attacks were a "women's problem." This is certainly untrue. Although men are more hesitant to present for treatment, both women and men are affected by these Disorders.

Although Anxiety Disorders have been on recently officially recognized, they have existed throughout the history of mankind. Many great and influential people in history have reported experiencing panic attacks and Anxiety Disorders.

The various treatments that they received is diverse and sometimes humorous. In many cases, the treatments offered were ineffective, and sometimes quite dangerous to the person. Some treatments that were used previously were various herbs and balms (in the medieval/ ancient times), bathing in extremely cold rivers and streams, hydropathy (applying extreme temperatures to the body), health spas, blood letting (with the use of leeches). With the dawn of psychoanalysis and Freud, many people turned to the therapist's couch as a solution to their experience with an Anxiety Disorder. With the advent of pharmaceuticals, drugs were prescribed heavily for people presenting with an Anxiety Disorder (although it was not called an Anxiety Disorder at this time).

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People with Panic Disorder may experience this type of attack. Some people with Panic Disorder can be predisposed to having panic attacks in certain situations or places, although they are not frightened of the situation or place. For example, someone may experience panic attacks while driving their car. Sometimes they will have them, other times they won't. They are predisposed to having attacks while driving, but the attacks are not a response to a fear of driving.

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These occur in relation to specific feared situations or places. For example, social situations for people with Social Phobia. Revisiting the scene or scenes reminiscent of the traumatic events in Post-Traumatic Stress Disorder or exposure to a particular anxiety-producing situation in Obsessive Compulsive Disorder. These panic attacks are also associated with Specific Phobia, ie., people may experience a panic attack when in contact with a spider (if they have of fear of spiders) or panic while traveling by air, if they have a fear of flying.

The subjective experience of the panic attack is similar to the uncued panic attack. The 'cued' attack is rarely experienced in Panic Disorder.

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