Anxiety Skills revisited.

this topic might be an oldy but a goody. i know it is one i revisit repeatedly in therapy but I'm not sure if i have already banged on about it on-line. it is the topic of half done treatment for basic disorders such as panic disorder. i have in the past been referred (one way or another) clients of other therapists, counsellors, psychologists, GPs who have had "counselling" for panic disorder but have shown no improvement, or at least not enough. they arrive saying that they have "had everything already" or "tried everything already." Despite this early statement when i systematically review the skills they have acquired over the weeks/months/years of treatment, there is often some gaps that make all the difference.

There are some fundamental skills that if done properly will make very significant differences to managing panic. Most folk are refereed with some notion that panic has to do with breathing. they are told variously to breath deeply, breath slowly, breath (at all

) or breath into a paper bag. All these ideas are half right or a bit right. however if they are not done well they can cause more harm that good. Imagine the effect of "breathing slowly" only everytime you have a panic attack, remembering the last time you "breathed slowly" was when you were having the last panic attack. "Breathing slowly" then becomes a reminder of the previous panic attack and causes more panic. You see the point? A skill or a strategy can end up being associated with more panic, and increase the panic rather than reducing it. If well meaning helping people don't understand the science of psychology and apply techniques haphazardly they end up with (at best) no improvement and at worst a big deterioration with a considerable cynicism about psychological methods.

I was prompted to write this post by a lady i saw recently who needed a bit of a review of her skills. this post is only partially related to her. She reminded me of the many people I have met who report similar stories. Sometimes therapy is about timing, sometimes that skills need to wait until the client is well enough or desperate enough to hear them. If she is reading this Blog, I hope she realises the post applies to many.