“Rule number one is, don’t sweat the small stuff. Rule number two is, it’s all small stuff.”
– Robert Eliot
The psychology of suicide prevention can surprisingly teach us about controlling our everyday worries. Ad Kerkhof is a Dutch clinical psychologist who has worked in the field of suicide prevention for 30 years. He has observed that before attempting suicide people often experience a period of extreme rumination about the future. They sometimes reported that these obsessive thoughts had become so overwhelming that they felt death was the only way to escape. Kerkhof has developed techniques which help suicidal people to reduce this rumination and is now applying the same methods to people who worry on a more everyday basis. He has found that people worry about one topic more than any other — the future, often believing that the more hours they spend contemplating it, the more likely they are to find a solution to their problems. But this belief is misguided. His techniques come from cognitive behavioural therapy and may sound remarkably straightforward, but they are all evidence based and backed up by trials. His techniques won’t forever banish any and all worry and anxiety — but they do offer a promising way to cut down the time we spend worrying. Here are 2 practical exercises based on the technique
If you find yourself awake in the middle of night worrying, with thoughts of worry and anxiety whirling round repeatedly in your head, he has several strategies you can try. This one is where imagery comes in use. Imagine there’s a box under your bed. This is your worry box. As soon as you spot thoughts that are worries, imagine taking those individual worries, putting them into the box and closing the lid. They are then to remain in the box under the bed until you decide to get them out again. If the worries recur, remind yourself that they are in the box and won’t be attended to until later on. An alternative is to choose a colour and then picture a cloud of that colour. Put your worries into the cloud and let it swirl backwards and forwards above your head. Then watch it slowly float up and away, taking the worrying thoughts with it.
For those apt to dismiss this as psycho mumbo jumbo despite strong empirical evidence supporting the technique, here is another of his techniques for those who find themselves too sceptical to try the abstract imagery exercise:
Set aside a time for worrying. Your worries relate to real and practical problems in your life, so you cannot rid yourself of them altogether, but you can learn to control when you think about them. Fyodor Dostoyevsky famously commanded his brother not to think of a white bear, and we know from the experiment on thought suppression which followed that, given that instruction, you can think of nothing but a white bear. … Likewise, telling people not to think of their worries isn’t going to work. Instead Kerkhof recommends the opposite. Set aside 15 minutes in the morning and 15 minutes in the evening to do nothing but worry about the future. Sit at a table, make a list of all your problems and then think about them. But as soon as the time is up you must stop worrying, and whenever those worries come back into your head remind yourself that you can’t contemplate them again until your next worry time. You have given yourself permission to postpone your worrying until the time of your choice. Remarkably, it can work. It puts you in control.
Try incorporating this technique into your daily life and train yourself to stop worrying, and you might like to read Kerkhof’s Stop Worrying.
Imagine standing on the edge of a cliff. There are no barriers to prevent you from falling over, and it’s a bit windy. Look down. Feeling anxious? Good, that’s a perfectly healthy and helpful response to the situation you find yourself in.
Hold onto the feeling you had looking down the cliff face – and now imagine dealing with that feeling whilst doing the supermarket shop. Probably not so healthy or helpful.
These intense episodes are an alarmingly common for people who struggle from panic attacks and panic disorder, says Dr Ben Piper – and it’s an often misunderstood mental health issue. In everyday language we often refer to feelings of being nervous as ‘panic attacks.’ In this post, Ben flags up the most common misconceptions he sees people believe about panic, even long term sufferers.
Even though panic attacks can be very disturbing, they will not cause you to completely lose touch with reality. You may experience feelings of depersonalization and derealization, in which you briefly feel disconnected from yourself and the world around you. As uncomfortable as these symptoms can be, they are not signs of psychosis. Some other mental health disorders, such as depression and PTSD, do frequently co-occur with panic disorder. However, panic disorder is not commonly associated with schizophrenia.
This leads on quite nicely from the first myth. Many people believe that being diagnosed with panic disorder or having a panic attack means they’re going to develop another serious mental illness, such as bipolar disorder or schizophrenia. But panic disorder can really be something in its own right. If you’re still worried, bring up your concerns with a mental health professional.
Panicking people are often told to calm down and “take a deep breath.” But for someone hyperventilating during a panic attack, deep breathing is a bad idea. The increased amounts of carbon dioxide caused by deep breathing leads to feelings of dizziness and numbness. The new research suggests shallower inhalation and a deeper/ longer exhalation are more effective.
Learn how to manage anxiety and panic attacks
It’s a common misconception that [being diagnosed with panic disorder] means that you will have to be on medication for the rest of your life.I think this contributes to the avoidance factors and stigma towards counselling and mental health, which can make sufferers prolong getting help. However, the sooner you do so, the sooner you can control your panic.
People respond well to medication and generally and the research supports its use. Here at iRise Psychology we use Cognitive Behavioural Therapy without medications, or a combination of both if the client has been prescribed medication from a psychiatrist. There’s also a myth that there is no real help out there for panic disorder, which isn’t true. There are some high performing evidence based treatments for panic.
