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Author Topic: Group Therapy Disagreement  (Read 283 times)

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Offline e77

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Group Therapy Disagreement
« on: June 11, 2014, 10:32:13 PM »
Went to a group therapy meeting run by two therapists for anxiety/panic and depression.  The therapists tried to convince me that the physical sensations during a panic attack are like getting a workout and one therapist said a racing heart is good for the heart, even though I stressed that I had PVCs not a racing heart.  One therapist asked if I would consider doing intense physical exercise when the PVCs are triggering panic. When I explained the feeling of dread I get with the physical sensations I felt like they weren't getting it, that I had to convince them what the feeling of doom/dread is.  I felt stressed trying to explain my condition. I told them there are times when my brain crosses a threshold and panic settles in and it requires medication or extraordinary means, like a trip to the ER, to snap out of it. I believe panic, unlike exercise, is not good for me and did not agree with their views.  Am I wrong here or are their views more accurate?  I have been diagnosed with Panic Disorder.  Any opinions/advice is welcome.
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Offline insights

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Re: Group Therapy Disagreement
« Reply #1 on: June 11, 2014, 11:26:13 PM »
The therapists tried to convince me that the physical sensations during a panic attack are like getting a workout

Up to a point they are right. The physical effects of panic, the flight-or-fight response, are much the same as relatively vigorous exercise and becoming conditioned to these symptoms with exercise can help some to better cope with panic attacks. Whether it is the right way to go for you I can't judge, but exposure therapy is a valid treatment.

Exercise also has a direct affect on anxiety by promoting neurogenesis is the hippocampal regions of the brain just as antidepressants do, however, you don't need to run 4 minute miles to achieve this. A leisurely 30 minute walk 4-5 times a week can be enough.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline e77

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Re: Group Therapy Disagreement
« Reply #2 on: June 12, 2014, 12:57:49 AM »
Thanks for the feedback Ian.  I like exercise as long as I don't overdo it.   Too much tends to make me vulnerable to panic.
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Re: Group Therapy Disagreement
« Reply #3 on: June 12, 2014, 02:53:59 AM »
Thanks for the feedback Ian.  I like exercise as long as I don't overdo it.   Too much tends to make me vulnerable to panic.

Exercise increases CO2 and lactic acid levels in the blood, both of which are potent panic inducers. Indeed, both are used in anxiety research to trigger attacks. The point of exposure therapy is to do just as the name suggest, repeatedly expose you to the thing you fear most under controlled conditions until you become conditioned not to react adversely to it.

It can be an effective therapy, but it needs to be applied carefully under the right conditions or it can end up reinforcing the fear instead of extinguishing it, and it isn't for everyone. Part of the therapist's skill is picking the right candidates.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline forever young

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Re: Group Therapy Disagreement
« Reply #4 on: June 12, 2014, 07:51:59 AM »
Ian how can anyone get over agrophobia with out exposure therapy? I know you said it can renforce your fear if not done correctly. I am at a cross roads where I need to get over my fear of going far from home. I am trying to get on an effect medicine but even with that I still had the phobias. I have had these so long I have been afraid to do much facing but have done a little and gotten better. I am afraid to take the big plunge.
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Offline e77

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Re: Group Therapy Disagreement
« Reply #5 on: June 12, 2014, 12:06:01 PM »
Seems to me exposure therapy, like you said Ian,  works best under controlled conditions and applied carefully.  This is not the case with the therapy group I'm participating in as the therapists have the patients identify activities as individual assignments and to go home, do it and report back the following week how it went.   I would think careful coaching needs to be applied for each patient with active participation by the therapist, otherwise the therapists are just paying "lip service" to the treatment.  Kind of like, "go home take 2 aspirin and call me if you don't feel better."
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Re: Group Therapy Disagreement
« Reply #6 on: June 12, 2014, 07:00:26 PM »
Ian how can anyone get over agrophobia with out exposure therapy? I know you said it can renforce your fear if not done correctly.

You do it in baby steps. Go as far from home as you can until you begin to feel a little anxiety with the emphasis on 'little,' and stay there for say 5-10 minutes (or less if you begin to feel uncomfortable), then go home. Keep going back to that spot until being there no longer causes you concern then go further until you again begin to feel uncomfortable and repeat the exercise. Gradually you'll expand your horizons to encompass everywhere you want to go. The important thing is not to do anything which causes high anxiety as that quickly becomes counterproductive, so if this means your first step is only 2 ft from your front door then that's fine.

There have been times when I literally couldn't step outside my front door and going to the mailbox was an achievement ranking with climbing Everest for me, but using the above I can now pretty much go anywhere I want. Effective medication has also been a big help in the process.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline insights

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Re: Group Therapy Disagreement
« Reply #7 on: June 12, 2014, 07:09:55 PM »
I'm participating in as the therapists have the patients identify activities as individual assignments and to go home, do it and report back the following week how it went.

Yes, that makes it more difficult, but not impossible. As per my answer to forever young, the trick is to break down what you're trying to accomplish into small steps and do each one repeatedly until it no longer bothers you, in fact becomes boring, then going to the next level, rinse and repeat...

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

Offline e77

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Re: Group Therapy Disagreement
« Reply #8 on: June 12, 2014, 07:50:11 PM »
I like it.  Reminds me of Dr. Claire Weekes program of de-sensitization of symptoms and sensations with her focus on acceptance.  It seems to me the Australian medical establishment is more in tune with the needs of patients with anxiety disorders.  Lots of stigma here in the U.S. with psych taking a back seat in the world of medicine.  Thank you.   
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Offline forever young

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Re: Group Therapy Disagreement
« Reply #9 on: June 13, 2014, 09:41:39 AM »
Thanks Ian I love hearing about your struggles with this terrible condition. I know facing it is the only way to get over it. how long were you housebound. I was really area bound for yrs until I got on a good medication then going back out was not as bad. I have since gotten really bad with going off my medication and taking time to find something that works well this time.

e77 I have been reading the book by Claire Weekes and I have her cd that is pass thru panic. She says to face and go thru the panic and not recoil she says don't add second fear and if you think about it that is what we do. I don't like the thought of this and if would ran back home in the middle of the bad panic he would get worse so this is why you have to be careful and don't make your self worse.
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Offline e77

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Re: Group Therapy Disagreement
« Reply #10 on: June 13, 2014, 11:35:47 AM »
I agree with you forever young.  Acceptence can be very difficult and trying hard to do this can make it worse at times.  Buddhist monks spend a lifetime trying to do this.  Wishing you the very best.
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Re: Group Therapy Disagreement
« Reply #11 on: June 13, 2014, 05:55:25 PM »
I know facing it is the only way to get over it. how long were you housebound.

About 3 months.

Ian
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NOTE: I'm not a doctor, and particularly not yours, so there may be factors I'm unaware of. Therefore all advice is of a general nature and you should consult your doctor before following any of it, especially before changing med doses.

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