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Inviting the symptoms

In a paradoxical strategy your attitude must be this: "I want to bring these symptoms under voluntary control. I would like to increase all my symptoms right now." Then consider each symptom that typically bothers you. "I would like to start perspiring more. Let me see if I can become dizzy or make my legs shaky, right now." Through this attitude you accept your symptoms, and you permit them to exist. If you practice any relaxation techniques at that moment, you do so as a way to end your Emergency Response and reduce your Negative Observer comments so that you can continue to accept and encourage symptoms.

Fighting paradoxically is not only the instruction to increase your symptoms; it is an attitude and perspective to use whenever you face a panic-provoking situation. And it is a basic principle behind most of the practical skills in this self-help guide. For instance, in the Deep Muscle Relaxation exercise, you tense a muscle group to make it relax. In a panic-provoking situation, you calm your mind and relax your body. By calming yourself, you become more alert and better prepared to take control of panic than if you were to tense up for the fight.

USING PARADOX DURING PANIC

1. Take a Calming Breath, then begin natural breathing.

2. Don't fight your physical symptoms and don't run away.

3. Decide if you want to use paradox.

4. Observe your predominant physical symptom at this moment.

5. Say to yourself, "I would like to take voluntary control of these symptoms. I would like to increase my [name the predominant symptom].

6. Consciously attempt to increase that symptom.

7. Now attempt to increase all the other symptoms you notice: "I would like to perspire more than this. Let me see if I can become very dizzy and make my legs into jelly, right now."

8. Continue natural breathing, while you consciously and fully attempt to increase all your symptoms of panic.

9. Do not get trapped in worried, critical, or hopeless comments ("This better start working soon! I certainly must be doing this wrong. It'll never work.")


When you are controlled by panic you are run by your Negative Observer voice: "I can't..." ("I can't feel this way." "I can't get anxious, because someone will notice." "I can't handle this experience.") As you begin to gain control over panic, you will notice that your voice shifts to that of the Supportive Observer: "It's OK...I can..." ("It's OK to feel this way." "I can be anxious and still perform my job." "I can mange these symptoms.")

Using paradox, you progress to the opposite end of the continuum. You take full responsibility for your symptoms by inviting them: "I want to..." ("I want to make my heart beat faster." "I'd like to see just how might I can perspire right now." "I want to increase all of these symptoms immediately.") Keep in mind that this shift represents more than just a difference in semantics-it reflects a new attitude.

Start by practicing the use of paradox when you are feeling just a few minor symptoms. If you have trouble mastering the approach, look first at your attitude. Once your attitude is set -- your complete willingness to embrace the symptoms in order to diminish their power -- your skill will improve dramatically.

Experiment with using humor, because humor can put some distance between you and the symptoms. Try to prove to the world that you are a champion fainter. See if you can tie your stomach in knots so tightly that even the butterflies want out of there.

Don't be disappointed by early setbacks, because once this special attitude is in place, your entire perspective will have shifted. The goal of accepting and increasing anxiety is the object, rather than being free of anxiety. Panic comes when we try to control our anxiety and we fail. Since you are no longer trying to control your symptoms, it is much harder to experience a sense of failure. And when you don't think "I am failing right now," panic usually won't set in.

Listen to Michelle's description of her experience the week after she learned this approach.

MICHELLE: I took a long walk on Saturday. First I walked to a shopping mall and bought a few things. That only took about half an hour, so I decided to walk down some residential streets. I felt a little panicky because there were no stores, no telephone booths to turn to for help-unfamiliar territory. I took a few Calming Breathes and reassured myself. Again, I found that my anticipation of trouble caused me more problems than any actual symptoms.

Dr. W.: What kind of thoughts did you have?

MICHELLE: I would think, "Here I am...People don't know me...What if I faint?...No one would help me...I could start feeling dizzy?" Than I would remember to do my breathing exercise and to say some positive things to support myself.

Remember the exercise you told me about last week, "Try to bring on the symptoms yourself?" I was surprised that the thought came to mind, but at one point I said, "Why don't you go ahead, feel like you're going to faint and see what happens?" And I sort of brought things back into perspective.

Dr. W.: How do you mean "brought things back into perspective?"

MICHELLE: Well, for a few moments nothing happened. Then I said to myself, "No, you know you're not going to faint. You know this happens to you all the time. You can walk through this neighborhood, and you are going to feel good about that when you are done." It was easy after that.

Something else seemed to change after Saturday. I've noticed an overall difference in my attitude...about myself. I seem to be staying away from criticizing myself. I'm not as down on myself. It's as though I started accepting my symptoms and accepting myself. Then Tuesday I spent the night alone for the first time in ages. That went well, no problems.

Michelle's experience with paradoxical intention is typical. When you completely and honestly request that your symptoms increase, they will usually diminish instead. It is important, however, that you don't make a pseudo-request, such as, "I'm beginning to become anxious. Now, I'd like this anxiety to increase...but I hope it doesn't, because then I'll never be able to handle it. So this trick better work soon!" By fearing an increase in symptoms and hoping that they diminish quickly based on this "trick," you fall back into the trap of opposing panic, and thereby encouraging and supporting those symptoms.

To win over panic, you stop fighting it. To rid yourself of panic, you let it exist. To conquer panic, you stop resisting. And that is the paradox.