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Elisa Goldstein, Ph.D.Elisha Goldstein, Ph.D.
A blog about mindfulness, stress-reduction, psychotherapy and mental health.

How trying to avoid your fear, anxiety, and panic keeps it knocking on your door

Elisha Goldstein, Ph.D. Updated: Jan 26th 2009

rubbing templesIt seems like layoffs are becoming the norm of the day, even the almighty Google has had some layoffs. As a result of this and slew of other every day stressors, Mental Health workers are starting to see a rise in fear among people that are leading the way to increased stress, anxiety and panic. What is panic? Out of nowhere you might start to feel lightheaded or dizzy, shortness of breath, increased heart rate, chest pain, and sweating. You might think you're having a heart attack, dying, fainting or losing control, and experience a disassociation or detachment where you don't feel connected to your body.  To make things seem even more out of control, this seems to happen completely out of the blue, even when you're sleeping. The fact is, almost 25 million people in the United States suffer from these symptoms. The other fact is, it's a highly treat-able issue. If you relate to these symptomes or know someone who does, read on...

What many people naturally do when they experience panic attacks is try to avoid the very situations and symptoms that were involved in the panic. If you had the attack in a mall, you may avoid malls at all costs. If there was sweating or increased heart rate involved, you may stay away from exercise. While this avoidance may be helpful in the short term, it inevitably sews the seeds of greater suffering as fear of panic eventually striking again tends to increase. You might start to avoid more things that bring up these symptoms like taking medication, driving, and even having sex.

Franklin Roosevelt said, "There is nothing to fear, but fear itself".  Fear will not kill you, but it will grab hold of you tight and the more you try to "fix it" the stronger it will hold. This is tricky because our minds are wired to fight or flee from an impending danger. If it deems the danger as hopeless it will cause us to freeze. The way it reacts to panic is to frantically and stressfully think about what you can do to get away from these terrible sensations. In this respect, what is really happening is you are unknowingly pouring kerosene on the fire until it is a raging inferno. Sooner rather than later, your original belief of how distressing this would become is now confirmed.

The paradigm shift

  • Approaching Vs. Avoiding - The way out of a panic attack and to balance is to learn to approach the uncomfortable sensations instead of avoiding them. Through this practice, you will come to understand that these uncomfortable sensations are actually temporary and they come and go. The more you worry or catastrophize, the more intense they become and the longer they stick around. Try making a list of your most fearful situations and slowly begin to expose yourself to them from least fearful to most fearful.

  • Thoughts are not facts - It is only here where you will come to realize that all of these life threatening scenarios that are swimming around in your head are just temporary thoughts that come and go and they are not facts. Ask yourself the question, has this ever happened before (e.g., dying, fainting, rare disease)? If not, trust your experience.

Using non-judgmental present moment awareness  (e.g., mindfulness), notice these sensations that arise in your body in response to your fear (e.g., sweat, increased heart rate), remind yourself it is temporary. When catastrophic thoughts arise, remind yourself they are not facts, let them be and come back to just noticing the sensations. See if you can realize that they actually do come and go and you can indeed tolerate them. These are just a couple things to support you in starting to move away from the debilitating cycle of panic.  If you are suffering from severe panic attacks I always suggest seeking a competent psychotherapist and potentially a psychiatrist, in your area to give you the structured support and education to support you through this.

As always, please share your questions and comments regarding this blog. Your thoughts provide a living wisdom for all to share and benefit from.               

Elisha Goldstein, Ph.D.

Elisha Goldstein, Ph.D. is a clinical psychologist in private practice in West Los Angeles and is author of the upcoming book The Now Effect, co-author of A Mindfulness-Based Stress Reduction Workbook, Foreword by Jon Kabat-Zinn, author of the Mindful Solutions audio series, and the Mindfulness at Work™ program currently being adopted in multiple multinational corporations.

Check out Dr. Goldstein's acclaimed CD's on Mindful Solutions for Stress, Anxiety, and Depression, Mindful Solutions for Addiction and RelapsePrevention, and Mindful Solutions for Success and Stress Reduction at Work. -- "They are so relevant, I have marked them as one of my favorites on a handout I give to all new clients" ~ Psychiatrist.

If you're wanting to integrate more mindfulness into your daily life, sign up for his Mindful Living Twitter Feed. Dr. Goldstein is also available for private psychotherapy.

Reader Comments
Discuss this issue below or in our forums.

swallowing - anoymous - Nov 15th 2010

alright so heres the deal, in the beggining of july i started thinking about swallowing my own saliva but when i would be doing an activity i would be distracted from thinking about it. Ex; i would be playing golf and my mind would not be focussed on it. This carried on until the end of august. Once i started school in september this went away and I was fine. But in November I became really busy with school work and started to focus on the swallowing again. Im guessing its all the stress and anxiety? Do you think I have ocd? please let me know!

having problem with other people - luwan - Mar 7th 2010

I am forced to stare at people when I don't want to. In a movie theater, I will stare at people that are surrounding that are in my field of view even though I am watching the movie.

I tell myself not to look at them because it feels uncomfortable even for me and I can not not look at the people which I am trying not to look at. Also if I am watching tv with friends I am forced to look at them and it feels awkward unless I completely block them out of my field of view.

Even if I have just one of their feet in my sight I will try and look at the foot- but at the same time, I am watching the tv. Who knew this was possible? I didn't and I am dreading the fact that it is. Any advice? Any idea?

agree but many fears are real - kathryn - Oct 17th 2009

although i am also a mental health para professional having worked with inpatient psychiatric patients both civil and forensic i must disagree in these times.  for example, i have lost my home, my job, moved many times for jobs that disappear, ran out of food, in severe debt with no end in sight, inability to pay full rent which was mortgage payments, applied for and obtained food stamps, cannot drive vehicle due to no insurance, okay i can walk.  asking for help at every turn and often getting very disrepectful treatment.  i do not sleep well or have horrible dreams when in a deep sleep.  wondering where i will go or if i should go anywhere.  so, unless you have personally felt the fear of homelessness, no food, at the mercy of landlords who in the past have been abusive, then one cannot say that these fears are just panic attacks.  i agree that so often fears are not real, but now i find that there are many people who are experiencing the same issues as i am and unless you have faced the prospect of being without a home, living among desperate, often criminal people, then i guess this advice is helpful in normal times, but in these economic times, are just a bit short on reality. 

Thanks this Helped some! - Tina - Oct 8th 2009

I started feeling a little better after reading this. I am very jittery and I havent been feeling to well I have been so worried about my headaches and body pains and just not feeling rite. Thanks

Thanks!!! - Vineeth - Sep 9th 2009

Dear sir i am suffering the same issue (Stress and increasing heart beat headache and body pain..Thanks for the Valuable Information.


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