For Anxiety and stress assign ment .

Why do I worry? The Manual Includes answers to frequently Asked questions about Anxiety, panic attacks, phobias And also self-help techniques.

Contents Part I Part II Part III Part IV Glossary Recommended literature Understanding your anxiety Understanding your panic attacks Understanding your phobias Self Help Tools and techniques

Introduction

The Answer Manual is designed to help you to understand your anxiety from many angles and to obtain some knowledge as to how to you can handle anxiety. The manual is focused on helping you become aware of your particular anxiety, and encourage changes in your thinking and acting patterns. There are a few self-help tools and techniques that you can effectively use to bring about desirable changes in your behavior.

This manual is based on my experience as an anxiety specialist, and also trained in Cognitive Behavioral Therapy, Hypnotherapy and Life Coaching.

Cognitive-behavioral therapy focuses on changing negative thoughts and behavior which maintains activity. (Please, read Glossary explaining the terminology). The benefits of Cognitive-Behavioral therapy CBT have been well researched in New Zealand and other English speaking countries. The good news is CBT is very successful for treating all

types of anxiety, including panic attacks and phobias, with studies demonstrating improvements in 80 90% of patients treated.

Self-help tools and techniques in Part IV include the basics of selfhypnosis as the most powerful tool of self-growth and anxiety management.

In part IV, you will also find some exercises used in life coaching. Have you seen The Kings Speech? If yes, you might remember some healing techniques the language therapist Lionel Logue was using to help the Duke of York to overcome embarrassing stammering. The future king had an anxiety problem and his coach Lionel Logue encouraged him to do a number of exercises which helped him to release his tension. Watch this film again if you want to have a better idea of self-help techniques that I am offering in part IV.

My credo: As an experienced anxiety specialist and Hypnotherapist, I am responsible to motivate you and offer you the most appropriate strategies. But, I am only a coach. It is you who bring about the desirable changes in your behavior. To obtain the best results, read the Manual carefully several times and email me if you have any questions. I wish you a smooth journey to the destination of Calmness, Confidence, and Contentment. Part I Understanding Anxiety 1. What is Anxiety? Anxiety is fear without the clear threat. The fear is a natural response to some threat. When you have anxiety, you tend to overestimate your risk, threat and danger. Physical symptoms of anxiety are similar (at least some of them) to that of stress: breathing increases, heart races, perspiration, and mind focuses on the threat. But, the alarm may be false. 2. What causes anxiety? The most common cause is early life experience. If this experience is traumatic, it leaves an echoing in the head. If your parents reinforced or rewarded anxious behavior, you may have learned that being anxious got you what you wanted. The anxious parent was a role

model for you in childhood. As a child you imitated the responses of your mother, for example. Anxious people over-emphasize the event. They very often overemphasize the significance of somebodys opinion. These are examples of fears that can be traced to early childhood with anxious parents: Fear Fear Fear Fear Fear Fear Fear Fear Fear Fear Fear Fear of of of of of of of of of of of of living. dying. failure. intimacy. ending relationships. losing money. starting a business. asserting oneself. being alone. public speaking. certain insects and animals. flying, etc, etc.

You may continue the list. There are other causes of anxiety: brain wiring, (read question 5), some hormones excess or deficit, your life style and thinking patterns. 3. How do hormones affect the anxiety? Hormones are chemical substances that are produced by endocrine organs, including pituitary, thyroid, parathyroid, adrenal, pancreas and other glands. Hormones change the blood chemistry and some of the hormones can considerably change our mood. They are: adrenalin, dopamine, oxytocine, serotonin, and melatonin. Adrenalin is secreted by two adrenal glands. It is known to cause increased heart rate and breakdown of glycogen to glucose for energy. Adrenalin equips the body to handle emergency situations. The situations are called Fight or Flight. We still have pretty much the same anatomy and physiology like our ancestors in the Stone Age who developed this survival mechanism fight or flight. The physical symptoms are: increased heart rate, sweating, shaking, tense muscles, and shortness of breath. Now we experience the same response when we are threatened to lose a job, to end relationship, to loose money or property, etc. Logically, people have to avoid the situations in which adrenalin is excessively secreted. In reality, quite a large number of people deliberately

create these situations, when they get the adrenalin boost and feel excited. In fact, many people voluntary increase the secretion of the adrenalin, apparently deriving pleasure from being constantly stressed out. They derive pleasure from running on adrenalin. Some people think that when they worry, they protect themselves from a disaster. Other people think they are having a fulfilling life. To reward themselves and relax they start practicing substance abuse: food, alcohol, tobacco, pot, drugs. Eventually, this life style causes adrenal depletion and many health conditions related to it: anxiety, depression, fatigue, obesity, insomnia, digestive and reproductive/sexual problems, various addictions. Dopamine is a hormone of achievement. This hormone is secreted by the pituitary gland when you get an award, promotion or similar. High achievers become dependant on this hormone which they usually secrete together with adrenalin. What happens when a high achiever fails? Depression is sure to come with all the consequences. Oxytocin is a hormone secreted by the pituitary gland and also by the ovaries. When we practice self care, self acceptance and feel safe and lovable, we secrete oxytocine. My main task is to teach my clients to feel safe and lovable to secrete oxytocin and feel more self accepting and content. Serotonin is also intensely involved in regulating the mood. Serotonin in one of the key neurotransmitters secreted by the hypothalamus. Low level of serotonin is linked to depression. Normal rate of serotonin helps you feel calm and content. Melatonin is the hormone which regulates biorhythms. To have a good sleep the pineal gland has to secrete more melatonin. To secrete more melatonin you need to practice positive thinking and start taking more self care. So, there are hormones like adrenalin and dopamine which make you feel more anxious. There is oxytocin; serotonin and melatonin which make you feel calm and more content. You may not be bothered by their names, just remember you need to increase your time for self care and relaxation. When you are listening to the hypnotherapy CD, you have a mini hypnotherapy session. Relaxation as part of it. When you allow yourself to be relaxed, you secrete oxytocin, serotonin, and melatonin. My clients always tell me they start yarning and fall asleep before the end of the recording. This is a sure sign that these mood enhancing hormones have been released. When you learn how to

encourage the secretion of these uplifting hormones, you can effectively handle your anxiety. (Read more about breathing techniques and progressive muscle relaxation in Part IV Self help strategies and tools.) 4. I have heard that benzodiazepines have many side effects. Is there natural alternatives? Your naturopath can recommend you some alternatives. Clinical psychologists recommend 5HT to help sleeping disturbances. This natural medication helps to increase the level of serotonin in the brain. Serotonin is a mood enhancer. Clinical psychologists say it is a good alternative for those concerned about addictive potential and the side effects of the benzodiazepines and other drugs.

Remember self help strategy: My self-talk behaviors strongly influence my level of stress. I use self-hypnosis to lower my counterproductive 90 to a more manageable and helpful 45. 100 maximum anxiety very unhelpful 90 80 70 60 50 moderate 40 30 20 10 0 no anxiety (unrealistic) 0 25 50 75 ___________________________________________________________ no anxiety mild anxiety moderate anxiety extreme anxiety ever 5. Why do I always worry about my health? First of all, some people have specific brain wiring. Sometimes, brain structures are tied to the alarm system differently. Sometimes, the primordial fear that helped human beings to survive in the Stone Age could be still very strong. Nowadays, the person who has this brain structure may be exaggerating the risk and danger. Hypochondrias is a disorder where someone fears developing concerning a dreaded disease. Besides fear, there may be a lack of attention the 100 most

person is suffering in the family. It is common for such people to seek medical attention and misinterpret harmless body sensation as indicative of serious illness. Despite the accumulated evidence suggesting no dangerous illness, the hypochondriac doesnt consider her beliefs as irrational. The focus can be so strong that they ignore other aspects of life: romantic, vocational, recreational. These aspects of their lives may be in a shambles, but they do not recognize it. My task as a therapist is to make a client become aware of other aspects of life and to give her/him strategies regarding contentment from simple things: looking at a candle flame, listening to meditative music, having a hot bath with aromatherapy, going for a walk to collect flowers in the fields, singing, dancing, etc. etc. (see q.3 about Hormones). 6. I have always thought that not worrying about your family means to be selfish. Am I wrong? Everything in moderation. When you stop texting your children or remind them of some simple precautions, they know any way that you still remain a loving and caring mother. Believe me, you will be much more appreciated by your children when you either use positive language or remain silent. A lot of words we use warning your children of danger, annoy them. They answer with irritation, and they are right. You worry because you get your adrenal hormone from worrying. You are addicted to this sensation and are reluctant to get rid of it because you do not know anything better. (Read question 3). I mean to say you do not know how to get contentment from other activities. Crack jokes with your children, meet them with smiles and laughter and you start enjoying oxytacin hormone of contentment. 7. Do I need to seek treatment for my worrying about my children? This depends on the extent of worrying. If you feel you cant stop worrying and it causes you a great deal of distress and interferes with your family, social life, work and recreational activities, then you need some help. In my experience, about six sessions of cognitive-behavioral therapy and hypnotherapy give significant results. People feel as if a gigantic weight has been lifted from their shoulders. They enjoy the benefits of freedom from worrying. 8. Is it normal to worry about what people think of me? We live in a social world, and interaction with other people is vital. Naturally, we want other people (especially those who represent your group of reference family members, colleagues, neighbors, friends) to think well of us. Getting along with people who surround you makes you feel good.

The problem arises when your dependence of others opinions becomes very strong. Most of our worries can be traced to our childhood. If your mother was cold, rarely or never praised you for your small but significant child achievements, you, probably, got used to please her, to seek her appreciation and depend on her mood and opinion. In adult life, you may be engaged in a thinking mistake known as mind reading. You assume that you know what the other person is thinking of you. You may start defending yourself. You may feel very upset when you think that somebody doesnt like you. Ask yourself a question: do you like everybody you meet in your life? No, of course not. You are not obliged to be liked like a golden coin. Give yourself credit for your strengths and practice self acceptance. Self acceptance is the key notion in my therapeutic practice. Maybe 90% of work I do with clients, regards increasing self acceptance. Excessive worries are caused by two main reasons: lack of safety and lack of self love. As soon as you feel safe and accept yourself considering yourself lovable, you become less and less dependent on others. 9. My parents always worried about money. I tend to worry too. Does it mean that I will be a worrier for the rest of my life? No, it doesnt. Your question testifies to the fact that you are aware of your excessive worry and you correctly trace the cause to your childhood. Self awareness is the most important step towards solving the problem. Still, action is needed. How much time and effort are you going to invest in the solution? When are you ready to start? As you have learned, Cognitive Therapy means therapy related to thinking. What was the attitude towards money in your family? Money is hard to earn, Money is not enough, Money has to be rationed, Money has to be saved for a rainy day, We are not a Rockefeller family to afford this is it familiar to you? This is the psychology of poverty. The people who practice it may be poor, may be average, and may have means beyond average. The psychology of poverty doesnt depend on the amount in your account. In fact, it is never enough for you when you practice this type of thinking. People who worry about money live in the Prison of negative thinking. They always tell themselves that something might happen and they often catastrophise the events. According to the law of attraction, the negative expectations attract negative energy form the Universe and

people with negative thinking very often lose money in some financial companies, or similar. The Universe response is like that: you dont use money for your comfort (comfortable house, traveling, leisure, health, fitness, etc), then you do not need this money. Imagine somebody who bought five properties during their lifetime, working hard and never had a proper holiday. Now this person complains that he lost $100,000 with EQC evaluations with each house. He lost $500,000 a half a million dollars. In my view, he lost much more. He lost all the opportunities the money could have given him. He has never enjoyed real freedom that comfortable money gives. Money is energy. Like every type of energy, it needs circulation. You, probably, know people who treat money like energy. The more money they spend on health, fitness, appearance, traveling, presents for the family, dining out, books, concerts, etc. the more money they receive from various sources. These people radiate positive energy of confidence and contentment and they are easily promoted. Money gives freedom. Do you use the money to expand your freedom or do you save it for a rainy day? What hormone does your saving money tend to secrete: adrenal dopamine, oxitocyn? What if you start thinking of money in a positive way: Money is coming to me from various sources on a continuous basis. This is the affirmation you may repeat ten times a day, breathing in confidence and security. In a week, you will notice the difference. In nine weeks, your perception of your abundance and prosperity will significantly change. Life is only 10% of what we do and 90% of what we think of it. 10. Does being a perfectionist affect anxiety? Yes, it does. Perfectionist tendencies can contribute to feeling anxious. In other words, it is fear I am not good enough. If you believe that everything you do must be perfect, you feel anxious because nobody can do everything perfectly. People can strive for excellence, but when we demand perfection, we set ourselves up for problems. Perfectionist people tend to think black and white. Perfectionism can be traced back to childhood. Here is an example of perfectionism created in childhood. The father wanted a son to be born, but the girl was born. She feels her fathers expectations, even though no words are spoken in this respect. The girl tries to do many jobs that boys normally do: she is perfect handling a saw, or a hammer, or a drill. She excels in academic subjects, or is a successful business woman, or she successfully makes her career. What ever the situation is, this group of women measure their lives with the yardstick of achievements. When they achieve, they secrete more dopamine hormone. When they fail, they fall into depression.

The sad thing about perfectionism is that it keeps you in a deficit situation. Imagine somebody who starts with a clean slate and seeing everything, she accomplishes as a genius. She is proud of her success. Now, you start out at 100% expectation to succeed, and all you see is what put you below this. When you notice the deficit, you become anxious, because you are not meeting your unrealistic expectations. Remember: everything in moderation. People who have great visions usually tend to achieve great things. But would you like to achieve at the expense of calmness and contentment? At the expense of relaxation? At the expense of some health conditions? Your therapist will help you learn a new skill if you wish: the skill of relaxation. Being a perfectionist, you tear yourself down for what you havent perfected. When you decide enough is enough, listen to the CD Relaxation. Stress and anxiety relief. Some simple exercises will also help you to enjoy your achievements more and have more leisure and pleasure in your life. (Read part IV for more self-help tools). 11. Are procrastination and anxiety related? Yes, they are related in several ways. Initially, when you feel anxious about the task, you may delay doing it. If you have thoughts It is too hard . Ill never do it well enough. You are anxious and you delay, fearing what needs to be done. Once youve procrastinated for a while and a deadline approaches, you may feel more anxious. The though I will never finish it in time . Makes you anxious, not the fact that the work has not been finished. You may change your thoughts to more realistic ones: I have been assigned this work, so I can do it. It will be helpful to break the task into small portions and focus on just the piece you are working on, rather than the whole project.

12. Is it possible to procrastinate less? Procrastination is a habit that takes hard work to change, just like other habits. Changing procrastination behavior includes changing your thinking and actions. Practice the thoughts that can help you. It is better for me to do it now than later. Its hard, but not too hard. Its better to go ahead now.

Behaviors: take action for five minutes.

If there is something you desperately do not want to do, give yourself five minutes to work on the task. At the end of five minutes decide: Can I keep working on it or am I going to come back to this later? People who procrastinate find themselves feeling very anxious or stressed many times in their lives. A woman, who is a home-staying mum, once asked me: I procrastinate with domestic chores. Instead, I like to watch TV. Can your therapy help me? Cognitive-behavioral therapy can always help. The woman is aware of her responsibilities. She knows her husband is discontent, but watching TV is her habit. It is probably an obsessive habit which has developed because some of her emotional needs are not met. Which ones? It may be self reward. She knows she deserves some time for herself and she chooses to watch TV, mainly films about crimes. Watching crimes she secretes adrenaline. Some people like to run on adrenaline because it makes them feel their life is fulfilling. The problem is that adrenaline depletion comes sooner or later. This health condition affects internal organs and causes fatigue. The therapist can motivate the client to try a new type of self reward just for a month. Combined with some other exercises, it usually works and people gradually change their undesirable habits. It is easy to learn to secrete oxytocine and be involved in some pleasurable activities. Humor and laughter help a lot. Laughter yoga helps many people. I recommend Ha exercise which I learnt in 1995 in Indian ashram.

13. Can anxiety make me angry? Yes, it can. People who struggle with anxiety often are short of temper. Anxiety makes your muscles tense and increases irritability. I give at least 3 4 exercises to do on a daily basis 10 times a day. Each exercise requires only a minute and helps to release anger and tension. One of the four exercises is imagining your anger as a disgusting insect. You can start your morning with turning on uplifting music and crushing the insect (spider, mosquito, etc) under your heel. All the benefits, together: good mood, physical movement, releasing negative tension, feeling better about yourself.

14. A part of me thinks my partners cheating on me. I worry about it all the time. What can I do to resolve this anxiety?

To find out if you are imaging things, ask yourself the following questions, and be honest with yourself. Do If If and the I have evidence? I ask my partner and he says no, will I believe him? I hire a private detective to determine if there is an affair detective says no, would I believe him?

If your answers show that even if you do not have substantial evidence and if the partner would deny it and a detective would find no evidence, you would still worry then your worry is excessive. Jealousy can be traced to childhood. People who are jealous were, probably, abandoned by the mother in childhood. Even if they had the mother, they were scared she might disappear because she did not show stable and consistent care. This kind of worry undermines the relationship and might even destroy it. The therapy is necessary. In the web page about Conflict resolution and relationships, you may see the bears hugging each other. Yes, hugging has therapeutic value and you may start straight away. There are many other strategies your therapist can do for you for effective resolving the issue.

15. I am constantly worrying about my daughters school performance. What can I do to make her work harder? You have to accept you cant control other peoples behavior. Even if the person is your daughter. You cant make her do something. You can only set up a system of incentives in regards to her school work. In my clinic, I often meet people who want to control their spouses or children. Every time I give them my CD What is in your control? which conveys this message you can control only your thinking and acting. Remember: life is only 10% of what we do and 90% of what we think of it. As soon as you change your perception of your daughters school work, start seeing it in a broader context and stop being anxious about her achievements, your relations will considerably improve. That is sure to help her progress at school. It also may set an example to her: start a course and excel in it. 16. I overeat when I am anxious. What can I do about this problem? When you feel anxious, it is natural to want to feel better and to get some comfort. However, it is probably no surprise to you that eating to feel better is a short term gain/ long term pain option. You get some relief in the moment by tasting food you enjoy, but over time, you develop a habit that is tough to break and you gain more weight than you would like. To improve this problem, keep in mind that just

feeling anxious isnt enough to get you to overeat. Many people cant eat at all when the experience anxiety. How do you respond to feeling anxious? If you tell yourself I cant stand it . And run to the refrigerator, this response is untrue and not helpful. You only increase negative emotions. More accurate and helpful responses would be: I dont like the way I feel now, but I can stand it. I need something to help me to feel better, but I dont need it to be food. What can help? Deep and slow diaphragmatic breathing. My hypnosis CD starts with this breathing technique. I explain about holding the breath when you inhale for five seconds and when you exhale for five seconds. (Read more in part IV about self-help strategies). You are sure to have many resources to make better choices than food: intelligence, self-discipline, determination, the desire to be fit and to look better, etc. Consider the following options, if you are ready for action. Keep a food log - if you are not going to write it down, do not allow yourself to eat it! Do not bring home fattening foods or ones in which you are likely to indulge. I would like you to focus on this point. We eat at home what we have bought. Have a list of enjoyable activities which do not include food.

Listening to pleasant music or a hypnotherapy CD. Giving a hug to someone in the family. Craftwork (I advise to make a badge I am unique, valuable and precious. It works!) Taking a bubble bath. Journaling. Joining a book club. Singing. Dancing. Asking a spouse for a back rub. Sex. Yoga. Arranging flowers. Going to a play or sports event. Walking in pretty area, etc. etc. Make a sign on the fridge that alerts you to stop and think: (I am working on the manual specifically designed to help people with excess weight to change their eating habits).

17. When do anxious people usually come in for treatment?

Here are some observations: A person having a panic attack often seeks treatment in response to it. By contrast, people with obsessive compulsive disorder may go for years without seeking help, feeling ashamed of the problem. People with generalized anxiety disorder often accept their worrying as normal. Only when the body symptoms start to seriously impair life (like sleep disorder, irritable bowel syndrome, high irritability and anger, etc), they might start thinking of some help. People with social phobia may be fearful about seeking help, as they are fearful doing things in front of others that will accuse them humiliation. (see question about social phobia). 18. You have said that people who come for treatment have 80% success rate. What happens to the other 20%? Not all people who come for treatment are ready to take responsibility for their condition and start doing something for self care. They expect the therapist to use a magic wand and miraculously give them freedom from their fear, panic attacks or phobias. The therapist has strategies and tools that can be called magic because they work when the patient constantly uses them with the expectation of success. But you need a minimum of six sessions and motivation to work between the sessions. (I would refer you to the number one bestseller The Kings Speech. Based on the recently discovered diaries of Lionel Logue (2011) Please make a note of how King George VI was working at his condition of fear of public speaking. Commitment led to success. Some of my clients use Grabone vouchers and expect the undesirable habit of disappearing after one session. For example, somebody comes complaining of sleep disturbances that he/she has been suffering for the last thirty years, but aggravated recently by the February earthquake and the loss of their property. Is it a reasonable expectation for a person who suffers generalized anxiety disorder? This person refused to listen to my CD Sleep well every night which other people found very effective. He left the clinic after two sessions convinced that hypnotherapy is unable to help him. Why didnt he use the opportunity to create new neural pathways in his brain and eventually form a habit avoiding ruminations? I will tell you why. It sounds paradoxical, but people who do not succeed are afraid of changes. Yes, changes are painful and there is fear to lose the fear. This group of people can predict the fear and subconsciously believe the fear protects us. The conscious, analytical mind understands I need to seek help for my condition. But, the subconscious mind is more powerful and has its own patterns: Your fear and worries protect you from getting worse. These kinds of people do not know how to deliberately secrete oxytocin, seatoninm melatonin. They run on

adrenaline and dopamine. My therapy is client orientated and I am able to take the person only as far as he/she wants to go. Being a sensitive and congruent therapist, I take it too close to heart when somebody leaves after one or two sessions. But, I am thankful to this group of clients. They are challenging. They make me constantly think what needs to be done to motivate them to focus on the future and have a clear vision of a smooth journey to the destination Calmness, Confidence and Contentment. Working with people who complain of high levels of stress or anxiety or mild depression, Ive realized they all lack one very valuable skill positive expectancy. People who are good health or security. They forward at the prone to depression tend to think they will never have good relationships, or a good job and financial project the past into the future. But, how can one look same time looking backwards?

The research done by psychologists have shown that it not necessary to constantly analyse your past in order to create a better future. What is really necessary is the ability to make wise decisions today, anticipating the consequences for tomorrow. Your choices are important. You can choose to be a victim of some circumstances causing depression or you can choose to take charge of your life and start making decisions today and act differently tomorrow. The past is over and the future has not happened yet. And I would like to encourage my clients to focus on feeling good and enjoy good relationships and financial stability in the future. Besides hypnotherapy, I took a course in life coaching in order to learn the skills as to how to motivate anxious and depressed people permit themselves to focus on their strengths and to feel good about the future. My teaching aid CD on self-hypnosis is called Focus on your Strengths and feel Good. 19. Are stress, anxiety and depression related? Yes, they are. Sometimes, prolonged stress and anxiety eventually cause depression. Sometimes, there is only a combination of anxiety and depression. I prefer to break this question into two following questions. 1. 2. 1. Stress is caused by external pressure while anxiety is caused by internal pressure. The physical symptoms of stress and anxiety can be very similar. Many people use the word stress instead of anxiety. How is stress and anxiety related? How is stress and depression related?

For example, you are a flight attendant. Since you have gotten used to secreting adrenaline, you may take the sensations for granted. In your situation, the threat of emergency is real. But, compelled to cope with stress for a number of years, you may develop depletion of adrenaline which is a symptom of anxiety. A number of health conditions can develop regarding digestion or fertility. As a conclusion, we have to admit that stress and anxiety are related. As soon as you remove the situation which causes stress, the anxiety can be considerably diminished. 2. Stress and depression are related as well. Suppose you are working on some research project or dissertation, or writing a book, or rehearsing for the piano international competition. You are living under stress imposed by the deadline and the nature of competition. You are running on adrenaline and dopamine. And you are suffering the lack of oxytocin, serotonin and melatonin because there is no time for self care, enjoyable recreational activities, laughter and proper sleep. What happens if you do not get the award? The depleted adrenal glands collapse and you are down in depression. Depressed people seek help in medication. It helps, but, medication doesnt teach you problem coping skills. You can stay on medication for many years suffering all the side affects you are aware about. You may continue to project negative thoughts into the future and not moving forward into a better place. Depression blows away the sense of security. People feel helpless and hopeless. They lack adequate resources to cope with limiting beliefs. Empowerment the key notion of CBT with hypnosis. Cognitive-behavioral therapy together with hypnosis will open the door to new perspectives and possibilities if you allow it to happen. Hypnosis which is often called guided relaxation takes you away from the demands and pressures of everyday life in order to spend the time with yourself feeling comfortable and empowered. Hypnosis is largely self-hypnosis. You allow (or not allow) it to happen. In my Opti-Health Clinic, I teach self-hypnosis and people leave feeling self-reliant.

20. What will happen if I dont deal with obstacles that create stress?

 The stress may find and outlet. You may displace your aggravation on your partner and start picking fights with him/her. You may experience physical ailments. You may feel burned out and get depressed. You may start forgetting things and have job related difficulties. You may turn to drinking or drugs. 21. What is the optimum way to cope with stress and anxiety? Taking responsibility is the most productive way. Developing more realistic and balanced thinking is effective. Learning self-hypnosis is useful. With positive visualizations and self suggestions, you will find new opportunities. There are no guarantees in life, only opportunities.

PART II Understanding Panic Attacks 22. What is a panic attack? A panic attack is a wave of fear coming over you. Typically, it can last only several minutes, or it may be an hour. But, the sensations may continue for longer periods. First of all, see the doctor, to rule out medical reasons such as cardiac, thyroid, or metabolic problems. If the doctor confirms that there are no medical symptoms, then it means your bodys alarm system is over functioning. There are many physical sensations that are happening in the body: like feeling unreal, detached, trembling, shaking, loosing control, chocking, shortness of breath, sweating. You can handle these sensations. 23. How can you stop panic attacks?

Amazingly, but you can stop it by reminding yourself "I can stand these symptoms. Two behavior patterns are important: Not trying to stop, but handle the fears. Not feeling like a victim, but in a position of handling the symptoms. Your thinking is supposed to be: It is uncomfortable, but I can get through it. The panic attack is only temporary. This is not the end of the world. I am not dying. I can ride it out. We learn the positive thinking at hypnotherapy sessions. Clinical psychologists recommend teaching the sufferer to bring on panic attacks. Yes, the skill to control panic attacks by bringing them on at your wish can be learnt! What skills can cognitive behavioral therapy and hypnotherapy offer to a panicky client? During panic attacks, your sympathetic nervous system is super activated. This is a fight or flight response to some circumstances your body perceives as a real danger. But it is a false alarm. And you need to remind yourself that you are not losing control of reality and you can stand the symptoms you dislike. One of the most important things I teach Feelings arent facts. The confusion, apprehension and sense of unreality are unpleasant. Still, people can continue to drive the car or talk at the meeting. Panic attacks will not make you crazy. All the symptoms you experience were originally designed for protection (muscle tension, chest tightness, nausea, sweating). Deep and slow breathing helps you to calm down. People with anxiety disorders and panic attacks are afraid to get rid of their fears. Sounds paradoxical? Not at all. Your conscious mind understands that fears impair and restrict your life. Your subconscious mind (and it is far more powerful) wants you to remain in fear in order to be able to protect yourself. Your subconscious mind was patterned in childhood (or later after some disaster) to protect you keeping you always on the alert, expecting that something dangerous might happen. Your subconscious mind is working well to safeguard you in a dangerous situation. The problem is that your subconscious mind cant clearly differentiate whether the danger is real or only perceived by you as being real. Is it possible to pacify your subconscious mind? Yes, it can be reprogrammed by you. You need to address your issues with commitment and realism to make efforts to learn and practice new skills. Remember, all the symptoms in a panic attack are the result of the fight or flight system kicking in through activation of the sympathetic nervous system.

The sympathetic nervous system is designed to protect you. You have to handle the fact that your fight of flight mechanism is responding to a lot of false alarms. You can learn to cope with it! 24. I dont like to talk about my panic attacks because Im afraid of bringing one on. Is it important that I get treatment for my panic? Yes, it is. You may have free help from Anxiety Clinic. They help you to become self aware. If panic attacks are left untreated, they may cause many difficulties in life: An increased tendency to use alcohol and other drugs for coping. Increased financial dependence on others. An increased fear of driving. Avoiding hobbies, sports and other pleasurable activities. A greater risk of attempting suicide.

It is a good idea to discuss your disorder with a trained professional. Disclosing concerns to a professional often brings relief. Remember: Fear is False Evidence Appearing Real. The therapist who was trained in treating panic disorders is sure to find some effective ways to manage your panic. The simplest but effective way: imagine the scale from 0 to 10, when you are in panic. Suppose it is close to 9. Can you imagine the mark moving backwards? As soon as you succeed, the panic is less and less threatening. The other simplest way diaphragmatic breathing. The first thing I teach people is diaphragmatic breathing. Almost all of my CDs start with a two minute breathing technique and relaxation. (Read part IV about self help tools). 25. Does relaxation always help during panic attacks? No, not always. For most people, progressive relaxation and positive imagery are very helpful. For some people suffering panic attacks, relaxation might not be helpful. These people are used to running on adrenaline. They have fear of fear. But, they have gotten used to this. Quiet time makes them nervous. They are not used to getting the energy of contentment from oxytocine hormone. They concentrate on body sensations expecting a panic attack. 26. My 25 year old daughter has panic attacks. She doesnt drive and lives with us. I often take her to her appointments. Is this the right thing to do? It is hard to answer this question without knowing the dynamics in the family. If you ask the question you are probably annoyed with her inability to learn to drive.

Give an honest answer to the questions: What have you done to help her with treatments? Do you really want her to live separately with flat mates or you like her to be at home and you control her life? If you want to stop promoting her anxiety symptoms, youd better motivate her to seek treatment.

PART III Understanding your Phobias 27. What is the difference between a fear and a phobia? Fear may be reasonable. There is some risk involved. (For example, seeing a snake on the porch of your house). Phobia is unreasonable. (seeing a photo of a snake, spider, etc.) You know your fear is unreasonable and excessive, but, the knowledge doesnt relieve the fear. Your life is disrupted by the need to avoid the feared object. 28. How do phobias develop? A phobia may develop in response to the following circumstances. 1. Experiencing a traumatic event. 2. Witnessing a traumatic event. (observational learning or modeling). 3. Phobias can develop as a result of the brain pairing certain stimuli with scared feelings, which is called conditioning. Three themes underline phobias: Fear of injury, harm, death. Fear of losing control. Fear of something strange and unexpected.

29. Are all phobias treated in the same way? If so, what is the standard treatment? There are variations in treatments but still every therapist would recommend at some stage exposure therapy, either through imagining the fear or in vivo. The benefits of repeated exposure of a feared stimular produced habituation, or desensitisation. Every time you practice it with your therapist or by yourself, your score on the anxiety scale becomes less. Anxiety would subside over time. There is an excellent research base to support it while participating in cognitive-behavioral therapy with the help of hypnosis.

Hypnotherapy addresses phobias by replacing the association between the stimulus and anxiety with feelings of security, courage and confidence. NLP methods with swish pictures have proved to be effective with phobias. 30. I am afraid of dogs. How can I know if I have a phobia? Some dogs in some situations can be threatening and the fear is reasonable. If you are afraid of all dogs irrespective of the size and with no threat of attack, then your fear is irrational and may be called a phobia. People with phobias experience distress when they face the feared stimulus. This is anticipatory anxiety. Phobias are characterized by avoidance of the feared object. If you avoid visiting friends who have dogs, cognitive-behavioral therapy will help you to obtain desensitisation. Start looking at pictures of dogs. Watch pet dogs. Look at a dog standing at the end of the park, watch it slowly approaching you. Every time try to make the distance smaller until you feel totally calm in the presence of the dog. 31. I have power struggles with my son who doesnt want to go to school. He seems really afraid. What should I do? Focus on investigating what is driving your sons behavior to refuse to go to school. Figure out what your child is afraid of. Talk about it when you are both relaxed. Children have different fears: of teacher yelling at them, of a test, of not seeing mother the whole day, etc. Watch physical symptoms of anxiety. Make it easy for school personnel to help your child let them know how much you value their assistance. Try a gradual approach bring the child only for part of the day. Spend some time in the school gym before going to school. (Some children like this). Provide the child encouraging notes and photos that let them know you are thinking of him. Teach the child deep breathing and relaxation. It is recommended to do it before going to school. Increase your childs motivation with rewards. Follow the reward menu predictably and consistently.

32. What is social phobia?

Some people develop an intense fear of embarrassing and humiliating themselves in public. Their anxiety maybe overwhelming. People with social phobia (or social anxiety disorder) may suffer in such situations, as: Eating in public. Talking to a boss. Dating. Using public rest rooms. Going to parties.

If you undergo social phobia, you may be imagining that people around you criticise you. Extreme self criticism is typical for people with social phobia. The cause of social phobia. If the child witnesses an always anxious mother who humiliates him/her for some mistake, the child is sure to have some anxiety problems later. Fortunately, cognitive-behavioral therapy and hypnotherapy effectively helps people who suffer from self criticism and fear to be criticized. The therapist will work on increasing your self-acceptance level and self-recognition. There is more than 80% success rate if a client has at least six sessions and committed to do exercises and listen to the CD between the sessions. I have been observing some young people getting relief, enjoying freedom from social phobia, being able to arrange their lives according to their taste.

Part IV Self-help Tools and Techniques In this section of E-book, you will find various techniques that can be used both for general anxiety, panic attacks and phobias.

If you had a course of cognitive-behavioral therapy, counseling, hypnotherapy, life coaching or similar, this Manual is still very effective for your self growth and your journey to the destination: Calmness. Confidence. Contentment. Self growth is an activity for life. The only human activity, in my view, where never enough is

appropriate and beneficial for your well-being. Self help techniques I am describing in the section are designed to change you energetically. Yes, your positive energy will be growing and negative energy will be decreasing. For example, if you had lived with the fear of being criticized and ridiculed, that will have established certain energy, namely patterns of thinking, speaking, walking, making decisions, and relating. It has been researched that your patterns of breathing and eating manifest the energy. There is an intimate link between the breath and the emotions, and everyone unconsciously uses the breath to regulate the emotions. So we shall start learning coping skills with diaphragmatic breathing. Diaphragmatic breathing is also called stomach breathing. When you inhale, you push your stomach out for five seconds and then exhale, holding for five seconds and pulling your tummy in. Your breath is continuously responding to all the passing emotions. Normal breathing rate is eight to sixteen breaths per minute. When you have a panic attack, you tend to do thirty breaths per minute. With slow diaphragmatic breathing, you do only six breaths per minute. Why is it important? The breath is responding to the emotions you feel. As soon as you feel fearful, start deliberately breathing deeply and slowly. Your emotions start changing: Yes, I am panicky, but I can stand it. I have the coping skills; I like to breathe deeply and slowly . Diaphragmatic Breathing is a tool to correct unnecessary over breathing and promote balance in the oxygen and carbon dioxide levels in your blood. Diaphragmatic breathing is the first technique that I teach people in my Opti-Health clinic. Every hypnotherapy CD of mine starts with demonstrating diaphragmatic breathing for a minute. Yes, you may choose to make the habit to stop doing what you are doing and start breathing. Take three deep slow breaths, drink a glass of pure water and repeat your favorite affirmation. Read bellow about this ritual. Progressive Muscle Relaxation. In any book about self growth, you will find the description of the benefits of progressive muscle relaxation. When you are anxious, your muscles are tense. (That is why anxious and depressed people often have back pain). When you learn to release the tension of the muscles, the two divisions of the autonomic nervous system become balanced. One is the sympathetic and acts like gas in

the car, the other is the parasympathetic, and acts like the brake in the car. If you are an anxious person plus prone to panic attacks or have phobias, you run on adrenaline (see question 5) and press on gas. You deplete your adrenaline glands, feel tired and suffer some pains and ailments. Your posture is not correct, the shoulders are bent and this creates a vicious circle. How serious is your determination to make self care your priority? If I ask you to assess your readiness on this scale. 0 ------------------------------------------- 10 Where is it now? What are your goals for three months? Are your goals set about releasing your tension and controlling your worries? If yes, you may like to obtain a CD about Relaxation and start listening to it every day at least for two to three months. On the back cover of my CD Relaxation, Stress and Anxiety Relief, you may read about new neural pathways created in during nine weeks. New desirable habits will be created that will allow you to successfully control your anxiety. The Ritual. I have designed a ritual which I advise all people suffering from high stress, anxiety, panic attacks and phobias. The ritual consists of three elements: a glass of water, two to three deep breaths, and your personal, present, progressive, positive affirmation. Examples 1. Every day I am feeling more and more relaxed, confident and content. 2. Every day I am feeling more and more content and proud of myself. 3. Every day I am feeling more and more in control of my life. These are personal, present, positive and progressive affirmations. If you dont make it progressive, open minded and just say I am relaxed. Instead of I am feeling more and more relaxed, you critical consciousness will be protesting and the affirmation will not work. Please, follow my structure and then your critical mind will allow you to feel relaxed. Anxious people usually tend to be extremely self critical. They doubt the idea that they feel content. They project their negative emotions into the future: I will never be able to feel relaxed, or I will

never be able to sleep the whole night without waking up. Why not? Because I have never had a good nights sleep before. In this case, I tell them the story about the farmer who plants, for example, beetroot. To cut it short: the farmer doesnt come out every night to check if the seeds are growing. The farmer is absolutely sure that the beetroot will grow at the appropriate time. I kindly ask my clients to visualise the farmer and feel the same certainty the farmer is feeling planting the beetroot. Returning to the ritual. To obtain the best results, you need to find ten minutes a day to practice it. Are you ready to spend an extra ten minutes for your self-care? If yes, you combine in one minute: a glass of pure water, two to three deep slow breaths (diaphragmatic breathing) and repeat your affirmation mentally or out loud. (The latter is more effective). For a number of reasons, I will not go into details why two litres of pure water are essential for your well being. Our brain is 85% of water, our body about 75 80% of water. Doctor F Batmanghelidj, in his book Bodys many cries for water has expounded what illnesses are provoked and aggravated by dehydration. Please, read the book and make your choice. Wear the badge, I am uniquely valuable and precious, in the purse and regularly look at it. This is the first step to empowerment. Creating the badge has a noticeable impact on cognitive and behavioral skills.

Keeping the Journal of Achievements. The benefits of journaling as an effective self-help tool have been researched and admitted in many psychotherapies. Journaling remains a powerful tool for raising self esteem with anxious people who present with low assessment of personal value. Self esteem rises when you notice your skills in living. Here are some clues as to what you may write. I liked the way I handled it, One positive thing I noticed today , The best things that happened this week were .. , What I am looking forward to tomorrow .. . I would advise you to order through Fishpond The Language of Letting Go Journal by Melody Beattie. Every day has a theme. Today is the 14th of August. I open the journal and read the theme Owning your Power. It is about the people in your life who challenge or undermine your ability to trust and care for yourself. Half the page is left for your own thoughts on this subject.

I strongly recommend that everybody who is on the journey to the destination: Calmness. Confidence. Contentment to keep the journal and register your positive thinking. The following benefits of journaling have been proved by psychologists: Empowerment through the growing ability of self-monitoring. Learning foresight skills. Reframing. Amplifying resources. Mentally rehearsing desired behavior. Enhancing responsibility. Assessing progress.

HA Exercise. I learnt it in India in Ashram in 1994. Start your morning with Ha Exercise, and you programme your day only for positive thoughts and emotions. Stand keeping your legs wide apart. Put your hands together as if you are going to chop wood and shout enthusiastically with laughter HA and repeat twice. Your movements must be vigorous, your voice strong and confident. You ridicule your problems of the day. They will hide away ashamed of their insignificance and your confidence. Therapeutic Hugs. Giving and receiving hugs promotes health and well being. A therapeutic hug says without words: I share your feelings. Hugging helps to meet such emotional needs as safety, security and trust. Hugging for health is a mutually healing process. Practice them with your family members and friends. A Self-Hypnosis Recording. Yes, you can create you own self-hypnosis recording. How beneficial is that? Dr Michael Yapko, clinical psychologist and the author of two books teaching about treating depression with hypnosis explains why self-hypnosis is the most effective tool of personal empowerment. New neuronal connections are being created when you listen to your recording on a regular basis. Your recording must be not longer than ten minutes. You start with breathing and relaxation. Then, provide your personal, present, positive visualization. It may be the description of the relaxing place you like best of all. Then, provide your own personal suggestions. (Read progressive relaxation). On my webpage Hypnostore, you will find CD Self-hypnosis Training. Focus on your Strengths and Feel Good. Listen to the sample of it and email me if you have questions.

If you want to listen to your recording while driving, cut off the relaxation and leave only self suggestions. As a conclusion, I want to underline that all these tools and techniques are really fun to do. They empower you making you selfreliant and self-sufficient.

Glossary Cognitive-behavioral therapy was developed in the 1960s. Dr Aaron Beck is considered the pioneer of cognitive therapy. The basic premise of cognitive therapy is that the way we think about events in our lives (cognitive) determines the way we feel about them and consequently our patterns of behavior. When you have a course with a cognitive-behavioral therapist, his/her main task is to make you aware of your distortative thinking and reframe it for the better with some exercises. Psychologists test self awareness. The test I included in part IV Self-help tools and techniques has been developed on the basis of Cognitive-Behavioral therapy. Hypnotherapy is the therapy with the use of hypnosis. Hypnosis is a natural state that you experience at least twice a day: before you completely fall asleep at night and before you are completely awake in the morning. It is called Alfa state. The rate of brain waves is lower than when you are alert, but, higher than when you are asleep. In Alfa state, your critical mind is resting and your subconscious is focused on the positive suggestions of your therapist or your own suggestions that you may listen to if you have recorded them. Practicing cognitive-behavioral Therapy in combination with hypnosis immensely increases the effectiveness of your sessions.