This post is based on actual events but the referenced client is an amalgam of people and/or a fictional person in order to protect therapist-client confidentiality.
As he walked into my office, he was cautious and intentional in his movements. He slowly sat down while his eyes swept around my office.
He started tapping his fingers on the wooden armrests while his leg bounced up and down on the carpet.
“What’s brought you in today, Gregory?” I ask as he squirms in his seat.
“I’m not sure how to explain it. Sometimes when I go to the mall or store I start to feel really weird. I almost feel like I’m going to die.”
That must be a scary feeling I say. Can you tell me more about how your body feels?
Gregory tells me that his heart starts racing, his palms feel sweaty, he gets dizzy, and he feels like he’s hyperventilating or not getting enough air.
With minimal eye contact, Gregory softly utters, “I feel like I’m going crazy.”
I assure him that he’s not going crazy and explain to him that it sounds like he’s experiencing anxiety and/or panic attacks.
Gregory looks at me with wide eyes and says, “You mean other people have felt like this before?”
I explain to him that yes, anxiety is one of the most common reasons people come to see me.
Gregory sighs and immediately starts crying.
I give him a minute and tell him that this is a safe space and that if he feels like crying, it’s okay.
The tears flow and I ask him what prompted the tears.
“Relief” he says. “It sounds like you understand exactly what I’ve been feeling.”
“Yes, I do, Gregory. And do you know what the best part of this is? With some hard work, I think we can get these panic attacks/feelings of anxiety under control.”
Gregory tears up again and now he’s looking directly at me. He suddenly appears more relaxed and he even smiles as he says, “I should’ve come to see you sooner. My friend told me that what I was experiencing sounded like anxiety but I didn’t believe him. I told him that I was probably having heart issues or worse, I was dying.”
After validating his fears and feelings, I explained the concept of Cognitive Behavioral Therapy to him. I told him that he may not realize it but his thoughts, feelings, and behaviors are all intertwined and affected by one another.
“Do you mean this is all in my head? he says.
I explained that his bodily sensations were definitely real but they were being triggered by automatic thoughts or feelings he doesn’t realize he’s having.
“So what do we do next? he asks.
“You’re going to keep an Automatic Thought Record” I explain to him.
Inching forward, he smiles and says, “Homework I’m actually looking forward to doing!”
We both laugh and it’s nice to see Gregory smile and eager to conquer his anxiety.
There are many variations of an Automatic Thought Record but the premise is to:
Identify the situation or trigger that’s making you feel anxious
Identify and write down the automatic negative thoughts in response to the situation
Identify and name how you’re feeling at that moment
Get some perspective: Are the Automatic Negative Thoughts true or false/fact or fiction
If you experience anxiety or panic attacks like my client, I recreated a basic version of the Automatic Thought Record that you can download for personal use.
It’s meant to be used over a one to two week period but feel free to print out additional copies if needed.
»»»In the next post, we’ll take a look at Gregory’s Automatic Thought Record and talk about what was triggering his anxiety/panic attacks. Let’s just say he was a bit surprised.
Note: If you ever find yourself experiencing anxiety/feelings of panic, interrupt it with the following:
The 3-3-3 technique
Take a deep breath:
1. Look around you and name three things you see.
Name three sounds you can hear.
Move three parts of your body — your foot, fingers, or arm.
Until next time dear readers, Kim.
This post is for informational purposes only and should not be considered medical advice. Please consult with your healthcare professional for individualized care.