Calm Panic Attacks With This Simple Breathing Technique

Emma (not her real name) came to see me recently because she was struggling with panic attacks. She had been to see a counsellor in the past about it but that hadn’t seemed to work. So she contacted her doctor who gave her some medication, but she didn’t like the side effects. Her doctor had also referred her for CBT but there was a long waiting list and she was keen to improve her panic attacks as soon as possible. As a last resort she did some research and read that hypnotherapy can help with stress and anxiety and so she called me and booked an appointment.

Her panic attacks were getting quite severe and she had many of the common symptoms:

  • An overwhelming feeling of fear
  • Her heart racing
  • Her mind in overdrive
  • Shortness of breath
  • A dry mouth
  • Feeling hot and sweaty
  • Feeling faint

A big part of the work that I do with clients is helping them to understand their anxiety better. I explained to Emma how the Stress Response is triggered when we perceive ourselves to be in danger (real or imagined) and all the symptoms she experiences are just the bodies way of preparing for fight or flight. I also explain to clients that the chances of fainting as a result of a panic attack are very rare. When we are anxious our blood pressure increases but generally we only faint when our blood pressure decreases.

During Emma’s first session we did some very simple hypnotic relaxation. This engages the parasympathetic nervous system, responsible for rest and relaxation. As I record every hypnosis session that I conduct, Emma was able to listen to the recording daily for 2 weeks until her follow up appointment. This meant that she was able to experience 15 minutes every day of deep, beneficial relaxation.

At her 2nd appointment Emma explained that she was already starting to feel calmer in general but had still had a couple of uncomfortable panic attacks. We discussed this in detail to understand more about how they start, where they happen, what she is thinking before an attack, what she is doing etc.

Emma explained that usually her first awareness that a panic attack is going to happen is a shortness of breath, followed by heart palpitations. This is very common as people with anxiety disorders tend to notice and focus on, rather than ignore, physical sensations. They then misinterpret normal bodily feelings as being abnormal, leading to feelings of worry and anxiety. For example, by rushing up the stairs to a meeting Emma found herself out of breath. Rather than attributing this to the exertion, Emma started to panic because she was out breath, and that usually means that she is going to have a panic attack.

Breathing is something that is fundamental to our survival and yet we take it for granted. Each time we breathe we bring oxygen into the body and release the waste product carbon dioxide. Poor breathing impacts on the balance of these gases in your body, making it harder to deal with stressful situations.

Chest, or thoracic, breathing is shallow and often irregular and rapid. It can cause symptoms such as light-headedness, heart palpitations, numbness, tingling and shortness of breath. It leads to a decrease in carbon dioxide levels in the blood, which in turn leads to too little oxygen reaching the brain and other parts of the body. In severe cases chest breathing can lead to hyperventilation, but for many people it is milder and can go unnoticed for years.

On the other hand, abdominal, or diaphragmatic, breathing is our natural breathing pattern and it is what we do when we are asleep. When we inhale the abdomen expands drawing air deep into our lungs. Diaphragmatic breathing is slower and deeper and more relaxing than chest breathing.

Working with Emma on her breathing technique would help to balance the oxygen and carbon dioxide levels in her blood, normalise her heart rate, reduce muscle tension and anxious thoughts. Diaphragmatic breathing is also a great way to trigger the parasympathetic nervous system and to elicit the relaxation response.

The technique below that I showed Emma is taken from The Relaxation & Stress Reduction Workbook but there are lots of different techniques you can try.

Breathing Exercise

  • Find a time and place where you won’t be disturbed
  • Try to breathe through your nose
  • Find a comfortable position that you are going to be able to relax in
  • Scan you body and release any tension
  • Take a moment to become aware of how you currently breath. Place your hands on your chest and your stomach and notice which hand rises the most when you inhale
  • Then exhale forcefully but slowly to empty your lungs. This will create a vacuum that will pull a deep breath into your abdomen
  • As you inhale imagine that your abdomen is a balloon and that as you inhale you are filling it full of air. You will feel the hand on your stomach gently rise as the abdomen expands.
  • Once you know what it feels like to breathe from your diaphragm you can inhale slowly through your nose and then breathe out slowly through your mouth as though you are breathing out through a straw. Take long, slow, deep breaths that raise and lower your abdomen.
  • If any thoughts, feelings or sensations catch your attention, just notice them and return to your breathing.
  • Practice diaphragmatic breathing 5-10 minutes every day. Work on extending the time you practice up to 20 minutes.

Emma came back to see me 2 weeks later. She said that once she had got past the uncertainty of what she was doing she started to become more aware of her abdomen rising and falling. This made her more confident with what she was doing and more able to relax into the practice. She practiced most days and had started to notice throughout the day that her breathing had become deeper and slower in general. She had learnt that if her breathing did start to become shallow or rapid, rather than panicking, she just took a few moments to take her attention back to her breathing and take a couple of deep breaths. She found this helped to settle her down and she was able to focus her mind again on the task at hand. She’d also noticed that her panic attacks were getting less frequent and less severe.

 

Exam Anxiety: what every parent of a year 11 should know

 

Last summer I did some exam invigilating at a Wigan School and will soon be helping out during mock exams for Year 11. The school is very well organised and all the exams run smoothly. They invest a lot of time in making sure that all pupils get the chance to practice going into the exam halls and sitting an exam paper well before their final exams in summer. However, there are still some pupils for whom sitting an exam is a traumatic experience. Children who get so overwhelmed by anxiety and negative emotions that they aren’t able to perform at their best on the day.

What is exam anxiety?

Exam anxiety, sometimes called test anxiety, is caused by the triggering of the stress response, also known as the fight or flight response. In the case of students sitting exams, the body and mind respond as if the danger (the exam) is a life or death situation. This overreaction causes uncomfortable symptoms such as shortness of breath, headaches, upset stomach, feelings of fear, racing thoughts, blanking out and panic attacks.

The truth is that some anxiety or stress before an exam is fine. Beneficial stress, sometimes called eustress, helps to keep us focused and alert, but when pupils are overwhelmed by their thoughts and feelings it can impact on their exam performance. Research shows that pupils who struggle with exam anxiety can score about 12 percentile points lower than other pupils.

If you are a parent of child taking exams this year I’ve outlined below 4 ways that you can help them reduce negative and unwanted feelings and go into their exams feeling calmer, more confident and more self-assured.

Help them to get organised

Developing good organisational and time management skills is essential for any young person as they move into adulthood. As they take on more responsibility for their own learning, or perhaps start employment or an apprenticeship, those skills are going to help them feel that they are more in control and so less likely to feel stressed. There are lots of systems and tools for increasing efficiency, such as Getting Things Done by David Allen, and it’s important that you work with your child to help them to utilise them.

Some young people might not see the benefits of organising and planning initially, or might find it too difficult. There are some helpful tips on managing your time from Kent University. I have also found it helpful to use software tools such as Microsoft Outlook which has some great calendar and “things to do” facilities that many people simply don’t make the most of. Another really good tool is Evernote which is a note taking app that can be synced across computers, phones and tablets.

Help them to be positive

Worry about an exam, or the outcome of an exam, is likely to lead to feelings of anxiety. If a pupil goes into an exam hall feeling anxious they are not going to perform as well as they would hope to. The first thing you can do to help your son or daughter is to make sure they keep everything in perspective.  Having worked previously in careers guidance for many years I know that exam results, whether at GCSE or A level, are not life or death situations or the “be all and end all”. As a parent you can help by focusing on the positive, building their self esteem and celebrating their efforts. Make sure they get some good careers advice about their future and they have explored a range of options depending on their results.

I explain to my hypnotherapy clients that the act of worry can be thought of as “negative self-hypnosis”. When we worry we visualise ourselves as not being able cope with the situation we are trying to deal with. This naturally leads us to deal with the situation badly. These negative autosuggestions become a self fulfilling prophecy. When we give ourselves suggestions that we can cope, that we can be calm, that we can focus on the exam paper we can start to become more positive about the outcome and our ability to handle the situation.

Hypnosis is a great way of helping to tap into our creative and imaginative nature, but it is easy to help your child create positive visualisations without using hypnosis. Just as an athlete might use positive visualisations to improve sporting performance, your son or daughter can use them to be better prepared for their exam.

  1. Find a quiet space with your child and make sure you won’t be disturbed for 5 minutes
  2. Ask them to close their eyes and make themselves comfortable
  3. Ask them to imagine they are in a cinema watching a film of themselves doing their exams. Ask them to imagine themselves as they wish to be; calm, composed, relaxed, focused, alert, motivated etc. Ask them to make the scene as vivid and lifelike as they can. Help them to become aware of what clothes they are wearing, the temperature of the room, how many people are in the exam hall, which teachers are there etc
  4. Then ask them to walk into the screen and see the scene through their own eyes, as if they are actually there. Help them to feel the positive emotions they would have, to visualise themselves holding the pen and completing the paper etc
  5. Finally, when they are ready let them hold onto those wonderful feelings and then have them open their eyes

Build this simple process into their exam preparations and they will start to feel more positive and relaxed about their exams.

Help them to let off steam

When the stress response is triggered our body is flooded with hormones that are preparing us for an action – run or fight. When the body doesn’t fulfill one of those actions the hormones, such as cortisol and adrenaline, stay in our system. This leads to ongoing feelings of stress or anxiety, and in the long term can lead chronic stress. To help your child reduce their anxiety you need to regularly get them away from their revision and moving around.

Research shows that aerobic exercise, using large muscles groups to make the heart and lungs work harder, has the greatest impact on reducing cortisol levels. There are lots of fun things children can do to let off some steam, reduce their anxiety levels and help them to feel more ready to tackle the next exam. It could be an organised activity such as football, rugby or dance lessons or fun past times such as skating, cycling or a game of badminton. Why not join them and reduce your own stress levels at the same time?

Help them to relax

The opposite of the stress response is the relaxation response, which is know to reduce stress levels, increase energy, reduce tiredness, increase motivation and increase productivity. When working with clients I help them to create a deep relaxation through hypnosis, but there are lots of simple techniques to achieve a pleasant level of relaxation. In his book The Relaxation Response Dr Herbert Benson describes a very simple process that you can follow and practice with your child:

  1. Make yourself comfortable in a quiet room
  2. Close your eyes
  3. Starting at your feet and working your way up to your head, imagine each muscle in turn relaxing deeply
  4. Breathe through your nose and with each breath out silently say the word “one”
  5. Continue for 10 to 20 minutes. Once you’ve finished sit quietly for a few moments and then open your eyes
  6. Throughout the exercise don’t try to relax or worry how relaxed you are. Maintain a passive attitude and just allow relaxation to happen at its own pace.

 

 

4 steps to quit smoking this Stoptober

1st October 2015 marks the start of Stoptober, a national smoking cessation scheme to get smokers to quit for 28 days. Stoptober is supported by the NHS, Public Health England and a host of celebrities including Al Murray and Rhod Gilbert. It promises free support and exclusive content for 28 days to make quitting easier. The good news is that once you’ve managed to stay off cigarettes for 4 weeks you will be 5 times more likely to stop for good.

There are lots of great ways to quit smoking these days, whether you use patches, gum, e-cigarettes or just go cold turkey. One of the most effective ways to stop, of course, is through hypnosis. Research conducted in 1992 concluded that people are 6 times more likely to quit through hypnosis compared to willpower alone.

There are loads of great reasons to quit during Stoptober and being clear and focused as to why you want to stop can really help boost your motivation and resolve.

For your health

Tobacco is responsible for more than 100,000 deaths a year in the UK – that’s 1 in every 5 deaths in this country. In addition to increasing the risk of cancer, smoking can also increase the likelihood of:

  • Coronary heart disease
  • Heart attacks
  • Strokes

For your family

If you can’t stop for yourself, can you stop for your family? In addition to the risk of harm to them caused by second hand smoking just consider the impact your smoking has on your relationships. Smoking can lead to reduced energy, ongoing ill health such as COPD or emphysema, impotence and low fertility. All of these things can put a strain on relationships with the people you love but so can having to live with someone who smells of cigarettes or has to sneak out of restaurants, pubs or cinemas to huddle outside with the other smokers.

For your pocket

Smoking costs a fortune these days. An average packet of cigarettes costs over £8. Even if you are not a very heavy smoker and only buy 4 packets a week then, at the current rate, that’s £16,000 over the next 10 years. Imagine what you could do with that money? Perhaps you could use it to pay for fantastic holidays, pay off your mortgage early or use it for your son or daughter’s university education.

So, to help you once you’ve made up your mind to stop smoking here are 4 steps to help you quit for good.

Step 1 – Set A Quit Date

Give some thought to the best date to quit and then put the date in your calendar or diary. Avoid choosing a day that you know is going to be busy or stressful or when you are more likely to be tempted to have a cigarette, such as a party.

Step 2 – Tell your family and friends

Quitting smoking is easier with support from others. Let them know when and why you are quitting and talk to them about how they can help. On your quit day ask them to check in with you to see how things are going and warn them you might be in a bad mood as the nicotine withdrawal kicks in. Make sure they help you avoid situations or places where you are more likely to smoke and most importantly tell them not to let you have a cigarette  – no matter how much you want one.

Step 3 – Remove cigarettes and paraphernalia from home, work and your car

Get rid of the cigarettes, matches, lighters and ashtrays from everywhere – you won’t need them anymore. Don’t save them “just in case” throw them away and be done with them. It’s also a good idea to clean the house and car out. Give them a good deep clean to get rid of the smell of cigarettes from your life.

Step 4 – Talk to your doctor or pharmacist about your options

Hypnosis is a great way of quitting but it doesn’t have to be the only way. Increase your chance of success by getting some good advice and combining hypnosis with nicotine replacement products such as chewing gum or patches.

 

You can find out more about Stoptober here. 

If you are interested in booking a hypnosis session to stop smoking you can find more information here.

Citations:

Chockalingam Viswesvaran and Frank L. Schmidt. Journal of Applied Psychology 1992: Vol. 77, No. 4, pp. 554-561 

Cancer Research UK