6 January 2014

Mindfulness and Martial Arts - Good for Mind, Body and Soul

by Amanda Williamson 


I often recommend a mindfulness based exercise, such as yoga, pilates or a martial art to my clients because this type of exercise "flexes" our frontal lobe as well as our muscles, and it is in doing so that we pop out of our automated way of thinking and provide our minds with the space to change. That is what learning is all about - forming new neural connections. This is also what unlearning is about - severing the neural links that have been long established and which cause us to react in the same old unwanted ways…unless we utilise our incredible frontal lobes and literally change our minds. This process is known as neuroplasticity and was introduced as an idea in the West by William James  in 1890, and was largely rejected until the 1970's. James stated:

"The greatest discovery of my generation is that a human being can alter his life by altering his attitudes of mind". 

It took us a while to get with the programme but getting there we are with the NHS embracing mindfulness and the University of Exeter investing in the clinical development and research of mindfulness based therapies.  

Here is a short video by Professor Williams from Oxford Mindfulness Centre, on The Science of Mindfulness:




Mindfulness alters our perspective and gives us the mental space to develop a new way of thinking, as well as calming down our emotional reactionary circuits.

Several years ago I tried kenjutsu which is the art of the Japanese sword.  I joined whilst I was training as a counsellor and tried weekly for about three years. It was helpful when I have been stressed, or busier than I'd like to be, or had challenging times in my life.


I am fortunate in that my counselling work is very mindful in that I am aware and present in the moment with my clients. It is easier to be mindful when we are doing activities which promote mindfulness. My enabling work with an autistic teenager is also very mindful. William is perpetually mindful of the immediate here and now. I had a dream about him several years ago; I was in a forest, taking part in a gruelling assault course. I was struggling to climb over and under things at breakneck speed. I glanced over at the other competitors and all I could see was William, skipping up and down on a tree stump, flicking a ribbon, whistling and smiling, totally at peace with the world.

I have many clients who are aware of the concept of mindfulness and have read books or attended a course but struggle to integrate it into everyday life. There are ways of weaving mindfulness into our everyday lives. Walking is an excellent way - thinking about what we can see and hear right now as we walk, rather than losing ourselves in thoughts/concerns/worries that are miles away from where our feet are…

A great martial arts class can be a highly effective way of developing strength of body and mind, of switching off the old, habitual thought processes and turning on that part of us that makes us uniquely human - our frontal lobes. Flex that frequently and you'll have a young mind as well as a young body.

Finally, I asked many people I know who do a martial art to tell what their Myers-Briggs type is. I was hoping to see a pattern. I had assumed that they would be mainly introverts rather than extroverts but actually, there was a fairly even spread. However, the majority of martial artists were *NF* types, that is intuitive and feeling (as opposed to sensing and thinking). Hmmn. Food for thought.





25 November 2013

On Working with Boarding School Survivors

By Amanda Williamson, Counselling in Exeter




Boarding school survivors?

To whom does this term apply? Would that be anybody who went to boarding school and was abused? Is it anybody who went to boarding school and was distressed at being separated from the family and home? Does it refer to everybody who went to boarding school?

The term has emotive and probably contentious connotations so I shall proceed with referring to those that attended boarding school as ex-boarders. The workshop I attended referred to the subject matter as "The Boarding School Experience" and was run by local counsellor/psychotherapist Jane Barclay, herself an ex-boarder and a director of Boarding Concern.

I was keen to go and learn more about the boarding school experience as I have worked with some ex-boarders. Certainly, I have found anecdotally that the impact of that particular education format has left an undeniable impact on some in respect of self-esteem, the insistence of denying vulnerability and/or having difficulties with intimacy (all intertwined).

I attended the workshop with an open-mind. I have never set foot inside a boarding school. I had my prejudices and sketchy preconceptions based on Enid Blyton books (sardine sandwiches and ginger beer at midnight). I was interested to hear about ex-boarders' insights and really learn about their experiences.

Of the 12 delegates, all of whom were either qualified, or trainee counsellors, 3 of us had not attended boarding school. Of the remainder, all had had a negative experience, apart from one who had had a very positive experience. It was agreed that it was good to have the presence of somebody who had had a positive experience to add perspective to the emotive topic.

The workshop was held over 2 days, split by a 5 week interval. The first day we looked at how a child might adapt to the boarding school existence and how they might construct a Strategic Survival Personality. This consist of the ways of coping with the separation from home and family at an early age. The child identifies with power and independence and disowns their vulnerability and dependence.  This way of existing then continues on into adult life.

We then watched a video of a documentary by the BBC in 1994 called "The Making of Them". It was watching this that evoked a very strong emotional response in me. I was so overwhelmed by what I saw that I fought tears. I struggled with my own perception of the parent-child bond and how my intuition informs me. Keeping an open mind became more and more unmanageable. The documentary itself is about a number of young boys and watches them and their families as they are sent off to boarding school. We see some of them blatantly suffering emotionally, and others, more stoic, and "grown-up" and having already started the construction of a Strategic Survival Personality. There were many poignant moments. One was when you see one of the mothers at home, denying any hurt that her son may be encountering, stating how good for him the experience is, whilst dotingly stroking the pet dog planted firmly on her lap. Also, one of the stoic little boys, convincing us (or himself?) at how good it is to be so grown up, just like an adult...then proceeds to talk about the red clown nose on his birthday cake in a manner completely befitting of a very young child, juxtaposing what he is telling himself and the reality of his vulnerability.

Afterwards, we split into groups to discuss the film and how we noticed how the children and parents managed their feelings. I burst into tears, and felt an utter fraud. I never went to boarding school. How could I find this so upsetting? This is something I struggled with for a week or so, and went on to examine - what is going on for me in all this? On the one hand, I want to retain a genuinely open mind and not judge the experience of any ex-boarder. Yet there I was having a very passionate response. Every cell of my body was screaming to me that it is wrong to send away a precious child to a school where yes, they may be looked after well, and have a great education and lots of friends (although many delegates at the workshop did not have such experiences), but, WHERE IS THE LOVE?

By the second day, 5 weeks on, I had calmed down quite a bit. We shared our journeys since the last workshop, and most people had had interesting and powerful process.

We talked more about the Strategic Survival Personality and how this translates to character traits, about how difficult it can be to change those traits, about examining whether they are appropriate or helpful traits in adulthood.

We looked at how the young child might learn to deal with the separation, and and what they might be missing out on in being sent away from the home. We also looked extensively at the older boarder, the one who is sent away at age 13, and the effects of being sent away by their parents, the development of sexuality without the safety of flirtation with the opposite sex parent (not restricted to boarders of course).

Throughout the course, I recognised elements of my convent grammar school education in some of the criticisms of the boarding schools. I was not a boarder, but I was affected by a heavily Catholic flavour to the education process. Sanitary towels were bricks that we pinned to our underwear. Our uniforms were the most unflattering, sexuality-repressing garments imaginable (long a-line skirt and deck-chair blazer and faun socks - gorgeous!). The nuns were cold and sometimes cruel. I could identify with some of the issues that the ex-boarders had to face.

Most of all though, I realised that the fact that my mother left the family when I was 13 meant that there were parallels between my experience and that of female boarders sent to board at the same age. Perhaps I was there for this subconscious reason.

Working with Ex-Boarders

So how about working with ex-boarders? Well, much like my GamCare training, which was not about "which technique to use with people with gambling issues", this course was not about "how to counsel ex boarders". The intention, as far as I am aware, was to equip us with insights and awareness around the potential issues that may be relevant to working with this issue. This was very much accomplished.

After the workshop I feel that I have gained wisdom around the issues, rather than information and techniques. Wisdom is so much easier to integrate into the counselling process.



Amanda Williamson Reg MBACP - Counselling in Exeter

Amanda Williamson in a counsellor working in Central Exeter. Please click here for more information.




14 October 2013

Video game Addiction or Poor Time Management?

By Amanda Williamson - Counselling in Exeter





I've been doing a bit of pondering since reading a few weeks ago about the release of Grand Theft Auto 5 and the anticipated endemic of "sickies" as a result of it's release.

I grew up with 4 brothers and a sister, in the 70's and early 80's. Early childhood was about going to the park by ourselves, playing in the garden, waiting to watch the tiny bit of kid's television that was on during allocated slots, and playing with an assortment of plastic and wooden toys. I recall the excitement of one year, receiving both of my either/or Christmas gifts selections - a Bontempi Organ and a Girl's World styling head! (I think that every Christmas has been an anti-climax since then). Hour upon hour of teaching myself to play "Puff the Magic Dragon" on the organ, and how to plait plastic platinum blonde hair...



The first opportunity at video gaming was of course, Pong. I think I first saw it at my Grandparent's house - my uncle is only 4 years older than me so I suspect it was his, although my Nanna was always a bit of a technophile. Of course it's hard to look back in retrospect and fully appreciate just how much fun this rudimentary game was. To the younger readers; believe me it was fun (see the scintillating game of tennis to the right). 




Then one Christmas, when I was around 9 years old, we received a joint Christmas present of an Atari 2600 along with Space Invaders, Pacman, Defender and Asteroids. Wow! We were in gaming heaven (honestly!). Shame we had to take turns with 5 of us (little sis was too young at that stage). Space Invaders was the best, and we worked out a "cheat", by pressing "reset" at the same time as switching it on, which resulted in being able to shoot out non-stop bullets, rather than waiting until the previously fired shot had reached the top of the screen. We busted some records big time with that cheat!

By adolescence I had discovered things outside of the house to keep me occupied, and my gaming stopped. It didn't really pick up again until when I was about 20 and I got myself a vintage Tomy Tronic for a boost of childhood fun, followed by a Nintendo GameBoy when I was about 24. My partner at the time was anti-gaming, so it was a solitary pursuit. Then I had kids, and there wasn't time for such frivolities. I guess you could say that I am hardly a gaming addict then.

These days, I only really like playing games that are so ridiculous, that don't in any way attempt to simulate real life. We're talking MarioKart, Rayman's Raving Rabbids, Wii games, that kind of thing. By the way, this may have something to do with a phenomenon which is currently being researched, that is, the mechanics by which many of us find virtual humans unsettling to look at, known as Uncanny Valley. I can tell even the most HD digital imagery from analog, so I think I am sensitive that way.

But this is really about whether gaming can be problematic, or even addictive, although I have enjoyed a trip down memory lane...

Does video game addiction exist?

Is there such a thing a video game addiction? Is it problematic? Or is it just hysteria. It certainly seems to be a highly emotive topic with people taking quite strong views either way. Here is a interesting paper entitled Problems with the Concept of Video Game "Addiction"  (link broken as of Jan 2024) which seems like a quite balanced and rational sounding argument that there is a lack of scientific evidence to their being such a thing as video game addiction. The case studies involved, by self-professed gaming addicts, seem to involve more of an issues with poor time management and prioritising than of addiction per se.

There also this post on the site Fit Family Together which has a strong opinion on the effects of video games on children. (link now obselete as of Jan 2024). There are some particularly interesting and rational comments on the post, in contrast to the usual trolling that seems to take place on any post expressing opinion.

What do others think?

So I put it out into the social networking world - does anybody have anything to say about video game addiction, or their experience of it? I'm not interested in jumping to conclusions about how addictive and harmful gaming is (although I have been tempted on occasion) so I really wanted to get some level-headed responses from gamers.

Well, one of my brothers responded thus:

"I'd take up too much of your time - I wouldn't know where to begin!!

Does this mean that it is more of a time management issue or an addiction?!

Another of my brothers, Ross (pictured with me above), 40, busy running his own business and raising two young children, offered the following:



"Back in the early 90's as I was locked into the virtual world of Amiga gaming. I have found myself cured nowadays and although an owner of a PS3 and Wii I only ever spend about 20mins per week overall. Video game addiction back in the early 90's was mine and my other brothers' escape from the boredom at that time and as I was not educated very well it took me into a world where visuals and sound would move me in the safety of my own bedroom. It felt wonderful at the time and gave me the release and maybe stimulation one required as a bored teenager that craved input in the mad world around oneself at that time. It's kind of like a drug in a way and one that can sap the life out of you if you choose to stay embedded within that lifestyle- luckily for me it was a phase I was going through but still to this day I find myself invigorated occasionally to play video games and really get lost within the world although I'm older and wiser so now know when to say goodbye rather then spend the wee small hours trying to crack a level or score a winning goal."

I also received the following message from Ben, who has a girlfriend, a responsible job and no kids:

"I don't think my addiction causes me true issues in life or relationships. Both me and the missus are gamers, geeks. We actually met through WoW. So sometimes that's a positive. But I do think that giving so much of your time and energy to something which is supposedly "fun" can make the game a job. I used to do "proper raiding" - pushing for content clearing, dungeons and such, but trying to get there before others. We weren't like the professional gamers, but did raid 4 days a week, 3 to 4 hours a time. With a group of between 25 and 10 people, each with roles and responsibilities, it was a job... but rewarding. However the rewards are fleeting. There is always something "else" to get to. new content, new things. The game (WoW) can't ever be "beaten" as new expansions or patches add new challenges. And that's a definite feed for the drug like aspects. I know I've let past relationships falter because of the game (I "had" to attend X, Y and Z dates every week). I know I've not met "real life" friends for that impromptu drink or catch up, because of something I "had" to get prepared for in the game.
But that was definitely in the past. The game has changed for me, and I take it much more as something interactive to do with a group of people who I do think of as "true friends". I've met most if not all of our guild, in real life. I've travelled around to see them in Europe and the UK. And that's a definite positive. I'd rather sit and play a game for an few hours and chat with people whilst doing it, than sit vegged in front of the TV on the sofa. A game might just be a game, but it can stimulate your mind in ways that TV pap doesn't.
I have chosen to "escape to games" before. It's easy, you are in control of something, where in "real life" you might feel you've lost control. Your character doesn't have to show fear, your avatar can be things you wouldn't be, or couldn't be (and I don't mean engaging in "horrible acts" or strange sexual forays - though I do know both are done). It's in moments like those, looking back, that I think it's definitely an addiction. Like turning to booze or drugs (and I've done both of those before). But it has for me been much less destructive than other drugs. I've gained much more than I have lost."
Here are some words from Brian, a married, working man with three kids:
"Looking back on it, gaming was probably problematic for me for around 10 years, between the ages of 15 and 25. I started gaming when I was age 11. By 15 gaming turned into a social impairment - friends would come around and we would just game rather than interact - gaming became more primary than socialising. At the time I regarded it as a cure for boredom; instant fun. I would play for 2 hours a day after school, and 4 or 5 hours a day at the weekend.
By age 25 I realised that gaming was a hindrance to my development as a person. I felt a bit stuck with it. I had done a Myers-Briggs personality test and it highlighted that addiction might be an issue issue for me. Sometimes I managed to give gaming up for a week, but then would return back to my old habits.

For me, the short term benefits of gaming are:
  • that it gives me a buzz
  • it activates a lot of my brain - I get a chemical hit
  • there is some amazing storytelling in gaming, particularly in recent developments
  • it's fantasy
  • I enjoy problem solving - gaming can be like a puzzle
However, there are drawbacks, and for me, I would say that the main short term drawbacks are that gaming is a distraction from responsibilities, and a distraction from my goals. In the long term, gaming is a distraction from personal development and from long term life goals.

Nowadays I have my gaming where I want it, I can pick it up and enjoy the escape, but I am still able to focus on my responsibilities and goals"

Louis is a 14 year old boy who shares his foray into gaming and how it has taught him some things about himself, and how it has affected his attitude to certain aspects of life such as competitiveness:

"For a large part of my early childhood, gaming was not a thing.  We first got a console when I was about 8 or 9 years old. For me and my brother, gaming was mainly a co-operative thing to us, and I think part of the reason that we enjoyed it was because of the fact that we were both pretty much just as good at it as one another. Due to lack of the practice, it was one of the few things I couldn’t do better than my little brother.

But that didn’t last long, as we soon realised that it was more fun to destroy one another in games, rather than do boring co-operative work. I believe that the reason for this is that spending so much time with one another we had a lot of frustration, but with physical Lego structures or drawings, there was no way to bring suffering without actually doing damage to something, but this was no such problem with video games.

To us, video games were a way that we could play together without making a mess or breaking anything, and also a way to do things to one another that we could never do in real life. (i.e. killing). For a while it was also a fun challenge, and we had plenty of fun with that , but then came the problem that when we lost it wasn’t good. Losing meant that we had to try again, and this was frustrating and time consuming, mainly because we were obsessed with doing it well. Video games brought out our competitive sides, against one another and the AI, and we got angry at the game a lot. This was the peak of the addiction, and it wasn’t always fun.

I think this stopped because of a certain game: Banjo Kazooie Nuts & Bolts, that was very free-reign and not taken seriously. It involved creativity mixed with practicality, and a universal enemy for the two of us, but the thing that made it so special to us is the fact that winning wasn’t really much of a thing in this game: it was getting there. And losing was usually actually funnier. It was through playing this game that we learnt to not take games seriously, as that way you feel no true anger at it, and no need to win, so the desire to play wasn’t nearly so great.

From thence to now, we have enjoyed playing games a lot more, and haven’t craved them nearly quite so much. We are still addicted, but it’s not so bad, and we do it for fun , not because we feel like WE NEED VIDEO GAMES   I find that the games I play, I normally play for a few months obsessively, then get bored of and find a new one. These games normally involve you doing your own thing, and being able to be different to everything else (hello Minecraft, Skyrim, Team Fortress 2 and Don’t Starve).

The Big She (my mother) discourages me from gaming, although allows it for short periods of time. My Dud (sic) is usually working, so gaming isn’t exactly stopped at his house, but he does everything in his power to discourage me. “Isn’t it embarrassing to have spent 200 hours on that game in total?” No. “Don’t you find things like sport and such more fun?” No.
Gaming is something I can do badly and find fun, which is hard to find in other hobbies, and that’s a large part of why I do it.  Most people play video games for fun, and you don’t have to win in order to achieve that. It’s also a good way for me and my brother to do co-operative work against other people (hello again Team Fortress 2) but not have to try hard to succeed, because the whole community shares our whole “We lost….. Yay! that means we did bad! Fun fun fun really who cares lets just play that’s what we’re here for” attitude.

Of course, there are some downfalls (who cares about homework  we can do it tomorrow.) but fortunately I haven’t been as much of a victim to that (lies). But I don’t feel it’s affected me too badly. I have never pulled a sickie though, and as for the whole “Gaming warps your mind balruaghalurah!” thing, my mind feels exceptionally un-warped, so I don’t perceive that as a problem for myself."

It seems to be, from these accounts, that the benefits of gaming are escape, fun or even social interaction for some, and the drawbacks more about time management issues rather than turning into violent, misogynists (although misogyny and video games is another topic that there is plenty of info on out there  and let's face it, is not confined to video games). 

Whether gaming is problematic or not surely depends on the games being played, and whether there is room in one's life to do the other bits and bobs that lead to leading a responsible and fulfilling life.


Frontal Lobe Development

Apparently, the frontal lobe is not completely developed until up to the mid-twenties. The frontal lobe is the part of the brain responsible for long term strategy. It allows us to recognize future consequences of current actions, to choose between good and bad actions, to override and suppress unacceptable social responses".

So perhaps this explains why Brian changed his gaming behaviour, or at least noticed his gaming behaviour when he was 25. There is an interesting post here from Psychology Today on the development of the teenage brain which I think helps explain some of the issues with teenagers, frontals lobes and addiction (in the sense of addiction being a struggle to control behaviour, rather than a clinical addiction). 

I believe that any behaviour where somebody is attached to behaving in a way that impairs their relationships or long term goals, and struggles to stop, even thought they know it is having a negative impact, is an addiction. 

My view 

As a parent, I lay down boundaries on the amount of time spent on gaming. I do believe that it is a parent's job to ensure their child achieves balanced and healthy proportions of everything such as food, caffeine, exercise, school work and video games. Banning the "bad stuff" won't give them any insight into self-control. Explaining why there are curfews will educate them and help them to make informed choices when they are adults. 

If you are an avid gamer, to the point that others in your life may be criticising you for it, ask yourself, are you addicted? What are you trying to escape from? Could you do without it for a couple of weeks?



Amanda Williamson is a BACP Registered Counsellor working in central Exeter, Devon. She has worked with all manner of addictive behaviours, such as addiction to alcohol, drugs, pornography, sex as well as more hidden addictions such as feeling shame, guilt, or caring what other people think too much.

Welcome to Counselling in Exeter






24 September 2013

A Frank Perspective on Panic Attacks

by Amanda Williamson - Counselling in Exeter



I would like to share some thoughts on panic attacks, including some of my experiences as a sufferer which may be helpful for you. Althought it is aimed at sufferers it may also help those that know a sufferer. I did lots of research over the years, to try and get a better understanding of what was happening to my body. I see many people with panic and or anxiety issues, so I thought that I would share what I have discovered.



Have you ever suffered with a panic attack? Do you know what it's like?


If you have never had a panic attack you may find it hard to understand just how horrific and debilitating they can be. I asked what people's experience of having a panic attack was like and got the following responses:



"Like your heart's going to explode out of your chest."



"Bloody awful you feel like your gonna die, legs go weak and you feel as though everything is going grey and no sound... very frightening"


"Your heartbeat becomes audible  - thumping in your ears and chest and throat."



"First your thoughts are like marbles rolling around in your head. They bump into each other and you can not think straight. Then the breathing becomes voluntary instead of involuntary. You think you are having a heart attack"



"It is like being really afraid of something, but you don't know what it is. Your heart is racing, and that coupled with not knowing the cause makes it worse. As it seems to have come from nowhere."




"I thought I was having heart problems and went to the doctor. In the waiting room, a howl crept up from somewhere deep inside and released. It didn't feel like it was me. I then went into hyperventilation and the nurse threw a bag over my face...! I'll never forget it because it was all beyond my control..."




"After losing my Mum and sister within a year I suffered massive panic attacks. Mine were not of the chest pain variety but of an inability to breath without trying really hard to concentrate. The breath would be shallow and very fast where I didn't feel I could take enough air in eventually it would pass but could go on for several minutes and several times in any day."



"I had my first adult panic attack whilst 30ft under water training to get my padi open water diving cert in Thailand. It was horrific and felt I was going to die. I had no control over my breathing or body , I said adult life because after suffering this it clicked that when I was a little girl at bed time I would get panic attacks but I didn't know what they were until I had that same feeling in my adulthood. They now manifest themselves when I least expect them. I can't swallow so start to panic then my breathing goes and the fear of this happening in front of people makes the feeling like a wave even worse. I have experienced violent shakes & cold sweats flu like feeling... it's all incredibly emotional , you feel you have no control." 


I used to think that I knew what a panic attack must be like. I had friends and acquaintances that suffered with them and thought to myself "That sounds a bit horrible" as well as secretly asking myself "Can't they just use rational thought to calm themselves down?". Well pride comes before a fall and I did end up going through a phase of suffering with panic attacks about 8 or 9 years ago.


The Ride of Doom

The first one happened in one of those "fun" simulator rides which consists of a moving, enclosed box in which you sit in the dark, facing a big screen with some sort of motion based movie of a racing car or rocket ride. The ride started and I immediately felt very sick and wanted to get off straightaway, except there was no way of doing so. The nausea was accompanied by a feeling of intense panic. I groped around in the dark for some kind of emergency stop button but there was nothing. The ride was full of people and I didn't want to let it be known that I was petrified so I panicked in silence. The feelings were incredible, like nothing I'd felt before. I felt like I was going to die of fright. It's hard to explain just how convincing that feeling is, but at the time, the only thing that could explain the intensity of feelings was that I was, in fact, about to die.

I didn't die, and when the ride eventually stopped I disembarked, looking around at the cheerful and excited expressions of my fellow riders. I was obviously alone in my terror. I vowed never to go inside one of those rides again.


The Tent of Doom

Then I had an attack in a tent in the middle of the night, in the middle of a field on Dartmoor, in the pitch black darkness. I couldn't find my torch so the panic rose and it was as intense as the time before. I started to take solar lights camping with me from that point onwards.


The Flight of Doom

After a very early morning (aka middle of the night) start I joined the mightiest check-in queue and nearly missed my flight. Once on board, panic started and by the time we took off, I was having a full blown panic attack, racing to the loo, eyeing up the other passengers to see who might have a Valium (having NEVER touched a tranquilliser before in my life). I considered jumping off the plane. This is after years of flying with no issues whatsoever. The flight was miserable and my holiday was blighted with the knowledge that there was no way I ever wanted to set foot on a plane again. I ended up finding a local doctor who prescribed "Trankimazin" (alprazolam - a benzodiazepine). So I did make it home.


The Caves of Doom

During the above trip, following the flight of doom, I went to visit an extensive network of underground caves. I'd always loved visiting caves and never felt claustrophobic or the slightest bit nervous. However, after the flight, I was in a heightened state of anxiety and wondered whether this would affect my willingness to be stuck underground. After quite a long queue I finally shuffled with the crowd down into the caves. The moment I was in I felt rising panic, felt like being sick, turned white as a sheet (apparently) and very quickly, almost automatically, bolted out as quickly as I could, passing the guards who, through their utterances, made it be known that the Spanish word for claustrophobia is pretty much the same as ours.

I sat in the car for a couple of hours, texting friends, nipping to the loo frequently, and trying to come down from the horrific onslaught of chemicals that my own body was flooding me with.


The Mobile Phone Shop of Doom

Things were really bad by this time - I ended up having to switch mobile phone provider because the Orange shop was too narrow and dingy (and orange). The service desks were at the back of a particularly long and narrow mini-shop. I switched to Vodafone who's shop was wide and light and I could breathe properly in there. I realised that this was nuts.


So why am I telling you all this?


Well, after suffering numerous panic attacks in various situations my lifestyle was being impeded and I felt terrible about it. I saw my GP who suggested relaxation techniques and counselling. I did see a hypnotherapist/counsellor who helped me to feel calmer, although I did continue to suffer in certain situations.



The Coach Trip of Doom

One particularly awful attack happened on a coach trip to London. I was going down with the flu, and had prebooked an early morning coach. This coach was driven by a woman who had to stop the coach once an hour to have a cigarette. To make up time, she was speeding in between breaks, and the coach was hurtling down the road, with her accelerating and braking like, well, like a really bad driver. I felt travel sick and very panicky. Because the ride was so long (over 4 hours) my panic attack just went on and on. I felt like I was in hell. Eventually, I lost all sensation in my right arm and my hands went numb. I was in a right state.

These incidents are just a few of many instances which I would describe as constituting a full-blown panic attack.  Eventually I started to notice a few things about my attacks:


  •  They often happened when I hadn't slept enough and/or eaten properly (certainly true for the ride of doom,  flight of doom and coach trip of doom
  • The consumption of a strong coffee often preceded daytime attacks (applies to ride, flight, caves, mobile phone shop and coach trip of doom)
  • The situations pretty much all involved some kind of change in the air I was breathing (more about this below as there is a theory about an increase in the level of CO2 triggering panic attacks)
  • They were worse, and more frequent, in the Winter (ride, flight, caves, mobile phone shop)


Here are some things I've learnt, and which I have applied and which have improved my quality of life considerably:

Why can't we talk ourselves out of panic attacks?


Our survival system is being triggered. The centre of this system is our brain stem which is the oldest part of our brain, often referred to as the reptilian brain because it's all about instincts. Emotions aren't even allowed a look in here (at least not in the immediate moment), and certainly, rational thought has a way to catch up. When it comes to survival we need instant responses, so our efficient systems, when sensing danger, fling us straight into flight-or-flight mode. You can read more about "fight or flight" here. We can apply rational thought afterwards, but by then, with the onslaught of panic feelings, it might be hard to access reason, when our bodies has just been telling us we're about to die. The centre of rational thought is our frontal lobe, the more recently evolved part of our brain. It takes longer to apply rational thought than to instinctively rip our hand away from an open flame. It's quite a good design really. We'd die a lot sooner without it. But if it's triggered unnecessarily, then it's no fun.

Don't be hard on yourself. You aren't weak or feeble. For some reason, you are having an involuntary physiological response to a hard-wired survival system.


Caffeine can make hypersensitive individuals more anxious

I suspected that caffeine was really not helping me at all. Then I read a paragraph on caffeine in the textbook "Abnormal Psychology" where they starkly lay out the facts about caffeine and it's effect on the sympathetic nervous system. As we all know, caffeine is a stimulant and it affects us by increasing our heartrate and brain activity. Our bodies respond by releasing adrenalin, which is the "flight or flight" hormone, which may be enough of a trigger for people who are prone to suffering with panic attacks. I knew that I was very sensitive to caffeine, and too much would make me feel jittery, but I was also very addicted. If I didn't get 2 good strong coffees a day then I would suffer terrible withdrawal headaches. I had a sneaking suspicion that giving up might help me. Most people can consume caffeine without any problems but for hypersensitive individuals, the physiological changes that caffeine induces may contribute to or trigger a panic attack.

It took 3 weeks of making gradually weaker coffee. The headaches were manageable but I did notice that I seemed to need a lot more sleep at first. This did pass and even now, over 4 years later, I do not miss the groggy, caffeine withdrawal feeling of early morning. I also have hardly any panic attacks. In fact, it's close to zero, but I did have one this year, which I go into below.

 There is a well written article here on the effects of caffeine on our bodies.

Could your panic attacks be caused by or contributed to by caffeine consumption?


Blood sugar highs and lows can impact on susceptibility to having panic attacks

When blood sugar levels are low the body responds by releasing adrenaline, which as we've already established, is the fight or flight hormone.  Many people inflict roller coaster blood sugar levels on themselves, by skipping meals or making poor dietary choice when it comes to the energy our food provides us with. Some of my panic attacks have happened on an empty stomach.

Having a strong coffee on an empty stomach is a particularly good way to induce anxiety in me.


Alcohol and anxiety

I can't really mention blood sugar levels without mentioning alcohol, which sends our blood sugar levels plummeting, especially the morning after. I know of many people who have said that with a hangover comes heightened anxiety. The NHS mention it here in their advice on dealing with anxiety.

Have a think about your diet - it can be very helpful to keep a food and drink diary to see if there are any links between what you are (or aren't) eating and drinking, and the occurence of anxiety or panic attacks.


Carbon dioxide sensitivity

I had wondered whether it was the change of air that sometimes triggered an attack. I did some research at the time but, at the time, there really wasnt that much available on the internet making the link between CO2 levels and panic attacks. There's a lot more out there now, although there are no hard and fast answers. The theory goes, that certain individuals have an increaesed sensitivity to increased CO2 levels in the air. So, looking at my doom list, we can see that to a certain extent, my experiences could involve that:


...even the titchy Orange Shop might have had elevated levels of CO2.


This explains why people feel claustrophobia in elevators AND large, packed shopping centres.

There's an interesting blogpost here on the link between CO2 and panic.


Stress

So this seems obvious I suppose, but having stressful occurrences can lead to panic attacks, because the stress has caused the body to go into a state of hyperarousal. This can be a result of Post Traumatic Stress Disorder, or a huge stressful event in your life such as the death of a close family member, divorce, work problems, relationship problems...you get the idea.

Some people end up with depression, others end up with anxiety and/or panic disorder. Unfortunately for some individuals they may have both.

Stress has definitely been a contributing factor in my experience of panic attacks. It can be hard to avoid all  stressors; sometimes we are going to have really difficult challenges in life and we need to be able to look after ourselves to navigate those times. You've heard it all before but my GP was right - relaxation tapes, meditation, counselling...these all can help to reduce the physiological responses to stress. I also recommend exercise and mindfulness. Mindfulness is a really good way of learning to listen to your body and stop the racing thoughts that may be plaguing you. You can attend mindfulness classes, or read books, listen to tapes, watch videos on YouTube.


Can panic attacks be "cured"?

I believe that certain lifestyles adjustments can be made to reduce the frequency and intensity of panic attacks. Or at least, these things worked for me:


  • Giving up caffeine
  • Eating sensibly and not skipping meals
  • Making sure I get fresh air where possible 
  • Counselling - this really helped me, so much so that I trained as a counsellor 
  • Sorting out my SAD (see my SAD article here)
  • Reading about it and understanding the phenomenon (here's a good book)

I did have a panic attack fairly recently, in an underground metro whilst abroad. This was the first one in a very long time. There were, I think, various contributing factors:

  • I had been going through a very stressful situation
  • I had received a highly stressful phonecall the night before and had had a sleepless night
  • The air in the metro was incredibly stuffy and, here is an article stating that CO2 levels are actually 20-50% higher on underground metros)

This was the first in a long time. It hasn't worried me. I have a good understanding of what was behind it. It wasn't very pleasant, but it wasn't anywhere near as bad as when I had no idea what was happening to me.

Maybe there are steps you can take to reduce the frequency of your episodes and/or the impact of them.   I sincerely wish you all the best in dealing with your panic.


Amanda Williamson is a professional counsellor working in central Exeter, Devon.












5 August 2013

Do Counsellors Need Counselling?



I am a counsellor. For the majority of my working day I am counselling people.

I also have a counsellor.

This fact sometimes surprises people. I don't make a habit of disclosing this to my clients, as quite clearly, they are paying for me to pay attention to their issues, not mine. But I am not defensive or scared about self-disclosure, and if asked, by a client or otherwise, I have no problem in sharing that I do see a counsellor from time to time.

Sometimes I am asked why. I thought I would share my reasons...for clients, fellow counsellors and the interested layperson to know, should they want to:

Therapy as a trainee

As part of my Advanced Diploma in Integrative Counselling, there was a requirement to engage in a minimum of 40 hours of personal therapy whilst in training. This is typical for many counselling courses but is not a requirement of the BACP. It is an opportunity to engage at a deep level with the lifestyle changes and issues that becoming a counsellor involves. I witnessed huge personal growth in many of my peers whilst we trained together. Part of the training involved practising on each other, with real issues. However, these mini sessions were only 20-30 minutes long, and anything that did come up in that time, could be safely taken to our personal therapist should the issues be requiring of more attention. It was a good experience in learning the value of what we do in our profession.

Putting my money where my mouth is

My hope, in being a therapist, is that people will be able to explore facets of the self that are impacting on their lives in a way which isn't helpful or wanted. This involves deep exploration of the psyche. This can be painful and/or excruciating work. How can I expect my clients to do this if I am not prepared to do likewise?

Keeping "my stuff" out of the therapy room

As a bog standard human being, I do encounter difficulties in my personal life just like everybody else. There may be illness, grief, stress and all manner of human experiences that I am exposed to. To be present with a client I have learnt to put those things "on the back burner" whilst counselling. Having done well over 1000 hours of counselling I am well practised in doing so. Some of these times are more stressful or challenging than others. During those times I will probably see a therapist weekly, so that I can discharge the emotions that the life events may be bringing up, which makes it much easier to put those things on the back burner. If I were to continue counselling other people, and not have an outlet for "my stuff" I would worry that not making the space for it outside, may affect my fitness to practice. Fitness to practice is something that the BACP Ethical Framework takes very seriously, and with good reason.

Continued Personal Development

I want to be a truly open minded person but, as a human being, I am blighted on occasion by prejudgements and misconceived assumptions. I see personal therapy as a way of continuing my personal development, to round off the continuing professional development I engage in.

Do you have any thoughts about counsellors having therapy?

Amanda Williamson is a registered MBACP counsellor working in central Exeter, Devon. 




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