Research supports the anti-panic measures

Research supports the anti-panic measures

I have written recently about the 5,4,3,2,1 exercise and the Strengthening Exercise devised by Captain Tom Bunn for nervous fliers and useful also in non-flying situations where the nervous system is challenged by fear. I thought you might like to hear about the research that supports the Strengthening Exercise so here is an excerpt from Captain Tom’s newsletter.

“When facing a challenge, an attuned and non-judgmental person can help us approach the situation with less anxiety. The parasympathetic nervous system (the system that calms by neutralizing stress hormones) is activated by the face, voice, and touch of such a friend – or by the memory of their face, voice, and touch. SOAR has helped countless people fly by linking the memory of being with a calming person to challenging moments of flight.

New research shows that having a calming friend in mind is as protective against stress as having the friend physically present. At the University of Arizona, 102 participants were put in a stressful situation. The participants, all of whom were in a committed romantic relationship, were split into three groups.

During stress, one group was asked to think about their day. A second group was asked to think about their romantic partner. The third group had their partner present. Both the second group and third group had lower blood pressure than the first group. Not only that, the researchers found no difference in the response of the second and the third group. One of the researchers, Kyle Bourassa, said “It appears that thinking about your partner as a source of support can be just as powerful as actually having them present.”

“Life is full of stress, and one critical way we can manage this stress is through our relationships — either with our partner directly or by calling on a mental image of that person,” Bourassa said. “There are many situations, including at work, with school exams or even during medical procedures, where we would benefit from limiting our degree of blood pressure reactivity, and these findings suggest that a relational approach to doing so can be quite powerful.”

As many readers know, in the SOAR program, we control high anxiety during flight by linking each challenging moment of flight to a person who, physically or psychologically present, activates the parasympathetic nervous system.

In day-to-day living, we can reduce stress by doing this three-step parasympathetic activating exercise:

When you notice stress,

  • Imagine you see a friend or a romantic partner come into the room.
  • Imagine hearing the person greet you.
  • Imagine the person comes over and gives you a friendly touch

By repeating this exercise each time you notice stress, you will establish a program in your unconscious procedural memory that will unconsciously calm you when stress arises.”

 

I hope so much that this will help others like me to cope better with daily challenges and to extraordinary challenges such as flying or other phobias. Please contact me direct if you would like to work on these issues with psychotherapeutic support.

Fear of Flying or Just Plain Fear

I wrote recently about the  5,4,3,2,1 exercise that Captain Tom Bunn describes in his book Soar and quite a few people have told me how they have successfully used it, not for flying but for other tricky experiences where our nerves can make life hell. Making Christmas Dinner under your mother-in-law’s critical eye. Driving on the motorway when you don’t like motorways. Waiting for an interview or an audition. Asking for a pay-rise. This simple exercise can interrupt the production of adrenaline which fear produces but which isn’t needed in those situations. Famously adrenaline is invaluable when you meet a tiger in the jungle. It give you the oomph to run away faster than you ever knew you could. However situations where no running away is going to be possible, all it does is wind you up, freeze your brain so you can’t answer simple questions and ruin your breath control so you can’t control your voice. Its effect is also cumulative. If the body cannot discharge or use up the adrenaline by direct action (shouting, running away, hitting someone) it builds up and the message gets through that there really is an emergency and more adrenaline is needed!

Today I have come back to tell you about Captain Tom’s other seminal exercise, designed for nervous flyers (read terrified) for whom other approaches have not worked. I can testify that this has brought my flying experience (six flights in the last 9 months and counting) well within the realm of bearable, sometimes even fun. It has also come into its own at the dentist’s and for you there may be other areas of your life where terror tends to win over common sense because the body is out of your control.

The second exercise is called the Strengthening Exercise and you need to practise it once or twice to learn it and then for a week or so before the challenging experience is coming up. (Incidentally you don’t need a week. I had two days and trust me, it works.) It is hard to believe that it will work for you but if you take a peek at the Fear of Flying website you will see hundreds of testimonials from people who didn’t believe it would work for them but did the exercise anyway (desperation is a great motivator) and now fly confidently.

The Strengthening Exercise is based a moment in your history when you had a deep empathic connection with someone. You knew about the empathic connection because of the eye contact you had with them in that moment. You felt you were the only person in their world at that moment. Bringing this moment of deep empathic connection to bear on the feared experience dispels the terror. Technically the visualisation of that moment produces oxytocin in the body and adrenaline production is inhibited. Oxytocin gives us the courage to connect deeply with others and we feel completely unafraid. Oxytocin is the enemy of adrenaline. They cannot both be produced at the same time.

The moments which produce that magical oxytocin are many. When you were just about to make love for the first time and you looked into each other’s eyes, when you were feeding your new baby or exchanging a look with your child are likely to work. Simply catching the eye of someone who makes you feel in that moment that you are the centre of the universe is the moment we are looking for. It DOESN’T MATTER what happened next!  if the relationship went on to be a disaster or if the person has subsequently died you still have the benefit of that moment and you can use it today. What matters is getting in touch with that feeling the eye contact produced. If you can, find a person. If you can’t, you may remember a moment of deep eye connection with a pet. Use that. When you have identified such a moment or two or three, what next?

If it really is flying you are dealing with I recommend you buy the Soar book because it conveniently lists all the various stages of boarding an aeroplane, taking off, flying, landing etc. You are going to connect that oxytocin-producing moment to the stages of the experience in your mind so the first thing you need is a list of the stages. If it is, for instance, going to the dentist, this is what you do. Make a list of every minute stage of the experience starting with walking out of the dentist’s surgery with a big smile on your face because it’s all over. Then work backwards to making the appointment. Your list for having your tooth filled might look like this.

  1. Leaving the dentist’s surgery
  2. Paying the dentist’s bill and saying goodbye
  3. Putting your coat back on
  4. Getting up out of the surgery chair
  5. Having that final rinse
  6. Hearing and feeling the dentist take his hands and equipment out of your mouth for the last time
  7. Feeling the drill polishing up the new filling
  8. Feeling the dentist put the putty in your tooth
  9. Having another rinse
  10. Hearing the drill stop
  11. Hearing the drill start again and opening your mouth extra wide
  12. Hearing the drill stop and having a rinse
  13. Having the drill in your mouth
  14. Opening your mouth extra wide as the dentist leans over you to begin work
  15. Feeling that parts of your mouth have gone numb
  16. Resting while the anaesthetic takes effect. Chatting with the dentist
  17. Feeling the anaesthetic injection go in
  18. Opening your mouth extra wide for the injection
  19. Letting the dentist find the problem through examination. Telling him what has happened
  20. Having the bib put on by the nurse
  21. Sitting down in the chair
  22. Taking your coat off
  23. Being called through into the surgery
  24. Sitting in the waiting room
  25. Talking to the receptionist
  26. Entering the surgery building
  27. Travelling to the surgery
  28. Leaving the house
  29. Getting washed and dressed
  30. Getting up on the morning of the appointment
  31. Going to bed the night before
  32. Waiting for the appointment day to come
  33. Making the appointment
  34. Noticing you need to visit the dentist

 

You can add to this list as many stages as you like. The more the better. Make a small photo in your mind of the first stage of the experience and imagine that loved person is holding it next to their face as they make that fabulous eye contact with you. Make the photo black and white and small. Make the experience of the eye contact live in your whole body. Then move on to the next stage and so on right through to the very beginning where you are making the appointment or booking the flight.

If you lose track don’t worry. Start again.

If  imagining yourself in the chair or on the plane produces more fear than you can handle you can imagine your favourite cartoon character in the photo instead of you. Cartoon characters, you will have noticed, come out of every situation unscathed. Imagine Micky Mouse in the picture, or Spiderman or Pop-Eye. Put your whole mind into this as you go through the stages. You are retraining your amygdalae, desensitizing them, to accept the experience you are working on as routine, non-threatening, nothing to get excited about. You are sending the message that you are safe.

On the first day do the exercise two or three times and then fewer times over the subsequent days. Don’t worry about it in between. The magical effect on your body responses will show up when you begin the actual experience.

If you suffer anticipatory anxiety, use the 5,4,3,2,1 exercise to dispel it as often as you need to. On the day use both exercises.

This is the kindest way to help yourself with fear and it builds on itself so that it gets easier. Gritting your teeth and giving yourself a good talking to is unkind and the fear does not go away.

I’d love to know how you get on.

Stormy Weather

Stormy Weather

About two months ago things went wrong for me visiting Lisbon for a wedding.  I ended up in casualty with a bad UTI and when I eventually saw the twelve year old doctor and got my hands on some antibiotics (you could get Ecstasy easier) I thought that was that. But no. There has been pain and panic ever since.

A major attack of IBS followed and by the time I was back in England a horrible burning pain in my side which especially played up at night when I had all the leisure in the world to worry about it. A trip to casualty in England (and let me tell you Lisbon makes the National Health look like Los Angeles) established that it wasn’t a kidney stone and then they sent me home with the pain which was now a hundred times worse courtesy of lying on the scanner and worrying.

The moral of my tale is twofold. Doesn’t worrying make things so much worse (and actually produces physical sensations to order)? Secondly cause and effect is usually so much more complicated than we imagine. After months of osteopathy I was still not able to sit and meditate nor go to my piyo classes. I foresaw a future of sloth and a balloon shaped me wearing shapeless dresses. Utter misery. I tried meditating lying down and other versions but it wasn’t the same. Opening the French doors and sitting on my cushion, semi-exposed to the elements, has become a precious way to start my day and I was very sorry for myself contemplating that this might be a thing of the past. Also I had a wardrobe full of clothes I felt too bloated to wear.

Gradually I came to accept what the osteopath gently broke to me : there was a disc involved which was causing referred pain. I can’t tell you how I fought against this diagnosis but I did stop exercising and it did stop being absolute agony and reduced to miserable. But I also realised that the IBS was also still shouting its head off. So I have stopped looking for one simple treatable-give-me-a-pill-or-an-operation cause. As ever it is my spine and my bowels playing up under stress. So not even the glamour of something serious.

I am sharing this with you (and you may well say I am sharing way too much) because it can really help to stop looking for a cause and resign yourself to kindness and forbearance as a way of treating things (once serious illness has been ruled out by scans and so forth).

Arriving in Venice yesterday in stormy weather (see picture) I felt the stress fall away and this morning I did some yoga and obtained some clicks from my poor spine which may just have set things on the mend. There was no hurrying this – I just had to wait and to all those who have put up with me patiently while I learned to wait : Thank you!

I’m not sharing a new recipe today but I include photos of porridge in its different guises, sweet and savoury and risotto which seems to help the IBS big time.

 

 

New Year New Ideas

New Year New Ideas

I can see how my entire life would have been a lot jollier if I hadn’t had a total aversion to things which did not come easily to me. The feelings of shame, disappointment, frustration, self-hatred and defeat which crop up when I get things wrong have separated me from achievements within my grasp. In fact I have watched others with less skill walk past me just because they were prepared to learn. Here’s my new year’s quote which is going up on flashing lights on the kitchen wall :

‘Say to yourself : but what if I’m wrong about everything? It is from this place of suspension of belief that you may begin to listen to her.’

Now this excellent advice was from a dog trainer and the ‘her’ he was listening to was a Pug! But it came up in an article about psychotherapy because it’s a very good starting point for a therapist who is learning to listen to clients. In 2018 I have the idea of approaching myself like that, with my ears open. Let me rephrase slightly :

What if I’m wrong about everything? It is from this place of suspension of belief that I may begin to listen to myself.  

So I shall start in the kitchen now that my food production is scaling down from the industrial (Christmas) proportions of feeding 12 people three time a day to the more normal one or two, there will be less firefighting and more space to make mistakes. I feel happy enough in the kitchen to experiment with assuming I am wrong about what I can do and what I can’t do and opening my heart to truly new experiences. One of the wonderful cookbooks I received for Christmas (yes, my family know me well) is Salt, Fat Acid Heat by Samin Nosrat and this will be my workbook because this is not the kind of cookbook I would buy myself.  It’s about technique and a rather scientific approach to cooking which is an area where I feel less able. Give me a book with lovely pictures and I will produce you my delicious versions of the food which I can rarely recreate exactly because I don’t measure or time things. Diagrams of salt absorption? Scientific explanation of how different fats affect pastry? That’s not me at all. Except, turns out, it can be. It is.

Because Samin has written the book so engagingly and encouragingly I am gripped by learning how to use salt properly, by different types of acid and what they are for. This book is for accomplished cooks and for beginners and it is a delightful read. I begin to hope that it will genuinely increase my skills without impinging on flair and imagination. First I have discovered that I can bear to become aware of the areas where I lack skill – and that is no small thing in itself – I generally cover them up with a passion for aesthetics. But the truth is I would dearly love to be able to the tricky, technical things  that I see others do and it just may be that 2018 is the year when I can learn. Watch this space.

Now I’d like to share with you another recipe from Nadine Redzepi’s delicious book which I have to say I adapted to my time schedule and the ingredients I had to hand and you may want to do that too. (The ingredients in brackets are my substitutions or suggestions).

Or you may want to take the trouble to muster the right ingredients before you start and take the time to follow the recipe exactly. Steering a healthy, creative, pragmatic and kind line between these two approaches is experimental work in itself.

Beef-Glazed Celeriac with Buttermilk Sauce

Celeriac – this is the main ingredient so for 4 people you need about 2 and a half pounds or a kilo

Rapeseed oil (or other neutral oil)

Beef or veal demi-glace 240 ml (and here is how to make a vegetable equivalent)

(beef demi-glace is a finishing jus sold in sachets in Waitrose and doubtless many other places. Or you could make one. The point is that it is full of umami flavour so if you’re vegetarian you will need to follow the steps on the link above to make a vegetable umami bomb. This time a few teaspoons of Marigold is not going to hack it. And if you can’t do that I would try some toasted sesame oil brushed on instead of a jus. It should produce something of the richness effect. Add a little liquid at the same time.)

pine nuts 3 tablespoons

salted butter 200g

curly kale, 2 large leaves (or any substantial green vegetable such as broccoli, chard or what you have in)

Parmigiano-Reggiano cheese 2 tablespoons freshly grated

Buttermilk 60 ml, preferably full fat

(I used kefir as I didn’t have buttermilk)

flaky sea salt and freshly ground black pepper.

 

Method

Preheat the oven to 180 or 160 with a fan. Peel the celeriac and chop into 4 slabs each about 8mm/3/4 inch wide. (I made mine too thin the first time). Save the other parts of celeriac for soup or puree.

Grease a baking dish large enough to hold the pieces in a single layer.

Turn the slices to coat them in the oil and cook for 30 minutes before turning over and cooking for another 30 minutes.

Raise the oven temperature to 200 and pour over the demiglace. Continue cooking and basting for another 20-30 minutes. Add a drop of water if it gets too dry.

Meanwhile toast the pine-nuts dry in a small frying pan.

Melt the butter and whisk over the heat until it turns a lovely nutty brown. Keep warm.

Fry the kale in small pieces, discarding tough stems, in the pan used for the pine nuts and some of the oil. Drain on kitchen towel. (I added a few chilli flakes to the kale but probably better without.)

Sprinkle the parmesan over the celeriac for the last few moments in the oven.

Stir the buttermilk into the browned butter over a gentle heat and arrange on four plates. To which add slices of celeriac and a garnish of kale leaves and pine nuts.

This dish was totally unexpected and wonderful. If you are not vegetarian do make the effort to get the demi-glace or jus. The celeriac becomes a truly meaty and different vegetable under its influence.

 

Apple Poem

All along I was the apple after all.

I thought I was the label. Blemish full of information

That increases my appreciation of the apple

Not one jot.

 

Apple meanwhile,

Broad, beaming and generous,

Tolerates the sticky label

With sublime serenity

Like an elephant disregarding a tic.

 

Busy with narrative, the tic

Is hero in his own story.

The elephant, like the apple, is

Too absorbed in being itself

To make correction.

 

Realising my mistake

I feel full of goodness.

My mind, entirely at peace with my apple-i-ness,

Is no longer compelled by the words on the label,

Even though I still haven’t made all of them out.

 

Put away the magnifying glass

And the dictionary.

All the label does is point to the apple

Like that finger pointing at the moon.

Making Friends

Making friends is what we first learn to do when we go to school or kindergarten. Anxious mothers ask that first question when we come home, ‘Did you make friends?’ Friends make the strangeness less strange, the frightening less frightening. New experiences with friends are an adventure, exciting rather than daunting. Eating, shopping, travelling, going to visit a garden or a museum – these things take on a much greater significance when we do it with friends. Friends make a little ceremony possible over a cup of coffee where on our own there was only the humdrum. Friends support us in our celebrations and our grieving. The lovely photo of the two friends above is by Survival International which works for tribal people around the globe. You can buy it as a Thank You card which feels especially appropriate since gratitude is an emotion closely allied with friendship.

Friendship seems to be an important part of being human and much of what I observe and write about concerns making friends with ourselves, treating ourselves as we would a much loved friend. Instead of chastising us for failing, a good friend would feel for us, might encourage us to try again, would honour the hard work and courage involved, the good already achieved. Focussing on what is not yet within our grasp and what we cannot yet achieve is not friendly. When positivity is needed a friend knows what to do. When a few home truths are what is required a friend will find a way of sharing them without shaming or humiliating us. This ideal friend is just the friend we need to be to ourselves!

And here’s a strange thing I have marvelled at over the years I have worked with clients : the more like that ideal friend we can be to ourselves, the more our friends will also be like that in the outside world. It seems unfair but inevitable that the world treats us like we treat ourselves. I have lost count of the delightful people who have sat in my room and told me, sometimes directly and sometimes indirectly, how mean they are to themselves. Very frequently those people have ‘friends’ and relatives close to them who are also mean to them. For some reason not clear to me, when our internal world is full of shame and punishment we find it out there too, in our jobs, in our yoga class, our choir, our team and in our intimate relationships. When people are being mean to you you don’t want to hear that the remedy might begin with how you treat yourself in the privacy of your own head. I say, ‘Try it and see.’

But what if you can’t shake off that chastising voice in your head? What if it’s there as soon as you wake up or even in your dreams. Some of us feel inadequate all the time and agree with the voice that we never live up to our own expectations. Then we have to make friends in a different way. We have to make friends with our experience even if that experience includes a mean, judging voice. Imagine you are minding a group of children in a playground. They are all playing nicely and being no trouble except for one who’s upsetting everyone else by taking their toys and acting mean. You have to include her in your care for the group because exclusion only leads to more trouble and more work. (Yes, a pity schools don’t take this line but exclude everyone they find difficult …)

The more we include the mean side of ourselves in our care for ourselves the quicker it ceases to make trouble. The important thing to remember is that you are bigger than that mean little person inside who needs taking care of just the same as the rest.

No recipe today, I’m afraid but stand by for a post about fermentation which I am completely new to. It looks like a fabulous way to introduce more healthy bacteria into my gut as well as using up the remaining vegetables from the garden before winter.

 

 

The Search for Honey

This is another story that tells of turning away from our habitual defences and the courage of trying something new. See what happens when we tread a different path : this is really the whole of psychotherapy.

 

At last I can wait no longer and I put on layers of clothing and open the door. I have to take off my gloves again to force the door which sticks and I hurt my hand getting it open. The wind near tears the door off and outside the bleak landscape is uninviting. My mouth is full of yearning and cursing; the hunger is insatiable now. My house was built long ago with wood from the tree of wilfulness and I leave it as little as I can. The tree still grows outside my door. Its fruits are bitter but I use the wood for the fire. It makes a poor fire but the wood is plentiful.

I venture out onto the hard beauty of the tundra and after a wearisome walk of some hours, encumbered by the thick clothes woven from pride, I find a small parcel of honey in a ruined building. I hurry back to the safety of my mean home where I give the honey to the children of my need and take some myself. The sweetness of giving the little ones honey gives way, when they are asleep, to the relief of filling my own mouth with what is left. The small fire has gone out. I fall asleep in the cold, bundled in most of the clothes I own, with sugar on my lips.

But sooner or later pride and wilfulness are not enough to keep the need at bay and I must brave the journey once more. Each time I must go further. Each time there is the fear that all the honey is gone. Each time the children cry harder.

And then, after years of such journeys a different thing happens. One day the needing takes me further from home, further into the cold than I have ever been before. The fear is great. I may freeze before I get home again to the cold comfort of the drafty hut and the smokey fire. I worry even more about the children.

My steps are heavy in my old boots and I pass the many ruined buildings where I have found sweetness in the past. These ruins are my friends and lovers of old and I pass them quickly for they hold nothing for me now. Their sweetness is exhausted.

After miles of slowgoing I can see another barn or such like ahead. Out here I am so far from the settlement that it is unlikely already to have been raided and my spirits lift with unbearable hope. My breath is short and my steps quicken. I do not feel the cold; I can see already the smiles of my children as I hand them the honeycomb later tonight; I can feel the stickiness on my tongue, the fullness in my mouth, the brief orgasm as I swallow. Don’t think about that.

And I am in luck. In a forgotten corner of this hay-barn is a jar of the sweetness I so badly need, the sweetness I do not know how to make. There is a relaxation within as I know that the need will shortly be assuaged, that my mouth will be full. I secure the jar in my top coat, tighten my scarves around my face, put on my gloves and step outside once more.

This way lies home. But see, the other way, the snows of make-believe autonomy and wilfulness run out and the bare earth is showing. I have never seen the earth before lying naked and unprotected by the snow. Here it is not frozen to stone as it is where I struggle every year to plant the terrible vegetables we must live on. Here there is mud instead. I am fascinated and I walk a little further away from home to see what I can find.

But the mud turns to mire. A man-made hell of unwanted rubble and shit emerges. Junk lies in dark oily puddles and there is scarcely anywhere to put one foot after another. I will never get my boots clean again. This is where I keep my blackest thoughts, thoughts of shame and murder and revenge and hope and self-harm. It is ugly here beyond imagination. This is why I live in the pristine snow where the suffering is less. 

I am pondering this long-forgotten decision when, beyond the mud, I see a fence. It has no doors or gates in it but it is a temporary fence such as builders erect around their work to keep out trespassers. The panels of the fence are not solid, nor are they heavy but every metre or so they are held in place by metal blocks of unimaginable weight. Each panel bears a picture of me and in every weight I see a refusal to forgive. I stand in the black mud and worse and contemplate the fence. Each weight had to be forged from the metal of unforgiveness and dragged into position. I remember each instance with an effort, each instance where I closed my heart with deliberation and turned away from forgiveness, away from the awful suffering of compassion. 

The sad work of erecting that fence took years and I called it growing up. 

Eventually I think to lift my eyes from the ground at last and I am overwhelmed to see, above the fence, the pink and gold domes of San Marco. The warmth, the pleasure, the plenty of Venice awaits there, within sight. I can hear music and laughter, like a party. Venice is like a party and I recognise that this is my heart, my journey’s end. The pink and gold domes sparkle in the sunlight with an inexhaustible supply of honey and I remember that within it is dark and private. Inside the cathedral there is the glimmer of the everlasting flame reflected in the ancient, gold mosaics which celebrate the deeds of the saints. There is the jewelled altar screen and an eternal holy singing and the smell of incense as the Blessed Sacrament is offered for adoration.

I begin to pick my way through the mire towards the singing.