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Transcript of Www.drbrianott.net Anxiety: Body, Behavior, and Beliefs Brian D. Ott, Ph.D. Massachusetts General...
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
Brian D. Ott, Ph.D.Brian D. Ott, Ph.D.
Massachusetts General HospitalMassachusetts General HospitalHarvard Medical SchoolHarvard Medical School
Massachusetts School of Professional PsychologyMassachusetts School of Professional Psychology
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Audience ParticipationAudience Participation
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What just happened?What just happened?
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
• Body ResponseBody Response
• Behavioral ResponseBehavioral Response
• Beliefs Beliefs
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
• Body ResponseBody Response
• Behavioral ResponseBehavioral Response
• Beliefs Beliefs
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
• Body ResponseBody Response
• Behavioral ResponseBehavioral Response
• BeliefsBeliefs
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
Were you feeling anxiety or fear?Were you feeling anxiety or fear?
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Anxiety or Fear?Anxiety or Fear?
FearFear helps you stay alive in an helps you stay alive in an immediately dangerous situation.immediately dangerous situation.
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Anxiety or Fear?Anxiety or Fear?
Anxiety Anxiety gets you ready for an gets you ready for an immediately dangerous situation…immediately dangerous situation…
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Anxiety or Fear?Anxiety or Fear?
that may not be as likely to happen or that may not be as likely to happen or dangerous as you think.dangerous as you think.
And…And…
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Anxiety or Fear?Anxiety or Fear?
……interferes interferes with living with living your life.your life.
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
same kind of response same kind of response
butbut
fear helps us move through lifefear helps us move through life
anxiety gets in our wayanxiety gets in our way
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
““Lots-O-Labels”Lots-O-Labels”
PhobiaPhobia
Panic DisorderPanic Disorder
Generalized Anxiety DisorderGeneralized Anxiety Disorder
Post Traumatic Stress DisorderPost Traumatic Stress Disorder
Obsessive Compulsive DisorderObsessive Compulsive Disorder
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Anxiety: Body, Behavior, and BeliefsAnxiety: Body, Behavior, and Beliefs
““Lots-O-Labels”Lots-O-Labels”
PhobiaPhobia
Panic DisorderPanic Disorder
Generalized Anxiety DisorderGeneralized Anxiety Disorder
Post Traumatic Stress DisorderPost Traumatic Stress Disorder
Obsessive Compulsive DisorderObsessive Compulsive Disorder
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Johnny and MaxJohnny and Max
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Johnny and MaxJohnny and Max
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Johnny and MaxJohnny and Max
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““It doesn’t make sense.”It doesn’t make sense.”
““It’s just a fence, a bell, a building.”It’s just a fence, a bell, a building.”
““Nothing bad about them, Nothing bad about them,
but I can’t stop the feeling.”but I can’t stop the feeling.”
““Why can’t I talk myself out of this?”Why can’t I talk myself out of this?”
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PhobiasPhobias
Answer:Answer:
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Johnny and MaxJohnny and Max
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Johnny and MaxJohnny and Max
TriggerTrigger
Body’s Body’s EmergencyEmergencyResponse Response
SystemSystem
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““It doesn’t make sense.”It doesn’t make sense.”
““It’s just a fence, a bell, a building.”It’s just a fence, a bell, a building.”
““Nothing bad about them, Nothing bad about them,
but I can’t stop the feeling.”but I can’t stop the feeling.”
““Why can’t I talk myself out of this?”Why can’t I talk myself out of this?”
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PhobiasPhobias
So how do we help Johnny?So how do we help Johnny?
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PhobiasPhobias
So how do we help Johnny?So how do we help Johnny?
How do we stop pooch drooling?How do we stop pooch drooling?
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PhobiasPhobias
So how do we help Johnny?So how do we help Johnny?
How do we stop pooch drooling?How do we stop pooch drooling?
How do we stop Brian Ott drooling?How do we stop Brian Ott drooling?
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PhobiasPhobias
Talk some sense into me!Talk some sense into me!
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PhobiasPhobias
Solution:Solution:
Hide the meat andHide the meat andring that bell.ring that bell.
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Johnny and MaxJohnny and Max
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PhobiasPhobias
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PhobiasPhobias
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Problem:Problem:
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PhobiasPhobias
More you avoid, the more you will avoid.More you avoid, the more you will avoid.
The more you avoid, the less chance of The more you avoid, the less chance of conditioned response extinction. conditioned response extinction.
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PhobiasPhobias
Solution:Solution:
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PhobiasPhobias
What have we learned so far?What have we learned so far?
Part of anxiety has to do with a learned physical Part of anxiety has to do with a learned physical “reflex” - the “reflex” - the BODYBODY on Automatic on Automatic
Conditioned body reactions have to be reduced by Conditioned body reactions have to be reduced by a change in a change in BEHAVIORBEHAVIOR – “All action, no talk.” – “All action, no talk.”
Need to move in small steps towards the situation Need to move in small steps towards the situation starting at a middle level of anxiety.starting at a middle level of anxiety.
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Johnny and MaxJohnny and Max
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Panic DisorderPanic Disorder
What is a Panic Attack?What is a Panic Attack?
What’s the difference between a What’s the difference between a
Phobia and a Panic Attack?Phobia and a Panic Attack?
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Panic DisorderPanic Disorder
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Panic DisorderPanic Disorder
Involves one of three concernsInvolves one of three concerns
Losing control (usually in public)Losing control (usually in public)
Going crazyGoing crazy
DyingDying
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Panic DisorderPanic Disorder
Seems perfectly reasonable.Seems perfectly reasonable.
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Panic DisorderPanic Disorder
I can’t I can’t control this.control this.
Emergency Emergency ReactionReaction
SensationSensation
Fail!Fail! Try to Try to StopStop
TriggerTrigger
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Panic DisorderPanic Disorder
I can’t I can’t control this.control this.
Emergency Emergency ReactionReaction
SensationSensation
Fail!Fail! Try to Try to StopStop
TriggerTrigger
Panic AttackPanic Attack
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Panic DisorderPanic Disorder
What to do with a Panic Attack?What to do with a Panic Attack?
Can’t Overcome a Strong Rush of AdrenalineCan’t Overcome a Strong Rush of Adrenaline
Distraction and Relaxation often make things worse.Distraction and Relaxation often make things worse.
(note: do relaxation techniques when feeling good)(note: do relaxation techniques when feeling good)
““Can’t beat them, join them.”Can’t beat them, join them.”
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Panic DisorderPanic Disorder
I can’t I can’t control this.control this.
Emergency Emergency ReactionReaction
SensationSensation
Fail!Fail! Try to Try to StopStop
TriggerTrigger
Panic AttackPanic Attack
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Social PhobiaSocial Phobia
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Social PhobiaSocial Phobia
Can have Can have
BOTHBOTH
Conditioned ResponsesConditioned Responses
ANDAND
Anxiety Triggering ThoughtsAnxiety Triggering Thoughts
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Social PhobiaSocial Phobia
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Social PhobiaSocial Phobia
BELIEFS can trigger a false alarm of BELIEFS can trigger a false alarm of
the bodies emergency systemthe bodies emergency system
when when expectationsexpectations don’t match don’t match experienceexperience
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Social PhobiaSocial Phobia
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Social PhobiaSocial Phobia
When predicting a catastrophe, ask yourself:When predicting a catastrophe, ask yourself:
Am I being a good bookie and a good actuaryAm I being a good bookie and a good actuary
In my experience is the likelihood of the In my experience is the likelihood of the emergency emergency
Is the damage estimate correctIs the damage estimate correct
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Social PhobiaSocial Phobia
If I look at MY personal experience, If I look at MY personal experience,
what are the odds a catastrophe will occur?what are the odds a catastrophe will occur?
If the catastrophe does occur, If the catastrophe does occur,
how bad will it be for me?how bad will it be for me?
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Social PhobiaSocial Phobia
If the belief is accurate – find a way to cope with a If the belief is accurate – find a way to cope with a bad situation.bad situation.
ButBut
If the belief is inaccurate – time to create a new If the belief is inaccurate – time to create a new belief about the situation that better matches belief about the situation that better matches your experience.your experience.
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Take Home MessagesTake Home Messages
When anxious:When anxious:
First ask: First ask: how much how much BodyBody conditioning conditioning
and how much and how much BeliefsBeliefs? ?
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Social PhobiaSocial Phobia
For Body conditioning:For Body conditioning:
• Build a staircase Build a staircase • Ring the bell Ring the bell • Keep ringing the bell until calm downKeep ringing the bell until calm down• Then go a bit farther up the staircaseThen go a bit farther up the staircase
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Social PhobiaSocial Phobia
For beliefs, the thinking part:For beliefs, the thinking part:
• Think about the horse race and hurricanesThink about the horse race and hurricanes• Ask self is what expecting match what I know Ask self is what expecting match what I know
has happened in the past?has happened in the past?• If yes, use your coping skillsIf yes, use your coping skills• If no, build a new If no, build a new BeliefBelief based on experience based on experience
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