If you recall, in part I of this article, Jane, my client who dictated her treatment plan to be biofeedback freaked out in her first biofeedback session with a full blown panic attack. After she left with her husband I thought I'd never see her again and hoped I wouldn't hear from her attorney in the form of a law suit. Actually as apologetic and embarrassed as she was, a law suit was a very remote possibility. But I wonder how many clients in similar situations might not be considering law suits against clinicians using inward focusing techniques that can bring on panic attacks. Then again, their personality is not that of a trouble maker and as long as they continue suffering from anxiety, they would never allow themselves to be in a court room for fear of having an anxiety attack and having to run away or lose control.
But Jane did call within a few days. She was too fearful to come to the office-she blamed her anxiety attack on my small 12'X12" treatment room (more than twice the size of most treatment rooms) as opposed to the inward focusing technique that I used. She asked if I'd consider in-home sessions. Reluctantly I agreed.
A week later I arrived at her home with an EMG biofeedback instrument in hand. I didn't want a repeat of our first meeting so I avoided using any relaxation exercises-inward focus. I took more time to get to know Jane. I got the feeling that she could talk for hours about her symptoms, but I wanted to know more about what led to the beginning of the anxiety attacks-what stressors brought on anxiety? According to the Homes-Rahe Stress Scale, I'd be looking for some rather significant life changes six months to a year before the onset of symptoms.
Yes, her panic and anxiety started about six months after she and her family moved back to NJ from the Florida Keys . "Ah ha," I thought to my self although I didn't know what to do with this information except to learn more about her. Seems that she was unhappy living in Florida -no close friends and she missed the camaraderie of her sisters and mother in NJ.
Eventually she convinced her husband to change jobs and move back to NJ with her teen age son in expectation of life being the way it used to be. But much to her disappointment, her sisters were married with other interests and the relationship with her mother was different-the camaraderie she remembered was gone. She wasn't any happier in NJ with her family than she was in the Florida Keys .
I could certainly understand that she probably would like to run away from this whole mess. How could she explain to her husband the move was for naught? And her teen age son was getting into some trouble with drugs-another disappointment for which she was unprepared.
I explained my take on her plight by asking her, "OK, you were unhappy in Florida, convinced your husband to uproot the family, change jobs, and move back to NJ so you'd be happy with your family only to find that your relationships with your sisters and mother has changed and that your son was getting into trouble. Wouldn't you just like to run away from this whole embarrassing mess?" She acknowledged that she'd like to escape the whole entire mess.
I explained that her brain was simply taking action on that desire. I explained the fight/flight reaction to stress-how when we feel threatened the unconscious intelligence gets us ready to fight or run-even a threat to our egos, family status.--and that since she is not a fighter (personality wise), there's plenty reason to unconsciously want to run away. But being a responsible person, she would never allow her self to run away.
OK, then we talked about diet and how certain foods can trigger anxiety-sweets, refined carbohydrates, caffeineated beverages.
All this was nice, but she still had trouble understanding how she was ever going to gain control of anxiety since it just happens "out of the blue."
Essentially, this is the first step-educating the conscious mind. I left her home without ever using the biofeedback instrument and focused on the challenge of making a difference in her life-how to shift her from the conditioned response of anxiety.
First it was apparent to me that the panic anxiety label her primary doctor gave her was in the absence of understanding much about her background. She came to a conclusion that she had a problem and no one knew how to cure it-certainly took her mind off her real problems in life-an escape. More in the next part of this article.