Panic Attacks - Dr. Craig Goodman

Shalom my name is dr. Goodman dr. Craig Goodman I'm a clinical psychologist and a neuroscientist i'm here at he de bruit today to talk about issues in psychology and Torah now one of the issues its most important I feel today and it's affecting a large portion of the population is the problem of anxiety disorders and panic attacks many people in even very effective successful people are not above or beyond experiencing from time two times these anxieties these panic attacks and it's becoming more and more an issue in psychology today and it's a very difficult thing to treat now what I actually do is I surprise a lot of my patients when they come to me with the problem of society or panic and I say to them that anxiety attacks actually very healthy healthy things very good things there are a part of you they're part of every person it's a natural part of our nervous that's our nervous system and our brain our cortex it's a system that is built in within us that can the time of danger we are built to react quickly and to escape this danger it's a built-in mechanism now what happens is that when there is this danger and the brain through our senses becomes aware of it our heart starts to beat rapidly so that we have more blood flow to the brain we start to breathe rapidly so that we have more oxygen to the brain into the muscles and our entire body becomes tense so that we can react quickly and see and think quickly now what happens is at that same time adrenaline and cortisone is released in the brain at the speed of 434 kilometers per cent per minute very fast that cortisone that adrenaline gets a completely into the mobilized situation that we can what they call the 2 f's fight-or-flight that if there is this danger we either will instinctively fight the danger or take flight to try to escape the danger now what does that mean within that also at the same time that I sense this problem of this danger in my environment it also elicits a internal mechanism that we all have that it's called the problem-solving mechanism every human being has it that in the time of an emergency at the time where I'm at the most stressed or most worried or most emphatic my body my automatic system my neurological system turns on this mechanism that helps me to solve problems immediately and with almost very little thought just automatically now let's say for example there was a little fire here in the room there was a spark it caught fire to a curtain or to the carpet and I may quickly just instinctively grab a bottle of water or couple wanna try to put out the fire and I may react very quickly and I may be tensed but afterward I feel relief I feel relaxed I feel we got through that we gladly put the fire out thank goodness or if I say that the fire is too great instead of fighting the fire I will take flight to the fire I will run for the fire either way afterward I removed myself from that danger and I feel more relaxed now what if the danger is imagined and not real what if the fear that exists within my mind has to do with something that's not particularly part of reality but only something within my own mind or my own personality it could be anxiety about speaking in public places or in being in social situations or the like I mean the list goes on could be from anything from test from various things that are difficult for us but the minute that I have this fear what happens is my brain does not differentiate between real or reality and imagine fear the same anxiety the same panic is brought out and the body responds accordingly now what happens is if a person has pre-existing fear in their mind basically what happens is this cancels out it presents the brain from bringing up and from allowing the problem-solving mechanism to turn on basically it it turns it off to prevent it from being the partisan and what happens is the person is stuck in their fear and the anxiety goes on and on and off continues for a period of time much longer than it was supposed to and the person does not feel relaxed afterward doesn't feel that feeling of accomplishment the feeling of I've gotten out of this danger it's enough that one person if a person has had that kind of terrible negative experience that they had you know their heart was racing they were breathing fast they were anxiety or they were in panic and it didn't seem to have any solution they become what's called a anxiety or they have anxiety about the anxiety attack they begin to start having fears or pre-existing anxiety that they will not have an anxiety attack you may even completely forget about the original thing altogether now what happens is what we have to do is strengthen our minds with the strength in our thoughts that we don't respond in such a negative manner that we control our problem-solving mechanisms and that we are able to not react in beautiful way now what does it say in the Torah the Torah talks about the strengths of persons of a person and that Hashem takes care of everybody and controls everything but there is a thing that's very well known in Hebrew and it says Kadosh Baruch umami been a diamond essential local arm of them what does that mean that Kadosh Baruch Hashem does not put a person into a situation that is beyond their ability to handle beyond their capacity that means that every single thing that occurs to me in my life I have to believe in divine providence I have to believe in the fact that a Shem is only allowing these things to occur to me because I have the capacity to handle it to overcome it to succeed to successfully maneuver and overcome these problems of these dangers or challenges in our lives my life or in your life now that means that I can feel confident I don't need to be in fear I don't need any pre-existing fear because everything by definition that happens to me happens to me for a reason happens to me for my good and it may be difficult and I say it's going to be easy but I don't need to be in fear I need to recognize my abilities to overcome that fear now let's say that I've already gotten into the sphere already I've gotten into an attack I'm an anxiety right now I'm feeling anxiety or panic and I'm starting to freeze that's what we put in a third s instead of fight and flight is freeze when someone is so overcome by fear they can't function they can't respond the camry act now let's get rid of that third f and let's start to believe in the abilities that Hashem gave us each and every one of us the abilities to real I think people will all in all usually be very surprised at how well they handle pressure or an emergency situation where something may be very very menial may be so frightening but something very very difficult and very challenging and even life-threatening you may find that same person functioning in a very high-functioning manner now once we're in that anxiety there's really three steps that we can do this is not preventive this is more once i'm already in that anxiety the first is to recognize that feeling so what do people do usually the first thing they say is I'm not afraid I'm not afraid I'm not nervous I'm not worried I'm not anxiety what is that it's denial you're lying to yourself you're not respecting yourself you have to respect yourself so you need to accept those feelings you need to embrace those feelings not be afraid of them you need to take a deep breath and say right now I'm feeling very afraid I'm feel very nervous I'm feeling very stressed I'm in a lot of pressure on very very full of anxiety allow yourself to feel that feeling don't be afraid of it don't feel you have to run away from it or to keep yourself busy or to occupy your mind no place that fear face that feeling and the second stage is to say to yourself at that point not only do I feel this feeling but it's just a feeling and feelings come and go this feeling will pass that's what I have to say to myself this is a feeling I'm not afraid of this feeling I'm feeling it right now and just the fact that I allow myself this ability in this right to feel what I feel and not feel bad about it and I feel that I need to run from it or be afraid of these feelings and already starts to relax me and the minute that I'm telling my brain it will pass it's just temporary just a feeling it also further makes me more relaxed the last and third stage the tool that I have to do get to imagine a time when I felt happy what I didn't feel this way when I felt something the opposite of what I feel right now it could be a wedding it could be a party or on vacation or laying on the beach what place I love or a thing I like to do and try to remember how you felt at that particular time once you can imagine that feeling it allows your psyche to differentiate and to say hey I'm capable of good feelings as well then all the more strength is this belief in my mind that what I'm feeling now really is just a temporary feeling and sleeting zar feeling feelings are fleeting they pass by it passed by and they don't last forever now there's four additional stages that were recently discussed in the research done by some people at the University of San Diego that they worked with navy seals and they not worked in neural science using PET scans MRI and the most advanced techniques and technology and they try to see how they can improve a success of in a combat situation now what they realized was that there were four steps that actually can help a person to react and respond much better to a situation of stress or fear what is that what are the four steps number one that we have to break it up into stages and chunks then not to take too much of a goal on ourselves but we have to kind of do it more in a progressive more one by one man okay gradual manner so I've set small goals for myself within the things that maybe are fearful or anxiety provoking to me and I thousand overcome this I start already program my mind before the fact second the second tool is using my imagination what we call a progressive relaxation okay can imagine a shin what you do with this imagination and you imagine how you want to be in that particular situation how you see or so how you see yourself overcoming that situation how you feel yourself being calm and being focused and being effective and thinking quickly and being successful and overcoming whatever challenges are in here in your particular task or whatever what do i do at that time by imagining forehand I'm preparing my mind for this event so what actually when I committing the event itself I almost react automatically naturally as I act I imagine myself acting it comes much easier because the brain does not as we said I'm differentiate between imagination reality many times and even by imagining something it actually can improve how I handle things in real life the third tool is what we call self-talk then I have to talk to myself I have to have an internal dialogue with myself that when I'm stressed I need to say I'm fine I can handle this I'm strong I'm capable I will overcome this there's nothing that I can't do once I'm having these conversations with myself take it easy don't get stressed don't get in to a state don't worry you can do this stay calm once I'm talking to myself I'm already sending signals to my nervous system into my brain to calm down and to start thinking and use my brain to my my thoughts to respond as opposed to my emotion the fourth and final stage or or tool that I can use its deep breathing using breathing techniques there are many breathing techniques but the most easiest way is just to take a deep breath now if you'll notice whenever we're stressed or work under pressure people tend to not breathe they hold their breath almost without knowing it or they don't breathe freely or regularly and their breath become more labored and short and then the brain lacks oxygen and there's less blood pump to the brain and then we handle stress in a less efficient manner we became more worried would became more full of anxiety now an important point to remember is with these car adults these fears they all reside in our fun now hopefully in the future we'll get more into this topic of water thoughts where do they come from how can I control them and various tools and techniques that we can use in order to overcome these thoughts but the most important thing is don't let these negative thoughts on these fears exist in your mind no matter what everyone has an ink evil inclination and a good inclination okay yessir Tobin Yetzirah we're all built with this we all are basically fifty percent good and fifty percent been so yessir ah our evil inclination is always trying to get the best of us he's only trying to throw obstacles in our path he's trying to put roadblocks is trying to trip us up we have to be ready for that we have to know that that's going to happen and we have to be vigilant and aware of it once it does though we can actually use our tools use our mind use our thoughts to control our emotions and be able to respond in a much more efficient and successful manner now there are two places in the brain that are relevant to this one is what we call that the limbic system and within the limbic system a small little circle called the amygdala but the size of your fingernail that controls all our emotions the frontal area of our brain this is the thoughts and our memory thinking logic all the things that have to do with intellectual function room now whenever our senses are the sensory perception our eyes or hearing or sight case feel whenever our senses send some danger or anything any kind of stimulus what actually is activated first the limbic system which is governs our feelings that is activated twice as fast as the frontal lobes to place the controls thought so that means that we are twice as likely every human being to respond in feeling through fields through emotions through fear what's your negative things if we're inclined or if we have these pre-existing fears so what we have to do is we have to put kind of like a signpost here or stop sign up in our mind saying no matter what you feel stop and tell yourself don't worry you can handle this this is not beyond you now in addition to that we have to remember that Hashem created us it created us with everything we have all the ability and all the function and mechanisms within ourselves within our brains within our souls within our psyches that will allow us to be effective successful human beings we don't need to suffer from anxiety and panic needlessly we can overcome our fears we can overcome any danger as it exists in our lives or curves to us when we're of going about our business or our lives and a day to day or overall I don't need to be afraid I need to know that haba b'shem I'm father's in heaven he's looking after us and we have the ability to go over everything thank you very much and have a wonderful [Music]