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ABIL Book Reviews
THE 60-SECOND SHRINK
Book Review / by Lynn
Maguire This book was written to help readers do just this: "gain control over...strong unpleasant emotions...and...increase joy and happiness"(p.2). Realizing that you can't change feelings without recognizing them, the authors suggest keeping a log, using their self-assessment exercises, asking friends for help, paying attention to your body, and observing your own behavior. The second chapter explores irrational beliefs - the power of "should/must statements" and catastrophizing and blaming - and the importance of listening to your self-talk. Since beliefs develop as a result of early childhood experiences, the authors remind their readers that, as adults, they can challenge those old, irrational beliefs, look for options, and substitute more healthy responses. After a discussion of short-term relief strategies, useful while you start the process of change, the authors begin what is the heart of the book: chapters that detail the strong feelings of guilt, anger, depression, stress, anxiety, and joy. In each of the six chapters, they ask you to look for the purpose behind your emotions, to challenge the irrational thoughts that may be maintaining them, and to 1)Accept yourself and your feelings; 2)Choose new purposes, beliefs, and feelings; and 3) Execute your new choices. In the chapter on joy, McKay and Dinkmeyer remind the reader that thoughts stimulate brain chemistry. Citing Paul Pearsall, they note "Joyful people get sick less often and less seriously than unjoyful people, and when they do get sick, they more readily mobilize their own natural healing powers."(p.177), The book concludes with chapters on visualization, communication, and conflict resolution, leaving the reader with a complete emotion-management toolkit. M. Scott Peck observed that "life is difficult;" and McKay and Dinkmeyer admit "self-change is hard work," too (p.263). But how you feel is, truly, up to you. The 60-Second Shrink (1997) is also strong on personal responsibility for emotions, including many suggestions for changing self-talk in order to build positive feelings. Topics covered include insomnia, perfectionism (strive for competence rather than perfection!), meditation, goal-setting, parenting, and weight loss. One example is Strategy #35: "Learn to Delegate: Don't Do Everything Yourself. Ask for help, delegate responsibility to others, and utilize the talents of professionals. You'll be freer to attend to more important matters, and you'll enhance the quality of your life."(p.49). Tips abound on establishing realistic goals and expectations and differentiating between facts and opinions, feelings and actions, all difficulties that those of us with anxiety problems often experience. Both Lazarus' book and the McKay/Dinkmeyer book emphasize humor as a healing tool, personal responsibility, the importance of physical exercise, effective communication (including the healthy expression of emotions), and building and maintaining relationships. Not only are the topics similar; the tools are, too. But, The 60-Second Shrink goes a few steps farther: the concluding strategies are aimed at the reader considering therapy and are filled with useful information on therapy itself, selecting a therapist, and most importantly Strategy #102: "Asking for help when you need it is a sign of courage and intelligence, rather than weakness" (p.137). These two gems empower readers by making suggestions concerning many varied mental and emotional health issues that are appealing in their simplicity and useful for anyone experiencing distress or unhappiness.
Zuercher-White notes that ALL her clients with panic disorder have CONTROL as an issue. Using examples from her practice, she discusses the relationship between control and worry about the future, urging readers: "You must face and embrace your fears, anxieties, and uncertainties, and by so doing, develop self-confidence and mastery" (p.25). The rest of the book is about "how". For those considering medication, she suggests using a cost/benefit ratio to determine the risks and benefits.. Dennis J. Munjack, M.D., contributed to the chapter "When to Consider Medications," which includes medications used, the advantages and disadvantages of each, and dosing levels. The authors conclude with the reminder that medications are not a cure for panic disorder. Part II of AN END TO PANIC contains the cognitive and behavioral treatment of the disorder, beginning with a consideration of the physiology of panic. Zuercher-White discusses hyperventilation in a simple but thorough way, explaining how to recognize it, determine if it plays a significant role in YOUR panic, stop it and, importantly, how to master diaphragmatic breathing. Because people with panic disorder think their symptoms are dangerous, the author teaches readers how to become aware of such automatic irrational and unhelpful thoughts, enabling them to stop the spiral of increased anxiety. After looking at specific thoughts, the reader learns to challenge them and find alternative hypotheses. Additionally, Zuercher-White helps the reader determine which core beliefs (such as "I can't cope" or "I am fragile") may underlie the automatic thoughts, thereby contributing to the development of the disorder. This work of restructuring, based on David Barlow, Aaron Beck, David Burns, David Clark, Jacqueline Persons, and others, is essential for building self efficacy, trust in one's own ability to handle things. The author then introduces interceptive exposure, a technique for overcoming the fear of panic sensations such as dizziness, lightheadedness, rapid heartbeat, and shortness of breath, in a safe, non-threatening way. Part III of AN END TO PANIC focuses on phobic avoidance, describing the development of agoraphobia and its treatment, with an emphasis on gaining mastery of coping skills rather than simply tolerating high levels of anxiety. By listing goals instead of fears, developing coping tools, gradually exposing him/her self to the feared situations, and using a worksheet to track practices, the reader will be able to measure progress, step by step, in a tangible and visible way. The author adds, "If you are too fearful to carry out your exposure task, exercise!"
Closing with discussions of acceptance of feelings, assertiveness, coping
with
stress, and general anxiety, Zueercher-White reminds readers that taking
control IS
gaining mastery. She suggests "...panic is a signal that something in your
life is not
right." And, citing her own experiences from a workshop with Jon Kabat-Zinn,
she adds
that learning meditation may be another way to learn to stay in the present,
observe
without reacting, and achieve greater serenity and self-awareness.
Book Review / by
Lynn Maguire In a series of lessons, he teaches skills for symptom reduction and stress management; presents information on recognizing and overcoming distorted thinking; discusses self-worth, self-esteem and acceptance; gives tools for goal setting and exposure therapy; and presents a clear and empathic discussion of the process of change and the difficulties inherent in letting go of old patterns of behavior. He reminds the reader that "...it is important to see your traits and reactions as simply normal variations of what is typical of people" rather than viewing yourself and your reactions as "abnormal or sick" (p.167). Importantly, Peurifoy devotes a chapter to a healthy understanding of anger and other oft-misidentified emotions and includes a section on the fear of losing control. Concluding with the topic "Standing Up For Yourself," he differentiates between aggressive and assertive behavior, offering the thought-provoking list "Your Rights and Responsibilities".
Appendices touch on such concrete tasks as developing a relaxation response,
selecting a therapist, finding a support group, overcoming sleep
difficulties and improving
listening skills. Reneau Peurifoy has discussed anxiety disorders and
precursors to
their onset in a thorough and readable manner and has included a
comprehensive
reading list for those who seek further information.
COPING WITH PANIC: A Drug-Free Approach to
Dealing with Anxiety Attacks Dr. Clum, head of the Anxiety Disorders Clinic at Virginia Tech, presents a detailed, well-thought out non-pharmacological approach to managing panic and agoraphobia. Evidence of the effectiveness of the Coping with Panic program is provided at the Self-Change Systems’ website (www.panicsolutions.com). The website summarizes results of published scientific studies of the program. The book and website provides information, not only on the effectiveness of the Coping with Panic program, but also on other treatment options and how to think about treatment effectiveness. The consumer is encouraged to systematically consider how many people drop out of a particular treatment, how many people who complete treatment get better, and how many people relapse after successfully completing treatment. The program actually consists of four books and an assessment profile taken before beginning the program and after completion. The Coping with Panic book by Dr. Clum provides the treatment manual around which the rest of the program is centered. The Coping with Panic Workbook, by Gloria Eldridge and John Walker, provides assignments, exercises and additional information which parallel each chapter in the manual. The Panic Monitoring Log conveniently provides forms to monitor and chart progress, including one’s confidence in the coping strategies that are being used. As noted in the Log and substantiated on the website, research has shown that individuals with anxiety problems who monitor their progress make more gains that those who do not. Finally, the Relapse Prevention Manual for Panic, by Joseph Wright, provides a follow-up program designed to maintain the gains achieved during the Coping with Panic program and to prevent relapse. On-line, real-time evaluations are also offered on the website, using the Comprehensive Panic Profile, to generate pre-intervention and post-intervention reports that allow individuals to assess the effectiveness of their efforts. Research indicates that the feedback report itself actually helps reduce the frequency of panic attacks and improve the use of coping strategies.
The manual would benefit from a revision to reflect the increase in
knowledge about
panic disorder and agoraphobia that has accumulated over the last decade or
so. For
example, the book does not discuss the efficacy of the use of selective
serotonin
re-uptake inhibitors (SSRIs) like Paxil or Prozac. However, the website does
include
this information. Also, a comparison of the effectiveness of some of the
self-help
programs that are available (i.e. Reid Wilson’s Don’t Panic Self-Help Kit,
Lucinda Basett’s Attacking Anxiety and Depression materials, and Barlow and Craskes’
Mastery of
Your Anxiety and Panic to name a few) would be very useful to the consumer.
However, as noted previously, we are fortunate to have a variety of
effective treatment
options for panic and anxiety. If one program or treatment does not provide
the
improvement that is wanted, it is comforting to know that there are other
options
available. Dr. Clum and his associates are to be commended for having
developed and
researched a comprehensive and effective program for those coping with
panic.
As part of the work of recovery, the author first discusses the emergence of panic symptoms in several different contexts, including physical illness, trauma, current stress, and psychological disorders. "Find a physician whom you trust" (p.13), he suggests; an accurate diagnosis is critical…as is following that doctor's advice. In discussing specific phobias, he adds that they "can develop from a current internal conflict and/or real life fear" (p.42). What is important is to identify the true fear. Dr. Wilson then writes about the personality that can develop agoraphobia, touching on issues of trust in one's self, dependency, difficulty identifying and expressing feelings, and fear of conflict. He reminds the reader that children develop by going through many steps and that missing a step can make independent thought, feeling and actions difficult. Part II of Don't Panic focuses on taking control of the anxiety attacks in order to regain a sense of trust in the body. "Keys to long-lasting change are challenging your attitude about your present-day life, exploring the roots of your many beliefs, learning from your emotional responses, and experimenting with new actions" (p.199), reasons Wilson. After explaining why the body reacts, he reminds his readers that the body already has a calming response; it's our job to learn to elicit that response consciously. To teach us how, he proceeds to describe the techniques of diaphragmatic breathing, deep muscle relaxation, and meditation. Central to Dr. Wilson's book is the idea "techniques will not conquer panic; attitude will" (p.247). The author offers Eight Attitudes of Recovery, each of which brings the sufferer TOWARDS the panic to greater understanding, to inoculate. And since panic is a problem because of the sufferer's reaction to it, he further offers a way to observe the panic in a way that is neither worried, critical, or helpless: as a supportive observer. Recognizing that the value of support is in the "untrapping" of feelings, he suggests using a helpful person as an ally in recovery. Part III includes the Special Issues. The Use of Medications, reviewed by James Ballenger, M.D., details individual medications, their advantages and disadvantages, side effects, and dosage ranges. "You always have the choice regarding the use of medications," Wilson adds. Two additional chapters address social phobia and the fear of flying.
In brief, recovery, according to Wilson, is
adopting an attitude of using the panic as a tool. With breathing skills and
relaxation training, an individual can face the panic, not avoid it. "It
dies from lack of attention," he adds (p.255). The goal is to trust your
body.
The path begins with instructions for planning an individualized program based on defining goals, dividing them into manageable tasks, preparing to practice, and working towards accomplishment. The author presents detailed examples explaining his method, including work sheets for the reader to formulate and complete each step. Wilson advocates flexibility, reminding readers "you can modify your task schedule any day based on your previous performance". The author next explains the significance of attitude in overcoming panic, a topic that is addressed in detail in his book Don't Panic: Taking control of anxiety attacks, Revised Edition. He stresses a shift from avoidance to encounter, encouraging acceptance of the feelings in order to learn to tolerate discomfort and practice coping skills. From this new perspective of acceptance, the author introduces relaxation skills, beginning with the importance of diaphragmatic breathing. Because he recognizes that his readers will respond to different forms of relaxation training, he discusses six different types of relaxation and meditation which, along with diaphragmatic breathing, are explained thoroughly on the tapes. "Explore as many of them as you can," he adds. "Then choose one or two to practice daily." Another section of the guide explores visualization, the use of imagination as a tool for learning. The included tapes also train the reader in this use of imagery, teaching readers ways to gain perspective, recall skills, and see themselves in control. To address the mental component of anxiety, Wilson includes a section on worry. He first suggests handling concern as a signal that a problem needs to be addressed; taking action resolves this type of worry. However, if the thoughts are unproductive and repetitive, he describes a way to handle them as simply "noise". The DON'T PANIC Self-Help Kit includes skill cards which address not only worry, but the earlier-mentioned attitudes, breathing and relaxation, as well as physical symptoms. Regarding this concluding section on bodily sensations, Wilson says "Once you notice your physical symptoms, accept them," that is to say, resisting them is not helpful. Readers can refer to the skill cards for hints, support, and encouragement as they practice, and to the book DON'T PANIC for more detailed information. In brief, the DON'T PANIC Self-Help Kit complete with guide, work sheets, skill cards and tapes, teaches many coping techniques for panic and severe anxiety that will benefit those who are seeking a way to overcome their distress and learn to trust their bodies.
Markway and her colleagues define social anxiety simply as “fear of the
disapproval
of others”, and give an excellent discussion of causes and contributing
factors.
Individuals may have a predisposition to social phobia due to genetic,
biological, or
environmental facts; however, this book provides skills to attack the
cognitive
misperceptions and maladaptive coping mechanisms that perpetuate the
disorder. Like most
successful self-help programs, this aid for social phobias requires work! Of
particular help, are questionnaires that allow individuals to assess how
they react
physically, cognitively and behaviorally when confronted with
anxiety-producing
situations. Personal questionnaires include:
Dying of Embarrassment also provides help with
social skills, general stress reduction techniques, tips on handling
setbacks, basic information on medication and a section on seeking
professional help. The book is based on solid research but uses examples and
situations to which individuals with social phobia will relate. It is highly
recommended.
Book Review / by Lynn
Maguire After discussing the roles of the environment, stress, emotions, self-talk and perfectionism, Bemis and Barrada introduce their recovery plan, one based on acceptance; their attitude towards recovery is simply that it takes time. Their solution is a cognitive approach based on managing the anxiety, listening to one's self-talk, and developing awareness which "allows us to see a correlation between how we deal with our anxiety or panic and how we deal with everyday life events (p.23)." About half of the book then focuses on these fourteen strategies for recovery, each of which includes a topic on anxiety management, related self-talk that is self-nurturing, and a section on awareness. Some of the management topics are acceptance, slowing down, letting go, taking risks, learning about anxiety, accepting set-backs, and reaching out to others. An example of an awareness topic is (Strategy 11) "Living One Day at a Time," which suggests "It will help if we try to work through past events that are troubling. When we accept them, we will be able to let go of them." EMBRACING THE FEAR concludes with examples of how their program actually works, concentrating on fourteen common avoidance's, such as dentists, malls, work, driving, and flying, giving specific examples of helpful self-talk and other useful strategies.
Book Review / by Carolyn
Johnson, M.S.W. The author starts by addressing many of the activities that chronically anxious individuals use to "feel better," - exercise, relaxation, socialization. He does not minimize the value of these techniques but maintains that to "get better" and "stay better" we must change the way we think about the frustrations and misfortunes of daily life. Additionally, he teaches us to change our "musts" and "shoulds" to "wants" and "desires." Jules, a 27 year old graduate student, sought Dr. Ellis' help when he was frustrated in his educational goals by a difficult professor whose excessive demands were making it difficult to graduate in record time and with the highest scholastic achievement. Jules had become essentially dysfunctional with depression, rage and panic. By using the principals of REBT, this student was able to substitute his "irrational belief" - that he must excel in the class or be a complete failure, with a "rational belief" that he would like to excel, but failure to do so would not keep him from achieving his long-term academic goals. Over generalizing - "all" or "never" thinking is another cognitive wrench thrower. "We invent helplessness from a few defeats" (page 112). The irrational belief that we will never succeed when we have experienced a failure can be challenged. Dr. Ellis devotes a chapter to Unconditional Self-Acceptance (USA) and Unconditional Other Acceptance (UOA) with techniques to see ourselves and others realistically. Techniques are also taught to minimize Low Frustration Tolerance and maximize High Frustration Tolerance. Albert Ellis is a believer in the use of humor as a psychotherapeutic tool. He encourages clients to utilize songs such as "I'm Just Wild About Worry," sung to the tune of "I'm Just Wild About Harry" by Eubie Blake, as anecdotes to depression and panic. The book also contains numerous "words to the wise," which can be used as "mantras" by individuals with anxiety disorder. An example from page 201 is the following: "If I take risks I may lose. If I take no risks I still may get hit by a truck. By refusing to take normal risks I will increase my panicking about taking them and will tend to make my life inert and boring." Feeling Better, Getting Better, Staying Better is a comprehensive guide to the principles of cognitive therapy. It contains a complete biography for additional information. Numerous practical exercises are included to help us recognize our destructive thoughts and replace them with realistic and emotionally mature thoughts. The book is highly recommended.
Most chapters seem designed as much for the sufferer as for the support person, reinforcing the author's special emphasis on open communication. In one particularly informative chapter, "Determining Whether the Sufferer is Ready to Recover and Finding a Recovery Program", Williams discusses suffering itself as the primary motivation, but recognizes that personal factors and secondary gains may delay the decision to enter treatment. She emphasizes (p.63) "sufferers only get out of treatment what they put into it". They must be ready. The author lists many "do's and don'ts" in Chapter 6,"The Basics of Good Support," but reminds the reader that attitude, interest, patience, understanding, and a willingness to help the sufferer help himself are critical. And since no one individual can be expected to be available at all times, Williams offers hints for enlarging the support system and ways the primary person can find his or her own support. T he author focuses on emotional needs in Chapter 8, noting that, as people recover, previously inhibited feelings begin to surface. She advises "Feelings…are neither good nor bad, right or wrong; they just exist," and concludes by suggesting that sometimes the support person may best help by simply listening. Later chapters focus on negotiation and compromise, assertion, and cognitive restructuring, the latter teaching concepts which can serve as tools for the support person in helping with reality testing, again reinforcing the author's team approach. Near the end of her book, Williams cites Dr. Arthur B. Hardy, founder of Terrap: "Getting well depends on change. If there is no change, there is no improvement." She concludes with a discussion of how to handle recovery changes and again cites Dr. Hardy: "Give your partner the freedom to be independent." And, above all, communicate. For readers interested in supported recovery, How to Help Your Loved One Recover from Agoraphobia, filled with basic information is an easy-to-read style, can serve as a tool to help the anxiety patient explain the disorder and help family members and other support persons be better able to understand and assist.
The premise of the book is that successful relationships begins with self-discovery - that a "healthy relationship with yourself provides a fertile seedbed from which health relationships with others can grow." Loving Choices is divided in to three sections: Your Relationship with Yourself; Communicating with Yourself and Others; and Your Relationships With Others. Going beyond theory, the book provides practical exercises at the close of each chapter for those willing to invest the time to improve their self-awareness and communication skills.
In a model called "the self-encounter," the reader learns to get in touch
with his
or her own inner feelings and conflicts, often residuals from our family of
origin.
The authors maintain that many people fail to recognize how influential
family traits
can be in creating expectations in future relationships. Starting on page
112, the
authors list 41 opposing traits through which one's family style can be
evaluated: The authors do a good job of describing power struggles in relationships, how they originate and what to do about them. Power struggles are likened to a "pot of stew" about to boil over. The stew contains such ingredients as "ghosts of your ancestors", "stockpiled anger", "rebellion", and "gender role behaviors". Power struggles lead to "polarization" in which each partner clings tenaciously to his position, leading to disharmony and eventual deadlock in the relationship. The authors provide an exercise for turning "power struggles" into "growing pains". Loving Choices: An Experience in Growing Relationships is designed as a personal growth and relationship "paper therapist". Each chapter contains practical exercises and a checklist entitled "How are you doing?" to emphasize key concepts. The concepts will not be new to advocates of self-help books, but there is much of value in this book for those who make the commitment of self-discovery and relationship growth.
Inhibition - the holding back of thoughts and feelings (suppression) - takes effort, effort that shows up in short term biological changes which can lead to cumulative stress. Research has shown that inhibition causes sweaty palms, which can be measured as elevated skin conductance. The lowering of skin conductance levels during confession has been measured, one indication of lowering stress. Also measurable after disclosure is a decrease in blood pressure and an increase in immune function (as measured by an increase in T-lymphocytes, which stimulate production of antibodies). It is important to realize that not just negative events, thoughts, and feelings may be inhibited; positive stressors such as love, passion, success, and excitement also disrupt our lives, our self-images, and our relationships and can be suppressed. Inhibition also leads to rumination, obsession, and dreams. Unwanted or intrusive thoughts, often triggered by trauma or the reminder of trauma, can develop a life of their own when people try to suppress the images or thoughts. Since it is harder to suppress when you are depressed, obsessions often seem more bothersome when depression lingers: the thoughts that can't be suppressed become more intense. Pennebaker suggests "allow the thought to enter and leave on its own." Additionally, he suggests that dreams may be our way of working through unresolved life tasks; since there has been no resolution, they surface while we sleep. The author continues by saying that not only is talking enjoyable, but that we find confronting problems with words makes them manageable; additionally, we are able to let others give us feedback and assistance; we are able to let others know and understand us better; we gain insight; and, with resolution, we are able to let the problems go. One difficulty with disclosing painful events is that friends tend to back away. This is one reason for the success of self-help and support groups; sharing similar problems allows the discovery of more options for dealing with them. Trust is easier to find among those who have the same problem - or with a professional, he adds, reminding the reader that writing or talking to understanding friends should never be a substitute for therapy. Writing can serve some of the same functions as talking, but not the social ones, Pennebaker observes. It can also facilitate dealing with loss, an event that often precedes many first episodes of panic. He does add that self-reflection itself can be painful and may or may not help, especially with ongoing life crises. Writing can help deal with positive stressors such as sex and love feelings, whose inhibition can often lead to obsession. Poets use verse to integrate emotional expression with self-understanding of the emotions themselves," the author comments, adding that art forms in general serve to "neutralize" the passion, to lesson the intensity of the feelings.
In summary, Pennebaker believes writing helps because we all have the human
need for
completion, for understanding, and for self-expression. Though many art
forms may
be used, it is the discussion of these other modes (including drawing, song,
dance)
that completes the process of understanding.
Writing helps fulfill these needs by forcing structure and organization of
our
thoughts, making images understandable, permitting both the acquisition and
remembering
the knowledge, allowing detachment and objective observation, and
simplifying.
Book Review by Elizabeth
A. Fallen Throughout the workbook Dr. Carbonell reminds his readers that the catastrophic feelings of death or loss of control often experienced during a panic attack are part of the “trick” of the panic attack. He places a great deal of emphasis on the importance of understanding that the thoughts of catastrophe are merely symptoms of fear and not clear and accurate warnings of actual danger. It is with this premise that Dr. Carbonell assures his readers that facing their fears during a panic attack is not only not dangerous, but necessary in overcoming the phobia and returning to a healthy life. The workbook is divided into four sections (Unmasking the Trick, Laying the Groundwork for Recovery, Doing Exposure, and Notes on Common Phobias) each consisting of several chapters. Each chapter combines expert knowledge and advice with questions, surveys, and checklists with space provided for the reader to respond. The questions pertain to the reader’s experience during panic, as well as those questions regarding exposure therapy and relaxation methods and techniques offered by Dr. Carbonell. The questions serve to help the reader examine how they feel and what they think as they are actually experiencing the fear. The workbook, which is 234 pages, includes a panic diary that can be photocopied and carried with the reader to document physical symptoms, thoughts, emotions, and behaviors during a panic attack, as well as where, when, and with whom the attack occurred. At the close of the book Dr. Carbonell has included a reference section of books, internet web site sources, and support groups.
This book is very readable and a solid source of information for the panic
sufferer.
I would definitely recommend it for both personal use, and for use in a
support
group or other small group setting. It allows you to work at your own
individual pace,
or at a pace established in a group setting.
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