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Gustavo Tolosa: Dr Doug Lisle Live Webinar Anxiety and Panic Attacks
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welcome everybody and here we are in another life with dr. mcdougal webinar only that this week we have a guest dr. dr. Lyle and he has been with us many times so I don't have to give you a long introduction it is always pleasure to have him here and an honor just so that you know if you new here dr. dr. Lyle is a psychologist for the mcdougal wellness program and the director of research for TrueNorth Ellis Center and he has written the book the pleasure trap and it also has a wonderful website called esteem dynamics which you would see in your screen in your screen just a minute and you can contact him and appointment to talk to him on the phone or Skype and the email is also going to appear in just a few seconds on the screen is dr. Lyle calm so we are very excited to have you talk to Lyle here today and Ray talk about a very important topic how are you doing today okay great to see it star ball always it's always fun to see you even though we're miles apart with the magic of the technologies like we're sitting in the same room yes absolutely well you know this is a topic that a lot of people have requested at one point or another and it is the topic of anxiety and panic attacks which actually I would like if you don't mind starting with the question of the general question as are these two conditions I don't know what the government the same thing and if not what is the difference between anxiety and then panic attacks well I you should think of it as a continuum where as anxiety is kind of like being you could you could say that would be the equivalent of a a little bit of a bad mood or a little down mood and then major clinical depression would be like a panic attack in other words it's a it's a matter of degree so all of us are having little bits of anxiety all the time including you and I with the technical glitches that we've had so in other words these are that's normal and but then the issue is that you know you can get increasing escalated anxiety dependent upon what seems to be at stake for the person and they get greater and greater physiological responses and then all the way to the most acute form of anxiety which would be a panic attack so a panic attack is sort of the the culmination of what's possible in the nervous system and it's really designed for as well see it's designed really to to be a process of defending the person against life-and-death circumstances so the the you would expect to see panic attacks happen when people's lives are literally at stake and you often will so which you explain I don't know it just to give all of us an idea of how this is developed and sure absolutely we'll just we'll just explain this the next few minutes what's alright what's happening is the following let me explain what a panic attack feels like and and then we'll go from there so panic attacks generally have a whole host of things that happen so when people have panic attacks they will usually feel their heart pounding they will usually sweat they will usually feel like they want to escape or flee but they also interestingly enough feel frozen like they can't move sometimes they'll feel nauseous sometimes they will feel like once in a while sometimes people will feel like they want to pee or poop that will sometimes happen and so this is a this is sort of the also they'll be have a shortness of breath they'll feel like they can't breathe like they're choking so these are this is an amazing set of symptoms and it will appear to people like this is some terrible thing and it will feel terrible but once we put it in perspective and we see what it is our perspective can start to shift and it can tell us what we can do about it so let me tell people where again where panic attacks come from and and incidentally and then it'll it'll become apparent also why panic attacks happen in and they get chained and it was once you've had one then you're very lucky I have a second one once you've had two you're very likely to have a third so once a pattern gets set up people can have panic attacks it might last their whole lifetime one panic attack their whole life but they're a little edgy you know from that from that point on most people will never have one but the people that have that have them will oftentimes have them for quite a while and as I said sometimes indefinitely now here's what here's what's going on that if we look at these reactions well first of all if we look at anxiety in general what anxiety is is the warning device to tell you to avoid something that's what it is so whether it's your mother-in-law or the guy that's just cutting you off on the freeway whatever it is is that the little trepidation that you feel is little anxiety that you feel that's a warning device to tell you oops try to avoid this problem so we can expect that the ultimate of all anxiety being a panic attack should be something about avoiding something major and it's going to turn out that if we look back to our ancestral history we're gonna find what that major thing is pretty quickly so I want you to take yourself back in time all human beings a hundred thousand years ago or so were in Africa and so very much of your body was built in Africa it was built for the problems of Africa and and obviously you've had skin skin tone differences that have changed since people migrated Out of Africa into different parts of the world but the but the fundamental chassis of the human body and the human mind were built there and so if we go back there we're going to start to understand what a panic attack is so think about yourself walking back to the village with four or five of your friends then you decide to take a little detour for a second and go down to a little creek and you're gonna have a little drink of water there's some high grass there and you kind of gently push back the grass and you're a little bit careful because you don't want a crocodile to come up and eat you so you're kind of looking at the water and it looks like it's fine and then you look across the creek and about 50 yards down the creek you see an African lion now what you're going to do is going to be interesting at this point so let's walk through this because this is in the anatomy of a panic attack the first thing you're going to do is you're going to freeze you are going to not move and the reason is you don't want to catch the attention by your movement of that predator so there's going to be a tremendous sense of instant freeze and we've all seen this for example in rabbits rabbits will take one look at you and then they will absolutely freeze then not move a muscle and now hoping that you haven't seen them so this is a standard prey havior and that's what will happen with people they'll freeze the if you're starting to walk down an alley in San Francisco to to cut cut that block off so that you don't have to walk around the block to get your car and you hear the tin can rattle down the thing you will instantly fruits okay so this is a normal reaction so what's gonna happen next is you will start to sweat and the reason you're going to sweat is you are about to run for your life and so when you start running for your life you're going to generate the maximum amount of heat that you can generate and that heat will actually wear you out and make you less efficient so therefore what your body is doing is it's going to start sweating now so that when you send start to run it will cool you off so this is giving you a head start on the biological stress that you're about to face the other thing that you're gonna do is you're not going to hardly breathe you're gonna feel like you're choking and you can't hardly make a sound the reason why this is going to be true is that by constricting your this is a mechanical method for raising your blood pressure you'll see this in Olympic weightlifters you'll see them hold their breath and as you hold your breath what happens is is that it raises the blood pressure and allows the cardiovascular system to push blood away from your viscera into the big muscles of your legs and in your arms in your chest so what's happening is when you're shortening your breath it isn't that you can't breathe nobody with a panic attack ever ever suffocates okay what happens though is is that that that shortness of breath is driving oxygen into the big muscles of your legs because you're about to run for your life now the next thing that we're going to see is inside the person's head they have a tremendous desire to flee obviously we now know why okay they don't know why they want to run from their mother-in-law they just do okay so the so they've got a desire to flee this situation however they also feel frozen so they've got two gigantic motivational systems that are clashing inside their head and they're they're balancing each other on a knife's edge so the one hand they want to run for their life and on the other hand they can't move this is exactly the situation that you should be in if there's a predator 50 yards down on the other side of a little creek in other words you should be completely focused and poised on that predator and as soon as it turns its attention to you and starts to move towards you you should run for your life so you are ready at a moment's notice to actually completely change survival strategy and to do everything you can possibly do to escape the predator that means for example that you are no longer going to be digesting any food as soon as you see that predator and begin to have this experience all digestion will instantly stop the reason is is that there's no point the food is there for longer term issues it's for later on this afternoon what you're burning up now is the blood the sugar that's in your blood now and the glycogen that's in your liver now you don't need to digest this food for anything so I'll guide Justin stops the blood starts moving away from the digestive system into the muscles the the breath is now short in order to push push the blood into those big muscles the heart is also pounding so people can feel their heart pounding and it feels to them like they may be having a heart attack but actually what's happening is normally the heart is in about a 20% resting rate when you're just walking around doing not much of anything whereas when you when you're in the beginnings of a panic attack that heart rate will go up to 40% so in other words the heart rate doubles so people that are having a panic attack they think that they're gonna die from this or that their heart's gonna burst or something they can can't breathe it just feels like it's some disaster it's not even close to a disaster your heart isn't anywhere near its capacity what it's doing is it's getting a running start okay so just like your sweat is getting you a running start on cooling you down and just like the the constricted breathing is getting you ready to run before you start to run so does the heart also start pounding as it raises the the heart's capacity you know raises its efficiency up to 40 percent instead of 100 as it's essentially like if you were in the Olympic Games and you were gonna run 100-yard dash if you got or if you got a running start where you got to run at 40% of your maximum speed before you then hit the hit the tape and started the race and these sprinters that guy that had that advantage would win every time and that is exactly what the heart is doing to help you get essentially a running start on this cardiopulmonary problem your job is going to be to grab as much oxygen as you can and to push as much blood as you possibly can into those muscles so that they can work at their maximum capacity for as long as they possibly can because that could be the difference between life and death so now when we come back and we look at what a panic attack is a panic attack actually isn't an attack it's a it's an adaptation it's an adaptive mechanism this is your for goodness sakes and it's there to actually help you deal with a life-or-death predator-prey situation lions don't have panic attacks as you can imagine they don't have a predator they have to worry about so they don't have this situation we have that situation because very often people were prey and actually I think we know what the numbers are very mostly was children were prey but adults were also occasionally prey and so being on the wrong end of a predator prey situation was a very real problem for people and as a result they developed this capacity so it's actually capacity as they say in the technology industry when they don't like something they tell the engineers will tell you it's not a flaw it's a feature okay this is exactly what this is this is not a flaw you have this is a feature yeah the way we the way we fix it is as follows the very often people are told to you know sit down and relax and to run breathe deeply etc etc this generally doesn't work in my experience as a clinician when I work with people with panic attacks this is not typically been very effective it's also not been very effective to do what we call cognitive therapy to essentially tell them well what's the big deal what's the big risk you know is there anything in the environment that's gonna kill you no this doesn't seem to be very effective what I have found to be very effective in my practice is to actually let the system do what it wants to do what this thing wants to do is it wants to fundamentally contract the big muscles of the body it does not want to sit it will sit in frit in a freeze as long as it needs to until it has to break the freeze when you are a prey as soon as the freeze is broken you are all in on a new strategy the new strategy is you're going to run for your life for as long as you can and look for cover and hope to survive so it's going to turn out that the best thing for panic attacks is to get up out of your chair and break the freeze and start to jog in place and what people will find is after about 15 seconds or 20 seconds of jogging in place they will be gasping for breath and very tired now here's what's interesting about this you haven't even come close to your capacity to run okay but the truth is is that you're really not that afraid because there is no predator so as a result suddenly this becomes very inconvenient and the breathing gets hard and you're tired and your legs feel tired and and so then you feel like sitting down and when you sit down what you'll find is that your breathe breathing will become deep and as the breathing becomes deep as you gasp for breath what will happen is other areas of the mind that are monitoring this whole situation will say looks like we escaped the predator or we wouldn't have stopped running as I'm saying there was a result other areas of the mind basically make the inference that we must be safe and as a result they start dialing down the adrenaline which is exactly the root of this entire thing this is all being orchestrated by adrenaline and so adrenaline is going to be responsible for all of these mechanisms that I've now shown that the sweating the heart rate the the constriction of the breathing the the shutting down of the digestive system all of these things are secondary to adrenaline it's a very simple well it's obviously really complex but I mean it's biochemical a pretty simple process in order to cause this to happen okay the if you drink too much caffeine that's effectively the same thing if you sit down drink six cups of strong coffee you will get effectively a panic attack you will want to get up and move you'll be feeling frozen you won't know what's going on etc so that that will mimic that situation for you the now there's a lot of times there's more adrenaline in you then you can burn off in 20 seconds not 15 20 seconds or 30 seconds later you'll you'll still feel the edgy panic attack you get up and jog again and do it again for 15-20 seconds and you'll get tired again and then you sit down and you just go back and forth and usually you can break a panic attack apart in three or four minutes sometimes faster panic attacks normally if you don't do this they can last for an hour they can last for about the length of the time that in Africa you needed to sit there and do nothing and watch that predator before that predator finally rolled around on the grass and then walked off back to the lion pride see though it's very possible for panic attacks to last for an hour but if you short-circuit them like this they will pass very quickly now here's another benefit to this Gustavo that once once you have broken apart a panic attack this way then the reason why people have habitual panic attacks is because they actually become conditioned or panicked about panic attacks themselves they become once the you've ever had one then the feeling of that adrenaline surge sends you into a panic because inevitably you're saying oh no we're having another one of those terrible things and so it's useful extremely useful clinically to to basically break a panic attack apart when you have one by this technique because then you may not ever have another panic attack for one but then when you break that one up then your nervous system is no longer intimidated by adrenaline Rises and you never have a panic attack again I've had many people that after they left my office with this explanation couldn't wait to have another panic attack I never had one because they literally felt in command and the system was no longer actually feeling that overwhelmed I'm throwing it yes I had a little lady recently when she heard this he was like a miracle for and I got up and made her she was actually starting to have one in the room which was great I said oh start to run and I said you're running from the lion and she's a silly sweetheart and she said what was it okay if I yell too good sure so she's yelling and moving her arms and screaming like the Lions racing and then she's laughing Ekans this this huge relaxed relief comes over her and we end the panic attack here's another point to this it isn't running per se it's actually the contraction of muscles technically all right very useful because if you're let's suppose you're a famous great panels you're starting to have a panic attack in front of a big concert and you know it's got the cameras on what you want to do is you want you can sit right in your chair like I'm doing now and I'm contracting the big muscles in my leg but I cross my legs and then I push the ankles against each other and I can exhaust those legs pretty quickly and I can also have the arms right on my side and I can push my elbows into my hips and I can basically make muscles with my with my arms and by doing that over and over again you can do the same process and it will pause me like right now I had to take a little bit of a deeper breath because I knew those big muscles right now take that deep breath that starts to break down the adrenaline so that's how we do it one thing I find very interesting well with me and then I've been talking to other people I found that I button cuz me is that many times the panic attack started while I was sleeping so I was woken up by the panic got that already yes with the pool and I wonder if it was a dream that was happening quizzes that I just relaxed and I don't know sure a lot of dreams or predator-prey situations and I so it's very very likely that you're having something like that or you never know a lot of people it's their mother-in-laws chasing them redditor predator prey situations are common in dreams of one sort or another and so it's not uncommon for people to wake up in a panic and and so this very same thing if you get up break the freeze you know I'm saying get up and move those big muscles around sometimes within seconds even friends you can be much more comfortable so why do you I mean it's an explanation why some people get these panic attacks and some don't the thing is is that this sort of has to do with with the propensity to rise adrenaline pretty high and so there's going to be people that are going to be different as far as that goes and it's also going to be the case that that if people are using things like caffeine that actually already up those things or for example if people are fatigued and under a lot of stress there are adrenaline is already high so but it's going to be is so of course there's there's a genetic underlying component that there's going to be a heritable component to this as there usually is for most things and then on top of that there's going to be environmental circumstances that are going to add to this so this is how it all works but the biggest problem of all is once you've ever had one now the problem is that you may not have another one but now you are set up and it's very possible that it could start a little cyclic cascade and so it's it's very useful to know how to break them apart because once you start breaking them apart then they start going away forever right I think I heard you talk about something similar and you said this it's probably not a good idea to use yeah the medication that that you're gonna typically get prescribed for this is going to be a benzodiazepine like a xanax or something like this or then then sometimes doctors feel like they need to be really responsible and not give you a xanax so they'll put you on an antidepressant or a mood stabilizer or some spoons thing these are terrible ideas the benzodiazepines are the things that work they work extremely well to to bring down panic the problem is is that they are horrendous ly addictive and and so there you are in way worse shape two weeks after starting to take xanax than you were before you ever started so essentially they I have met many psychiatrists who would love to give more xanax because they their heroes because the person as soon as they start taking it they are they are they feel way better that the problem is is that they are setting them up for a wicked trap that trap was not understood until relatively recently so you know a lot of people have been trade treated with these kinds of medications in and shoved into a benzodiazepine trap but this is happening less frequently now as the as the risks are understood and for everyone listening this is no solution the solution is to break the freeze break the freeze you feel frozen and you've got a very strong compulsion in your nervous system to not move you feel helpless and absolutely like you cannot do anything that's exactly how you're supposed to feel if you're so looking at a predator 50 yards away that cannot see you okay you shouldn't move a muscle and you should feel incapacitated to move the that is how it is that that system is going to extraordinarily discourage any movement okay but we can break the fries you can consciously get up and break the fries start moving and start jogging in place once you do that you start breaking apart the panic attack and you will you will essentially pull the weed of a system if you've been having them repeatedly as you start to do this you'll start to empower yourself in terms of your knowledge of your ability to defuse these panic attacks and then you won't have them okay so that is actually the solution and and medication has no place in this problem so what would you say to people that have been driven to this trap and happy patient annex or some other thing for five years I would rehab them read two books okay if they are so inclined anatomy of an epidemic by Robert Whittaker and also then I get heard drug withdrawal by I forgot his name bragging Peter Breggin dr. Peter Breggin and so those the notion is psychiatric medications in my personal opinion are a bad idea and in so for taking in particularly for panic disorder and so the the solution is to come off of these drugs but you you need to come off of em much more slowly than anybody realizes that they are this is the equivalent of if you're on four cups of coffee I would have you take six months to get off those four cups of coffee you might think well why can't I just get off them in a couple of weeks and the answer is because I mean coffee you could you could do it in two weeks but you can't do these things in two weeks you have to take a long slow time to to get off these things or you will have a relapse that you know relapses there will be quite disturbing okay is changing a little bit now to maybe if there is any connection with food I mean I think that a lot of people that switch from the standard American diet to wait not so well what would you say to anyone they out there that it's feeling anxiety over food I mean is it possible to get panic attacks because no food isn't really related to panic just right is best that I know it's a completely these are apples and oranges kinds of things but but but your broader discussion of people that are thinking about making these changes and they're worried and they're feeling anxiety and stress about whether or not they're going the right direction my my solution to all these things is to is to essentially look at this as an experiment so I would say a more common more common source of stress in our arena with the people that we talk to Gustavo is people that are having anxiety and stress about giving up the last chunk of junk food that stands between them and some significant success so they they're staring down the Barrell have given up the cheese or they're staring down the barrel of giving up the junk some kind the ice cream and and they just look at this and they feel like they feel an agitation and a discomfort and even a depression about the idea of given these things up and they feel like they're about to enter a steel cage or a steel tube that they can't get out they have to go down this path and then they can't go down the other path and my solution to this is to not look at it this way that you are not you don't think that you are making such a big decision you are making a small decision it's a decision that you can revoke at any time and the whole purpose of of sticking your toe in the water and giving up something that we think may be problematic for you is to see whether or not the cost benefit is worth it and so you can decide that in six weeks you know you can you can decide that in a couple of months that if you after you drop twelve or fifteen pounds and you can wake up in the morning and your sinuses are clear instead of cloggy and your skin feels better and you feel better and you your digestion feels better and you feel more energetic and you're sleeping better it's like well now maybe that's worth it okay but you can decide that then you don't have to take anybody's word for it now and so this is I see I see a lot of very smart adults sort of circling around this thing like circling around it it's circling around it you know have been with some kind of trepidation your your word of honor it's not on the line here okay this is not you aren't being knighted and told that you have to defend that the Holy Land you know this is this is nothing that you have to do this way this is just an opportunity to live your life differently and to see whether or not it seems like it's worth it and if it's worth it then you won't be an angst over it later okay and that's that's how we approach this regarding oh I think I would add the following thing about anxiety and stress in general and that is that probably the biggest thing that causes people to feel stress and anxiety is time pressure and and so but the smartest thing that you can do is to essentially be cognizant about and to give yourself more time to do things in other words you're the the biggest thing that causes people the most stress and anxiety in their life is they they schedule things too tight they tried to cram too much into a too small space and that they wanted them very stressed and so one of the things that that I do better these days than I used to do is I give myself more time when it comes to driving so in the old days it took me 30 minutes to get across town to the dentist appointment I'd leave with 32 minutes to spare okay and then be stressed the entire time whereas I leave with 40 minutes or so I've got 10 minutes extra I literally feel rich I feel that relax no problem a long time at a red light it doesn't even occur to me that it's an issue and so using this what I call a buffer zone approach to your time management is there's reasons why people don't do that and that is that you've also got desires in there to to essentially do everything that everybody else wants you to do in order to gain as much as steam as possible so you've got a an esteem seeking mechanism in us that wants to be very productive and efficient and to put a lot into our days be at the PTA meeting go hang out with your kids take them to the park you know talk to the church people make sure you do the extra project for your job but cook something really great for your family it's like you can see how easy it is for people to get overburdened and and that overburden starts to put time pressure on everything and that time pressure then leads to a low grade of anxiety they can be in the system and be uncomfortable so those those sorts of issues which I explore in a video it's on my website it's called success forces and that that issue of how it is to sort of manage our lives in a way that reduces that stress and anxiety that's a useful set a few set of techniques on there that are good for people to have it that if that's you if you had any recommended weeding and you already gave us had a video and you just mentioned a video yes website is Dynamics NAV asteroid that's right okay we're on the screen and the name of the video is a success forces okay they're very good I went to encourage everybody to have a one-on-one session with you because it's incredible with what dr. Lyle can do in 30 minutes and it's a very reasonable fee and how do we get in the content yeah they could just email me at dr. Doug viola yeah who calm or they can also just go to my website and esteem Dynamics organists you can the email thing is there and you can also phone me or just sign up recession if you want it alright and I'm going to encourage people today to email questions as well to webinar at dr. McDougall the comp that way when we have our webinar next month in October we can have many some questions issue that's great terrific very good and I remind me are you going to be at the events wedding weekend or yes I will I don't know what I'm talking about yet we'll take okay well very good because everybody remember that next week is the Advanced Study weekend in Santa Rosa California and I think you can still sign up on the website dr. McDougall calm but if it's stalled out you can actually sign up to watch it from your own home and it's really cool of course you cannot taste it the wonderful food that they have like we can tonight you can watch the whole thing and of course is much less expensive but still it's a very reasonable fee and it's you can do it from dr. Mabuse website so dr. Lyle again thank you so much for your time today my pleasure thanks for having me and we look forward to seeing you next week and I look forward to seeing everybody is there next week and then we'll do another webinar at the beginning of October Oh terrific look at well to it okay bye good bye bye everybody
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