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When Panic Attacks: The New, Drug-Free Anxiety Therapy That Can Change Your Life [Anglais] [Broché]

David D. Burns M.D.

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Chapter 1

I Think, Therefore I Fear

Practically everybody knows what it's like to feel anxious, worried, nervous, afraid, uptight, or panicky. Often anxiety is just a nuisance, but sometimes it can cripple you and prevent you from doing what you really want with your life. But I have some great news for you: You can change the way you feel.

Powerful new, drug-free treatments have been developed for depression and for every conceivable type of anxiety, such as chronic worrying, shyness, public speaking anxiety, test anxiety, phobias, and panic attacks. The goal of the treatment is not just partial improvement but full recovery. I want you to be able to wake up in the morning free of fears and eager to meet the day, telling yourself it's great to be alive.

Anxiety comes in many different forms. See if you can recognize yourself in any of these patterns.

Chronic Worrying. You constantly worry about your family, health,
career, or finances. Your stomach churns, and it seems as if something bad is about to happen, but you can't figure out exactly what the problem is.

• Fears and Phobias. You may be afraid of needles, blood, heights, elevators, driving, flying, water, spiders, snakes, dogs, storms, bridges, or getting trapped in closed spaces.

• Performance Anxiety. You freeze up whenever you have to take a test, perform in front of other people, or compete in an athletic event.

• Public Speaking Anxiety. You get nervous whenever you have to talk in front of a group because you tell yourself, "I'll tremble and everyone will see how nervous I am. My mind will go blank and I'll make a complete fool of myself. Everyone will look down on me and think I'm a total neurotic."
• Shyness. You feel nervous and self-conscious at social gatherings because you tell yourself, "Everyone seems so charming and relaxed. But I don't have anything interesting to say. They can probably tell how shy and awkward I feel. They must think I'm some kind of weirdo or loser. I'm the only one who feels this way. What's wrong with me?"

Panic Attacks. You experience sudden, terrifying panic attacks that seem to come from out of the blue and strike unexpectedly, like lightning. During each attack, you feel dizzy, your heart pounds, and your fingers tingle. You may tell yourself, "I must be having a heart attack. What if I pass out or die? I can't breathe right! What if I suffocate?" You try to hang on for dear life. Before long, the feelings of panic disappear as mysteriously as they came, leaving you bewildered, frightened, and humiliated. You wonder what happened and when it's going to strike again.

• Agoraphobia. You're afraid of being away from home alone because you think something terrible will happen--perhaps you'll have a panic attack--and there won't be anyone to help you. You may fear open spaces, bridges, crowds, standing in line at the grocery store, or taking public transportation.

• Obsessions and Compulsions. You're plagued by obsessive thoughts that you can't shake from your mind, and compulsive urges to perform superstitious rituals to control your fears. For example, you may be consumed by the fear of germs and have the irresistible urge to wash your hands over and over all day long. Or you may get up and check the stove repeatedly after you've gone to bed, just to make sure you didn't leave the burners on.

• Post-Traumatic Stress Disorder. You're haunted by memories or flashbacks of a horrific event that happened months or even years ago, such as rape, abuse, torture, or murder.

• Concerns about Your Appearance (Body Dysmorphic Disorder). You're consumed by the feeling that there's something grotesque or abnormal about your appearance, even though your friends and family reassure you that you look just fine. You may think that your nose is deformed, your hair is thinning, or your body isn't shaped correctly. You may spend vast amounts of time consulting with plastic surgeons or staring into mirrors trying to correct the defect because you're so convinced that everyone can see how terrible you look.

• Worries about Your Health (Hypochondriasis). You go from doctor to doctor complaining of aches, pains, fatigue, dizziness, or other symptoms. You feel certain that you have some dreadful disease, but the doctor always reassures you that there's absolutely nothing wrong with you. You feel relieved for a few days, but soon you start obsessing about your health again.

If you're plagued by any of these fears, I have a question for you: What would it be worth to you if I could show you how to overcome them? Imagine, for a moment, that you had to give a talk or take an important test tomorrow, and you could go to bed tonight without that knot in your stomach, feeling confident and relaxed.

If you're lonely and struggling with shyness, what would it be worth to you to feel relaxed and spontaneous around other people so you could easily engage anyone, anywhere, in a rewarding conversation? And if you're suffering from phobias, panic attacks, or obsessions and compulsions, what would it be worth to you if I could show you how to defeat these fears for good?

These goals may seem impossible, especially if you've been struggling with anxiety or depression for years, but I'm convinced that you can defeat your fears without pills or lengthy therapy. That may not be the message that you're used to hearing. If you go to your doctor, she or he may tell you that you've got a chemical imbalance in your brain and that you'll have to take a pill to correct it. Yet the latest research confirms what my clinical experience has taught me over the years: You can defeat your fears without drugs.(1) All you'll need is a little courage, your own common sense, and the techniques in this book.

There are many theories about the causes of anxiety, but we'll focus on four of them:

• The Cognitive Model is based on the idea that negative thoughts cause anxiety. "Cognition" is simply a fancy word for a thought. Every time you feel anxious or afraid, it's because you're telling yourself that something terrible is about to happen. For example, if you have a fear of flying and the plane runs into turbulence, you may panic because you think, "This plane is about to crash!" Then you imagine passengers screaming as the plane crashes toward the earth in a ball of flames. Your fear does not result from the turbulence but from the negative messages you give yourself. When you change the way you think, you can change the way you feel.

• The Exposure Model is based on the idea that avoidance is the cause of all anxiety. In other words, you feel anxious because you're avoiding the thing you fear. If you're afraid of heights, you probably avoid ladders, high mountain trails, or glass elevators. If you feel shy, you probably avoid people. According to this theory, the moment you stop running and confront the monster you fear the most, you'll defeat your fears. It's like telling a bully "Take your best shot. I'm not running away from you any longer!"

• The Hidden Emotion Model is based on the idea that niceness is the cause of all anxiety. People who are prone to anxiety are nearly always people-pleasers who fear conflict and negative feelings like anger. When you feel upset, you sweep your problems under the rug because you don't want to upset anyone. You do this so quickly and automatically that you're not even aware you're doing it. Then your negative feelings resurface in disguised form, as anxiety, worries, fears, or feelings of panic. When you expose the hidden feelings and solve the problem that's bugging you, often your anxiety will disappear.

• The Biological Model is based on the idea that anxiety and depression result from a chemical imbalance in the brain and that you'll have to take a pill to correct it. Two types of medications are generally recommended: the minor tranquilizers, such as Xanax, Ativan, and Valium, and the antidepressants, such as Prozac, Paxil, and Zoloft. Your doctor may tell you that these medications represent the only truly effective treatment for depression and anxiety and that you'll need to keep taking them for the rest of your life, in much the same way that individuals suffering from diabetes will have to take insulin shots forever to regulate their blood sugar.

So we have four radically different theories about the causes and cures for anxiety. Which theory is correct? According to the Cognitive Model, you'll have to change the way you think. According to the Exposure Model, you'll have to stop running and confront your fears. According to the Hidden Emotion Model, you'll have to express your feelings. And according to the Biological Model, you'll have to take a pill.

All four theories have their advocates. I believe that the first three theories are correct, and I use Cognitive Techniques, Exposure Techniques, and the Hidden Emotion Technique with every anxious person I treat. The Biological Model is much more controversial. Although I began my career as a full-time psychopharmacologist and treated all my patients with drugs, I strongly prefer the new, drug-free treatment methods for anxiety and depression. In my experience, they're far more effective, they work much faster, and they're also superior in the long run because you'll have the tools you need to overcome painful mood swings for the rest of your life.

However, it's not an either/or type of situation. If you and your doctor feel that medications are necessary, or if you strongly prefer to be treated with an antidepressant, you can use a combination of drugs plus psychotherapy. But for the millions of people who haven't been cured by pills, as well as those who strongly prefer to be treated without them, the development of these new, drug-free methods should be good news. Let's see how they work.

The Cognitive Model

The Cognitive Model is based on three simple ideas:

1. You feel the way you think.

2. When you're anxious, you're fooling yourself. Anxiety results from distorted, illogical thoughts. It's a mental con.

3. When you change the way you think, you can change the way you feel.

The French philosopher Descartes once said, "I think, therefore I am." The techniques in this book are based on a slightly different idea: "I think, therefore I fear." In other words, anxiety results from your thoughts, or cognitions.

For example, you're probably having thoughts about what you're reading at this very moment. You could be thinking "This is just another stupid self-help book. What a rip-off!" If so, you're probably feeling disappointed, frustrated, or even annoyed.

Or you might be thinking, "This book couldn't possibly help me. My problems are way too severe." If so, you're probably feeling discouraged and hopeless. Or you might be thinking "Hey, this looks interesting, and it makes sense. Maybe it could help me." If so, you're probably feeling excited and curious.

In each case, the situation is exactly the same. Every reader is reading the same thing. Your feelings about what you're reading will result entirely from the way you're thinking, not from the words on the page.

We constantly interpret what's happening, but we're not aware that we're doing this because it's automatic. The thoughts just flow across our minds, but they have the power to create strong positive and negative emotions.

Cognitive Therapy* is based on the idea that each type of thought, or cognition, creates a certain kind of feeling. Dr. Aaron Beck, from the University of Pennsylvania School of Medicine, has called this the Theory of Cognitive Specificity. For example, if you feel sad or depressed, you're probably telling yourself that you've lost someone you love or something important to your sense of self-esteem. If you feel guilty or ashamed, you're telling yourself that you're bad or that you've violated your own personal values. If you feel hopeless, you're telling yourself that things will never change. And if you feel angry, you're telling yourself that someone is treating you unfairly or trying to take advantage of you. You may also be telling yourself that the other person is a self-centered jerk.

From the Hardcover edition.

Revue de presse

“Few truly great books on psychotherapy have been published, and this is one of them. When Panic Attacks tells you how to deal with all kinds of anxiety and with most other emotional problems. It is clearly and charmingly written.”
—Albert Ellis, Ph.D, founder of the Albert Ellis Institute and bestselling author of A Guide to Rational Living

“Another masterpiece from the author who helped millions help themselves with Feeling Good: The New Mood Therapy. Dr. Burns’s elegant writing style, compassion, and humor translate powerful psychotherapy methods into accessible, practical, and helpful tools for the vast number of individuals who struggle with anxiety.”
—Henny Westra, Ph.D., associate professor and director of the York University Anxiety Research Clinic

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Amazon.com: 4.5 étoiles sur 5  131 commentaires
328 internautes sur 344 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 20 years later-no new cognitive distortions have been found 21 mai 2006
Par Self Helper - Publié sur Amazon.com
It probably sounds somewhat dramatic, but I can only recall two self-help books that had a drastic effect on my life-by giving me a reasonable relief from anxiety and depression. The first one, Mind over Mood, by Greenberger and the second one, Feeling Good Workbook by Dr. Burns. Both of these books are based on solid research, reason and practicality.

Almost 20 years since his workbook, Dr. Burns has finally written another book. To my disappointment and relief, it looks like he has nothing major to report. The good news is that after all these years of cognitive therapy evolution, there are still only 10 types of cognitive distortions. The bad news is that it takes only 10 to manage a perfect job to make you miserable.

Cognitive therapy is based on the premise that our own automatic and often unnoticed thoughts WITHIN us, not the events that happen TO US, scare us to death which in turn create a warped reality providing fertile soil for depression, anxiety, self-doubt, loneliness, and procrastination. Virtually everyone who is depressed or anxious is at mercy of these distorted thoughts. To get a relief, each distorted thought must be noticed and dealt with. As you can't relieve your hunger by just reading a cookbook, you must apply it to your own situation for at least 15 minutes a day 5 days a week. Once learned and practiced, the technique will offer you resilience to life's day-to-day challenges, unlike the antidepressants where the relief exists only while you take them.

Burns lists various applications to become aware, challenge and rewire your thought pattern and beliefs about yourself and the world. There is no magic, no parent-blaming, just common sense stuff dealing with the here-and-now.

What is so valuable here is his clear writing, convincing arguments, along with the examples of application that anyone can find an immediate use.

What sets this book apart from other self-help books is that it's packaged into a system one can use in a consistent way. Moreover, the improvements one feels can actually be measured with various tests that Burns provides. Once I saw it worked after many years of doom and suffering, I refocused and dared to feel hopeful. This added to my feeling good.

If I were to find faults with this book, I'd say this: in all honesty, there really was no need for this book at all. True, in this book he struggles to find some new ways to tackle problems to justify the new edition, and true, there is some fine-tuning of the previous methods, however, non-essential ones. In my opinion, Feeling Good Workbook is so effective, it has all you'll ever need, which is enough to make a substantial change.

In the end, each Burn's book can stand on its own, and will do a perfect job to diminish panic, depression and anxiety.

Even though the system sounds simplistic, its power lies in consistency of application-easier said than done for the depressed and unmotivated-but it does become easier if you find it within yourself to stick with it.

If this is pretty much the same book as the one written 20 years ago, why am I giving it 5 stars? It's very simple: If you are a person whose life has been robbed of feeling good for decades, any of Dr. Burns' books = be it this one or the ones published 20 years ago-offers a real tool for change. And this fact alone, deserves all the stars in the skies.
131 internautes sur 135 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 An Outstanding book not just for FEELING BETTER, but GETTING BETTER! 2 février 2007
Par Tina Miller - Publié sur Amazon.com
Dr. Burns incorporates the last 25 years of research and clinical developments since writing the best-seller FEELING GOOD (strongly recommended as well.) He has written a book which markedly refines and elaborates on FEELING GOOD, rendering the Cognitive Therapy approach found in FEELING GOOD even more effective for quick and long-term relief from distressing emotional conditions, including depression, anxiety, anger, and low-self esteem.

In case you don't know, the book FEELING GOOD has been clinically proven to relieve major depression JUST FROM READING IT and following its instructions. I am confident that a clinical trial on WHEN PANIC ATTACKS would yield similar results for individuals suffering from anxiety disorders. The new book is very readable and far more versatile, and addresses some of the implicit gaps left from the former book.

WHEN PANIC ATTACKS easily stands on its own, and doesn't just address panic attacks, but rather every conceivable type of anxiety, including chronic worrying, phobias, agoraphobia, shyness, public speaking anxiety, writer's block, procrastination, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, and Body Dysmorphic Disorder. As far as I am concerned, Dr. Burns should win a Nobel Prize for what he has accomplished here. Beginning with the "Daily Mood Log" --a sophisticated yet elegantly simple worksheet for documenting and combating one's emotional pain-- he has developed a veritable "technology" for overcoming even the most disabling of human emotions.

Why do we suffer? We suffer because we hold onto some core self-defeating beliefs (SDB's) that leave us rather vulnerable to painful mood swings. Accordingly, he identifies 23 common SDB's. Many of these SDB's (such as Achievement Addiction, Approval Addiction, Fear of Rejection, Conflict Phobia, and Emotophobia) are far more widespread than even the common cold! All of our emotional suffering can be traced back to the SDB's that are always there, lurking somewhat hidden beneath our suffering, until we take the courageous and pro-active step to identify and revise them. He then provides 40 ways to "untwist" your thinking, divided into 15 types of methods. These types of techniques include Uncovering Techniques, Compassion-Based Techniques, Truth-Based Techniques, Semantic Techniques, Logic-Based, Quantitative Techniques, Humor-Based Techniques, Role-Playing Techniques, Spiritual Techniques, Motivational Techniques, Anti-Procrastination Techniques, Classical, Cognitive, and Interpersonal Exposure Techniques, and last but not least, the Hidden Emotion Model.

He additionally shows you how to select the techniques that will work best for YOU, and the whole trial-and-error process is easily recorded onto another handy-dandy worksheet! By encouraging you to "fail as fast as you can" (a brilliant concept in its own right!), he clearly demonstrates how anyone who is serious about their mental health and overall well-being can overcome even deep-seated emotional problems, and thereby attain robust self-esteem. He even provides specific and simple methods for "relapse prevention," because, as he states, EVERYONE relapses! Surely there's a BIG difference between FEELING better and GETTING better.

Because Thoreau was correct when he said, "The mass of men lead lives of quiet desperation," I think it would be a tragedy to limit this book to those with mental health diagnoses. In fact, I cannot think of a single individual who would not be significantly helped by the information contained in this book. ********** 10 Stars on a scale of 5!
84 internautes sur 89 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 A life saving book 2 octobre 2007
Par Suzanna - Publié sur Amazon.com
Format:Broché|Achat vérifié
As someone who struggled with panic attacks for over 25 years, I have read a lot of books about anxiety. I now plan to get rid of all of the others! I read Dr. Burns' Feeling Good at my lowest point last year and it was a lifeline for me. That book focuses more on depression, and while some of the information in it applied to anxiety, I kept wishing he would write a book specifically on anxiety. This book has advice and exercises for every type of anxiety. Whether you have job performance anxiety, social anxiety, fear of riding in elevators or having blood drawn, the tools you need to overcome your fears are in here.

The key is--and Dr. Burns reinforces this point--you have to do the exercises in order to feel better. This means actually writing your answers on paper. It also means, in many cases, facing your fears. His methods combine exposure therapy and cognitive behavioral therapy. His words are warm and humorous, and you will feel supported as you break down barriers you may have built up for years.

Dr. Burns has improved my life immeasurably. I, and all of my loved ones who have had to suffer along with me for so many years, are grateful! Buy this book and try the exercises.
19 internautes sur 20 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 "don't believe everything you think" 27 mai 2009
Par Kathryn Shimmura - Publié sur Amazon.com
I've been a fan of Dr. Burns for a long time because he explains cognitive behavioral therapy/theory (CBT) so well and has plenty of techniques for using it. The main idea is that the way we think strongly influences how we feel and sometimes, how we act. When we can change our distorted ways of thinking, the door opens to greater happiness and satisfaction. Of course, when the door opens, you have to go through it, that is, you have to practice the techniques to gain the benefits.

Although I like his Feeling Good books, I like "When Panic Attacks" more because the writing is better. It flows more and is funny in places. It has much of the same material as in his earlier books, so you can benefit either way. This one is just easier to read.
Although CBT has helped me with depression and anxiety, it helped me A LOT with anger. Once I really accepted that no one died and made me queen, and that I didn't need to waste energy on trivial annoyances, I became calmer and easier to get along with and that has been a huge thing for me.
20 internautes sur 22 ont trouvé ce commentaire utile 
5.0 étoiles sur 5 Helped me beyond words! 7 janvier 2008
Par Michelle B. - Publié sur Amazon.com
Having suffered from panic attacks for many years, I was finally fed up. I searched the library and choose this book. It is hard to face the fact you suffer from panic attacks when everything on the outside appears so wonderful. I could not hear or look at the words "panic attack" with out feeling anxiety. This book saved my life without question. I did the exercises and the mood charts. I have checked the book out 3 more times. I don't know why I have not bought it because it is inexpensive ($7.00). It is good to keep for reference.
In another review there was a comment on the successful people in the book. That was a huge help to me because even successful people suffer from anxiety disorders. Would you want to hear that you suffer from a disorder that only unsuccessful, depressed people suffer from? I don't think so. If you want freedom from a panic attacks, you must pick up this book. I wish I could contact Dr. Burns myself to let him know that he changed my life.
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