Walking and Breathing Exercise for Panic Attacks and Anxiety

When we’re anxious or starting to have a panic attack it can be hard to sit still and breathe. Here’s a breathing exercise that helps slow our breathing down while incorporating walking in with our breaths. We begin walking at a slow-ish but comfortable pace, and then tie our breathing in with our footsteps. So we breathe in for three or four steps (or maybe more, or maybe just two steps, depending on how quickly we’re walking), and then breathe out for the same number of steps.

This breathing exercise can be very relaxing, and help ensure we’re not breathing too quickly. And paying attention to our footsteps reconnects us with the present moment, and helps get us out of our heads, which reduces anxiety. Paying attention to our footsteps can also shift our focus away from any distressing physical sensations that are feeding in to our panic. And it helps disengage the catastrophic thoughts we’re having about these sensations that can bring on a panic attack.

Guided Walking and Breathing Meditation Instructions

Extended Guided Walking and Breathing Meditation

If you have any questions or comments, please leave them on the YouTube video page.

Worrying and Insomnia

Worrying can be a big contributing factor in insomnia. We can lie in bed, worrying about things that happened during the day, unable to sleep because we can’t slow our minds down. Or maybe we’re worrying about what we have to do tomorrow, these thoughts racing around in our heads and keeping us awake. Or maybe we’re just worrying in general about whatever pops into our minds. Regardless of what we’re worrying about, worrying can make it difficult to sleep.

One of the best ways to reduce worrying and make it easier to fall asleep at night, is to spend some time going over our worries in the evening. We look at what we’re worrying about. And we ask ourselves if there’s anything we can about whatever’s worrying us. And if there is, we do it. But if there isn’t, then we just try to let our worries go for today, since there’s nothing we can do about them now, except continue to worry about them, and give ourselves insomnia tonight.

The Best Tip To Reduce Worrying

If worrying is contributing to your insomnia, you’ll find more posts about how to reduce worrying in my Self-Help Course for Anxiety. If you have any questions or comments, please leave them on the YouTube video page.

Cognitive Defusion for Insomnia

In Acceptance and Commitment Therapy (ACT), cognitive fusion refers to when we become so stuck in our heads, we become fused with our thoughts. When we’re in a state of cognitive fusion, it can be hard to quiet our minds enough to fall asleep, and so cognitive fusion can contribute to insomnia.

The opposite of cognitive fusion is cognitive defusion . Cognitive defusion allows us to un-fuse ourselves from our thoughts. And then we can let our thoughts go and quiet our minds enough to be able to fall asleep. So if our thoughts are keeping us up at night and giving us insomnia, cognitive defusion is a great way to clear our heads so we can get to sleep.

Cognitive Defusion

Worries are one of the most common types of thoughts that keep us awake at night. If worrying is contributing to your insomnia, you’ll find a number of posts about how to reduce worrying in my Self-Help Course for Anxiety. If you have any questions or comments, please leave them on the YouTube video page.

The Thought Record in CBT

The most effective way to practice cognitive restructuring is to complete a thought record or thought diary. The thought record is one of the foundational tools of CBT. In the thought record we write down:

  • Our automatic negative thoughts
  • The situations that triggered them
  • The moods, emotions, feelings, and physical symptoms or sensations we experience in response.

Then we identify the automatic negative thought most responsible for how we feel, and use cognitive restructuring to come up with alternative and more balanced thoughts. The thought record is the main tool we use in CBT to change the way we think. It helps us see things from a different perspective, and as a result, change the way we feel.

The Thought Record in CBT

There are a couple of different formats of the thought record you can download below. The first is based on Mind Over Mood by Dennis Greenberger and Christine A. Padesky. The second is based on the thought diary from the Centre for Clinical Interventions. For this format there is a full two-page thought record, a condensed one-page version, and a filled out example of a completed thought record:

If you have any questions or comments, please leave them on the YouTube video page.

Insomnia and Letting Go of Thoughts

It can hard to sleep if our minds are racing. Perhaps we’re worrying about tomorrow, planning our days and going over things in our heads as we try to fall asleep. Or we’re stuck dwelling on something that happened earlier in the day, ruminating and thinking in circles, unable to quiet our minds. Or maybe we’re just lying in bed thinking about how hard it is to fall asleep.

No matter what sorts of thoughts are keeping us up and giving us insomnia, we don’t have to keep thinking about them. We can learn to just watch our thoughts and let them go. And when we’re able to do this, our insomnia will start to improve, and we’ll be able to get to sleep.

Letting Go Of Thoughts

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

We have tens of thousands of thoughts a day but most of them barely register. And the ones that we do notice often aren’t even related to anything we’re doing at the time. Usually the best way to deal with automatic negative thoughts is to not give them your attention in the first place.

They’re like a clickbait headline that looks like it’s gonna be really interesting, but once you click there’s really nothing worth seeing and the best course of action is to just not click on them in the first place. But sometimes we can’t resist and we click anyway. And then we find ourselves going down that rabbit hole and keep clicking on another and another and another, at which point it can take quite a bit of effort to pull ourselves back out.

And the same is true once we start following our automatic negative thoughts. A big part of mindfulness is about learning to let go of these types of thoughts and refocus our attention in the present moment. But that’s often easier said than done for a couple of reasons.

First we tend to believe that if we have a thought it’s somehow interesting or important and something we should pay attention to, so we don’t want to just let it go. But of our tens of thousands of thoughts every day, most of them are just noise in our head, mindless distractions that don’t need our attention at all. And once we come to terms with this it’s a lot easier to just allow these thoughts to pass from our mind without even thinking about them.

But secondly, the thoughts that we tend to notice are the ones that provoke an emotional reaction. And these are not as easy to simply let pass from our minds, because as we’ve seen once our thoughts and emotions start interacting together, they feed into and reinforce each other. And as a result thoughts that carry some emotional weight are much more difficult to just let go, as the emotion acts as a kind of magnet, and keeps pulling these thoughts back into our head.

One way to let go of thoughts is to treat them as if they were just sounds going on in the background. We generally don’t pay attention to these sounds or think about them very much, and we just allow them to pass in one ear and right out the other. And we can do the same sort of thing with our thoughts, not give them any undue attention and think about them or try to figure out what they mean, and just treat them like mental noise in the background allow them to pass into our mind and then right out again.

Another metaphor for this way of relating to our thoughts is to simply treat our thoughts as if they were clouds passing through the sky, noticing as a cloud or a thought passes into our field of awareness, sticks around for a while, and then continues to float through the sky or through our mind until it passes away.

Or sitting back and observing our thoughts as if we were at the movies and watching our thoughts being projected on the screen in front of us, not actively participating or getting caught up in the action on the screen that is our thoughts, and just sitting back and watching them as they unfold.

But often it’s not that easy to just sit back and watch our thoughts, and in the next video we’ll learn some additional strategies and techniques we can use to help us step back from our thoughts and let them go called cognitive defusion.

If you have any questions or comments, please leave them on the YouTube video page.

Cognitive Restructuring and Reframing Thoughts

In CBT we use a technique called cognitive restructuring to modify our automatic negative thoughts to make them better reflect reality. With cognitive restructuring we’re not trying to engage in “positive thinking.” Positive thinking isn’t helpful because it doesn’t reflect reality either. Instead, cognitive restructuring involves reframing our negatively biased thoughts in order to see things from a more balanced perspective.

When we modify our thoughts with cognitive restructuring, we end up with alternate ways of looking at things that:

  • More accurately describe the situations we find ourselves in
  • We can believe because they make sense to us and aren’t just trying to force positive thinking
  • Improve our moods and how we feel because they’re not negatively biased or distorted

Cognitive Restructuring and Reframing Thoughts

Cognitive restructuring is one of the most important CBT techniques because it enables us to change the way we think, which, as we’ve discussed, is one of the keys to changing the way we feel. If you’d like to practice cognitive restructuring, you’ll find the questions from the video in the Cognitive Restructuring Worksheet (PDF):

In the next post we’ll look at the thought record, which guides us through the process of cognitive restructuring in detail. If you have any questions or comments, please leave them on the YouTube video page.

Automatic Negative Thoughts

We constantly have all sorts of thoughts automatically popping into our heads. In CBT, it’s our automatic negative thoughts (sometimes referred to as ANTs) that we’re most concerned with. Automatic negative thoughts play a huge role in both initiating and maintaining our negative moods. And they often set off vicious cycles and downward spirals that are extremely difficult to break out of. If we struggle with depression, anxiety, or any number of mental health issues, we can experience an endless barrage of automatic negative thoughts all day long.

Automatic Negative Thoughts

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

A lot of our thoughts are automatic. A thought just pops into our head without us even thinking about it. Some of our automatic thoughts can be pleasant or neutral, but more often than not they tend to be negative.

Automatic negative thoughts have a strong effect on our mood and how we’re feeling, and learning how to respond to our automatic negative thoughts in ways that help us feel better is an important part of mindfulness based cognitive therapy. So now we’re gonna look at some common automatic negative thoughts that people have that tend to be associated with depression, anxiety and anger.

When we’re feeling depressed we tend to have very negative thoughts. And these thoughts center around three themes: negative thoughts about ourselves, negative thoughts about the world, and negative thoughts about the future. Examples of automatic negative thoughts about ourselves are things such as: I’m such a loser. I’m no good. I keep disappointing everyone. What’s wrong with me? I can’t do anything right. I’m a failure. I feel so helpless. Nobody even cares about me.

And automatic negative thoughts about the world, which is just a general sort of negativity about everything: life is so unfair. Things should be easier. The whole world’s falling apart. Everything’s so stupid. Life stinks.

And automatic negative thoughts about the future: things are never gonna work out for me. There’s nothing i can do about it. I’m always going to feel this way. I’m never going to be happy. There’s no point in trying anymore. It’ll never get any better.

And when we’re feeling anxious we tend to have thoughts that overestimate the likelihood that something bad will happen. And we overestimate the severity of what will happen. And we underestimate our ability to cope with things.

And so we have automatic negative thoughts about threats and danger: oh no! What’s happening? This is terrible.

And automatic negative thoughts about our ability to cope with things: i can’t handle this. I’m never gonna be able to do this. People are gonna wonder what’s wrong with me. This is just too much. What am i gonna do? I should just quit now.

And all sorts of what-ifs which are probably the most common types of thoughts people have when they’re feeling anxious or worried what if this happens what if that happens what if what if what if

And when we’re feeling anxious, our thoughts are too a future-oriented, and we end up spending a lot of time and energy worrying about how things might be in the future. And even though these things haven’t occurred yet and may never occur, we tend to respond as if they’ve already happened, or that they’re inevitable. And so we wind up suffering the consequences right now. And even if the things we’re dreading never actually occur, we’ve already made ourselves pay the price and suffer over them whether they actually happen or not.

Our automatic negative thoughts that are associated with anger are things around the need for fairness and respect; becoming aggravated, frustrated or losing patience; violations of rules; and revenge.

This is so unfair. Why does this keep happening to me? I can’t stand this anymore. What’s wrong with him? You can’t treat people that way. He’ll pay for that!

And in the next couple of videos we’ll learn how we can improve our mood and help ourselves feel better by managing our automatic negative thoughts through cognitive diffusion and letting go of thoughts and with cognitive restructuring.

The first step towards reducing both the frequency of our automatic negative thoughts, and how detrimental they are, is to learn to recognize and record these automatic negative thoughts when they arise. This is part of what we do in the CBT Interrelationships worksheet from the first post in this course. In addition to completing this worksheet, it’s good practice when learning CBT to just pay attention for and write down automatic negative thoughts whenever they come up.

The next step is to assess the accuracy of these ANTs. Then we can reframe our thoughts to look at things from different perspectives that don’t have such a negative impact on our moods. And as a result, we start feeling better. We’ll look at how we can do this in the next few posts. If you have any questions or comments, please leave them on the YouTube video page.

Thoughts Are Not Facts

One of the main things we focus on in CBT is how we can modify our negative thoughts in order to improve how we feel. But why is it okay to change our thoughts? If we have a thought, isn’t it important? Shouldn’t we listen to our thoughts and what they say?

Well it is important to be aware of our thoughts and what they’re telling us. But it’s also important that we recognize that, in most cases, our thoughts are not facts. Our thoughts are just our subjective interpretations of our environments, situations and experiences. When we use CBT techniques to dispute and modify our thoughts, we’re not trying to change the facts. We’re not denying reality, or forcing ourselves to believe things that aren’t true. We’re just reframing our understanding of situations and looking at things from different perspectives.

And the reason we can do this is that our thoughts are not facts. Given the same facts about a situation, it’s possible to have different thoughts about that situation. If we’re having thoughts that are making ourselves feel bad or making things difficult for ourselves, we have the ability to change these thoughts. We can see things from a different light, and as a result start to feel better and make things less hard for ourselves.

Thoughts Are Not Facts

If you have any questions or comments, please leave them on the YouTube video page.