1. Exposure and Relaxation Techniques Anxiety Disorders

2. Prevalence of Anxiety Disorders (National Co-morbidity Replication, 2005). 18.5% Any anxiety disorder in a given year. 8.7% Specific Phobia. 6.8% Social Phobia. 3.5% PTSD. 3.1% GAD. 2.1% Panic Disorder. 1.0% Agoraphobia.

3. Steps in a Panic Attack Step 1 Real Stressor (Danger) Step 2 (Rapid breathing, heart pounding, trembling, etc.) Step 3 Fear of Having Another Attack Step 4 Increased Attention to Body (You start paying more attention to your heart rate because you think it will warn you of another attack) Step 5 More Fear (Noticing your heart is pounding and thinking you are going to have another attack is scaring you)

4. Summary The fear of having another panic attack just makes you more frightened. This “fear of your fear” increases the chances of future attacks. Solution

5. Exposure Therapy Systematic Desensitization. Graded Exposure. Flooding.

6. To Reflect On… Our deepest fear is not that we are inadequate. Our deepest fear is we are powerful beyond measure. It is our light, not our darkness that frightens us. We ask ourselves, Who am I to be brilliant, gorgeous, fabulous? Actually, who are we not to be? You are a child of God. Your playing small does not serve the world. There is nothing enlightened about shrinking so that out people won’t feel insecure around you. We are all meant to shine, as children do. We were born to make manifest the glory within us. It is not just some of us; it is everyone. And as we let out own light shine, we unconsciously give other people the permission to do the same. As we are liberated from our own fear; our presence automatically liberates others. --Marianne Williamson

7. Quotes About Fear If you surrender to the wind, you can ride it. --Tony Morrison Other people’s opinion of you does not have to become your reality. --Les Brown Fear grows in darkness, if you think there’s a bogey man, turn the light on. --Dorothy Thompson I’m not afraid of storms, for I’m learning how to sail my ship. --Louisa May Alcott Do not be too timid and squeamish about your reactions. All life is A experiment. The more experiments you make the better. --Ralph Waldo Emerson Worry never robs tomorrow of its sorrow, it only saps today of its joy. --Leo Buscaglia For peace of mind, resign as general manager of the universe. --Author Unknown Somehow our devils are never quite what we expect when we meet them face to face. --Nelson DeMille

8. Diaphragmatic Breathing Why is diaphragmatic breathing important? The difference between diaphragmatic and chest breathing.

9. Progressive Muscle Relaxation What is PMR? Why does PMR work?

10. Mindfulness What is mindfulness? A deep state of passive awareness. Being firmly rooted in the present, rather than past or future. Settings in which one could practice mindfulness. Other types of meditation.

11. Special Place Exercise What is a visualization exercise? Essential components of the special place exercise. The image must be safe, pleasant, and soothing. The image must be filled with sensual (i.e., visual, tactile, auditory, and olfactory) details.