ELEANOR CRISWELL, Ph.D. Clinical Psychologist

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Worry, Fear, and Panic
What is it? 

Worry, fear, and even panic underlie much of what troubles many people:  the possibility of things going wrong, or even the
possibility of complete failure.  Worry and fear cause people to avoid important actions, events, or people, or to undertake things in an uncertain, uneasy way.   

People become worried or stressed out about various things in everyday life, such as work, partner,children, money, the future, and so on.  They may be confident and successful people in many ways, but find themselves worrying frequently during the day, to the point that they want some self-improvement to decrease their worry.  

Some people have specific fears or phobias, such as a fear or phobia about being in public, fear of heights, or driving in traffic, that make them want to avoid the things they fear.  Sometimes panic and panic attacks accompany these fears.  Panic and panic attacks are very frightening physical, emotional, and cognitive reactions to extreme stress.  Avoiding the things you fear, though, is only a temporary "win" because avoidance does not help you overcome the fear. 

What are the Psychological Treatments?  There are several options. 

Cognitive and Behavior Psychotherapies are good ways for many people to learn what causes worries, fears, panic, and phobias, and then how to change their thoughts and behaviors to help manage these stress-related problems.  Many people manage their stress by avoiding the things that stress them out, and psychotherapy helps them to gradually and systematically learn to face those things. Often, people with worry and fear have serious doubts about their own abilities to cope.  Cognitive psychotherapy gets a person to examine what they think about themselves and try to adopt more realistic and objective self-views.  Often it is useful to make a hierarchy of stressors, then work on reducing their impact gradually and systematically, one by one. 

Acceptance and Committment Therapy is another option.  This approach gets someone to accept that some problem thoughts and feelings are part of being human, to not respond (or unknowingly reinforce) them, and to commit to trying new behaviors even before the problem thoughts and feelings diminish. 

Many people also people benefit from explicit Stress Reduction Techniques, such as relaxation, guided imagery, and better time management so they don't feel hurried and rushed. 

Some people with worries, fears, and phobias may also have tendencies toward fearful obsessions and associated compulsions.  During the initial sessions, we typically try to sort out worries from obsessions/compulsions.  The treatment procedures are similar, but there are some differences (see page on OCD).  

Some people want to try medicine to help in managing worries, fears, and phobias.  I can refer you to physicians who treat these problems. Even for people who end up taking medicine, it is helpful for them to learn as much as possible about psychological management of stress-related problems.