Thinking about unpleasant symptoms will tend to make them worse. We begin the “fear of fear” cycle, provoking further symptoms as well as preventing existing ones from disappearing.

It is difficult simply determine your attention away from unpleasant feelings. To do so, two things are necessary

  1. Be determined not to think about or dwell on the symptoms
  2. Fill your mind with other things; distract yourself


  1. Mental games; doing puzzles, crossword or other word games, reciting a poem, singing a song or counting backwards from 100, all are useful distraction exercises. The important thing is that they take your attention away from the panic thoughts.
  2. Environmental focus; concentration on a specific detail of the world around you, for example, make words out of number plates, guess what people do for a living. Focusing on the outside world will prevent you thinking about what is going on inside your own head.
  3. Using a bridging objects; this might be a photograph or a special object or souvenir from happy time. Looking at the object generates positive, anxiety reducing thoughts.
  4. Physical activity; giving yourself a task to do takes your mind off worrying maybe it is exercise or going for a walk.  Keeping yourself physically active is one of the best insulators against stress.
  5. Meditation; this techniques is derived from Eastern meditation systems and can also be very useful. Sometimes a mantra for a special word can be used. The meditator focuses the mind upon the mantra in an effortless, relaxed way and with gentle practice can block out other thoughts and ideas to achieve a level of relaxation



Worrying thoughts can make us feel physically anxious (heart racing, muscle tension etc), which then leads to us worrying more. (“Here we go again, I’m going to panic”). A vicious circle soon gets established, running faster and faster under its own momentum.

Sometimes we are aware if these thoughts but often we are not.  They may take the form of fleeting images or half – formed pictures in our minds. The thoughts tend to flash by automatically and very quickly.

An example may help to make this clear. Imagine you are running upstairs when you feel a sudden sharp pain in the chest. It gives you a fright, and the thought goes through your head, “May be there’s something wrong with my heart”. The thought itself makes you more afraid, your heart beats faster, and the pain seems to take a long time to die away. Later on that day the same thought comes back to you. Once again, your heartbeat increases and you feel afraid. The symptoms produce the thought, which made you anxious and added to the symptoms. Positive self-talk; is a coping strategy, which involves breaking this vicious circle, where negative thoughts lead to increased symptoms. It involves a number of stages.

  1. Find out exactly what you are thinking: This is not always easy, as thoughts tend to flash through our minds so quickly and automatically that we are not always aware of them. Writing your thoughts down on a dairy sheet or a journal.
  2. Challenge the thoughts for how rational they are:  Research suggests that when people are under stress their thinking can often get distorted. Question your thoughts. Are you exaggerating? Are you thinking in all or nothing terms? Are you ignoring the positive?
  3. Replace negative thoughts with positive ones: After you have challenged your existing thoughts, rewrite them in a more positive realistic language. It is sometimes useful to carry these positive challenges around with you on an index card.  Reduce needs, must, should to maybe, might, possibly.

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