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

452 Pages·2006·9.19 MB·English

Praise for
When Panic Attacks
“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
“Dr. Burns has a truly unique and remarkable ability to present the most current evidence-based
therapies for anxiety in a way that is engaging, compelling, easy to read, and—most important of
all—useful. Readers will be able to make immediate practical use of the concepts and strategies
Dr. Burns presents here. I’m sure this book will change many lives.”
—Jacqueline B. Persons, Ph.D., Director of the San
Francisco Bay Area Center for Cognitive Therapy and
Associate Clinical Professor at the University of
California, Berkeley
“Besides being well written and accessible, with lots of patient narratives to spark interest, When
Panic Attacks lays out exactly what readers need to do to feel better.”
—Library Journal
Also by David D. Burns, M.D.
Feeling Good: The New
Mood Therapy
Intimate Connections
The Feeling Good Handbook
Ten Days to Self-Esteem
Ten Days to Self-Esteem:
The Leader’s Manual

Copyright © 2006 by David Burns All Rights Reserved
A hardcover edition of this book was originally published in 2006 by
Morgan Road Books.
Published in the United Sta tes by Morgan Road Books, an imprint of The Doubleday Broadway
Publishing Group, a division of Random House, Inc., New York.
www.morganroadbooks.com
MORGAN ROAD BOOKS and the M colophon are trademarks of Random House, Inc.
Library of Congress Cataloging-in-Publication Data
Burns, David D.
When panic attacks : the new, drug-free anxiety therapy that can change your life / by David D.
Burns.
p. cm.
1. Panic attacks—Treatment. 2. Panic attacks—Alternative treatment.
I. Title.
RC535.B87 2006
616.85′22306—dc22
2005052260
eISBN: 978-0-76792389-7
v3.1_r3
AUTHOR’S NOTE
T
he ideas and techniques in this book are not intended as a substitute
for consultation or treatment with a qualified mental health professional.
The names and identities of the people in this book have been disguised
to such an extensive degree that any resemblance to any person, living
or dead, is purely coincidental. Most of the cases represent composites of
many patients with similar problems. I’ve done this to protect patient
confidentiality. However, I’ve also attempted to preserve the spirit of the
work we did together. I hope these stories ring true and resonate with
your own personal experience.
ACKNOWLEDGMENTS
I
would like to thank my daughter, Signe Burns, for her enormous
contributions to the creation of this book. Without Signe’s brilliant
editing and spirit, this book would have been radically different. We
worked on it together for over a year—a joyous but sometimes humbling
experience, because Signe’s feedback was always ruthlessly honest. We
had tons of fun and spent lots of time giggling uncontrollably just about
the time our brains were starting to turn to mush toward the end of the
day.
I also want to thank Amy Hertz for giving me the chance to write this
book and to work with her new publishing imprint, Morgan Road Books.
I’ve been knee-deep in academic research and clinical teaching at
Stanford for more than ten years, and there have been many new
developments in the treatment of anxiety and depression that I’ve
wanted to share with my colleagues and with the general public. I’m
especially grateful to Marc Haeringer, associate editor at Morgan Road
Books, for his fabulous editing and collaboration in the creation of this
manuscript.
I would also like to acknowledge many gifted colleagues whose
creativity and innovation have contributed so greatly to the development
and validation of the methods in this book. Of course, Drs. Albert Ellis
and Aaron Beck were two of the earliest pioneers, but it’s really been a
team effort. Thousands of gifted clinicians and researchers worldwide
have worked together to put Cognitive Behavior Therapy on the map.
Finally, I want to thank the psychiatric residents at Stanford
University School of Medicine who have attended my Wednesday
evening psychotherapy seminars over the past several years. This has
been a dynamic personal and professional experience for me, and while
I’ve been the teacher, I’ve also been the student. I’ve learned
tremendously from all of you every single week. Your enthusiasm,
compassion, and zeal have been an incredible gift!
CONTENTS
Cover
Other Books by This Author
Title Page
Copyright
Author’s Note
Acknowledgments
Introduction
Part I. The Basics
1. I Think, Therefore I Fear
2. Are You Anxious? Or Depressed?
3. Do You Have an Anxiety Disorder?
4. Placebo Nation: The Truth About Antidepressants and Anti-Anxiety
Medications
5. What Would It Be Worth If I Could Show You How to Change Your
Life?
6. The Daily Mood Log
Part II. The Cognitive Model
7. Uncovering Your Self-Defeating Beliefs
8. How to Modify a Self-Defeating Belief
9. The What-If Technique
10. Compassion-Based Technique
11. Truth-Based Techniques
12. Logical and Semantic Techniques
13. Quantitative Techniques
14. Humor-Based Techniques
15. Role-Playing and Spiritual Techniques
16. Motivational Techniques
17. Anti-Procrastination Techniques
Part III. The Exposure Model
18. Classical Exposure: Taking a Page from the Tibetan Book of the
Dead
19. Cognitive Exposure: The Monster in Your Mind
20. Interpersonal Exposure: The Fear of People
Part IV. The Hidden Emotion Model
21. The Hidden Emotion Technique: Sweeping Your Problems Under
the Rug
Part V. Selecting the Techniques
That Will Work for You
22. The Recovery Circle: Failing as Fast as You Can
23. Putting It All Together: The Woman with the Scar on Her Nose
24. Feeling Better versus Getting Better: Relapse Prevention Training
References
Your Anxiety Toolkit
About the Author
INTRODUCTION
D
o self-help books actually help anyone? During the past fifteen years,
Dr. Forrest Scogin and his colleagues from the University of Alabama
Medical Center have conducted a series of innovative experiments
designed to answer this question. The researchers randomly divided sixty
patients seeking treatment for episodes of major depression into two
groups. They told both groups of patients that they’d have to wait four
weeks to see a psychiatrist. In the meantime, they gave each patient in
one group a copy of my first book, Feeling Good: The New Mood Therapy,
and encouraged them to read it during the waiting period. The patients
in the second group did not receive the book. A research assistant called
all the patients each week and administered two widely used tests that
can track changes in depression.
The researchers were surprised by the results of their study. At the end
of the four-week waiting period, two-thirds of the patients who read
Feeling Good had improved substantially or recovered, even though they
did not receive any medications or psychotherapy. In fact, they improved
so much that they didn’t need any additional treatment.
In contrast, the patients who did not receive Feeling Good failed to
improve. The researchers then gave them a copy of Feeling Good and
asked them to read it during a second four-week waiting period. Two-
thirds of them recovered and did not require any additional treatment.
Furthermore, the patients who responded to Feeling Good have not
relapsed, but have maintained their gains for up to three years so far.
These were not fly-by-night studies, but peer-refereed studies
published in top psychological and medical journals. The researchers
concluded that Feeling Good “bibliotherapy” should be the first line of
treatment for most patients suffering from depression because it often
works faster than drugs or psychotherapy. In addition, it’s incredibly
cost-effective and entirely free of the troublesome side effects of
psychiatric medications, such as weight gain, insomnia, sexual
difficulties, or addiction.
The therapy I described in Feeling Good is called Cognitive Behavior