FEAR vs. the ACT Principles

I saw my doctor yesterday for a routine med check. He’s a really awesome guy. The first time we met, I had called for an emergency appointment at my doctor’s office and I hadn’t yet established myself with one specific provider. I was in the middle of a multiple day, horrible panic attack that wouldn’t break. I’d called out of work more than once and even left work once because of a panic attack. It was horrible. I got an appointment with him and it turned out that although this was a G.P. office, he was duel certified in family medicine and psychiatry. He spent half of his shifts at the family medicine office and half at his psychiatry office. I got really lucky.

He’s a very nice, caring man that’s easy to talk to. I’ve now been seeing him as my GP for a couple years. And because of our introduction, where I was a pale and shaky mess begging for help, he truly appreciates my anxiety issues. So, at each of my visits he asks not only how I’ve been doing in general, but how my anxiety has been. Yesterday I told him about my panic attack and anxiety that lasted about 3 days on our trip to Alabama. Pretty awful. But outside of that bad attack, I’ve only had smaller flares of anxiety since I last saw him. That is the term I use for when anxiety flashes through my system (hot flash, stomach drop, anxious thoughts). When that happens I worry it will turn into a panic attack or it won’t go away. Then, I do what I can to diffuse it & it eases off before becoming debilitating.

Of course, then this morning I have a strong anxiety flare. Just figures. I work the next three nights and occasionally the day before my first shift will be a trigger. Those times I had horrible panic attacks where I missed work I would have this building anxiety through the day, knowing I had a deadline for when I could call out by. My brain would run in circles, trying to figure out if my anxiety would be bad enough that I just couldn’t handle it or if I’d get it under control and be able to manage the shift. Even knowing once I got there, it would often dissipate with the distractions and business of the shift, I would still be paralyzed with indecision. So, because of those days, sometimes before a shift my anxiety will flare.

As I mentioned in a previous blog entry, when anxiety flares up I will often turn to my panic workbook and read more pages and do more exercises. I still haven’t made it through the whole thing, mostly because I read it around the times I’ve had anxiety issues. Today, I’m doing something different. Awhile ago we signed up for the Great Courses monthly subscription (we are nerds) and they have a course on cognitive behavioral therapy (CBT) which is lead by Jason Satterfield. This course features three patients wishing to use CBT to overcome challenges. One person has severe depression, another has anger/rage issues, and the third is dealing with anxiety. I’ve watched 3.5 of the episodes so far & decided that would be my project for defusing this mornings flare of anxiety.

In the current episode, he is explaining the acronyms FEAR vs. ACT. So I thought I’d write them into the blog. ACT is a subset of CBT therapy. 

F – Fusion with your thoughts. Rather than seeing thoughts as transient things that come and go, you see your thought as a part of you – you and your thoughts are one.

E – Evaluation of your experience, or misevaluation of the experience. Misunderstanding of what is going on.

A – Avoidance of the experience.

R – Reason-giving behavior, making excuses.


A – Accept your reactions and be present.

C – Chose your direction.

T – Take action.

Core principles of ACT:

  • Thoughts and opinions are separate from who you are. Thoughts are just mental noise. Thoughts are neither true or false.
  • Acceptance – accept the thoughts as they are & let them be
  • Stay in the present, don’t focus on the future or fortune-tell, develop mindfulness
  • Observe the self – There are events in your life there are situations you find yourself in – but the core of *you* is present through it all
  • Values – remember what your values are, are you being true to your actions?
  • Commit to your actions – decide the direction you want to go and commit

I wasn’t familiar with the ACT principles, so I found the episode interesting. I find that learning about anxiety helps me with mindfulness, be present and not “letting my thoughts run away”. I’ve been drinking my calm tea, writing this entry and watching the episode and I’m feeling better. The next episode is about stress and coping… I might as well keep watching.

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