Case Study: Effect of Increasing Resilience on Anxiety and Panic Attacks

25.03.17 05:28 PM By Mignon Walker MD, Lead Resilience Coach

A 26 year old woman with a 10 year history of anxiety with debilitating panic attacks, on medication and meeting weekly with a therapist seeks somatic coaching for panic attacks.

Client Background

  • Married woman employed part time in an entry level position
  • Grew up with a chronically ill parent who was emotionally abusive, and had been frequently insulted and criticized when she was younger
  • She developed very low self-esteem, and felt sad and unmotivated most days  
  • Believed she said she had a chemical imbalance that caused her anxiety, and that she was stuck in her situation because of it
  • She was married, but did not want to have children because "all [she] could teach [her] kids is how to be anxious" 
  • She was living in her parent's basement and could not work more than part time due to frequent anxiety attacks
  • She was compliant with taking 3 medications prescribed to control her anxiety, but did not like that they made her feel emotionally numb and caused her to gain weight 


Symptoms

  • Constant fear of dying
  • Constant negative self-talk and low self-esteem
  • Diffiiculty speaking up for herself
  • Uncomfortable meeting new people and in groups
  • Low expectations of her potential at work
  • Almost daily episodes of immobilization, paranoia, rapid heart rate, concerns that something was wrong with her, and that whe wasn't good for anything


Diagnoses

  • Anxiety
  • Paranoia
  • Panic Attacks
  • Depression


Previous Treatments

  • Talk Therapy for 10 years
  • Cognitive and Behavioral Therapy (CBT)
  • Trauma Informed Dialectic Behavioral Therapy (DBT)
  • EMDR
  • Group therapy


SLIP™ Resilience Coaching Experience

Britanny was referred to SLIP™ Resiience Coaching as a last resort. 

  • Weekly sessions for the first two weeks then,
  • Biweekly coaching sessions with home ketamine therapy alternating with unmedicated sessions 
  • Total of 8 weekly home ketamine sessions with coaching, and a total of 12 coaching sessions without ketamine
  • 2 Years after coaching, she remains resilient with no anxiety, panic attacks or negative self-talk 

Transformational Moments
  • Resolution of core belief wounds causing self-doubt and constant negative self-talk
  • Resolution of fear causing anxiety and panic attacks
  • Increased self-confidence
  • Became able to speak up for herself
  • Overcame the fear of dying
  • Understanding how to work with her emotions and allow them to heal
  • Learning to trust herself and her gut sense
  • Able to enjoy the present moment without anxiety


Discussion

In the SLIP™ Coaching model, "anxiety" is not the focus of the sessions. It is a symptom of unresolved emotional wounds caused by intensely fearful experiences. By helping clients heal their deep emotional wounds, they move beyond the limitations and stigma associated with their clinical diagnosis. When clients no longer feel bad because of intense anxiety, isolation and self-criticism, they become more grounded, confident, connected, and able to create a life they enjoy.


How the Method Works

SLIP™ Resilience Coaching is a trauma informed somatic resilience coaching method that targets non-verbal aspects of memories associated with stressful events and periods of overwhelm. It targets deep brain functions related to the limbic system which governs memory, learning, pleasure, immunity, survival reflexes (fight, flight, freeze, surrender) and automatic essential body functions (heart rate, breathing rate, digestion). 


When an experience triggers survival reflexes, the limbic considers these important and attaches the intense reflex responses to the experience to the memory. That is why a certain sight, sound, or smell linked to a stressful or traumatic memory can trigger rapid heart rate, tense muscles, breath holding, and intense fear, for example when something linked to a stressful or traumatic memory is encountered again.  With frequent triggering of the survival reflexes, a person can become hypervigilant.  This focus on survival supresses other emotions like pleasure and happiness because they are less important for survival.


These deeper areas of the brain, sometimes referred to as the reptilian brain, do not engage language.  They are reflexive responses that occur automatically and talking does not prevent them.  The parts of the brain responsible for talking are overruled by the instinct to survive. When a person experiences frequent threats, or is chronically afraid, they can get stuck in a loop of being hypervigilant and having extreme responses to people and situations that are out of proportion tot he threat. This is how people become chronically anxious, paranoid, and prone to panicking.


In this case, the client's symptoms of anxiety and panic had been treated with medication to improve her brain chemistry, and talk based therapies that provided coping strategies for responding to the symptoms, but nothing she had tried was able to address the root causes of her debilitating symptoms, the frequently triggered survival reflexes and hypervigilance.


Somatic processing allows release of survival reflexes attached to stressful and traumatic memories so that the nervous system can reset without hypervigilance.  This is true whether the system is prone to anxiety, depression, or other post traumatic stress symptoms. Uncoupling the survival responses from the memory allows the limbic system to "refile" the memory from "high alert" easy to trigger, to less intense, like any other not survival related memory.  The memory remains intact but the response to the memory is neutral. This process restores balance to the nervous system and unlock access to non-survival related feelings like joy, satisfaction, and connection.


The client had develped maladaptive (inaccurate based on her experience) core beliefs as a result of chronic insults and criticisms from one of her primary caregivers from early childhood through young adulthood. Because of the negativity she experienced, she came to believe that she was unlovable, unworthy, sickly, and any health issue was percieved as life threatening.  SLIP™ Resilience Coaching protocols enabled Britanny to resolve these maladaptive beliefs and reconnect with her pre-conditioned beliefs of being lovable, worthy, healthy and a good person.


After three months of coaching, this client was off all medication, open to working full time whan a position became available, and had a more stable supportive relationship with her spouse. She felt happy most of the time and her self-talk as "always positive."  At two years of follow up, she remains emotionally balanced, more highly functioning at work and in her relationship, and her self-talk is still "always positive."



Mignon Walker MD, Lead Resilience Coach