I experienced a severe anxiety attack recently, which reminded me how bad anxiety really is. How could I forget? I am a person who will stuff unpleasant things away and forget them soon after the stress is gone. This is probably typical for other people too – a panic attack is something we’d all like to forget.
Okay. So, what is this post all about?
I’m going to type up several passages from a landmark anxiety book – “Hope and Help for Your Nerves” by Dr. Claire Weekes. In doing so, I’m hoping to help anyone who runs across this post by introducing them to this amazing panic & anxiety resource.
At the end I will include a link, so that you can go buy the book from Amazon if you wish (and you really should!)
This book is a pioneering text in the field of anxiety self-help. When I first began suffering from severe anxiety, reading this book provided me immense comfort and was my first step in getting better at that point in time. Claire Weekes was a fantastic writer. Additionally, based on her own descriptions of conversations she had with patients in this book, I believe that she was a superior doctor.
Before we begin, I have an important point of caution – this book is old. It’s from the early 1960’s. Despite the publication date, the coping strategies in this book are effective. Panic and anxiety have always existed, no matter which name was given to this condition in past eras.
The goals that Dr. Weekes has set for panic disorder sufferers are extremely challenging. This is serious work. She asks that we learn to do things like “Float past” fear at the “peak of experience”.
In other words, when you’re experiencing your worst moment of panic, she’s asking you to recall and use the tools she prescribes in this book.
Naturally, this seems like an impossibly difficult task. I just had severe anxiety two days ago. It’s fresh on my mind. It felt impossible during my anxiety attack to “float” past the issue. The only solution is to reread this text and practice the concepts so that we can slowly master these skills over time.
SELECTIONS FROM “HOPE AND HELP FOR YOUR NERVES”
Dr. Claire Weekes, 1963
The Three Main Pitfalls Leading into Nervous illness
“Three main pitfalls can lead into nervous illness (anxiety attacks). They are sensitization, bewilderment, and fear.
Sensitization is a state in which our nerves react in an exaggerated way to stress; that is, they bring very intense feelings when under stress and they may react this way with alarming swiftness, almost in a flash.
There is no mystery about sensitization. We have all surely felt it in a mild way at the end of a day’s tense work, when our nerves feel on edge and little things upset us too much.
Constant tension alerts nerves to react in a mildly exaggerated way. It’s not pleasant and we don’t like it. If it is more severe, we may be alarmed and think that our nerves are in a very bad way indeed.
So much nervous illness is no more than severe sensitization kept alive by bewilderment and fear.
When a person is constantly sensitized and afraid of the state he is in, we say he is nervously ill. Fear must come into the picture to bring this kind of illness. Sensitization alone is not enough, because without fear a body will quickly repair its sensitized state.
Many people are precipitated into nervous illness by the fear induced by some sudden, alarming, yet harmless bodily sensation such as their first unexpected attack of palpitations. Such an attack can be frightening to a highly strung temperament, especially if it comes at night and there is no one to turn to for comfort and reassurance. The heart races wildly and the sufferer is sure it will burst. He usually lies still, afraid to move for fear of further damaging himself. So, fear arises.
It is only natural to be alarmed by sudden, unexpected, uncomfortable happenings in our body, particularly in the region of our heart.
Fear causes an additional outpouring of adrenalin, so that a heart already stirred to palpitations becomes further excited, beats even more quickly, and the attack lasts longer. The sufferer may panic, thinking he is about to die. His hands sweat, his face burns, his fingers tingle with “pins and needles” while he waits for he knows not what.
The attack eventually stops – it always does – and all may be well for a while. However, having had one frightening experience, he dreads another and for days remains tense and anxious, from time to time feeling his pulse. If the palpitations do not return, he settles down, loses himself in his work and forgets the incident.
If, however, he has a second attack, he really is concerned. Apparently, the wretched thing has come to stay! Not only is he afraid of palpitating, but he is also in a state of tension, wondering what further alarming experience may yet be in store for him. It is not long before tension, releasing more and more adrenaline, makes his stomach churn, his hands sweat, and his heart constantly beat quickly. He becomes even more afraid, and still more adrenalin is released. In other words, he becomes caught in the fear-adrenaline-fear cycle.
Chapter 5 Selections:
If you have the kind of nervous illness just described, you will notice that, as already mentioned, you have certain symptoms as a fairly constant background to your day, while others come from time to time.
For example, the churning stomach, sweating hands, and rapidly beating heart may be more or less always with you; while fear spasms, palpitations, “missed” heartbeats, pains around the heart, trembling spells, breathlessness, giddiness, nausea come in attacks at intervals.
The constant symptoms are those of sustained tension and fear, hence their chronicity; while the different recurring attacks are the result of varying intensity in sustained fear, hence their periodicity.
‘This is Too Simple for Me’
The treatment of all symptoms depends on a few simple rules. When you first read them you may think, ‘This is too simple for me. It will take something more drastic to cure me.’ In spite of this, you will need to be shown how to apply this simple treatment and may often have to reread instructions.
The principle of treatment can be summarized as:
Letting time pass
There is nothing mysterious or surprising about this treatment, and yet it is enlightening to see how many people sink deeper into their illness by doing the exact opposite.
Let us look again briefly at the person described in the last chapter, the person afraid of the physical feelings aroused by fear and see if we can pinpoint his own reaction to these symptoms.
First, he became unduly alarmed by his symptoms, examining each as it appeared, “listening in” in apprehension. He tried to free himself of the unwelcome feelings by tensing himself to meet them or pushing them away, agitatedly seeking occupation to force forgetfulness – in other words, by fighting or running away.
Also, he was bewildered because he could not find cure overnight. He kept looking back and worrying because so much time was passing and he was not yet cured, as if this were an evil spirit that could be exorcised if only he, or the doctor, knew the trick. He was impatient with time.
Briefly, he spent his time:
Running away, not facing;
Fighting, not accepting;
Arresting and “listening in,” not floating past;
Being impatient with time, not letting time pass
Need we be impressed if he thinks it will take something more drastic than facing, accepting, floating, and letting time pass to cure him? I don’t think we need.
Now, let us consider how you can cure yourself by facing, accepting, floating, and letting time pass.
Chapter 6 Selections:
First, look at yourself and notice how you are sitting in your chair. I have no doubt that you are tensely shrinking from the feelings within you and yet, at the same time, you are ready to ‘listen in’ in apprehension. I want you to do the exact opposite.
I want you to sit as comfortably as you can, relax to the best of your ability by letting your arms and legs sag into the chair as if charged with lead. In other words, let your body flop in the chair. Now examine and do not shrink from the sensations that have been upsetting you. I want you to examine each carefully, to analyze and describe it aloud to yourself.
For example, you may say, ‘My hands sweat and tremble. They feel sore…’. This may sound a little silly and you may smile. So much the better.
Begin with the nervous feeling in your stomach, the so-called churning. This may feel like an uneasy fluttering or may bore steadily like a hot poker passing from your stomach to your back. Do not tensely flinch from it. Go with it. Relax and analyze it.
Now that you have faced and examined it, is it so terrible? If you had arthritis in your wrist, you would be prepared to work with the arthritic pain without becoming too upset. Why regard this churning as something so different from ordinary pain that it can frighten you?
Stop regarding it as some monster trying to possess you. Understand that it is but the working of oversensitized adrenalin-releasing nerves and that by constantly shrinking from it you have stimulated an excessive outflow of adrenalin that has further excited your nerves to produce continual churning. By your anxiety you are producing the very feelings you dislike so much.
While you examine and analyze this churning, a strange thing may happen: you may find your attention wandering from yourself. This “thing” which seemed so terrible while you stayed tense and flinched from it, may fail to hold your attention for long when you see it for what it is – no more than a strange physical feeling of no great medical significance, and causing no real harm.
Just as A Broken Leg Takes Time to Heal
So, be prepared to accept and live with it for the time being. Accept it as something that will be with you for some time yet – in fact while you recover – but something that will eventually leave you if you are prepared to let time pass and not anxiously watch the churning during it’s passing.
But do not make the mistake of thinking it will go as soon as you cease to fear it.
Your nerves are still sensitized and will take time to heal, just as a broken leg takes time. However, as you improve and are no longer afraid, and do not try to cure it by controlling it, and are prepared to accept it and work with it presently, you will gradually become more interested in other things and will gradually forget to notice whether it is there or not. This is the way to recover.
By true acceptance you break the fear-adrenaline-fear cycle.
True Acceptance: The Keystone to Recovery
From this discussion you will appreciate that true acceptance is the keystone to recovery, and before you continue with the examination of your other symptoms, you should make sure that you understand its exact meaning.
I find that some patients complain, ‘I have accepted that churning in my stomach, but it is still there. So, what am I to do now?’ How could they have accepted it while they still complain about it?
Or, as one old man said, ‘After breakfast the churning starts. I can’t just sit there and churn. If I do, I’m exhausted after an hour, so I have to get up and walk around. But I’m too tired to walk around, so what am I to do?’
I said to him, ‘You haven’t really accepted that churning, have you?’
‘Oh yes I have,’ he answered indignantly, ‘I’m not frightened of it anymore.’
But he obviously was. He was afraid that after an hour’s churning he would be exhausted, so he sat tensely dreading its arrival, shrinking from it when it came and worrying about the exhaustion to follow.
Of course the churning, itself a symptom of tension, must inevitably come while so tensely awaited.
I tried to make him understand that he must be prepared to let his stomach churn and to continue reading his paper while it churned. He must try to loosen that tight hold on himself, literally let his body sag into the chair and go toward, not shrink from, any feeling his body brings him.
Only by doing so would he be truly accepting. In this way, and only in this way, would he eventually reach the stage when it would no longer matter whether his stomach churned or not. Then, freed from the stimulus of tension and anxiety, his adrenalin-releasing nerves would gradually calm and the churning would automatically lessen and finally cease.
The Symptoms are Always a Reflection of Your Mood
The symptoms of this type of illness are always a reflection of your mood. However, it is well to remember that it may be some time before your body reacts to the new mood of acceptance and that it may continue for a while to reflect the tense, frightened mood of the preceding weeks, months, or years.
This is one reason why nervous illness can be so bewildering and why this old man was bewildered. He had begun to accept, but when the symptoms did not disappear immediately, he quickly lost heart and became apprehensive again, although trying to convince himself that he was accepting.
It takes time for a body to establish acceptance as a mood and for this to eventually bring peace, just as it took time for fear to become established as continuous tension and anxiety. That is why “letting time pass” is such an important part of your treatment and why I emphasize it again and again. Time is the answer, but there must be that background of true acceptance while waiting for time to pass.
True acceptance means letting your stomach churn, letting your hands sweat and tremble, letting your heart thump without being too disconcerted by them. It does not matter if at first you cannot do this calmly – who could? It may be impossible to be calm at this stage. And you may find that one minute you can accept, the next minute you can’t. Don’t be upset by this – it is normal in the circumstances.
All I ask for at this stage is that you are prepared to try to live and work with your symptoms while they are present.
To float is just as important as to accept, and it works similar magic. I could say let ‘float’ and not ‘fight’ be your slogan, because it amounts to that.
Just as a person, floating on smooth water, lets himself be carried this way, that way by the gentle movement of the water, so should the nervously ill let his body “go with” the feelings his nervous reactions bring instead of trying to withdraw from them or force his way through them.
Let me illustrate more clearly the practical application of ‘float.’
A patient had become so afraid of meeting people that she had not entered a shop for months. When asked to make a small purchase she said, ‘I couldn’t go into a shop. I’ve tried but I can’t. The harder I try, the worse I get. If I force myself, I feel I’m paralyzed and can’t put one foot in front of the other. So please don’t ask me to go into a shop.’
In Deep, Cool Water
I told her that she had little hope of succeeding while she tried to force herself in this way. This was the fighting of which I had previously warned her. Then I showed her a trick I show many patients.
I placed my hand on her chest and asked her to move forward against my pressure. When she strained to do this, I pointed out that this was exactly how she had been trying to conquer her illness.
I then asked her to stretch her arms before her, level with her shoulders, and to move them as if swimming breaststroke. I also asked her to imagine at the same time that she was swimming forward in deep, cool water. I could feel her relax immediately.
If [you fear water], don’t upset yourself by trying to cope with the thought of deep, cool water. Choose some other way to ‘float’ that may appeal to you. For instance, the woman I have just been talking about later admitted she did not like the thought of water, so she imagined she was on a cloud floating through the door.
Masterly inactivity, a well-known phrase, is another way to describe floating. It means to give up the struggle to stop holding tensely onto yourself, trying to control your fear, trying to ‘do something about it’ while subjecting yourself to constant self-analysis.
The average person, tense with battle, has an innate aversion to practicing masterly activity and letting go. He vaguely thinks that were he to do this, he would lose control over the last vestige of his willpower and his house of cards would tumble.
As one young man said, ‘I feel I must stand on guard. If I were to let go, I’m sure something would snap. It is absolutely necessary for me to keep control and hold myself together’
When he was obliged to talk to strangers, he would dig his nails into his palms while he tried to control his trembling body and conceal his state of nervous tension. He would watch the clock anxiously, wondering how much longer he could keep up this masquerade without cracking.
Loosen Your Attitude
It is to such tense, controlled, nail-digging people that I say, ‘practice masterly inactivity and let go’ Loosen your attitude. Don’t be too concerned because you are tense and cannot relax. The very act of being prepared to accept your tenseness relaxes your mind, and relaxation of body gradually follows. You don’t have to strive for relaxation. You have to wait for it.
When a patient says, ‘I have tried so hard all day to be relaxed,’ surely he has had a day of striving, not of relaxation. Let your body find its own level without controlling it, directing it. Believe me, if you do this you will not crack. You will not lose control of yourself.
In your tense effort to control yourself you have been releasing more and more adrenalin and so further exciting your organs to produce the very sensations from which you have been trying to escape.
Float past tension and fear
Float past unwelcome suggestions
Float, don’t fight
Go through the Peak of Experience with utter acceptance
Let more time pass
Analyzing Fear. Two Separate Fears
Cure lies in desensitization, and there is no doubt that the key to desensitization lies in learning how to cope with panic.
Recurring panic, more than any other nervous symptom, helps to keep nervous illness alive. To cope with panic, it is important for the nervously ill person to understand that when he panics, he feels not one fear, as he supposes, but two separate fears.
Because his nerves are sensitized, one fear follows the other so swiftly it is as if the two fears are one.
With each wave of panic there are always two separate fears involved. I will call these the first and second fear.
The importance of recognizing these two separate fears cannot be overestimated, because although the nervously ill person, as a result of sensitization, may have no direct control over the first fear, with understanding and practice he can learn how to control second fear, and it is this second fear that is keeping the first fear alive, keeping him sensitized, keeping him nervously ill.
Everyone experiences first fear from time to time. It is the fear that comes reflexively, almost automatically, in response to some threatened danger. It is normal in intensity – we understand it, we accept it. We cope with the danger and the fear passes.
However, the flash of first fear that comes to a sensitized person in response to danger is not normal in intensity.
It can be so overwhelmingly intense, so electric in its swiftness, so out of proportion to the danger causing it that a sensitized person cannot readily dismiss it. Indeed, he usually recoils from it, and as he does this he adds a second flash of fear to the first flash.
He adds fear of the first flash.
Indeed, he may be much more concerned with the physical feeling of panic than with the original danger. And because that old bogy, sensitization, prolongs the first flash, the second flash may actually seem to join it. This is why the two fears so often feel as one.
A flash of first fear may follow no more than the sudden impact of a cold blast of wind. It may follow merely some mildly unpleasant memory; it may come in response to a thought only vaguely understood, or, as I mentioned earlier, it may seem to come ‘out of the blue’.
‘Oh my goodness! Here it is again!’
A nervously ill person has only to think of being trapped for first fear to flash instantly. To this he immediately adds plenty of second fear as he thinks, ‘Oh, my goodness! Here it is again! I can’t stand it. I’ll make a fool of myself in front of all these people. Let me out of here. Quickly! Quickly!’.
With each ‘Quickly!’ he adds more and more panic, more and more tension, and as the tension mounts, naturally the panic mounts in intensity, until he is never quite sure just how intense the panic can become or what crisis it may bring.
No mounting panic
If he were prepared to sit in his seat, relax his body to the best of his ability – let it sag, flop into his seat – and let the panic flash, let it do its very worst, let it flash right through him without withdrawing tensely from it, there would be no mounting tension, no mounting panic.
His sensitized body may continue to flash panic for a while, but the panic would not mount, and he would be able to sit there and see the function through.
It is bombardment by second fear, day after day, week after week, for one excuse or another that keeps nerves alerted, always triggered to fire that first fear so sensitively, flashing electrically when under stress.
Unmask that second fear
How important it is to learn how to spot second fear and send it packing. Recognizing second fear and coping with it is the way to desensitization, the way to recovery.
Recognizing second fear is made easier when we realize that it can usually be prefixed by ‘Oh my goodness!’ and ‘What if…?’.
‘Oh my goodness, it took four capsules to get me to sleep last night. What if four don’t work tonight?’
‘Oh my goodness, what if I get worse, not better?’
So many Oh my Goodnesses and so many What Ifs make up that second fear.
All the symptoms that come with stress, the pounding heart, churning stomach, weak feelings, etc. can be called first fears because they, too, come unbidden like the flash of fear that comes in answer to danger; and to these symptoms the nervously ill person certainly adds plenty of second fear, certainly adds many Oh, my goodnesses, many What ifs, more than enough to keep his fires well burning.
By analyzing fear and its symptoms in this way and seeing them as physical feelings that conform to a set pattern and are of no great medical significance, you unmask fear and with it your own illness, and only a bogy remains.
And when you decide to accept this bogy and add no more second fear (or as little as you can manage) the road to recovery lies open before you. Now, even with great success at learning how to cope with second fear, it takes time for desensitization.
The nervously ill person must understand and accept that his sensitized body will flash first fear from time to time for some time to come.
To face and accept one’s nervous symptoms without adding second fear and to let time pass for recovery – it works miracles if you are prepared to do just this.
But it is not easy to face, accept, and let time pass. It is especially difficult to let time pass because you may already have let so much time pass in suffering and despair that asking you to let more time pass may seem an impossible demand. It is difficult but necessary.
Also, don’t think I underestimate the severity of your panic. I know how severe it can be and I also know that even with the help of daily sedation and the best of intentions and determination to accept it, you may think yourself too exhausted to do so.
[At this point, Weekes goes on to describe that in certain extreme situations hospitalization and “sedatives” may be required until the patient can recover enough to begin following these guidelines].
[Many passages follow detailing various well-known panic symptoms and she comments on each symptom. She outlines how to squash second fear when you experience palpitations, slow heartbeat, “missed” heartbeats, “trembling turns”, inability to take a deep breath, throat lump, dizziness, etc. I am skipping to the section on eating / difficulty swallowing. I chose to include this section because it’s my biggest problem. Reading her text in this section helped me two years ago when I stopped eating for several weeks]
Eating may be a problem. You have probably lost weight and feel nauseated at the sight of food.
Do not make the mistake of thinking that because you feel nauseated and are under stress, your food is doing you little good and that therefore you need not eat much.
Even when eaten in these conditions food will nourish you, although it may take longer than normal to digest. Malnutrition and anemia can bring symptoms like yours, so you must eat enough.
If you have eaten poorly for weeks, your stomach may be unable at first to hold a normal-sized meal. If so, take small meals frequently. Eat egg flips and drink plenty of milk. Also, take a daily dose of vitamins.
Difficulty in Swallowing
The lump in the throat described earlier may be most troublesome at mealtime. The sufferer is sure he cannot swallow solid food, or at least finds this difficult.
‘I’ll never get it down!’
I keep biscuits [crackers or dry cookies] in my office especially for such a patient. Biscuits are dry, and at the sight of one the patient usually recoils. When I ask him to chew one, he says, ‘I couldn’t swallow a biscuit! I’d never get it down!’
I remind him that I asked him to chew, not swallow. Reluctantly he bites and chews. After a while I say, “Now remember, I want you only to chew. Don’t swallow.”
But already he has swallowed some of it. As soon as the moistened, softened biscuit reaches the back of his tongue, his swallowing reflexes take over and at least some of the biscuit is on its way.
You need not worry about trying to swallow, simply keep chewing. The swallowing will look after itself as the food is carried backward. And it will eventually find its way backward in spite of your nervous resistance. If you keep chewing, the food will all eventually disappear.
Losing Weight: Keep off those scales
Provided you are practicing accepting and letting time pass and are eating your meals, especially that last extra bit you don’t want, your weight is not important.
People with nervous illness place unnecessary significance on losing weight. They view their protruding bones with growing alarm, wondering just how far the fading-away process can go before they fall to pieces completely. [Second Fear].
They haunt the bathroom scales, eyes glued to the dial, while they try to jiggle out a few extra ounces. Cover your scales and resist all temptation to stand on them until you are so fat that you think its time to diet.
It is interesting to note the direct and yet temporary effect of emotional stress on appetite. I have seen a distressed person gag at the sight of food, only to devour it ravenously an hour later after hearing good news.
The body made thin by fear is not diseased and is waiting to recover lost weight as soon as you will pass the food down to it.
So place no importance on your wasted looks, your “poor thin body”. Eat up and forget those scales. Even when some cheerful friend says, “good heavens, you are thinner than ever!” still resist the temptation to step onto the scales.
Why not think, ‘I may look awful today, but nervous illness is not a disease. As soon as I am a little better, I will put on more weight. In the meantime, I’ll eat up, even if I have to chew the food for hours. And I’ll float past my neighbors comments.’
It is essential that you be occupied while awaiting cure. However, I must warn you against feverishly seeking occupation in order to forget yourself.
This is running away from fear, and you can’t run far from fear. I want you to be occupied while facing your symptoms and to accept the possibility of their return from time to time during recovery. There is a world of difference between these two approaches.
Every short respite from fear helps to calm your nerves so that they become less and less responsive to stimulation and your sensations less and less intense, until they are only a memory.”
This is a good place to stop. The other night after I had a severe attack, I re-read some of these passages and found myself laughing at how I did everything completely wrong.
She says not to worry about how much time is passing. I remember saying, “This has been going on again since November!”.
But again, it’s very hard to avoid feeling that way while in the heat of the moment. Personally, since my anxiety is apparently here to stay, I think I might actually write this in a notebook and tape it to my fridge:
Let time pass”
***Buy the book “Hope and Help for your Nerves” here: https://www.amazon.com/Hope-Help-Nerves-Claire-Weekes/dp/0451167228
An excellent article about Claire Weeks from the Syndey Morning Herald: https://www.smh.com.au/lifestyle/health-and-wellness/face-accept-float-let-time-pass-claire-weekes-anxiety-cure-holds-true-decades-on-20190917-p52s2w.html
All Claire Weekes Publications: https://claire-weekes-publications.myshopify.com/
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