I have been treating several clients over recent months who have been struggling with anxiety, more specifically, panic attacks and panic disorder. As part of their treatment process, my clients have been taught how to apply Claire Weekes’ anxiety management principles. Using these principles, clients are reporting that their panic attacks have reduced in frequency, duration, and intensity. This blog discusses these principles in simple and easy to understand ways.
Dr Weekes was a medical practitioner in the mid-20th century who was considered by many as the pioneer of modern anxiety treatment. She wrote several books on the topic and although she passed away over 30 years ago, many today continue to cite her work. Weekes was curious about the high failure rates of recovery of her anxious patients who underwent various psychiatric treatments. She developed her own program based on four principles that addressed fear-avoidance habits, often made worse, or caused, by a very responsive "sensitised" nervous system.
Dr Weekes’ taught her patients that the goal was not to get rid of panic attacks, but to manage them more effectively by applying her four anxiety management principles:
Face it:
Doctor Weekes taught patients that although their fear is real, the danger isn't. As such, there is no legitimate need for escape. She wanted them to understand that anxiety is simply a few brain chemicals out of place for the current situation. It is just adrenalin. This chemical causes the same body sensations patients feel in other situations, such as when they exercise, jump in scary movie, or scream in exhilaration on a rollercoaster. These body sensations also feel very uncomfortable, but we don’t avoid doing these things. When having a panic attack, the mind tricks us and would have us believe that something sinister is happening and must be avoided. But avoidance fuels the anxiety and our worlds start to shink. Weekes advised that when we truly face our anxiety, we stay with the discomfort of the body sensations without escaping or using safety behaviours. She got her patience to purposefully do experiments in the community to bring on panic/anxiety. Through this process, they soon learned that by getting more afraid, they eventually got less afraid.
Accept it:
Doctor Weekes’ patients learned that the goal of recovery is not to be free from anxiety or panic attacks, but to not be scared of them anymore. She knew they were getting better when they didn’t fear their panic attacks or body sensations any longer. Her patients learned to accept that it is possible to be both afraid and safe in the same moment. Accepting involves ending the fight and struggle and yielding to the biological process, once adrenalin has dropped, because it is then too late to do anything about it. When patients tried to control the body sensations or escape their circumstances, they would speed up and just get more adrenaline, prolonging the discomfort and the panic attack. Her patients, learned to slow down and do absolutely nothing. They learned to be open and curious about their body sensations and witness how the body tries to keep them safe. When working with my clients, we get quite cheeky with our biological sensations and say to the panic attack. “Is that all you’ve got? That’s only a four on the panic scale. Come on, you can do better. Hit me with least a six!’ By doing this, you know you are truly in acceptance, and you are unmasking your fear as baseless.
Float through it:
Floating is about observing what is going on in your mind and body, and watching it come and go, just like clouds passing by in the sky, or leaves floating down a river. It’s like you are in a snow globe sitting at the bottom and just observing the flurry of thoughts, feelings, body sensations, memories and other intrusions just floating above you. When floating, patients do not engage with or fuse with any distorted thoughts or irrational beliefs about being unsafe. They do not answer any questions or concerns or get hooked into the thoughts or identify with them. When floating, your thoughts are separate to yourself. Floating slows everything down like you are walking through slow, deep, cool water. Floating enables you to see your anxious thoughts like drunken thoughts that cannot be trusted. They need time to sober up (for the panic attack to pass). Anxious thought are also bully thoughts. They want to grab all your attention, disempower you, make you to feel miserable, boss you around, and give you crummy advice (e.g., escape, use safety behaviours). We never give in to a bully so take back your power and simply watch those thoughts float by.
Let Time pass:
Doctor Weeks wanted her patients to know that rewiring their brains required lots of exposure practice and so getting well requires time and patience. She stressed that you can't learn your lessons and rewire your brain by only reading or listening to content and that her patients had to prioritise the time it will take to do their graduated exposures. She told them not to waste time on exposures in which they did not experience any discomfort, or they wouldn’t learn anything. She urged her patience to do their exposures frequently and to take regular steps up their exposure ladders. This will lead to the need for less time to realise that there is no danger. She also encouraged her patients to take the time to reflect on the lessons learned, even when the exposures did not go as well as anticipated. She encouraged them to end the narrative by reminding themselves of their courage to try and to extract the lesson they learned about what they will do differently next time. Progress is also not linear and so her patients understood that getting well involved some steps forward and some steps back over the passage of time.
Many clients I am working with are achieving significant success under my guidance using Dr Weekes principles. Their worlds are starting to expand again, and they no longer waste their time trying to identify or eradicate their triggers. They have recognised that this is not the goal and use their time more effectively to live a more fulfilling life. I would welcome the opportunity to work with you on your panic and anxiety if you think this approach could be helpful.
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