Fear, Learning to Manage Anxiety and Panic Attacks *
by Judith Bemis and Amr Barrada, PhD
(Published by Hazelden, 1994)
book offers an alternative approach in dealing with anxiety and panic attacks, one that is built on paradox. Through this
program you will acquire new insights, helpful coping strategies and a self-talk that is supportive and nurturing. You will discover
that there is hope for recovery. 'Embracing the Fear' offers a three-part program: Managing Our Anxiety, Listening to Our
Inner Dialogue, and Lifestyle Awareness. Managing Our Anxiety consists of 14 strategies for dealing with panic attacks, as
well as chronic or generalized anxiety. Listening to Our Inner Dialogue explains how self-talk plays an important part in
initiating and perpetuating our anxiety and panic, as well as helping us make it more manageable. Specific examples are included.
Lifestyle Awareness helps us gain a better understanding of how we feel about ourselves and how we relate to others. It raises
our awareness of how we deal with everyday life events and how our way of dealing with them can set us up for anxiety or panic
PART 1 - THE PROBLEM: FEAR OF FEAR
What Causes Anxiety Disorders
Anxiety Disorders and Alcohol
Gaining a New Perspective
What is Recovery?
PART 2 - THE SOLUTION: A COGNITIVE APPROACH
Introduction to the Program
Managing Our Anxiety
Listening to Our Inner Dialogue
THE FOURTEEN STRATEGIES
Strategy 1: Accepting Our Anxiety Disorder
Strategy 2: Practicing a Self-Nurturing
Strategy 3: Allowing the Sensations of Anxiety or Panic
Strategy 4: Slowing Down
Strategy 5: Letting Go of Control
Strategy 6: Taking
Strategy 7: Allowing Catastrophic Thoughts
Strategy 8: Learning and Talking About Our Anxiety Disorder
Strategy 9: Keeping Our Expectations
Strategy 10: Accepting Setbacks
Strategy 11: Taking the Time Limit Out of Recovery
Strategy 12: No Longer Anticipating Panic Attacks
Strategy 13: Recognizing
Our Inner Strength
Strategy 14: Reaching Out to Others
PART 3 - INTEGRATION: TAKING RISKS
Putting the Program to Work
Going to Church
Going to the Dentist
Going to the
Going to the Hair Salon
Shopping at the Mall
Going to a Restaurant
Going to the Theater, Concerts, or Large Group Events
Going to a Social Event or Party
Going to Work, to a Conference, or on a Job Interview
Riding on a Bus, in a Van, or in a Carpool
Driving on the Expressway
Taking a Trip
Flying the Unfriendly Skies
PART 4: APPENDIX
Some Thoughts on Self-Care
Organizing an Anxiety/Panic Support Group
Strategies and Corresponding Self-Talk:
(Practicing a Self-Nurturing Inner Dialogue, pages 31-33)
2: Our self-talk, which tends to be shaming and non-permissive, has been partly responsible for our anxiety or panic. It continues
to be a problem because it affects the intensity and duration of these feelings. It will help if we practice an inner dialogue
that is nurturing, We might begin by giving ourselves permission to be anxious.
A-talk: What's wrong
with me? Why am I so anxious?
B-talk: I'm probably anxious because . . (offer explanation, e.g., I didn't sleep
well last night, my job is very stressful, I need to slow down, etc.)
A-talk: This shouldn't be happening to me.
I must be dying (passing out, going crazy).
B-talk: I'm having a panic attack. It's only the thought of dying (passing
out, going crazy) that is frightening me. I'm not in any physical danger.
(Letting Go of Control,
Strategy 5: With the onset of intense anxiety or panic, our first reaction is to try
to stay in control. It will help is we practice letting go; the less we attempt to stay in control, the more in control we
A-talk: I must not let this get out of hand. I've got to stay in control.
I'll try to allow myself to let go of control. The more I can let go, the better.
A-talk: I can't leave because
of these feelings. If I give in to them now, it will be just that much worse the next time!
B-talk: I do have
the option to leave, in which case I could practice being okay with leaving. Knowing that I have that option will make it
easier to stay, now or any other time.
(Lynn's Story, page 29)(Delores's Story, page 82)
"At a recent support group meeting, a young man asked, 'Does anyone else get up in the morning dreading
a panic attack?' Now, I can remember feeling that way, but to my surprise I realized I no longer think about that. This question
made me reflect on how far I've come. I know that I might have setbacks, but I also know that 'allowing' them to happen, getting
lots of practice, and accepting where I am now in my recovery help me through the tough moments. I used to panic everywhere--church,
movie theaters, restaurants, home, social functions. I thought I was nuts! I avoided most of these places in fear of the dreaded
attack. However, I am enjoying my successes now and it's wonderful!"
"The early days of agoraphobia were confusing
and terrifying. I remember holding onto my desk at work and asking, What is happening to me? That was the fall of
1965. It's a wonder I was even able to hold down a job. In the beginning I had no idea what was happening, nor did the medical
profession have any answers. For months I struggled with the belief that I was either seriously ill or that I was hopelessly
caught up in the grips of a mental illness. My days and nights consisted of fighting the feelings that had become so overwhelming.
I was constantly analyzing them, asking Why? and desperately trying to cling to some sense of sanity. There were times I thought
I was dying. A therapist said, 'No, you're not dying, but there will be times when you'll wish you were.' I didn't believe
him at the time, but the day would come when I would understand what he meant only too well. Survival was the name of the game in those early days. I wouldn't give up trying to find a solution to my problem.
What I did discover was by hit or miss, since no one could give me any answers. One thing I learned was that keeping
busy helped. Unfortunately, it was like being on a treadmill; I was okay until it stopped. My life became a whirlwind of activity
with the ever present fear of what would happen if I ever stopped to relax. I also discovered that by not being so impressed
with the feelings I was able to keep some perspective. (This was the 'grit-your-teeth-and-plow-through' period.) Most important,
I discovered that when I no longer cared whether I had a panic attack or not, they occurred less often. As though
it were yesterday, I remember remarking to my doctor, 'I've decided that if I pass out on the street someone will help me.
I just don't care anymore.' It was the beginning. Later, I was told by my therapist, 'It's when you stop caring that it goes
away.' And it did! Therapy was the final step in my recovery. I
learned definite strategies to use when dealing with panic attacks. A complete change of attitude evolved, which helped give
me back my zest for life. Fear was replaced with accepting and allowing. My expectations were lowered; even my whirlwind pace
was challenged. Someone had finally helped me to get off the treadmill."
This is one
of the best self-help books I have read on agoraphobia. I wish this book had been around when I was afflicted by my panic
disorder. I would highly recommend Embracing the Fear as worthwhile reading. -Al Kasha, Oscar-winning
composer, writer, and producer-
I have found that recovery
comes from acceptance, from letting the panic come without fighting it. I’ve learned this and so much more from Embracing
the Fear. It has given me my life back. -Lori-
‘Embracing the Fear’ my life has changed from anxiety-controlled to self-acceptance and self- love. It has taught
me a new approach in overcoming my agoraphobia and has encouraged me, once house-bound, to return to college to renew a career
abandoned 2- years ago. I recommend this book to anyone suffering from anxiety. -Debby-
A book reviewer once wrote, "If you can imagine,
there is no straining and striving to overcome your disorder, no 'hard work,' no guilt or shame, no pressure or deadlines.
The basic principle is a most permissive one that is sensible, balanced and emotionally healthy."
July/August 1994, Scottsdale, AZ. Written by Pat Merrill, Editor-
(The following reviews are from
This book saved me!! - I must admit that Lucinda Bassett’s program
(15 week taped program) and Dr. Bourne’s ‘Anxiety and Phobia Workbook’ are remarkable. . .but I feel that
this book ‘Embracing the Fear’ was the last ‘pill’ I really needed to help in my recovery from agoraphobia.
Once housebound, I have read many books on this topic. This book is wonderful. . .I have underlined and highlighted almost
the entire book. THIS is the first book that talked to me about MY fear. . .not fear of dying like so many other books describe
but fear of the TERROR of a panic attack. I KNEW I was not dying. . .I was just avoiding my life trying to protect myself
from having one of those dreaded attacks away from home. I HIGHLY recommend this book. I am currently finishing up my master's
degree in counseling and will definitely use this with my anxious clients. I can't tell you how much this book has helped
me. It is like my second bible. -Matthew's Mom-
This one is the best because I’ve read them
all - I have consumed every book out there on this subject. This is the best book for helping the patient cope and
understand the condition. It has more helpful coping strategies than any other book on the market. It is upbeat and gives
you the sense that you can handle this, and that you will be fine. I love their attitude. -A Customer-
years of terror - This remarkable book helped me to understand and see myself and my world in a new light. Being
a male who "white knuckled" my life for 15 years, the book allowed me to seek a new awareness nearly opposite from
what I felt the path to serenity and peace would be. No one can know the traps of panic disorder like those who live it. The
recovering authors’ insights have moved my struggles to insights, understanding and acceptance of myself, turning burdens
into gifts. A life changer for me, I have shared with others, on my fourth copy.
- When I read this book a few years ago I thought bull this will never work. But trust me it does. Facing and embracing
the fear instead of running from it does work, but you need determination and keep practicing the steps in the book. It WORKS!
A new way of thinking about anxiety - When the author said we give ourselves
two impossible choices by telling ourselves we can't stay because of fear and panic, yet we can't leave because of the failure
and humiliation, she really hit it on the nail for me. Giving myself two possible choices - it's okay to stay, and it's okay
to leave - opened up a new reality for me. I never told myself before I read this book that it's okay if I leave a panicked
situation. I always beat myself on the head and feared it meant I could never go back. I didn't realize how harshly I was
treating myself until I saw another possibility, the "B-Talk," which is about accepting myself, giving myself
options, and seeing anxiety from a new way. This book is a real life changer. - My Two Cents"-
This book is available at Amazon.com, Barnesandnoble.com, & local bookstores
Also through Hazelden Publications (1-800-328-0098)
Power of Acceptance, Finding Peace from Anxiety and Panic Attacks by
(Lightning Source, 2008)
Power of Acceptance' is a sequel to 'Embracing the Fear.' It delves deeper into the psychological factors that trigger anxiety
and panic attacks. It stresses the importance of a healthy self-esteem, of setting boundaries, and feeling more in charge
of our lives. Its content is more personal than the former book. It answers readers' questions, such as "What are our
thoughts about taking, or not taking, medication?" "Does acceptance mean that I can't do anything about my anxiety?"
"Am I being negative by lowering my expectations?"
Written by a recovered agoraphobic, this book speaks from the heart. Those of us trying to cope with persistent
and unexplainable anxiety or panic attacks need to be reminded that we are not alone. We discover, through coping strategies
and gentle self-talk, that we no longer have to try so hard to fix or control our anxiety. We no longer have to live in fear.
Chapter One: Origins
The First Panic Attack
Looking at the Problem
a Panic Attack
Diagnostic Symptoms of a Panic Attack
Why Am I Panicking?
Panic Attacks and Heredity
Other Factors to Consider
What Can Trigger
Anxiety or Panic?
Chapter Two: The Power of Acceptance
Meaning of Acceptance
The Gentle Voice Within
This is Who I Am Today
Slowing Down in a Fast-paced World
Expectations, a Positive Approach
Feeling the Fear
and Taking the Risk
Goals, Time Limits, Setbacks
Chapter Three: Acceptance in Everyday Life
Chapter Four: Growing in Awareness
Growing in Awareness
Getting in Touch With Our Feelings
of Our Lives
Becoming More Assertive
Dealing With Confrontation
Moving into a New Comfort zone
Chapter Five: Awareness Through Journaling
How to Journal
Recording Our Progress
Recording Our Feelings
Writing Unsent letters
Prose and Poetry
Six: Beyond Acceptance
Questions on Self-care
Thoughts on Medication
Parting Thoughts - Recovery
Questions from the Support Person's Perspective
Chapter Two: The Power of
Acceptance (pages 33-34)
The power of acceptance is a challenging concept for those of us who feel trapped in a cycle of
fear. Perhaps the notion of accepting or allowing seems too simple a strategy for dealing with anxiety or
panic attacks. Seeing the problem as complex, we look for complex answers. However, I repeatedly hear people say, "The
thing that helped me the most in my recovery was acceptance." Despite its effectiveness in breaking the anxiety-panic
cycle, accepting seems contrary to what we think we should be doing, that is, trying hard to control our anxiety
symptoms. However, this need to control only builds up a resistance, which, in itself, creates a problem.
How do I know when I'm accepting
Tuning in to our self-talk is one way
of knowing whether or not we are accepting our anxiety. What are we saying about it? If we are telling ourselves that
we shouldn't have this problem or that we have to get rid of the anxiety we are not accepting. Instead, we are trying hard
to control our symptoms. However, we need to allow them to run their course. At a support group meeting, someone once commented, "I understand the
concepts we're discussing--acceptance and allowing the sensations of panic. I really think I'm doing that. So, why
am I still panicking?" She then went on to say, "Each time I feel the anxiety building I say to myself,
Oh, dear! Here it is again. How long is this going to go on?" This inner dialogue tells us why her panic attacks
are continuing. Still feeling overwhelmed, she is merely putting up with her symptoms while desperately hoping to get rid
of them as soon as possible. Even when some of us think we are accepting our anxiety, we don't always realize what we are
saying to ourselves and the difference our self-talk can make.
Does acceptance mean I'm always going to have this problem?
"I'm having a difficult time
with the idea of acceptance," said another support group member. "I feel that if I give in to my anxiety
or accept it, it will continue to get worse and I'll always have it." Many of us think that if we don't put a stop
to the anxiety or panic it will get worse. However, fear of being unable to control the anxiety and the anticipation of it
getting worse play a big part in perpetuating the problem. It's the accepting, the surrendering to our anxiety and panic symptoms--not
fighting them--that can help break the anxiety-panic cycle. While acceptance on a long-term basis may seem overwhelming, if
not impossible, trying to accept our anxiety one day at a time is more realistc and achievable.
Taking a Closer
Look at Our Self-Talk
(Slowing Down, page 80)
1. I'm running late. It will help if I give myself permission not to be on
time so that I won't have to rush.
2. It will help to slow everything down and focus on the moment. I can handle what I'm doing
I feel I'm not getting as much accomplished now that I've slowed down. The best I can do is accept that.
4. I just can't seem to slow down
today. It will help if I allow myself to feel rushed, even if it means being anxious.
(Goals, Time Limits, Setbacks, page
I can deal with this one day at a time. Today, I'll try to be patient with my progress.
2. The more I take my time in recovery,
the better. Trying to rush through the process is not helpful. I can try to see this as a time to continue practicing
helpful coping strategies. i am still making progress.
3. It has been quite a while since I've felt this anxious, but it makes a lot
of sense considering the stresses in my life (the pressures at work, family conflict, financial difficulties, etc.)
4. Why wouldn't I feel this way?
This is how I sometimes react to stressful situations.
(Mara's Story, page 75)
"I remember standing at the entrance to the grocery store, anticipating
the anxiety I was sure I'd have as soon as I stepped through the door. While mustering up my courage, I visualized the locations
of the items I needed. I then went directly to the shelves, quickly gathered up my groceries, and headed for the checkout
counter. With any luck there wouldn't be a line. I had rushed through the store on many occasions seeking to get outside before
the panicky feelings hit. What a surprise I got when I discovered
that slowing down and allowing the panic actually made it easier for me to stay in the store and finish my shopping. As I
became more accepting of the anxiety symptoms, I discovered that I was no longer afraid of them, and they became less and
less of a problem."
(Bev's Story, page 105)
"The first night I went to my support group I felt hope. I sat quietly and listened. The aloneness
I had been experiencing diminished. I heard that I wasn't the only one having those crazy feelings. Whew! What a relief!
Naturally, I expected the quick cure. I would get these terrifying feelings in tow and get on with my life! But that's not
how recovery works. Yet hope remains. Sometimes my day begins with fear, but the feeling is shorter-lived, nowhere as intense,
nor does fear haunt me as often as it did in the past. I allow the fear to do whatever it needs to do, remembering always
that it is only a feeling and that I am safe. Letting go takes practice, but it really has worked for me. So many areas of
my life have changed for the better. This program works! The difference is amazing when I keep my expectations low, stay with
the panic feelings, and believe that they will pass. This is a process that moves slowly. No time limits. No quick fixes.
But there is hope."
"We finally have a whole book devoted
to the healing properties of self-acceptance. People suffering from emotional problems should find this book extremely helpful
in their quest for recovery."
Amr Barrada, Ph.D.
Book Reviews(The following excerpts are taken from reviews on Amazon.com)
If you finally want to break the anxiety/panic cycle READ THIS BOOK (Oct. 30, 2008) - There are many good
books today that tackle the issues of anxiety and panic disorder. I’ve read the majority of them since the 1980’s,
and I featured several in ENcourage Newsletter (no longer in print) for the benefit of folks with panic disorder and agoraphobia.
But I’d like to make it clear that this particular book and author truly offers the most immediate practical help I’ve
seen. In keeping with Judith Bemis’ previous book, Embracing the Fear, the reader finds "real world" examples
of the actual use of ACCEPTANCE in anxious situations. This fills a big gap in available literature. More importantly,
perhaps, is the clarity with which ACCEPTANCE is described and defined. (Readers will be relieved to know the acceptance is
far from resignation.) The paradox and living experience of true acceptance is what heals us – on many levels. Rather
than ardent striving and controlling (which is exhausting and futile), one will learn just how to treat anxiety with a light
touch and gentle spirit. And it works beautifully.
P. Merrill , Editor (Scottsdale, AZ)
(see full review on amazon.com)
This book hits close to home - This book is
not a "how to" but rather a personal perspective that many anxiety sufferers have been looking for. When I was diagnosed
with generalized anxiety disorder (GAD) I began thinking that I was the only one who was experiencing emotions and traumatic
feelings of these levels. In her book, Judy simply tells her story and it is amazing how it can parallel your own world. As
she states, "You are not alone," and she means it. Realizing that I was truly not the only one, I began to cry and
shortly after, an immense weight began to be lifted, giving me hope.There is comfort in numbers, so they say, and realizing
you are one of many that suffers, brings hope, determination, and eventually peace with your anxiety. In combination with
professional help, these books (The Power of Acceptance and Embracing the Fear) have given me the tools to manage my anxiety
unlike any others, and courage to begin moving forward to a more enriching life.
A. Wachholz, anxiety recoverer
(see full review on amazon.com)
This book is available at Amazon.com, Barnesandnoble.com, & can be ordered through local bookstores
About the Author
Judith Bemis, a recovered agoraphobic,
started experiencing panic attacks in 1965. Thinking that it was a serious medical problem, she continually searched for answers
concerning the cause, but to no avail. After a period of being semi-housebound, she managed to white-knuckle it until a major
setback in 1981 prompted a renewed search for help. A year of cognitive therapy proved to be a turning point in her life.
Wanting to share her freedom with others, she
founded Open Door Outreach, Inc. (a network of support groups for people with agoraphobia and other related anxiety disorders)
and has served as director and facilitator for the organization since 1986. In January of 2007, Open Door merged with NAMI
Minnesota (National Alliance on Mental Illness). Ms. Bemis currently serves on the NAMI Minnesota Board of Directors.
Ms. Bemis holds a Bachelor of Science Degree in Education from the University
of Minnesota, and did graduate work at Michigan State University. Before retiring, she taught public school music for thirty-five
years and worked as a consultant for two years at Abbott-Northwestern Hospital's Behavioral Medicine Clinic in Minneapolis.
She is committed to helping improve the lives of people who suffer with anxiety and panic attacks.
Photograph by Bruce Schnack Photography