The 80 per cent law. This law is useful for perfectionists. Perfectionists expect their lives to be 101 per cent, and if anything is not what they expect it to be they feel it is the end of the world. Since the world is a real world and is always short of 101 per cent, they are forever disappointed, dissatisfied, and distressed. Let us go back to our school-days. If you scored 80 per cent in an examination, you felt content and happy. Our lives cannot be 100 per cent all the time. Our problem is that, when stressed, we magnify that 20 per cent that is not doing well and let it become exaggerated to ruin whatever we have achieved already. In times of disappointment

and stress, be optimistic and look at the 80 per cent This is similar to a psychological test for identifying optimists and pessimists. A glass is filled with milk to half way. The optimist will say the glass is half full; the pessimist will say it is half empty.

What do we do with our biological reactions? There are two ways to deal with this locked up energy which has nowhere to go, as modem stress does not normally require physical action. One way is to let it out by some action, like punching the car, although my patient told me it did not make him feel any better; in fact it made things worse. When a person gets upset, it is quite common for him to throw things at the alleged enemy, usually the husband or wife. I always admire the Greeks for their wild parties, in which people throw and crack plates by the dozen. This is probably a more controlled and socially acceptable kind of release. The other ways of letting off steam is through exercise—walking for hours, playing golf or tennis, swimming, riding a bike, etc. All these are good ways of coping with the excess energy built up through the normal biological reaction to stress. Or there are relaxation exercises, whereby this energy is absorbed back into the system and put to a more constructive use. Differrent forms of relaxation exercise exist in different cultures: yoga, transcendental meditation, Tai Chi, and self-hypnosis are examples.

Coconut, apple, or tomato? Whether or not a situation stresses us depends on how we perceive it. A certain situation may be stress for one person, but a source of pleasure for another. Jumping out of a plane is a real stress to most of us, but there are a lot of people who enjoy it as a sport. The level of anxiety produced by a stressful situation is dependent on the person who is experiencing the stress. Beauty is in the eyes of the beholder, and it is the same with stress and pleasure.

Tao and Chinese philosophy. Chinese philosophy very enlightening. Tao’ is the Chinese philosophy of The Way’. In this philosophy, our lives follow a mysterious way and may not be under our full control. We may experience disappointment at one point in time, but further along the way this disappointment may turn out to be a blessing. To illustrate this, read this short story of a farmer and his son.

Once upon a time, there was a farmer who had a teenage son. He was a good man who believed in the philosophy of Tao. One day his son went hunting. He found and captured a fast white horse which was running wild in the countryside. He brought the horse back to the village. The villagers were very excited. They all came and congratulated the father. However, the father was not excessively excited, but smiled and said: This is the way, this is the way’. The son rode the horse every day and enjoyed himself. A few months later, there was an accident. He fell off the horse and broke both legs. He was unable to walk, and had to sit in a chair all day. The villagers were all shaken and came to express their sorrow. They were surprised to find that the father was not excessively sad. The father said: This is the way, this is the way’. A few months later war broke out in the country. AH the young men in the village were conscripted into the army. The villagers were proud of these young men as they were fighting for their country. Battle drums were beating loud, and these young men were expected to destroy the enemy and bring back honour and glory. The son who had broken his legs was still on crutches and was not able to join the army. The father said: This is the way, this is the way’. A few weeks later it was learned that they had lost the battle. The young men of the village were killed in an ambush, and there were no survivors. The only young man left in the village was the son with the broken legs. The father said: This is the way, this is the way’.

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pain-relieving procedures.

Excessive Pain-Of course, under some circumstances a warning may be too strong. As a psychiatrist I see examples of this almost every day. The child who is warned too much about the dangers of life may grow up to be a coward, and the warning has done as much harm as good. The little girl warned too strongly about boys may live out her life as a spinster, and what was intended well has done her harm. So it is with pain. Our body is not always able to regulate the strength of the warning according to the exact needs of the case. The pain may be too severe or last too long. Conversely, pain sometimes is not severe enough. This is so in the early stages of some forms of cancer. In these cases the disease may spread to other organs of the body before the pain is sufficiently severe to bring the patient to seek help.

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If we have the ability to dissociate, we will find meditation quite easy, because we are already accessing various states of consciousness. We can use meditation as an ‘exposure’ technique to become more familiar with altered states. The more familiar we become with them, the more we will lose our fear of them.

Our recovery depends upon our ability to bring down and keep down our anxiety level. Recovery means having to change some of our previous ways of dealing with certain aspects of our life. Becoming disciplined in a relaxation technique is an important step in our overall commitment to recovery.

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Anticipatory anxiety is the fear of having a panic attack while meeting a specific commitment. The overall defence against ongoing anxiety and panic attacks sometimes reduces them to a manageable level. However, the relative safety is lost when we have to break through our invisible boundaries to meet a specific commitment. It can be caused by going to the local shop, going out with family or friends, or anything.

It doesn’t matter if the event is five minutes or five months away. The anticipation of having to go past our invisible boundaries means breaking our tenuous control of our overall defence. This’triggers the ‘what ifs’: ‘what if I can’t do it?’ ‘what if I do have a panic attack?’. By the time we have to leave home to meet the commitment the anxiety level may be so high we cancel our plans and stay home. In other words, we avoidbecause of a specific spiral of anxiety.

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Social phobia can also be an extremely restrictive disorder. People fear being watched by other people. They become frightened in case they embarrass themselves. They may fear public speaking, eating in front of other people, social occasions or talking to people. Some people are frightened to walk down the street or go into a shop in case people look at them. People can suffer extreme anxiety in these situations, and it is not unusual for them to experience ‘cued’ panic attacks.

Combinations

Although each disorder has its own primary manifestation, symptoms of other disorders can be experienced in conjunction with the principal disorder. A diagnosis is made by the primary presenting symptoms. Treatment will be directed to the primary disorder, along with associated treatment/s towards the overlap of the others.

This book is about what I have discovered about myself and other people who suffer from a panic-related anxiety disorder. It draws on my own and other people’s experiences of the disorder. It is difficult to distinguish between the examples. The many people I have spoken to will recognise themselves, but so too will the many millions of other people who have the disorder.

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