Abramowitz, Deacon, Whiteside - Exposure Therapy for Anxiety torrent

Abramowitz, Deacon, Whiteside - Exposure Therapy for Anxiety (epub)

Internal Cues

Arousal-related sensations most commonly feared by patients with panic attacks include heart palpitations, chest pain or pressure, shortness of breath, dizziness, sweating, feeling of choking, chills or hot flushes, trembling or shaking, nausea, numbness or tingling, and feeling detached from oneself or one’s surroundings. These symptoms may be exacerbated when the individual becomes anxious, is under stress, or ingests a stimulant such as caffeine. Bodily signs and symptoms not generally exacerbated by the fight-or-flight response include musculoskeletal pain, fatigue, and skin anomalies (lumps, rashes, moles). Some patients exhibit a circumscribed fear of a particular sensation, like the 42-year-old man who presented with the sole concern that his perceived difficulty swallowing (despite no medical findings) meant that his throat was closing in, which would cause him to suffocate. More often, patients fear multiple internal cues and worry about the occurrence of multiple health catastrophes.

TABLE 11.2. Functional Assessment of Bodily Cues and Health Concerns at a Glance