Many people with panic disorder suffer from unhealthy self-esteem or lack of self worth. This is in part because many panic sufferers experienced a dysfunctional or abusive childhood. One of the most common messages that is sent to a child in an abusive or dysfunctional situation is the message that “you’re not good enough”. That is to say “you’re not a good enough of a person to deserve to be treated in a loving way.” Abused children who receive this message again and again will start to believe it. Let me explain.

Among the ways that a child thinks are these two ways which contribute to this esteem destroyer. They are: A child is self-centered. They believe that the whole world revolves around them. They think that what ever happens in there life is a direct result of something that they have done. We know this because young children think that if they close their eyes - you cannot see them. Also, young children do not think rationally. An example of this would be if you offer a child a quarter in one hand and seven shiny pennies in the other hand they will pick the pennies almost every time.

Children do not think rationally and they believe that the would revolves around them. Consequently, if a child is part of a dysfunctional family system or if they are abused - they believe that they must have done something to cause it. They believe that they must have done something bad to deserve such painful treatment as they are experiencing.

Furthermore, a child will think “if I have done something bad to deserve this bad treatment then I must be bad. I must not be worthwhile.” This kind of thinking is - of course - illogical but nevertheless is how a child thinks and mentally responds.

If this kind of thinking response continues throughout the his or her childhood, then he or she will reach young adulthood will a very low self image. They will have internalized the thoughts “I am not a very worthwhile person” and “I am a bad person not worthy of any love or respect from others.”

This “lack of self worth” can contribute significantly to a host of psychological disorders including anxiety and panic. One of the reasons for this is that people with a low sense of self-worth are dis-empowered. A person who does not feel very worthwhile has lost her power position in life.

When you feel powerless the world can indeed, seem like a very scary place. A place filled with plenty of panicky situations. A healthy sense of self-worth can be built by cognitive awareness and disputing these childhood internalized myths with the Truth. In addition to these recovery therapies there are three patterns of thought and speech habits that people with anxiety disorders have in common. I would like to explore them now for you to add to your anxiety arsenal with some additional panic pattern breakers. The three common patterns of speech and thought are:

1. The “What if” syndrome

2. Learning to say “No”

3. Learning to say “I want”

THE “WHAT IF” SYNDROME

The “what if” syndrome is a pattern of thought common to many people with panic disorder. Here are some common “what if” thoughts. See if any of these sound familiar.

What if I do something embarrassing
What if I trip and fall down in front of other people.
What if I don’t get the promotion
What if she won’t go out with me
What if he doesn’t like me
What if I make a fool of myself in front of him (or her)
What if I can’t (you fill in the blank)

The “what if” syndrome is actually a form of the distorted thinking pattern “catastrophizing” or “magnification.” It is imaging the worst case scenario and exaggerating the consequences.

The “what if” syndrome can easily be its own self perpetuating “roll” and roll your worries right into a full blown panic attack. For an example: “What if he doesn’t like me” - “What if I make a fool out of myself in front of him” - “What if he tells everyone at school about how foolish I was” - “What if everyone laughs at me” - “What if no one will be my friend anymore” - “What if I am all alone” - “What if I need help and since I have no friends no one can help me!” The trick is to stop the “what ifs” before they get started on their roll. You can easily dispute the “what ifs” with the truth/misbelief worksheet because saying “what ifs” is similar to saying “It would be horrible”. (IE: “It would be horrible if he doesn’t like me.” - “ It would be horrible if I make a fool out of myself” - etc...) Another easy way to dispute the “What ifs” is to simply put the word “So” on the front of the statements as they occur. Let me show you what I mean.

So what if he doesn’t like me...The world won’t end
So what if I make a fool out of myself...I’ll have a good laugh too.
So what if he tells people things about me...My friends will still like me
So what if everyone laughs at me...It is doubtful that everyone will even listen but if some do laugh, I’ll be just fine. I can laugh with them.
So what if no one wants to be my friend... Doubtful...True friends “stick” and I can always make new ones.
So what if I’m alone...I am perfectly able to be alone and totally capable of taking care of myself.

It is easy to feel the self empowerment just by saying these old “what ifs” in a new truthful way. Try to spot as many “What if” statements in yourself as you can and dispute them with the “So what” truth. It may help sometimes to write them down.

LEARNING TO SAY “NO”

A person who has been dis-empowered can often have trouble saying no. The underlying thought or “logic”behind this dis-empowerment is that “if I say no to that person then they might not like me.” A person who has little self worth and who feels unloved or unworthy of love will many times spend their days seeking out the acceptance, approval and love of others. Sometimes in very self destructive ways.

The inability to say “no” is one of the most common ways that this search for acceptance will manifest itself. These people are often perceived as “doers”. When asked by a church of school to volunteer their time and energy to various projects and activities they cannot seem to say no. They are often very tired having over extended themselves to other people and will sacrifice time that their family needs and their own needs to make others happy. This is the extreme form of the “people pleaser” person.

Another common phenomenon of “no-a-phobics” is the ability to invent excuses. They cannot say “no” so instead they make up excuses to get out of doing things. In other words - they lie. I used to be an “expert” at this. I could make up an excuse in a split second and deliver it with a “poker” strait face. In retrospect I should have won an Academy Award for my acting (lying) abilities.

“Oh, I wish I could help you move on Saturday but I’ve got to go down town and look for a chair for my grandmother”. “Wednesday, uh, I’d like to but we’ve got relatives coming on the weekend and that is my only time to get the house ready”

Seldom were any of my excuses true but it did not matter to me. I wanted it to appear as if I wanted to help but just couldn’t do it at the given time. Now, however, I am much better at telling the truth and saying no. I will simply reply, “No, I’m sorry, that won’t work out for me.” or “ I’m sorry, I really don’t feel like it today.” What was amazing to me when I first tried this was that I didn’t lose any friends. In fact, most people seemed to appreciate and respect my new found straightforwardness.

The first step in learning to say “no” is to realize that it is OK to say no. Many dysfunctional family systems and church systems try to make people feel guilty if they say no. They will make a person feel as if they owe them and that they should do this thing that they ask. I find this particularly troublesome in some Christian church systems because Jesus Christ said Himself “Owe man nothing but to love one another”

It is OK to say “no”. It is OK for you to not want to do something or to not feel like doing something. Your feelings are important. Your wants and desires are important. It is very common for people with low self worth to feel as if their feelings and their desires are not important. After all - or so their thinking goes - no one was considering my feelings in my dysfunctional childhood so my feelings must not be as significant or as important as other peoples feelings are.

Your feelings are important and they are significant. You do count. If you don’t want to do something then say “no.” No, I’m sorry I really don't want to do that”

Make a list of five to ten truthful ways that you can say “no” to someone without making excuses. Then start trying them out. You may feel shaky at first. (When a child is first learning to walk his or her first steps are bound to be a bit shaky but after a while he gets the hang of it and is off and running.) But do it anyway. Practice until it becomes easy.

LEARNING TO SAY “I WANT”

Examine for a moment the following statements.

It was a good play wasn’t it?
Didn’t you think that salad dressing tasted a bit odd?
It might be a nice night to take in a movie.
Who wants to be in a movie theater?
It’s a perfect night for a walk.
That movie wasn’t very good.
They don’t make movies like they used to.

Notice the conspicuous absence of the word “I.” Many of us were taught that to use the word I too much was being self-centered or and egomaniac. We were told that we would sound too conceded if we made too many ‘I’ statements. Consequently, we now walk around being poor communicators seldom saying what we really mean to say. In addition many of us were taught that it was wrong to express our feelings directly. We were taught not to say “I’m angry with you” or “I’m feel really unhappy with the way you’ve been treating me.”

Not only were we taught not to say these things in our families and our churches but many “I” statements were social taboos as well. Consider the statement: “I think you’ve had way too much to drink and I want you to go home.” In many circles this statement is still not socially acceptable.

Not only does the lack of “I” make us poor communicators but it inhibits us from expressing ourselves in a way to achieve our desires. Now examine the following statements. I have taken our previous example statements. I have and them into self-empowering “I” statements.

I really liked that play.
I thought the salad dressing tasted a bit odd.
I’d like to go to a movie tonight.
I do not really want to go to the movies on a nice night like this.
I would much rather go for a walk.
I didn’t much care for that movie.
I don’t think that modern movies are as good as the old ones.

In these statement the person is saying exactly what they mean to say. There is no mistaking the persons feelings and communication is excellent. It is also empowering to speak the truth in this way.

Many people are so afraid of how others will respond to their feelings that they hide or disguise their feelings by avoiding the use of “I.” This is in part due to low self worth. If you feel worthwhile you are not going to be overly concerned with what another person thinks of you. A person with healthy self esteem will be confident enough to express themselves clearly and concisely.

As our self worth becomes healthier we may need to spend some time breaking old “low self worth” habits of communication. Start becoming aware of the times when you avoid the use of “I.” Then take a risk and put the word “I” where you mean it to be. Change statements like “Someday, maybe with some luck, these panic attacks will be gone” to statements like “I want my panic attacks to go away now and I am going to work diligently to accomplish my goal.”

It is OK to say “I” when “I” is what you mean to say. Practice speaking in this new and powerful way.

SUMMARY

Why do we want to practice these tendencies toward dis-empowerment speech and thinking? Because when we are dis-empowered we have left the door open for fearful thinking to manifest itself. When we become more self-empowered we lower our level fearful thinking thereby decreasing our susceptibility to anxiety and panic.