What Are the Causes of Panic Disorder?

Those who are afraid to look at others or think that the light of their eyes are peeping at others, so they are apprehensive. The disease is characterized by avoiding fear of objects, situations or activities; the patient knows that the terror is unreasonable or excessive but cannot be controlled. The clinical manifestations are special, so the diagnosis is not difficult.

Phobia

People who are afraid to look at others, or think that the light from their eyes is looking at others, so they are apprehensive

Phobia of people, or people who think that the light of their eyes is peeping at others, so those who are apprehensive are called phobia of people or phobia of people. The disease is characterized by avoiding fear of objects, situations or activities; the patient knows that the terror is unreasonable or excessive but cannot be controlled. Human phobia is a type of social phobia.

The diagnosis of human phobia is not difficult due to its special clinical manifestations. Some people think that the name of the disease is easily misunderstood as being horrible to specific people. Like horror to certain animals, it should be understood as fear of "someone's situation", preferably called "social situation". In fact, when the patient's specific performance and inner experience are carefully studied, the target of his or her fear is not the situation.

In what we see

There may be transient symptoms of horror, but other psychiatric symptoms coexist, which can be identified.

1. Overcoming fear:

Fear of people is mainly caused by a "fear" mentality, such as fear of seeing strangers, embarrassment, and self-expression. This kind of illness is formed during many years of daily life, work, and study. Therefore, prevention and treatment needs to gradually cultivate the ability to adapt to the outside world during long-term daily life, work, and study, and consciously increase contact with people and things around it.

2. Remove inferiority and increase self-confidence:

Remove psychologically

Phobia of people is also known as social phobia

Should be treated with drugs

Phobia case 1

College student, male, 20

My symptoms started in high school. When I relocated, the male student sitting behind me said, "It's annoying."

Because he is the biggest hit in our class, I care very much. After that I always wondered why he said I hate it. I wanted to talk to him, and I was afraid he would ignore me, so I didn't go to him.

I can't help worrying about whether I hate me when I'm with good friends. High school life became very painful.

After graduating from high school, I felt the ferocious look of pedestrians. Began afraid of stranger eyes. I wonder if I have "phobia"? Just went to the neurologist but it didn't work. Eating Chinese medicine sold on the market has no effect.

After dropping out of school for two years, he was admitted to Zhiwang University. However, there are no signs of improvement. My parents and I said that I couldn't take it anymore, so I was admitted to the hospital of Hamamatsu Medical University.

I have been avoiding my symptoms during absolute bedtime and before being hospitalized. I have now realized my weaknesses and are no longer avoiding them. Regardless of whether it can be cured, first of all, Morita therapy must be turned into its own, otherwise it may be cured but not cured.

The absolute bedriding was over, and I began to study Morita's theory. I knew the crux of the concept of obsession, and I was mentally prepared to understand it. With psychological preparation, you can act in a targeted manner, that is, the "purpose-oriented action required".

I also learned a lot from other patients and their actions. After leaving the hospital, I will make persistent efforts and strive to realize myself. And we must study philosophy well and become a scholar in the future. You have a neurotic strength and you are doing well. But when you were first hospitalized, you didn't see it as a phobia. The attitude is arrogant, and he is not afraid of heaven.

You care about what others say and do to you, but what you think is not the same as the impression you leave on others. If you don't say that you are unwell, others will not know. You've been here from a long distance. You must be upset inside?

You can't tell from your appearance that you are neurotic, but when you interact, you find that you have neurotic strengths. Not free and casual, methodical. If you think about it, most people do. Others think that you are just annoyance, and being hospitalized because of annoyance is an escape from reality.

You have a strong self-esteem and are not convinced. If you are not sick, you still won't lose to others, do you have this idea? Blaming everything for the illness is exactly your weakness.

Anything you say will be encountered. Do friends hate me? Actually means secretly speaking bad words to each other. I have encountered it before. When I was an intern, one night I was on duty and studying in the X-ray room, I heard the nurse room next door discussing me. The head nurse and the little nurse both said, "How can I get that young doctor on duty?" They are talking bad about me. I heard it, but there was nothing I could do. The little nurse echoed, and I was upset. The head nurse said so, and the little nurse followed, so I was very concerned. No, I still remember it now.

Someone is going to say it, and no one is saying bad things about you anymore. No, there are now. Professors are always criticized. Discuss me in person, and I will get angry. The discussion behind it is sometimes praised, so I am also very satisfied. If I heard bad things behind me and heard it, then it's another matter. Maybe I don't know each other yet.

When you say that you are adjusting your seat, the celebrity in the class says "I really hate" and you are immediately connected with yourself. Rather than talking about you, it is better that you are talking about yourself. It's a kind of mentality to have bad things and take bad things for yourself. An arrogant person, even if others say that he "really hates", he will not think that he is talking about himself, but that he is talking about the person next to him. If someone is said to be "true smelly", because of the lack of self-confidence of a body phobia patient, he will think "Is my body odor causing trouble for everyone", and I will be upset. "I change my underwear every day. Is there someone with a strange smell and self-confidence in other places? Even if someone says he smells bad, he doesn't take it for granted. He wouldn't think about what kind of impression his body smell makes on others. Maybe he would think it was a man Taste. If so, it's troublesome.

Interpersonal relationships need to pay attention to each other, and to get along with jealousy, so as to grasp the balance. Arrogant and over-confident people will somehow attract people. So it's good to be cautious.

You want to be a philosopher. Who do you like among philosophers? Nietzsche said: "If there is a goal in life, even the greatest difficulties can be overcome."

The analysis theory of the author of "Night and Fog", Frank Luke, inherits Nietzsche's thinking, and feels uneasy if there is no clear goal in life.

There is a suicide prevention center in Los Angeles. The results of research conducted by Junadman indicate that there are more rich people than poor people who commit suicide. Maybe some people think that the poor are suffering, so many people commit suicide. In fact, even if you are rich, you cannot prevent suicide, and if you are rich, you may not be happy.

If there is a clear goal in life, even the poor do not want to rush to death. Without a life goal, even the rich will want to die for doing nothing. Patients with neurosis without a clear life goal are unexpected. It is important to have specific goals.

Human stupidity

There are also many philosophers. The end result of the study of Greek Stoic philosophy was to choose suicide. I don't think such a philosophy is necessarily a good one.

Seneca said "suicide is a human privilege." "Only people will commit suicide, not even God." The person who commits suicide shortens his life himself, that is his privilege, and no one has the right to blame. It was thought that led Seneca to commit suicide.

Does Seneca's Greek philosophy still work? The answer is nowhere! Gone are the days when philosophy and religion were used to justify suicide.

Suicide must be demonstrated using psychology and science. People who want to commit suicide must be helped. In science, no one wants to die. The other side of wanting to die is to save me. This is not just from philosophy. Psychology can also draw such conclusions. So suicide is the object of psychiatry or psychotherapy. Seneca's doctrine no longer works. There are many things that only humans can do besides suicide.

Example: Atomic bombs can only be made by humans. No animal, plant, monkey or elephant can make it. Is human beings great because of the atomic bomb? No! Making an atomic bomb is a stupid habit of human beings, and it is a disadvantage.

Whether it is suicide or the creation of an atomic bomb, these are human shortcomings and should feel guilty. If I think of it this way, I think modern philosophy must be a philosophy that enables modern people to advance with the times and a philosophy that can bring happiness to modern people.

The absurd philosophy of learning to learn does not work. It is important to play a constructive role in real life. People who think hard about life are philosophers.

Your scruples are good, and I hope you will work towards your stated goals.

Phobia case 2

Patient male, born in 1971, graduate, graduate

The first meeting with a doctor on March 1999.

For more than ten years, the main demolition was afraid of seeing strangers, feeling panicked, blushing, unnatural expression, and very distressed.

Recalling the onset of illness is as follows:

In 1985 (14 years old), when studying in the third grade of junior high school, she got along well with a girl in the same seat. She had a good impression on her and often talked about her together. Soon, the seat was adjusted in the class, and the girl and the other boy were seated in a seat behind him. The patient has a bad relationship with the boy. Once, the guy borrowed a ruler from the patient, and when he turned back to deliver, he looked at the girl he liked. Suddenly thought that the boy would find that he was "interesting" to the girl and sang out, causing classmates to "coax". Thinking of it this way, I felt my face flushed suddenly, my heart became faster, and I turned back quickly. It took a long time to calm down. Later, I found that the boy was intentionally observing and paying attention to the activities of him and the girl, and seemed to want to discover some secrets, and was very nervous. At that time, patients worked as reporters in the class and often had to stand on the podium to read newspapers. I used to do this job naturally and without difficulty. After blushing this time, I felt nervous when I read the newspaper to the classmates. This is especially true when reading news reports about the relationship between men and women, and hooliganism. The more nervous I feel, the more I feel unnatural, and even blush and sweat. Soon after, I heard that a few stubborn boys often shouted "flirt", "catch the hooligan", etc. The patient speculated that these words were insinuating him and meant to be heard, thinking that they must be talking about him The girl was "engaged in" and found that other classmates were also paying attention to him during the class. Therefore, try not to look back to avoid misunderstanding. During work or meetings, try to avoid the girl.

In high school, she was still in the same class with the girl. Although the patient is as usual on the outside, he has always been nervous and has less interaction with others. For one semester, he was seated with another lively girl. The other party often stared at him. He felt restless, always afraid of being discovered by others, and picked up his faults in the relationship between men and women. Soon, I found that the teacher also looked at him with scrutiny during the class, and seemed to see his nervous expression. Once the teacher said by name: "I really don't know what's on your mind?" I think the teacher is also misunderstanding him. Uneasy all day. So he barely finished high school.

In the autumn of 1988, I was admitted to the university and changed to a new environment. The situation is better. Soon, he had another bad relationship with a male classmate. The other party often "glared" at him, and he felt unbearable. Gradually look at other students, men and women, dare not look at each other. This fear was more uncomfortable than blushing and panic, which severely hindered his interaction with others.

After blushing for male-female relationship for the first time during junior high school, she felt nervous and unnatural when she faced the girl. She was also afraid of the other person s discovery and misunderstanding, thinking that he might think too much about men and women More ", leaving a bad impression. During college, when he heard words like "rogue", "improper style" or "thief", he was nervous, afraid he would be described as an improper person. I can't rest in my head all the time, and I have difficulty learning. Although my academic performance is good, I feel exhausted by being "tortured".

In order to prevent others from discovering his blush, embarrassed expression, and facial muscle stiffness, sometimes he deliberately covered his face with his hands and turned his face to the side when he had to laugh. After his first year of college, when he and others were talking face to face, the other side reacted, such as turning his head or sighing lightly, thinking that the other side must have seen that his expression was unnatural and awkward, so that he felt "awkward." Ever more ashamed to see people. In the future, the object of fear will continue to expand. Regardless of whether they are men, women, strangers, or acquaintances, whether they go to the store to buy things or ask people questions on the street, they feel scared, nervous, and blush when they contact and talk with people. So as little contact and talk as possible to reduce the chance of others discovering his embarrassment.

After graduating from university in 1992 and joining the work, the situation remains unchanged.

In 1994 he was admitted to a university graduate. When coaching students for internships, try to talk as little as possible, especially not speaking to the students face to face. I sometimes speak when I participate in academic discussions, but I am afraid that abnormal expressions will cause people to criticize, so I never speak except to say a few words when necessary. When replying to the graduation thesis, he looked at the wall with his eyes as far as possible, and did not face the audience, and reluctantly passed.

In 1998 (27 years old) was assigned to work in a certain unit, and met a female colleague who was 4 years younger than him, and had a good impression on her, and the other party intentionally approached him. But when she was with this female colleague, she didn't dare to look at her face to face. Once I met her occasionally, the other party immediately turned his head, thinking that the other party saw that his expression was abnormal, and he would think that something bad was in his mind. So sad. The patient said that he really wanted to fall in love, but worried that the woman would see from his expression that he always thought of "bad" things in his heart and looked down on him.

The patient's expression in front of the doctor was still natural, but there was some anxiety, and he urgently hoped that the doctor could cure his "heart disease". -Diagnosed as phobia.

Psychological consultation and guidance:

(1) The doctor is telling him the nature of the disease and what to pay attention to in psychotherapy

(2) Encourage investigation and inquiry, and use your own direct investigation results to check whether your judgment is correct. Explain that the horror of seeing people is totally imaginary and has no basis.

(3) Point out that its horror is related to childhood experience, and encourage to recall sexual fantasies and sexual experiences in childhood. Explain its relationship with current symptoms. It is pointed out that sexual fantasies in puberty are normal and there should be no concern.

(4) Point out that the symptoms are a recurrence of childhood psychology, indicating that the inconsistency between actual age and psychological age is the cause of its onset

After telling him the nature of the disease and the matters needing attention in psychotherapy, the doctor asked him how he concluded that others saw that his expression was unnatural. The patient enumerated the various reactions that others had made in front of him, and concluded that others were "sure" Already. He thought that his illness was mainly an abnormal expression. The doctor did not argue with him, and encouraged him to boldly investigate and inquire about others, and use the results of his direct investigation to test whether his judgment was correct. The patient expressed embarrassment at first. Reluctantly agreed with the encouragement of the doctor. The doctor also instructed him to recall his childhood life experience, contact his symptoms, think about what made him so shy and blushed, and wrote it in writing.

Meet for the second time a week later.

The patient wrote written materials that described the appearance and development of symptoms and part of his life history.

The patient said that after the last meeting, he went back and asked his sister and brother-in-law to see whether his expression was unnatural and what he was thinking about. They did not understand why the patient asked this question, because he never noticed anything special about his expression. A game. The patient said that before asking, an elder sister and brother-in-law must have seen the embarrassment of his expression, and must be thinking about some unsatisfactory thoughts in his psychology, but did not expect that they didn't notice anything. Doubtful in my heart. I asked two colleagues who worked together and the results were the same. Because they didn't believe what they said was true, they repeatedly asked them. One of his colleagues said that he didn't really find out how he looked. They just felt that they had seen some people who were somewhat restrained and hesitant, but didn't know what he was thinking.

The patient said that through investigation, he believed that others had not noticed his expression. In the past few days, I feel much more relaxed and tolerant of myself. I have experienced a sense of relaxation that I haven't experienced in years.

The doctor pointed out that through preliminary investigations, it can be believed that others did not notice his expression, proving that his distress was not caused by others or the environment, and the reason for making him blush and nervousness was from his heart. Ask him to remember why he turned blushing and flustered after turning to look at the girl in junior high school, what was in his heart, and what life experience made him so shy.

The patient is willing to cooperate because the condition is mild.

Meet for the third time in 10 days.

The patient asked the doctor to tell him some of his childhood and adolescent experiences, which are summarized as follows:

It was also during this period that I had a good impression on female classmates. Want to have fun with them, play with each other, and give each other gifts. It doesn't make much sense to think it's a low-level thing. Sometimes I also think that I have a good opinion of girls. So I just think about girls, but I haven't approached them. Sometimes male classmates often coaxed a male classmate and a female classmate to "engage in an object." He believes that "engagement" refers to activities with a decent style. I want to be a "decent" student. Just then, the above-mentioned blushing after seeing girls for the first time appeared.

When I was in the fourth grade of university, I was 22 years old and wanted to have a girlfriend, but I didn't dare to get close to the female classmate because of the flushing and nervousness. When I think of "engagement" in this period, I no longer feel indecent things, but I still can't tolerate myself in my heart, and it is difficult to calm down.

Doctors point out that when people reach puberty, it is normal to even approach some of the opposite sex. Many people feel a little shy at this time when they see the opposite sex in their hearts, but with age, this feeling of shame will soon disappear naturally. When he was 14 years old, he was understandable because he was afraid that others would find he liked the girl and blushed. But he is now 28 years old; adolescence's sense of shyness is always present and exacerbated. Ask him to think, why is so contradictory and naive, and what is hindering his further development and maturity?

The patient said that the doctor's conversation was enlightening.

Another week passed and we met for the fourth time.

The patient wrote down the memories of his childhood experiences. In recent days, several people have been questioned and investigated, and they all said that he did not see his expression abnormal, let alone what he was thinking. Through investigation, he really believed that others would not know that he was faint inside.

law. I used to think that everyone's actions were directed at him, but now I don't think so. I admit that I may have been suspicious before, and my heart is much calmer than before. I am afraid that the phenomenon of people will be lessened. I am 80% better.

The patient said that after thinking about it carefully, he thought that his symptoms of embarrassment and shame were getting worse, which was related to his character and the strict discipline of his father. He was timid, cowardly, and face-saving since he was young, afraid that others would discuss what was wrong with him. His father usually had a serious style, and disciplined his children, often scolding him. The patient has one brother and one sister, all afraid of his father. When I was young, I was most afraid of reviewing my homework in front of my father and felt nervous. Sometimes when my father is away on a business trip for a few days, the children feel "liberated". His father was particularly disgusted by the improper relationship between men and women, and often heard him expressing intolerance when talking about it. The patient believes that his attitude to sexual restraint may be related to this experience.

The doctor pointed out that although he no longer held self-blame for his childhood experience, due to his father's influence, he felt that it was disgraceful when he first felt about the opposite sex at the beginning of adolescence, and was afraid of being ashamed when he was discovered Such as blushing, sweating, etc., and because of his unhappy personality and low self-esteem, this shame reaction affects his interaction with people and hinders the normal development of psychology. Although he is almost 30 years old, he still stays at the level of the beginning of adolescence. His father's sternness also impressed him, adding to his restraint and fear. After understanding this principle, when dealing with others, especially with the opposite sex, you should think that you are already an adult, and you have to say goodbye to your youth.

The patient expressed a new experience.

I met three more times later. Roughly repeat what was discussed above. The patient is willing to think and ask questions to discuss with the doctor. The condition improved rapidly. Seeing someone is no longer blushing, let alone feel that others are talking about him. I admit that I have been cured. At the end of the treatment, the patient wrote a written experience, which mentioned the psychological activity at the time of the initial onset and subsequent malignant development. Finally wrote: "Recalling my symptoms when I was in contact with people, the more I think about it, the more I feel like a child, and I am very uncoordinated. Although I am completely a person regardless of age, job position, experience and appearance Adults even have a certain experience, but in terms of interpersonal relationships, it is still a child's psychology. When others see the tension and restraint when I contact people, they will find me childish, ridiculous, and even incomprehensible. Here, I also feel unacceptable and despise to myself. Especially when I realize that I am childish in not eating and I am naive in my attitudes and ideas about sex, I feel more unacceptable to my realization and symptoms ... Nowadays, my illness is getting lighter and milder, and sometimes there is tension occasionally, and the above thought naturally emerges. The tension disappears immediately. I am very happy. "

In this case, we can see the important role of shy personality, germination at the beginning of puberty, and critical attitudes formed in early years. After entering the vicious circle, a delusion of sensitive relationships appeared, which gradually aggravated the fearful symptoms. Although there is no serious self-blame for juvenile experiences in adulthood, shameful reactions and naive evaluations of behavior are enough to prevent his psychological development from becoming mature.