Matt Casarino

I am one-half of Hot Breakfast!, Delaware's Premier Acoustic Dork-Rock Power Duo. The other half is Jill Knapp, who is the most wonderful thing on the planet.

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So, panic attacks. I get 'em. They became a part of my life again a year ago, and I can expect one once every six weeks.

A Friday afternoon a few weeks ago, one arrived while I was in the Verizon store, staring at the wall of phone accessories while waiting to pick up my new phone. I was happy walking into the joint, for not only was I about to have a new toy, a glowing hand-held communication & porn machine, I was also about to spend the weekend looking after one of the best dogs in the world. I was in a happy place. But then - to make a long story short - I wasn't. 

We got outta there as soon as we could - i.e., once we got our damn phones - and I was able to mostly recover before our gig that night. (Yep, a gig. My timing sucks.) By Monday, my brain was back to normal (for me). Soon enough, it was time to return to the Verizon store.

And oh, shit.

Just thinking about the Verizon store, picturing that cursed wall of accessories while imagining facing the friendly but Sales-101 people, was giving me another fucking panic attack. And fuck. That. As I tried to calmly let Jill know the thought of returning to the store was getting to me, my voice cracked, everything went blurry, and once again, tension overrode reason.

I did two good things: I went to the store anyway for a successful purchase of phone cases, and soon as I could, I called my therapist. 

I can live with panic attacks. In fact, for a while, they're kind of neat. Sure, they eventually turn terrifying, and they sure are inconvenient. But every six weeks? That's not too bad. My life can accommodate that. 

But. An attack caused by considering returning to the location of the last attack? That there is some bullshit. And I'm not having it. So let's see what the good doctor can do.

Here, in the simplest, shortest way possible, is what said doctor told me:

  • Remember when I said panic attacks are kind of neat? (No? Geez, it was only, like, 80 words ago.) Well, what if I was able to think of them as neat while I was having them?
  • Panic is tension. By trying to calm down, you are pushing against your panic, and what do you create when you push against something? Tension. You feed the panic by fighting it, even by fighting with "peaceful" tools like meditation and grounding exercises.
  • I told my therapist I experience good anxiety and bad anxiety. The good, I explained, is the kind I feed on when I'm about to perform for people; I can turn it into focused energy and let it drive my performance. The bad, of course, is the stuff of attacks - chaotic and unfocused, it makes me feel out of control, sending me into a mess of emotions while making my body shake, sweat, and twitch uncontrollably.
    Doctor: "Matt, good anxiety and bad anxiety are exactly the same. There's only one kind. It's your perception that makes it good or bad."
    Me:  =0

I used to meditate, I found it a great exercise in both relaxation and humility, because as it turns out it's really fucking difficult to just sit and focus on your breathing without thinking. I think it's ultimately about acceptance - accepting who you are, where you are in the moment, what you're feeling, what you're thinking. I was thinking I should really get back to meditating when this happened:

"How about you have a panic attack now?"

Wait, what?

"What if I were to induce a panic attack right now? Then I can show you what I mean about accepting it."

I...uh...

"Actually, no, we're not going to do it now. I can see how much tension the idea is causing you. How about next week?"

If you're thinking "how is this guy going to induce a panic attack? Is there, like a brain button I don't know about?" then you and I were ridin' the same bus (except for that stuff about a "brain button." Where the hell did you get that? That's just silly. Brain button. Come on). But I was game, and willing to bypass my skepticism and work with him as best I could. I made my appointment. And when the day came, I wanted my attack. I doubted it would happen, of course. How could this guy - a guy I trust with my soul, a small, gentle, wonderful man, give me a panic attack?

He didn't He gave me two. 

They weren't complete - they didn't bloom into full-on, out-of-control anxiety - but if he hadn't stepped in to help me stop them, they both would have sent me spiraling into chaos. I'm still reeling from what happened.

The session went like this: I stood behind his desk, staring at his wall of bookshelves, while he stood next to me, blocking my only exit (the desk was against the wall). And while we stood, he asked me to imagine a hundred people in that room, watching us. He used some specifics to ramp up the urgency, and within 10 minutes, maybe 15, I was in the first stages on a full-on anxiety attack - losing touch with visual reality, as though one of my contact lenses was replaced with a tie-dye plastic film. Or...something, the visuals are hard to describe. But my breathing was shallow, my throat was so clenched it was hard to answer his questions, and my neck was on fire.

At that point, when I was on the verge of really crossing over, he asked me to give my body permission to feel what it was feeling. This required saying it, out loud, until I meant it. It really was okay for my neck to be glowing. It was okay for my breathing to puddle-deep, for my legs to feel rubbery, for my brain to be in a cloud. My body was just doing what it had to do, and it's okay. I give it full permission to do these things.

And once I started believing what I was saying, My tension level dropped 15%. A little later, I was taking full breaths, and I could move my legs without effort. 

Neat, huh? But I'm not quite done, and this next part is really important. I'm trying to be concise, because I think this can be really helpful to anyone reading this, and I don't want to risk boring you any further. 

He stepped away, we sat down, we got ourselves together. (His tension had risen too - turns out, he doesn't like to be crowded with imaginary people either.) We talked about what just happened. We chatted, maybe joked, relaxed and reflected. And just when I was almost back to baseline:

"Okay. Let's do it again."

Dude, I - I really, really don't want to.

"I know. But please trust me, you have to do it again. You'll see."

We got in our same place, and he told me about the people, staring, judging. This time, it took only two minutes to get me to the tension level I was before, which is maybe 65%. The sweat started to roll again, and my neck was getting that freshly-slapped feeling I know so well. 

"Okay. Tell your body what you need to tell it."

I took the deepest breath I could. "It is perfectly okay for my neck to feel exposed, for my body to sweat, for my pulse to race. It's okay because once I accept it, my tension will fall."

The tension in my neck spilled onto my cheeks. My heart rate went up.

This wasn't right. 

"I give my heart permission - I give it -  dude, this isn't working. I don't like this please stop, please make it stop please."

"Matt. You just said 'if I accept it, my tension will fall.' That isn't how it works. You're giving it a condition, and panic doesn't accept conditions. You just gave energy to your tension. Don't do that - just accept it. Accept what you're feeling."

I did, to a degree, but I was struggling and really thrown. He let me off the hook, stepped away, and gave me another little grounding exercise to do.

But you see what happened? These attacks don't respond to reason, and they certainly don't respond to if/then logic. I told myself I could make it go away, when I should have just been telling myself to let it happen, to feel my heart race and think "that's okay. In fact, that's good." To feel my neck get red and angry and think "that's okay, neck. You're doing fine. In fact, how cool is it that the body reacts like this." To feel my legs turn to rubber and think "that's okay, legs. You go ahead and get rubbery. People take expensive drugs to feel like this - thank you for letting me feel it all on your own."

So yeah. I'm not remotely there yet. I have to practice, which I'm not looking forward to. But I really need it. My life is too good to have these odd little interruptions scuttle my momentum. That was an incredibly intense hour, and it had an emotional and physical effect on me I'm still feeling, some 32 hours later. But man, what a lesson. So if accepting the anxiety is what I gotta do, I'll be more accepting than an 80s German metal band with a chubby lead singer in K-mart clothes.

       I went a long, long way for that last reference. That's commitment, yo.

Calmly yours,
Matt

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4/2 '16 9 Comments
Thanks for this. Your therapist went in a direction I never would have imagined.
This therapist is a miracle worker.
I love your therapist. In a totally non-weird way.
I have to ask: is your therapist a follower of Peter Levine/Somatic Experiencing therapy? Levine is renowned for his work on trauma and anxiety, and your therapist sounds like he at least borrows from some of Levine's work. (Levine is brilliant in my opinion; actually the whole Levine tribe is probably a pack of geniuses as I used to see his brother Robert for acupuncture.) Anyway, when I developed PTSD/anxiety following a couple of closely-spaced major car accidents, I found an SE therapist who combined SE with hands on body work (she was also a massage therapist). So incredibly helpful for me! I mean, duh. I'm a massage therapist, so of course massage would work well for me. Ultimately though, I think it also just took TIME, lots of time (and lots of one particular breathing exercise that actually forces cortisol levels in the body to fall; yay science!).

Hmmm. You're a musician... I wonder (if you're not already) if somehow combining music/singing with your therapy would boost it.

Okay, I'll stop nerding out about this stuff now.
Anne, I'm sorry it's taken me three months to answer. (In my defense, it was a difficult question. :) )

Yes, my guy likes Levine and SE. My previous therapist did too, but he was WAY too into...that...culty thing that EST became. The name escapes me, which is hard to believe, as Fran (the previous guy) was really into it and talked about it every session. He desperately wanted me to attend. It's one of those 2-day things where you don't really have time to eat, and you get yelled at and you have to call people and make lists and stuff. Lots of folks like it; many others think it uses cult-like methods to trick you into thinking you've been cured. I dunno. I just know I have a natural aversion to such tactics; as soon as I feel it "working" I'll find a way to shut it down. Anyway, when I discovered Fran was one of their speakers and recruiting people was part of his responsibilities, I quit him. Felt super-creepy.

But none of that Peter Levine's fault. :)

I don't nerd out about my own anxiety enough, to be honest. I can dive into the most minute detail about recording pop songs, or who played bass for what and how this chord sounds against that one, but when it comes to, like, my own self-improvement, I put up a wall. Yes, music helps, in many ways - I like to put on headphones and certain music, and sometimes picking up a guitar and playing chords gets my brain in a much better place. I also recently realized some songs I wrote and recorded in the 2000s are actually about my own anxiety; I honestly had no idea at the time. (I ain't too bright.)

LANDMARK! That's what it's called now. Landmark Worldwide. Yep. People do like them, but...I can't. I just can't.

Jill and I like to go to a "petting zoo," I guess you'd call it, 50 minutes away. The place is literally wild - ducks, geese, and chickens walk around free, often demanding you feed them. Pigs & hogs, goats, llamas, and other wonderful creatures are also there, hoping you'll share some eucalyptus leaves or dried corn with them. (Sometimes the denizens get a little aggressive; one asshole cock kicked Jill hard, drawing blood. I'm amazed the keepers haven't been sued.) Anyway, going there is incredibly therapeutic. I'm calm and free of anxiety while I'm there, even when the foul are at their most demanding. Jill bonded with a pelican named Hemingway; there's a duck named Angel with whom I connect. She's got a damaged wing (it's called "angel wing" - ducks get it from eating too much bread offered by well-meaning park patrons) so she'll never fly, but she's doing okay anyway. We seem to get each other. And if she's not around, well, one cannot pet and feed a llama without feeling one's blood pressure drop 20 points. We don't have pets, so going there fills a hole for a while. And I'm generally good for a few days afterwards.

CBD is great too. :) As a preventative or a delayer, that is - once I'm roarin', I'm roarin', and the only recourse is to let it roar.

But animals - just - wow. I never use the term "cat lady" derisively; in my book, shut-ins who care for multiple felines win at life.
Oh wow. Yeah, Landmark used to be The Forum used to be EST. Werner Erhart founded it, didn't he? Freaky deaky guy as I recall. I participated in a couple of Forum seminars back in the day--but not because anyone was nagging me to do it; I was just my usual monkey curious self. I came away with a few interesting and useful tricks to keep in my mental toolbox, as well as the impression that the whole thing was a culty-pyramid schemey kind of operation. I would never in a million years, though, have connected Levine's work with that. Is there some connection between the two that I don't know about, or is it just coincidence that your therapist was really into both? How weird.

I love those petting zoo/free range kinds of places! But I'm stupid for critters in general; I seem to collect them...
I've been a massage therapist for... shit, almost 30 years now. Wow. Dang. Sorry, tangent.

Anyway, I've done it for a long time. And there is one, count 'em, ONE instruction that I was given in my initial training that has remained at the core of my work.

"Don't go after tension. Allow it to rise to the surface." ["Why not?" I asked. "Aren't I supposed to be DOING something?" "Nope. Don't get in a fight with it; you'll lose. Allow it to come to you, and then just sit with it."] Which made no sense to me at the time I was learning it, and it sounded mostly like New Age crap to my ears, but being a studious sort of student, I followed instructions. In class, on clients, and eventually in a much broader sense in my own life. Turns out it works! You sit with something, unconditionally, and that gives it the space to transform.

Quite recently, I was tumbling down a rabbit hole of anxiety and fear which kept me from getting up on stage. And I was all pissed off and confused. I'm not anxious about being on stage! Why is this fear eating me alive??! This is bullshit! Then I heard a snippet of a radio program while driving, about personifying ones fear, actually talking to it and THANKING it for, you know, all the times in your life where fear was actually useful and kept you safe. And the second thing that happened, a wise and dear friend listened to me pissing and moaning about not being able to get on stage, and she [politely kept from rolling her eyes and] said, "You know, why don't you just listen to that and accept it? Give yourself permission to be okay with being anxious and not getting on stage. So what, if now is not the time?"

And I was like, oh right. Just let it rise.

And while my stage fright hasn't completely evaporated, it's back down to reasonable and rational levels, the sort of nervous tension one expects to have, the kind that isn't debilitating. It flares up now and again, and I ... I just sit with it.

Thanks for telling your story; it's SUCH a good reminder of how capable we humans are of transformation. Somehow it didn't click until I read it that I was struggling all over again with something I supposedly learned 30 years ago. But I guess that's the nature of these things. We learn them, and then we relearn them, and then we relearn them again. Context after context after context.
What a wonderful response. Thank you so much for sharing all this.

My therapist shared his own issues with anxiety, and how he deals with it, and it always comes down to the same thing: fighting feeds it. I love the imagery you provided - let that tension rise so it can just...dissipate into the air.

It really is weird how hard that is to do sometimes. I'm overwhelmed with the deisre to either run or fight it off. And sure enough - all I do in those moments is feed it.

Again, thank you so much for this beautiful response. :)
My brain is in such a funk today that when I read the first line of your post, I thought, "Oh no! He just said, 'Thanks for sharing,'" and I mentally cringed the way a roly poly bug curls up when you touch it.

But then I read the rest and felt all better again. :)