[healed84]

So, at my last appointment I found out I can call T outside of my sessions even after hours, and say it is urgent and he will get back to me. He did stress that I keep it to those really urgent situations, but please do call if I need to.

Now, I have been wondering what classifies as urgent. When I called him in between sessions last week it was b/c I had been dealing with panic allllll day and was try to fight off an attack and I just wanted somebody to calm me down. He seemed to be okay with why I called him then. So, now I wonder what you and your T classify as urgent???

[granite1]

that is kind of a vague statement i would ask him to clarify it some so you don't get set up by calling and thinking something may be urgent and he may think differently

[Ygrec23]

I would tend to think that "urgent" is to a great extent self-explanatory. If you feel you just can't hang on any longer without doing something stupid, that (to me) is urgent.

If it were me, though, I'd do a number of things to try to work it out by myself before I called T. Including doing calming exercises T had previously taught me, trying to go to sleep, eating something, etc.

I'd suppose that none of us want to develop a negative reaction in our T's where when they think of us or are reminded of us they feel "Oh, him!" or "Oh, her!"

Which really means finding out just how our individual T's react, because different T's will react differently. Some will happily put up with frequent crises and some won't. Figuring out how far you can go with a particular T is something each of us has to do anytime we have a new T. At least that's what I think. Take care!

[lostmyway21]

Hmm I don't really know the answer to that..I only ever called my twice in 3 months. One time I was in full blown disociative panic and the other I was in situation, that I didn't know what to do, again I panicked.

I have only called my therapist twice in the past two years. Both times were when I was REALLY having a bad experience and needed her to help me not turn to unhealthy ways to cope. But I am not really one to talk on the phone, I email alot. That is my way of communicating with her.

If I were in your situation, I would ask my therapist what he/she calls urgent. I would rather know up front, than to call and be told, "This could have waited until our next session."

[SoupDragon]

Yes I have never quite understood what urgent means. In the past I have contacted the Samaritans when it was urgent - I didn't want to disturb T and I am aware of the crisis teams who I could contact (haven't so far needed to).

Maybe it is good to clarify these things with our T's? - Soup

[with or without you]

to me, it means you're suicidal. My T says on her voice mail you can call her cell phone "only in the case of a clinical emergency", and I interpret that to mean hurting yourself.

[BlessedRhiannon]

My T's voice mail says to call her cell if the subject is "time-sensitive" and to call an emergency number or crisis hotline if it's life or death.

However, my T has also been encouraging me to actually reach out, so she has expressed before that she WANTS me to call if I feel like I need to. If I feel like I need to reach out, then there's a good chance that it's urgent for me.

My general rules for calling my T are:
1) More intense suicidal thoughts than usual
2) Extreme panic or anxiety...unable to control the panic attacks
3) Having something happen that I need to talk to her about right away (something triggering or that I simply can't sit with until our next session)
4) Questions that I feel can't be addressed in email, can't wait until our next session, and won't require more than 10 minutes or so of her time.
5) Any scheduling changes (but I only call about those during her business hours)

Anything else, I either email her about, or just journal about it and bring my journal to the next session.

I call my T when, despite everything, I'm not able to pull it together. Usually it has to do with racing thoughts/ruminations or with suicidality. He's never said I can only call when it is "urgent", but I absolutely will not call him after hours or on weekends unless it is urgent. If it's not urgent, it can wait until he's in the office. Now I call him during office hours usually for urgent matters, but phone calls during work hours don't have to be urgent by any means. He really doesn't mind phone calls at all.

[confused and dazed]

I asked my T this very question , and his response was if I considered it urgent, then so does he. Sorry that it does not answer your question very well.
Hugs

[healed84]

Okay... I am trying to figure out if I should call T tomorrow during buisness hours. I would call today, but he is out of his office, but I am not sure what for. I have been have multiple panic attacks a day since Friday.. it is not good. I just had another one.. and I can't take them anymore. At my last appointment T and I talked about meds. He said if I decided to go on them I would go on zoloft and Xanax. He was going to refer me to a Dr friend of his.. but didn't know how long it would take to get me in.

Well, I can't spend the next week and a half (no appointment this week) having multiple panic attacks until I talk to T about getting meds. So, I don't know if I call him and tell him that I want at least to have the Xanax now.. If there is anything he can do, since he can't give me the rx himself. I don't know what to do now.. I called my husband home from work b/c I can't take care of my kids like this. Should I call??

Your T will not be able to get you a prescription. If you have the name of the pdoc he was recommending, go ahead and call to get an appointment -- it could take some time to get it. If you don't know the pdoc's name, call your T to get that information and then call to make an appointment.

You probably should call your T anyway to let him know what is going on with you. He might have some suggestions that could help you ride this out.

One option you might try in the meantime would be to go to your family physician. He/she might be willing to prescribe something to get you through until you can get into see the pdoc.

[pbutton]

I called my primary care doctor during the worst of my panic attacks. She called in my prescription for Ativan while I was waiting for my therapy appt.

I didn't take any of the pills for 9 months, but that's a totally different story.

[Chopin99]

Firstly:

Secondly: Urgent is a vague term. Different people define words differently. My T said I was in crisis when I had two panic attacks and said I had a PTSD-type reaction to something.

To me crisis was what I did in my teens and early 20's when I used to have screaming fits and hit my head against the wall (literally) and was sui!

[healed84]

Although, I do consider my situation urgent.. I don't think that I have to have the answer today. So, since he was out today.. I will call first thing in the morning an hopes he has a suggestion for getting the meds.. and maybe a way of managing the panic attacks. I am so miserable right now

[healed84]

Oh and thanks for the advice everybody! I am so new to all of this thearpy stuff, as well as my worsening anxiety. So, I am feeling overwhelmed at the moment. It is good to have people to ask questions to!

[pbutton]

I hope you are able to find something that helps you deal with the panic attacks.

I think the main trick is to find the things that work for you. I know this is a terrible thing to say, my T keeps trying to get me to try again, but breathing stuff does not help me at all. Paying any type of attention to my breathing makes me panic harder. It is some sort of mental block that I have in my head, because it's supposedly the best way to overcome attack. I do fine without the breathing stuff, thank you very much. So there's hope, I promise.

Things that do help me:
-counting backwards from 100
-proving that I am in control; picking a specific thing to do and doing it (i have a lot of attacks in the car, so I'll tell myself to change the radio station 4 times or roll down the left side rear window, etc.)
-If I am having mental panic I do something physical (If I keep thinking about something that causes me panic I will go do a load of laundry.) If I am having physical panic I will do something mental (If I am concentrating on the fact that my face feels numb and my heart is pounding I will try to learn something new, play a computer game, watch TV, or read something.)

When worse comes to worse I sit and look at what is actually happening. I was having terrible attacks at home. I tried to think about how I was safe at home watching TV and how it is not even remotely dangerous or scary, no matter what it felt like.

I also started tracking how long the attacks lasted. It gave me something else "scientific" to focus on. The more I got into tracking, the shorter the attack. I read somewhere that your body can ramp up to full alert in 3 minutes and that it takes about that long to ramp back down. I always tried to test to see if that felt true or if I could relax enough to drop down closer to a 6 minute attack.

I tend to worry that I'm going permanently crazy and that the attack will never stop. Obviously those things aren't true. I rarely panic that I am going to die (in fact I'd probably welcome death to be blatently honest) but panic won't kill you either.



Oh, T once told me to grab an ice cube in each hand and stand outside. I've never tried that one. I think it was summer when he told me that though.

And I will shut up now. I just know what it feels like when they won't stop coming and it feels so out of control. It can get better.

[healed84]

Originally Posted by pbutton

I hope you are able to find something that helps you deal with the panic attacks.

I think the main trick is to find the things that work for you. I know this is a terrible thing to say, my T keeps trying to get me to try again, but breathing stuff does not help me at all. Paying any type of attention to my breathing makes me panic harder. It is some sort of mental block that I have in my head, because it's supposedly the best way to overcome attack. I do fine without the breathing stuff, thank you very much. So there's hope, I promise.

Things that do help me:
-counting backwards from 100
-proving that I am in control; picking a specific thing to do and doing it (i have a lot of attacks in the car, so I'll tell myself to change the radio station 4 times or roll down the left side rear window, etc.)
-If I am having mental panic I do something physical (If I keep thinking about something that causes me panic I will go do a load of laundry.) If I am having physical panic I will do something mental (If I am concentrating on the fact that my face feels numb and my heart is pounding I will try to learn something new, play a computer game, watch TV, or read something.)

When worse comes to worse I sit and look at what is actually happening. I was having terrible attacks at home. I tried to think about how I was safe at home watching TV and how it is not even remotely dangerous or scary, no matter what it felt like.

I also started tracking how long the attacks lasted. It gave me something else "scientific" to focus on. The more I got into tracking, the shorter the attack. I read somewhere that your body can ramp up to full alert in 3 minutes and that it takes about that long to ramp back down. I always tried to test to see if that felt true or if I could relax enough to drop down closer to a 6 minute attack.

I tend to worry that I'm going permanently crazy and that the attack will never stop. Obviously those things aren't true. I rarely panic that I am going to die (in fact I'd probably welcome death to be blatently honest) but panic won't kill you either.



Oh, T once told me to grab an ice cube in each hand and stand outside. I've never tried that one. I think it was summer when he told me that though.

And I will shut up now. I just know what it feels like when they won't stop coming and it feels so out of control. It can get better.

Thanks for all of the good tips!! Those are all very helpful!!

I'm not sure I've had what you could consider a panic attack per se, but I've definitely had episodes where I freak out. Like pbutton, focusing on my breathing at those times makes me feel worse. What I've found that helped is saying to myself "I'm okay" out loud or in my head over and over and over, gradually slowing it down (which also slows my breathing down without me focusing on it) until I actually am okay again. Maybe that might work for you?

As to what Ts consider urgent, I have no idea. None of my Ts have ever been contactable outside of session other than for scheduling. I would imagine wanting to hurt yourself or others is 'urgent' but, to be honest, I've never called my Ts/Pdocs/GPs when that's happened. I do struggle asking for help though; always feel like I have to sort everything out for myself (that I can't rely on anyone else).

All the best

*Willow*

[lostmyway21]

Originally Posted by WeepingWillow23

I'm not sure I've had what you could consider a panic attack per se, but I've definitely had episodes where I freak out. Like pbutton, focusing on my breathing at those times makes me feel worse. What I've found that helped is saying to myself "I'm okay" out loud or in my head over and over and over, gradually slowing it down (which also slows my breathing down without me focusing on it) until I actually am okay again. Maybe that might work for you?

As to what Ts consider urgent, I have no idea. None of my Ts have ever been contactable outside of session other than for scheduling. I would imagine wanting to hurt yourself or others is 'urgent' but, to be honest, I've never called my Ts/Pdocs/GPs when that's happened. I do struggle asking for help though; always feel like I have to sort everything out for myself (that I can't rely on anyone else).

All the best

*Willow*

I have this same problem. When I am feeling that way, I can never bring myself to call my T. Even though he made me promise I would if it ever got bad. I always feel like it's something I need to handle on my own, and I don't want to worry T.