IAPT: Helping Londoners to cope with anxiety

Professional fitness trainer Paul from Islington is healthier than most. But one day in 2012, he had the shock of his life when he thought he was having a heart attack.

“I was out for lunch and these chest pains developed from out of the blue. I just didn’t feel right and my heart was bursting in my chest. The paramedics came and rushed me to hospital, but after 12 hours they couldn’t find anything wrong with me and told me to go home!” said Paul.

“I didn’t know what was going on with me. The next day it happened again and before I knew it I was having these attacks three times a week.”

On two occasions he was suspected of having a heart attack, on another three occasions a potential stroke and at one point medics thought that Paul might be suffering from a blockage. However, each time his test results came back negative – leaving Paul in a terrifying state of not knowing what was causing his collapses.

The attacks began to have a knock on effect on the rest of Paul’s life. Everyday pleasures soon became problematic as was constantly worried about when the next attack would happen and if he’d be able to get help.

“I ended up taking time off work. I needed to figure out what was wrong with me. It affected everything in my life to the point where I couldn’t even take my own little boy out. I couldn’t go to the gym, meet my friends. In the end I became a prisoner in my own home,” explained Paul.

Paul never had any signs before an attack and with an inconclusive diagnosis, he naturally became more and more concerned.

“One evening in October I was coming back home on my bike and ended up in hospital. After that, my GP who referred me to my local IAPT service (Access to Psychological Therapies) run by the Camden & Islington NHS Foundation Trust as its “iCope” programme, suggesting I could be suffering from anxiety.

“Most people cope with health problems by doing research and getting answers, but because I wasn’t getting answers to why I was collapsing it was causing my anxiety to increase. Eventually, and with support, I had to build the belief that it was anxiety itself that was giving me problems, and not something physically at fault with my heart.

 

“I was given counselling as part of IAPT and one of the biggest issues I had with it was whether it would actually work. I was uncertain and had a lot of questions. But I wanted to get my life on track so I gave it a go.”

Clinical psychologist, Libby Watson, worked with him to combat the issue. “In the early stages it was difficult for Paul to get back into exercising. At this stage it was often more natural for him to be guided by his feelings particularly as he was conscious that the attacks came ‘out of the blue’.”

Paul’s therapy forced him to leave his house and go to the iCope centre in Islington and this in itself helped.

Libby explained, “He approached the therapy with commitment and an open mind, which really helped him progress. He made a good start because he was ‘forced’ into anxiety-provoking situations. These included going to places he normally would’ve avoided, like coming to see me at his own therapy sessions for example.”

Libby soon realised that sitting in a clinic room wasn’t an ideal way to help Paul understand there was nothing wrong with his heart, so they began to go on runs together.

“I thought it was worthwhile to intentionally help him raise his heart rate to ‘prove’ that nothing bad would happen,” she said.

“We began by running on the spot before venturing outside and running around the block. We worked through a hierarchy of increasingly challenging situations that saw increases in the time and pace of the running, whilst dropping other ‘safety behaviours’, such as focusing on surroundings rather than body sensations and getting Paul to run on his own without his mobile phone.”

These exercises helped him to take control of his anxiety and believe that he wasn’t suffering from a heart condition.

Libby explained, “When the anxiety showed up, he would see it for what it was ‘just anxiety’ rather than a symptom of a physical health problem. He knew it would eventually pass.”

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