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We knew we couldn't make it illegal to be either against the [Vietnam] war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin, and then criminalizing both heavily, we could disrupt those communities . We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night on the evening news. Did we know we were lying about the drugs? Of course we did. By prosecuting this drug war, the Nixon team believed they would gain the white vote, especially in the South (his "Southern strategy"), and remain in the White House. The wonderfully acted and ironic film Elvis & Nixon (2016) has Elvis (played brilliantly by Michael Shannon) arrange to meet with President Nixon (played deadpan by Kevin Spacey) in 1970. Elvis, "the King," more famous than the president, wants to become an undercover agent for the Feds to help break the backs of hippies and druggies, a soldier in Nixon's War on Drugs. Whatever the truth of their encounter, the photo of the two shaking hands in the Oval Office is the most requested picture in the National Archives Catalog. In one of the strangest White House photographs ever taken, Elvis Presley shakes hands with President Richard Nixon in the Oval Office on December 21, 1970. Regardless of the cause of your panic attacks, though, it is important to keep in mind that none of these things is your "fault." And remember as well that - just as we saw with anxiety above - the specific cause of your panic may turn out to be irrelevant to how you are ultimately able to treat it. No matter the origin or etiology of your panic, many of the same methods and strategies for managing and overcoming it will still apply. Panic attacks are a vivid experience, and those who suffer from them often come to recognize their symptoms over time. Some of these symptoms are physical. The most recent edition of the DSM, mentioned above, lists some of the bodily feelings or sensations that often accompany a panic attack. Oftentimes people struggle to identify what they are experiencing as a panic attack, however - especially the first time they go through one - because panic attacks do not just "happen" to you. They do not fall out of the blue. Rather, they are connected to escalating or "cascading" thoughts of fear. Many people who experience panic attacks describe a sensation of the "floor falling out from under them," metaphorically speaking. As their thoughts seek grounding in a feeling of safety, that is to say, their panic keeps thinking up ways in which that safety is imperfect, and in which they might still be in danger. To see how this happens, it might be helpful to look at some examples of the kinds of thought patterns that characterize a panic attack episode and to see how panic can originate and escalate from other fears, or other kinds of anxiety disorder.

If you have experienced a panic attack yourself, the chances are that one or more of these thought patterns will seem familiar to you. Most people dislike the thought that they or their loved ones will one day die, and some degree of fear of death is a normal part of life. Indeed, the plot of the classic novel White Noise, by the author of Don DeLillo, deals in depth with the question of whether being afraid of dying is a normal reaction to the fact of mortality, or a sign of mental illness, after a mysterious new drug is placed on the market that promises to be able to "cure the fear of death." When we discuss "fear of dying" in the context of panic disorder and panic attacks, however, we do not mean the kind of discomfort with the idea of death than many - if not most - people will experience in the course of their lives. Rather, we mean fear of dying right now, as if one's body is going to simply up and quit on one as soon as one thinks of the possibility. It's amazing that my heart keeps beating on its own, without my having to do anything to help it along. How would it feel if it just stopped one day? How painful is a heart attack? What would a heart attack feel like? How can people tell if a heart attack is coming or not? How do I know I'm not about to have a heart attack right now? What if it's just seconds away? I wouldn't be able to do anything to stop it. How would I get to the hospital if one happened? Is my cellphone on? Is it working? Am I in range of a cell tower? If I really had a heart attack right now, would I be able to dial the phone? Or is it too painful and sudden for me to do anything at all? How quickly do people die after they first start to have a heart attack? Is there anyone else here who would be able to call the hospital for me?

Who do I trust to do that? Before they know it, the person thinking these thoughts is experiencing a pounding heart, sweaty palms, and all the rest of it. They are in the midst of a full-on panic attack. Be extremely strict on yourself. Be hard on yourself. Don't leave anything to chance. Don't fill your life with guess work. Don't be clueless about what you'll face each day. Don't wing it. Don't give yourself wiggle room to mess up or get it wrong. The stricter you are on yourself, the better. It assures you'll do what needs to be done. It means running an extremely tight ship and keeping everything squared away. Nothing slips through the cracks. Nothing is left to chance. You're paying attention to details most overlook and you're more in control of your thoughts, emotions, behavior, and habits. Being extremely strict is triple-checking everything for accuracy and making absolutely sure you're on the right track. It's smart and important to implement personal processes and procedures for everything needing to get done. They ensure your time is used wisely and efficiently. Decide what things need to happen, create processes and procedures, triple-check them, rehearse them in your mind, and follow the steps laid out to guarantee it's executed properly.

When you notice steps can be improved, implement the changes, move forward, and repeat the process. If you need to be up at 4 AM, like I do, be extremely strict about it. Mentally rehearse detailed steps for how you'll do it. Be strict about going to bed at the same time every night. No leniency. When the alarm goes off, put your feet on the floor, walk to the bathroom, wash your face off, take a shower, etc., and start your day. Act without hesitation. If you know the orders are correct and they'll get the desired outcome, then put your emotions away and strictly follow the orders. Don't worry about how long it takes, how hard it is, or how hard you're being on yourself. All that matters is the target, goal, and the outcome. You can feel shame because you believe you have broken one of your value rules - one you hold about yourself or one you believe about others. If you believe you have behaved in a way frowned on by friends, family, or society you may feel shame. You may remember the term catastrophizing from the Anxiety-Free Thinking' section of this book. <a href=''>You</a> tell yourself that it isawful' if you feel a certain thing or have behaved in a certain way. Awfulizing'</a> is often expressed in terms of criticism about personal weakness . <a href=''>If they saw me being so indecisive, that would be awful. What would they think of me?' People who experience shame have a great capacity for avoiding people and places that remind them of what they see as their weakness. Humiliation usually means you believe you have lost status in some way. It is closely linked to the same kind of thought processes connected with shame and guilt, in particular around the issue of worrying about how others will somehow think less of you as a result of your loss of status. Ronald Reagan too could not resist this ersatz and fabricated war, contributing to enormous rates of incarceration.

The number of people in jails and prisons, largely people of color, for nonviolent drug law offenses went from fifty thousand in 1980 to more than four hundred thousand by the late nineties. Concerns about crack cocaine were all over the press when Reagan took office in 1981. Nancy Reagan had already begun to contribute to the ill-begotten war with her Just Say No campaign. President Reagan proposed and enacted an even more militant war than Nixon. Reagan declared that "drugs were menacing our society" and asserted that his administration would achieve drug-free schools and workplaces, more vigorous law enforcement and drug interdiction, and greater public awareness. By 1986, Reagan had passed and signed legislation that appropriated $1.7 billion to fund his War on Drugs. This included mandatory minimum prison stays for drug offenses and massive programs, at home and abroad, for crop eradication and interdiction. Public education, prevention, and rehabilitation programs had their funding reduced. Nancy Reagan traveled the country to speak about the dangers of drugs. Meanwhile, they both turned a blind eye to HIV/AIDS, which had begun to ravage the country. The consequences of our history of punitive approaches to drug addiction are manifold. Public safety, particularly from incarcerating nonviolent offenders, is not significantly improved; families are broken and shattered, especially when the parents of young children are incarcerated; and recidivism is terribly high, indicating that this method of control does not effectively address the intended problems. According to the Brennan Center for Justice in New York, 39 percent of the people in US prisons are there unnecessarily since no degree of public safety is achieved. We know, as well, that two-thirds of people in correctional settings have a history of abusing drugs or alcohol or both. The Brennan Center report notes that "approximately 79% of today's prisoners suffer from either drug addiction or mental illness, and 40% suffer from both. Among inmates, suicide is now the leading cause of death, accounting for 34% of deaths in 2013." Vast amounts of money are ill-spent and thus unavailable to fund prevention, alternatives to incarceration, more robust community policing, and reentry programs for prisoners upon their release. Hopefully, this hypothetical example helps us to see why panic attacks can seem to "sneak up" on one. The person thinking these thoughts doesn't say to themselves, "I'm having a panic attack." Rather, they are going through an escalating or cascading sequence of anxious cognition - in other words, a thought process - linking together ideas that make them feel increasingly less safe. Before they know it, they are panicking. This example may also enable us to see why panic tends to become associated with avoidant behaviors.