The point of exit methodology is a thought process that I’ve been perfecting for over twenty years now. The point of exit in the context of the following methodology is the point in which you finish a full blown anxiety attack. Click here to see graph – Click here for video explanation
What Is The Poem System
In a nutshell, the point of exit methodology (or POEM system) is a thought process that deflates the extreme nature of a anxiety sufferers emotional state. When exercising the poem system the panic sufferer learns to not fear a possible panic attack. As the sufferer masters the poem system they can effectively eradicate their fear of panic attacks, and henceforth stop having panic attacks.
How To Practice The Poem System
When you are in a high enough state of anxiety that you are entering into the anxiety cloud state, and fearful of a panic attack, you can avoid the attack by focusing on the end (or point of exit) of the attack.
The anxiety sufferer focuses only at the end of the panic episode and practices disregarding the the actual panic attack. They focus on how they are going to reward themselves when the panic attack is over. I suggest using a walk as the reward. Look at a walk in the fresh air as a fantastic reward. It’s exercise and it’s small celebration of life.
Another reason a walk is recommended is because you can usually achieve that. Outdoors is preferred, but indoors can work to on a treadmill or simply walking up and down stairs. Any kind of exercise can be good, but a walk outdoors is preferred. Rain or shine. However, the reward can be anything you enjoy.
When you are highly stressed, and you begin fearing a panic attack, tell yourself that the panic attack would be “no big deal”, and that if it happens you will reward yourself when it’s over. No matter what your imagination tells you during your time of panic, remember that facts – you are not alone, the panic attack won’t hurt you, and focus only on your reward that is coming.
It’s key that you let the panic attack come and don’t try to fight it. Practice telling yourself that “a panic attack is no big deal”, and if you have the panic attack, really focus on telling yourself that it was “not a big deal”.
Carry out rewarding yourself, and make sure you launch into some kind of activity that has you moving. Walking, running, or working with your hands…..anything – but get yourself moving. If you are OK to drive, then go for a drive. Take a bus ride. Just get moving.
Practicing Point of Exit
When you practice the point of exit methodology, you must focus all your thought at the moment you feel your panic attack subsiding. Right when the cold sweats appear, or after you have cried, etc. At that point of release you are entering your point of exit. You must get some physical activity at this point. Tell yourself how it was no big deal, and how much you are going to enjoy your reward.
If you have multiple panic attacks in a day, you can’t sleep, and you are extremely frightened all the time, the POEM system will help you, and it might even pull you completely out of your anxious state. It might not if you don’t practice diligently. You may need to see a doctor and get a prescription to get your anxiety and depression under control.
Don’t ever forget – you are not alone. You are not a victim. You are a perfect creation of universal energy and universal intelligence. Your anxiety is actually a gift in disguise my friend. You will certainly appreciate the moments of your life when you are not anxious and afraid. You will very likely be enlightened when your journey to recovery is over. At the very least, you will be able to help other people who suffer from the same problem.
In my long effort to finally find a lasting relief I ended up using a low dosage of Paxil. It’s been a wild ride, and some days I still have panic attacks, but I rebound from them much faster now because I have educated myself.
In the end….it’s no big deal. In the end (which will be soon) you will recover from your anxiety and/or depression.
Jacob
May 3rd, 2010 at 3:19 pm
[...] which works for me, but it takes a while to get your head round it (you can read about it here http://www.saneadvice.com/point-of-e…y-poem-system/) I also find going outside helps. Unfortunately there is no definite method that will help, but [...]
March 11th, 2009 at 6:22 am
Great comment and statement Chris. I’m so glad you told your story so that people who have just discovered they have an anxiety challenge can see how it does settle down like a wave coming to shore.
I had a few good chuckles reading your story. Every emotion and idea you mentioned I’ve thought through as well. When you mentioned that people around the world are “really suffering” and so many of us panic fanatics actually live in decent homes in a free Western society with decent incomes and family backgrounds, I had to chuckle because I have thought the same thing so many times. HOW DARE I COMPLAIN or worry about myself when so many other people have problems.
This is another example of how anxiety problems can actually change you for the better. I ended up donating to a charity (Freedom Writers) every month because of these feeling and emotion.
I now take better care of myself, and I practice empathy and sympathy instead of just feeling empathy and sympathy. I much more aware of my ego-state and have become better company for others.
February 1st, 2009 at 9:43 pm
Hello everyone!
Well, I guess I’m a psycho because I had my first 2 panic attacks this past week.
Wow, here I am, 46 years old and never had anything like this!
I had surgery (a very simple procedure) and when they were putting me under they held the cup over my nose and mouth and told me to breath deep but it seemed there was no air flowing. The only air seemed to be around the cup because the nurse was not pushing it tight or anything. Then he told me take 3 deep breaths and I tried but it felt like there was really no air because he was pushing it a little tighter to my face. I tried to pull away one way and the other and then he pushed it tight and I felt like I was being murdered. Suffocated.
Then I was out. The surgery went fine. I woke up fine. Then they gave me pain meds through the IV and I felt pressure on my chest like I couldnt breath and tingling sensations and extreme numbness in my arms and legs. I THOUGHT I was having a reaction to the pain meds. I THOUGHT I was going to die very soon.
I had a full blown 20-30 minute panic attack but didn’t know that’s what it was till 2 days later.
They checked all my vitals mid attack and everything was normal they said but I did not believe them. I thought they were just saying that so that I would stay calm before I died.
Then it passed and I was fine. I still thought it was a possible allergic reaction to the pain meds.
That happened Monday.
I was perfectly fine the next day and I was released and went to my hotel room. I was to fly home the next morning (Wednesday).
That morning I was sitting in the hotel lobby waiting for my ride and here came another episode. I ended up on the lobby floor shaking uncontrollably. Again, thinking something was REALLY bad wrong and that I needed an ambulance fast or I would die.
I went to the hospital and this time they were pretty sure what was wrong but did other tests just to be sure. After everything was fine again I thought about all that had happened and I broke down and cried about the feeling of being suffocated when put under anesthesia the day before.
The panic attacks didn’t scare me ~ the nurse putting that cup over my face and forcing it down on me was most disturbing : (
This may be what triggered this whole thing. IDK
Anyway, I ended up flying home Friday but had some minor waves which I fought off by trying to be happy and laugh about it being simple panic attacks plus they gave me Xanax and that helped too.
I was so happy to get home late that night and I have laughed about this now even to the point of crying.
In the hotel lobby, I told the nurse that if they didn’t hurry with the ambulance, that I was going to die. He said, “It’s okay, you’re not going to die.” I said to him, “You don’t know.”
Me saying that to him just cracks me up now.
I am so embarrassed but I can also laugh about the whole thing now that I know.
Still feel just a little numbness and tingling in my pinkies.
I only took the Xanax to get me safely home. I won’t need anymore ~ unless someone tries to suffocate me that is!!!
I now feel so bad for people who have to deal with this on a regular basis!!!
I hope 2 is all I will ever have!
Scared the bigeebies out of me at the time.
I wish I had found this site 3 days ago when I was in the midst of it all. I searched and searched on my computer while in the hotel and found some useful info. I pretty much did what you recommend and only knew to do it through prayer.
I knew that God could help walk me out of it.
I believe your theory is right on.
Obviously it is, judging from those posting.
Good luck to you all!!
January 19th, 2009 at 5:09 pm
Hello Jacob,
Great site, very helpful.
I am a trained health professional and understand the panic disorder 100% from the physiological point of view. Nevertheless, it did not stop me from experiencing a few episodes a few years ago, and several new ones just recently as well. Understanding the disorder does not prevent one from having it – our bodies are truly miraculous.
What triggers them in my case can be somewhat absurd – when I solve a big issue/life problem this is when I get them. This happened a few years ago, and again a month ago… The problem out of the way obviously opens up all this space in my mind to worry about other silent issues. And I do and this precipitates the attacks because the silent issues are making themselves heard through an attack. I never get any episodes while i am under stress, it’s when I am out of the danger zone that they happen.
I’ll tell you a bit more – some people could recognize themselves in this.
When my body is not in the panic state but is going through something/anything that causes it to start experiencing/resembling something like the ‘symptoms of panic without the panic itself’ – this is when they potentially kick in. E.g., when I am exercising, walking fast, when the weather is extremely hot and humid, when i have gastrointestinal problems, bloating, gas, low blood sugar, etc… – all of these things push up the heart rate, make people rather breathless, worked up… and it’s almost like my body thinks in these instances – ‘why not, I am already worked up, I could now easily slip into the panic mode because I’m already having some symptoms of panic anyway’… it is like the body itself, the mind itself, craves the panic for a reason!
I strongly believe that panic attacks are telling us a lot, speaking volumes to us. They are a blessing! And they suck too. Like they need to happen so that we see ourselves better. I personaly experience some of the best moments of clarity, simple uncomplicated type of clarity, during my panic attacks (I’ve only had, perhaps, 10). Mind you, they are exhausting despite their short duration (from 10 to 30 mins).
What helps – another paradox. Despite the dizziness and the feeling like you’re going to collapse, sitting for a very short time helps. sipping on an energy drink also helps. but then starting to walk in the middle of the attack helps too – the oxygen in your blood gets used up more easily, the alkalotic state improves and all of the sudden you’re taking deep breaths because your CO2 levels are up and making you breathe! crying helps too. writing down all the questions that are buzzing through your head helps (especially if you re-read them later). in my case, being alone helps. i tell my loved ones to leave me alone in those moments.
and, finally, distractions in the form of an unexpected something always ‘interrupt’ the attack. like an important phone call – it interrupts the attack completely and all of the symptoms of panic go away. sadly, you go back to your attack when the distraction is over. it’s ridiculous.
wishing you all the best of health & lots of joy & glorious honesty with yourselves…
cheers,
m
January 18th, 2009 at 10:39 pm
This website has helped calm my anxiety down by a lot. I have been suffering from anxiety since I was small, when I was 19 I had a terrible bout of anxiety that lasted for a period of 6 months. I was put on effexor and then tried zoloft but stopped taking them as soon as I felt better, unfortunatly I didn’t seek therapy at that point. I have anxiety triggered by feeling sick and I have IBS which has recently started up my panic attacks. Now I am 26, I recently enrolled myself in university and work part time. I have been pushing myself really hard at school and started to get panic attacks about once a week for the last two months or so (aka just after exam periods). Any type of feeling from my stomach (especially feeling any kind of heartburn)or even just needing to go to the washroom in a public washroom sends me into a frenzy. My stomach keeps me on my toes and when I get anxious I get really bad nausea.
Of course I then automatically think I have cancer or some sort of seriously life threatening disease. Over the last week or so it has been really bad but because I experienced this before I have avoided going to the emergency room because I know it is just my anxiety. This website has encouraged me to go and seek professional help for my anxiety and has helped to remind me that it is only anxiety after all NOTHING SERIOUS. I do not really want to go on meds but I know that my anxiety has the potential to make me miss out on enjoying my experience with school, friends, and family and I don’t want my life to be clouded by something that is completely treatable in this day and age.
Thank you Jacob for providing hope, information, and support for people dealing with this.
AND THANKS FOR NOT TRYING TO SELL ME ANYTHING
January 17th, 2009 at 9:40 pm
This is for you Anny;
A year ago a drank some really bad milk and I got so sick that I lost too much water because of diarrhea. I passed out cold, threw up a few times, the ambulance came and took me to the hospital to have my fluids topped up and have all my vitals checked out.
KEEP READING MY FRIENDLY PANIC FANATICS.
So as I’m laying there in the hospital hallway in a stretcher I started having panic attacks one after the other.
I asked the nurse to please watch all my vital signs, blood pressure, heart rate, etc. while I was in the peak of a panic attack.
You know what she said happened! Almost nothing!
Remember this.
It’s usually never a medical problem – just in our heads as we roll around scary thoughts as a form of sick recreation.
Usually people who suffer from anxiety are more inquisitive and sensitive.
It’s important to remember that you are not your things, your body, your job, your marriage, family – you get the point.
I am also most effected by ailments the most – money second.
If I have even a patch of dry skin I assume it’s a flesh eating disease or skin cancer. Ridiculous.
Next time you have a panic attack remind yourself that it can’t really hurt you and say something like;
“GO AHEAD – HAVE FUN – PANIC AWAY because I don’t really care anymore and it’s no big deal”
January 15th, 2009 at 2:07 pm
I wonder if this could work for me too. I have panic attacks at the gym, during or after working out. I had one so bad last year I went to the hospital in an ambulance because I was sure I was having a heart attack. They found nothing wrong with my heart, or lungs and told me I had a panic attack. I have suffered from general anxiety for years, but never this bad. I also get them driving sometimes, or sitting at an intersection or at a crowded store. Even if the doctors told me they couldn’t find anything physically wrong with me, I keep thinking there must be because the symptoms are so severe. I can’t breathe, I have chest pain, my head feels funny and my hands go sort of numb sometimes. If I take an anxiety pill all the symptoms go away within a short time ( xanax from my psychiatrist) but, I still keep thinking it’s a medical problem because it happens after I work out. Shouldn’t exercise make anxiety go away? It used to work for me until last year. My husband thinks it is because I fell off a treadmill at the gym ( minor injury). Should I just stop excercising? I am going to a different gym tonight, but been sitting here all day fighting anxiety.
January 8th, 2009 at 4:12 pm
Good for you for taking action and getting on with fixing your anxiety.
I’m encouraged by all of the comments from people getting themselves help.
Stay relaxed in 2009!!
Jacob
November 15th, 2008 at 10:02 am
It is so great to have found this website! I have been suffering from anxiety for several years now, but have definitely had a slight case of OCD (obsessive compulsive disorder) for mostof my life. I’m a complete perfectionist. I think that the anxiety was brought brought on by trying to be perfect and failing. Apparently no one’s perfect! Anyways, the severe anziety started about a year ago. I, unfortunately, started using alcohol to self-medicate and calm myself down, but, of course, that just adds to the problem. Recently I was given a prescription from a so-called ‘anxiety specialist’ for depakote. The drug worked wonders for my anxiety in general, but the side effects were brutal: hair loss, weight gain, difficulty sleeping, etc. Once I decided to stop taking Depakote my anxiety returned even worse. I had the worse panic attack ever last night; I am still really shaky and exteremely anxious. I was so fortunate to come across this website where there are others like me, suffereing from the same disease. I defeinitely know how many of you feel; that no one knows how you feel! When trying to explain a panic attack to others they just look at you with a blank face; there is never any compassion. Anyways, thank you so much, again, for your website. I can’t wait to put your system into good use.
-E
November 2nd, 2008 at 6:38 pm
Hi everyone!
I’ve been reading your posts and they have been helpful. I suffer from PTSD, and panic attacks. My doctor put me on Lexapro, and it controlled the attacks until I had an accident and now have severe pain in my neck and back. I am not getting proper help for my pain. I used to walk 6 miles a day. Now I sit because the pain is so bad. Disc problems and bad osteoarthritis are causing me to retreat. Today I was out with my husband to get a few things and I started sweating badly with blurry vision. My back and neck sre so bad I cannot stand the pain. My first attack since I’ve been on meds. Noone seems to understand the chronic pain and it is wearing on everyone I love. What can I do to help if I can’t exercise? It was really helping me before this. I have gained a lot of weight on meds, and now its even worse.
November 2nd, 2008 at 5:04 pm
Hello Everyone,
I have to say it was a great feeling today that I was able to get on the computer and do some research on my anxiety without getting overly anxious or getting the feeling that I was going to have to deal with an attack. It was quite liberating. I came across this site and started reading some of these posts and could not go about the rest of my day without sending out a message to you all. So here’s my story:
I am 24 yrs old and I have been dealing with my anxiety for three years now. Looking back, I realize this was brought on by three things 1) It runs in my family (yes u can be predisposed to anxiety/panic per your DNA) 2) Family turmoil 3) Major life changes/transitions.
Before I get into this, I first want to repeat others messages that YOU ARE NOT ALONE. YOU ARE NOT CRAZY. LIFE IS ALWAYS WORTH LIVING (because this WILL go away and one day you will be able to view this period of your life as the benevolent voice posted on June 20th that said u “can see it as a âcostly/painfulâ but enriching experience that exposes to deeper levels of reality, ordinarily ignored in the humdrum of life”. At this point in my life, I am sad that I had to deal with this for years, but glad in a way as I see things much more clearly and have realized many things about myself and my life that I probably never would have unless I had dealt with this horrible experince. Also note that you DO NOT have to deal with this for years before you get a handle on this. You can get your life back on track starting NOW if you take my advice and many of the others advice listed through out this blog.
Over the years (and according to my therapist), I have experienced just about the worst panic experiences one can possibly have. I used to get every symptom in the book during my attacks and to the most severe extent, which is why I wanted to take some time to write to you all. My heart goes out to anyone who experiences ANY one (or all) of these symptoms as I know how scary/confusing/life altering they can be. But again, this is only a phase and this WILL come to an end.
If you are getting panic attacks for the first time, you NEED to get a list of the symptoms of panic attacks. I had no idea what a panic attack was until my dad forced me to see a doctor when I was visiting my home in Chicago during my college years. The therapist showed me the symptoms from a medical book. I felt SO relieved. All my symptoms were listed right there. That is step one: assuring yourself that you are NOT crazy, are not going GOING crazy etc. Rather, you are simply dealing with a very common “issue” (i call it an issue rather than a disorder because I used to see the word “disorder” and freak out and try to convince myself that I didnt have one). I wouldn’t call an alcoholic someone with a disorder. Rather, they have a problem that can be tackled and they need to deal with it accordingly. Everyone has their own problems in many different forms, anxiety is just ours. It’s tough. But like I said, one day you can look at this in a positive light.
Next, you HAVE to realize that your mind and body are in sync. If you treat your body like crap, then ur mind will follow suit. So, before you do anything you need to start getting healthy. I wish I realized this in the past. I partied hard in college and I studied hard in school. I was always run down from lack of sleep and heavy drinking and thus, susceptible to panic attacks. Don’t run yourself down. You can’t handle stress and think straight when u are exhausted.
Well rested is easier said than done for some. I can relate to those whom lay in bed, heart pounding, having racing “crazy” thoughts. I used to dread bedtime as that was when my anxiety peaked. If that is the case, it is especially important for you to work out. The chances of you falling asleep and staying asleep increases 10 fold. Working out releases dopamine, which is ur best friend in fighting anxiety. It is the feel good drug that your brain releases naturally and working out triggers this. Even walking induces dopamine release so Jacob is EXACTLY correct. Take deep breaths, tell yourself positive things like “this panic will wear off.. I just need to ride this out and I will be ok” while u put on ur walking shoes, and get out there and start walking/running. It’s the best anti-anxiety natural drug there is. And you feel “tired” at night, not exhausted and can fall asleep a lot easier without the racing thoughts.
So, u now know u are not crazy and hopefully u’ve started/or are looking into getting ur body healthy to give urself a shot at beating this. And you CAN beat this. These two steps are a must and ur already on ur way.
Next step is to start talking to others. Whether it be a friend, your family, a therapist, etc. Keeping this horrible experience inside is the most unhealthy thing you can do. If you’re on this site reading this, you are on the course to recovering. I was too scared to see a therapist consistently because I thought crazy people saw therapists. So stupid. No one can go through life without help. And they are there to help you. There’s a reason why humans have lived in communities since the beginning of time. We are communal. We can’t go at this alone. So DONT!! So see a doctor. If you are too scared then at minimum find someone that has had these experiences and talk to them. MILLIONS of ppl experience this, but ppl are scared to tell others bc they dont want to seem crazy, or weak. Tell ur parents and friends, so they can support you and so u are comfortable if you are ever having these symptoms around them. Also, try to do things that forces you to FOCUS ON SOMETHING OTHER THAN YOURSELF. Focusing on urself all the time is unhealthy…and selfish. Community service, give $20 to a charity every month for starving children, help your friend/family move….anything to focus on others for a change. You’ll realize there are problems that others have that are far beyond panic/anxiety. And you can give your mind a break for a change and put things into perspective.
Next, start thinking about what stresses you out. What situations give you anxiety. What PEOPLE make your life more difficult. You need to start recognizing these things if you are going to tackle this. Also, if you are in a transition in life (as I was leaving college and living on my own 1000 miles away from friends and family, working a highly stressful job, dealing with family turmoil), give yourself some credit. Its normal to feel worried or anxious. But try to spin it as a positive thing. Change is ok. It’s part of life. And you need to learn to deal with the transition and learn from it as you will also learn to beat anxiety/panic/depression. You will be a stronger person after this chapter in ur life. Again: its just a chapter in ur life, this wont be a part of every chapter for the rest of your life.
If you can bear it, get some anti-anxiety medicine. Personally, I was too scared to take a drug every day. But there are prescription medicines to take at the point you feel this “cloud” coming as Jacob calls it or when the panic is coming. These drugs are made for these situations and are not a crutch. Panic attacks are natural….ie the fight or flight” situation. However, self induced panic attacks are not. Panic attacks “trick” ur mind into thinking u are in a fight or flight situation when in fact, u are not. Which is why u feel crazy because everything is fine, yet ur having all of these “abnormal” symptoms. These one at a time drugs (given by ur doctor) keep u from getting these intense symptoms of fight or flight. So keep this as an option if you are up to it. You take aspirin when u have a headache right? Thats what I tell myself, and its just that simple.
Anyways, I am at the point where I get about 4 panic attacks a year. They only occur when I’m tired from a long weekend of partying with friends, or massively stressed from work and havent slept much. And its nice to know that these attacks are not going to happen at any moment in the day and I can let my guard down. I say this as encouragement only, not to gloat. Once I get into some consistent therapy, work out a little more and eat better, age a few more years to where I wont drink much ever, I expect to be panic attack free for the remainder of my years.
So I said this has been a positive experience in the end right? Well….
-I know how important my health is. Both physical and mental. And their relationship to one another. Get healthy!
-I’ve reassessed my life and recognized what is important and what stresses me out. This is mandatory for those with panic, and in the end is a HUGE gift.
-I’ve learned a lot about myself, my fears, my weaknesses, my strengths.
-I feel proud that I have overcome something so awful and notably one of the worst things a human being can deal with. Yet, Im here. Im healthy. And Im happy again. Life goes on and will for you as well. And I feel stronger than anyone and prepared to take on anything. Because as you know, there isnt anything much worse than panic attacks.
-I’ve realized I cant always focus on myself and to be empathetic to others. After all this, I cannot honestly go through life and not think about the fact that other people suffer from much worse things that panic/anxiety. So silly to think we suffer from stressing over stupid things and there are people truly suffering in the world. You start to see life a little more clearly and a little more simply.
-I can deal with stress/anxiety. Everyone at some time or another will deal with life stressors. Im a PRO!!
I hope this has helped and given you hope that life will go back to normal, as that was what always worried me most. You are stronger than u give urself credit for and you can do this!! Just take baby steps towards conquering this, and you will find in the end you made steps towards becoming a better and STRONGER person too. And thank you Jacob for doing something for all those that suffer from this. I wish I would have seen this a long time ago!
“Dont worry. Be Happy”
God Bless and get started!!
October 27th, 2008 at 12:14 pm
Hi Jacob,
I’ve been having panic attacks for most of my life, but never realised it. Can you believe it? lol
One night I had a big attack where I thought I was going to die. I was running around the place trying to escape it, I must have looked ridiculous! When it was over I wondered what the hell had happened to me and so decided to start searching on the internet. Now I get attacks on a regular basis, sometimes twice a day. I’ve gotten so good at recognising when an attack comes, I can feel it like a wave coming over me. Sometimes I can stop it at that stage, other times it just takes over. I used to shout at myself to stop the attack, or after an attack and tell myself to stop being so stupid. This I found doesn’t work so well. Now I’ve found a better way to calm myself before or during and attack. I breath slowly, like you recommend and then I talk gently to myself and tell myself that it is ok. This works well for me. Now I just wish the attacks would stop coming. I will give your POEM thing a whirl.
Thank you for caring for all us neurotics out there! lol
Alison