Mastering Panic Attacks
© Elizabeth R. Lyons 2003
Panic attacks occur when there is some present reminder of
past experiences of anxiety, fear or powerlessness. The reminder
activates a huge surge of energy (adrenaline & other
stress hormones) in order to prepare the body to deal with a threat that no
longer exists in the present.
Since each of these three aspects is necessary for a panic attack
to occur, any (or all) can provide the most effective key to intervention
for different people:
* The present reminder/cue
A panic attack feels frighteningly unpredictable because the present reminder
or association with the past experience/s is usually obscure. The reminder
of the original frightening experience may be something similar in the external
environment or something experienced internally (such as nausea or an escalating
heart rate induced by exercise). Often the present cues are both external
and internal, and the panic attack “snowballs”, seemingly having
a life of it’s own, as the fear of the body’s response to fear
escalates panic exponentially. Even without identifying current triggers,
it can help to simply understand that something has just become a reminder
of past fear. Then, as present reminders become easier to identify, panic
attacks stop feeling completely unpredictable and uncontrollable. This alone
is sometimes all that is needed.
* Past experiences of panic
As panic attacks are essentially a re-activation of past experiences of panic, it is not helpful to deliberately reactivate detailed associations with the original experiences until you have a well-established sense of safety in the present. Instead, it is generally helpful to deliberately “ground” in the safety of the present reality by deliberately focussing on safe sensory details in the present. Given later safety in the present however, such as in a safe therapy context, there can then be a place for effectively re-processing the original primary cause of the panic attacks. In particular, it can prove invaluable to strengthen the connections between the present “observing self” and the age-regressed “experiencing self” (usually a child) that may have originally been so anxious or frightened. This allows the present intellectual self to reassure and calm this emotionally younger aspect of self. It is impossible for a younger ego-state to panic whilst feeling reassured and calmed and so a “dissonance” is created that reinforces a new calming connection with the experience of panic that will quickly dissolve a panic attack before it escalates.
*The surge of energy
During a panic attack, the perceived threat is responded to with a powerful
surge of stress hormones that are meant to protect you (through “flight”,
“fight” and/or “freeze”). However, as this energy
has no outlet (because there is no actual threat in the present), the adrenaline
charge is usually experienced as terrifying and incomprehensible in and of
itself. These powerful sensations of hyper-arousal can become a strong reminder
of both the original fearful situation and also of every subsequent panic
attack. This is why, in addition to learning to identify triggers, learning
some specific techniques to help your breathing and heart rate return to normal
can also help you re-gain a sense of control. Any sense of control can enable
you to rise above panic attacks in the future.