The pain of panic attacks
Suddenly you feel an immense wave of fear. Your heart pounds and you can’t breathe. You feel dizzy and sick to your stomach. You can’t catch your breath. The room starts to spin….
One of the worst things about panic is that it makes you feel that it is in control and that you’re just an unwilling passenger along for the ride. Much of the fear stems from the feeling that you cannot influence the course of an attack. Eventually the fear becomes the panic experience itself, as the person feels trapped in a vicious circle.
Panic attacks are increasingly common in the times we live in. Although the first one seems to ‘come out of the blue’, it typically occurs during a long period of stress. But they are very treatable and research shows that psychotherapy can be highly beneficial in learning to manage them, and also in discovering what triggered them in the first place.
What is a panic attack?
Broadly speaking, a panic attack is an extreme fear response which occurs when a person is convinced they are in extreme danger; although no real danger exists. (Tubridy, 2007: 7)
The symptoms of a panic attack
The signs and symptoms of a panic attack develop abruptly and usually reach their peak within about 10 minutes. Most panic attacks end within 20 to 30 minutes, and they rarely last more than an hour.
A full-blown panic attack may involve some or all of these signs and symptoms:
• Shortness of breath or hyperventilation
• Heart palpitations or a racing heart
• Chest pain or discomfort
• Trembling or shaking
• Choking feeling
• Feeling unreal or detached from your surroundings
• Sweating
• Nausea or upset stomach
• Feeling dizzy, light-headed, or faint
• Numbness or tingling sensations
• Hot or cold flushes
• Fear of dying, losing control, or going crazy
(http://www.helpguide.org)
Why do they occur?
Why me? Why now? These are questions that preoccupy people as they try to make sense of their panic attacks. This bewildering and frightening place can lead to escalating levels of fear for the future and wreaks untold damage on a person’s self-esteem. (Tubridy, 2007: 53)
The reasons why some people suffer panic attacks and some people don’t are unclear. Some evidence suggests that panic runs in families.
Unfortunately, panic is often frequently misdiagnosed and mistreated as a purely physical complaint. This is particularly due to its manifestation in symptoms such as breathing difficulties, dizziness and nausea.
In fact, panic is very treatable. Research shows that psychotherapy, particularly Cognitive Behavioural Therapy, can be very successful in treating panic attacks.
Can psychotherapy help?
“The word ‘psychotherapy’ is derived from the Greek word ‘psyche’, meaning soul, and ‘therapeia’, meaning attendance. In its truest sense this is what its function is, to give a voice to, support for and validation of the needs of your soul.” (Tubridy, 2007: 77)
Psychotherapy tries to clarify how the deepest aspects of your psyche speak through your distress, announcing itself through your desires, emotions and behaviours. A psychotherapist encourages you to look at the ‘bigger picture’ and to become aware of situations where your perspective may be slightly off kilter. This is achieved in a safe, trusting and caring environment.
It may also be useful to consider therapy with a cognitive slant, namely Cognitive Behavioural Therapy or CBT.
CBT involves two basic steps: learning how to identify what is in your mind, what you think; and learning how to re-examine the ways you think. (Butler, 1999: 133) We all have underlying assumptions and beliefs that can make it hard to focus on or change an unhelpful behaviour. This is where your therapist comes in – together you can work on uncovering negative automatic thoughts, identifying them, and challenging them. An example of this technique is provided below:
What went through your mind when you started to feel anxious? And after that? And when it was over?
What was the worst thing that might have happened to you at the time?
What is it about this situation that matters to you?
What does having this experience mean to you?
What does it mean about you?
(Butler, 1999: 134)
What happens in the therapy?
Psychotherapy can help to uncover unhelpful ways of being or behaviours that may be contributing to panic attacks. Through the process, the therapist and client may look at challenging negative automatic thoughts and coming up with alternatives.
Therapy may involve ‘homework’ for the client, including Thought Records and Panic Attack Records. The therapist may also engage the client in relaxation techniques.
Above, all, therapy provides a safe and non-judgemental collaboration between therapist and client to explore the best solution together.
References:
Tubridy, Aine. (2007) When Panic Attacks. Gill & Macmillan Ltd, Dublin.
Butler, Gillian. (1999) Overcoming Social Anxiety and Shyness. Constable & Robinson Ltd, London.
Smith, Melinda. (2010) Panic Attacks and Panic Disorder. (http://www.helpguide.org)
Karen Galvin is a counsellor practising at Mind and Body Works. To find out more about Karen click here