To say the least, panic attacks are no fun. People who suffer from them not only go through the pain of intense anxiety, but their body goes haywire as well—rapid heartbeat, accelerated breathing, profuse sweating, a vice-like tightening of the chest muscles, shortness of breath. These symptoms can be so uncomfortable that even the slightest hint of any of them may bring on fright.
I have had the privilege of helping many people overcome their panic. I think of Kristi, a thirty-five-year-old mother of three who, before leaving home, would map every doctor’s office and hospital on the way to her destination in case she’d panic and go into cardiac arrest on the way. Then there was Brad, an architect, who refused to leave home except to keep an appointment with his primary care physician. I also remember Silvia, a mother of two strapping young boys, who found it next to impossible to go to the grocery store or to Little League games lest she’d have an anxiety attack.
Kristi, Brad, and Silvia all overcame their panic attacks. So have scores of others I have treated over the years. If you suffer panic attacks like they did, you too can overcome this scourge once you know the cause and cure of it. So, make a cup of tea, sit back in your easy chair, and read on. Let me help you as well.
The Cause Of Panic Attacks
To rally the country’s spirits during the Great Depression of the 1930's, President Franklin D. Roosevelt famously proclaimed: “All we have to fear is fear itself.” Little did he know he spoke to those who suffered panic attacks as well as to those fearful about their financial future. Simply said, people experience the emotional and physiological manifestations of panic when they catastrophize about their own fear or anxiety. Though they are unaware of it at the time, their panic is the end point of the following four-step process.
(1) For whatever reason, a person who panics first notices their own anxiety which can contain all three of its components: the emotional experience of fear; the physiological components described earlier activated by the autonomic nervous system; and often the behavior expressions such as pacing, handwringing, and the like. In Rational Emotive Behavior Therapy (REBT) terms, we call the noticing of these anxiety components the A, or the Activating Event.
(2) This A, then, activates the brain to process these experiences. This processing is the B. At B, then, those who do not experience panic attacks think thusly: “This sucks and is very unpleasant, but it is bearable, temporary, and not dangerous.” To the contrary, those who bring panic upon themselves think about their anxiety in the following catastrophic terms: “Oh, my God, this is horrible and unbearable; I’m having a heart attack and will die (or will go irreversibly insane, or will act in some egregious way that I will be shunned forever) and therefore must get over this immediately.
(3) Step three then is the Consequence, (the C) of thinking in these catastrophic terms. In other words, the person, by virtue of thinking in such life and death ways, brings on the emotional, physiological, and behavioral consequence of panic
(4) As a result of these first three steps, the person has now wedded catastrophe to anxiety, thus making oneself deathly afraid of having anxiety in the future, thus being hyper-vigilant to the slightest hint of the activation of any degree of anxiety in the future, and thus avoidant of all situations in which anxiety might arise. Through this process, in other words, the person has developed or more accurately created an anxiety disorder.
To make this graphic, I illustrate this in the ABC’s of Rational Emotive Behavior Therapy (See Figure 1). At A, the Activating Event, the person experiences anxiety in some or all of its various manifestations—emotional, physical, and/or behavioral. This event activates the brain, at B to evaluate the A. If one perceives this event rationally, that is, dislikable but harmless, then that person will experience the emotional Consequence at C of displeasure and dislike, but not panic. But, if one catastrophizes about the anxiety as horrible, unbearable, and deadly, then he/she will bring on the experience panic.
The ABC’s of Panic Attacks
Activating Belief Emotional ' Event Consequence ' activates causes
A --------------------------> B --------------------------> C
Anxiety Horrible. Panic ' I’ll die.
The Cure of Panic Attacks
As you can see, a panic attack is merely an experience, an unpleasant one to be sure, but still just an experience. Its cause, the real disease, if you will, is the irrational thinking that brings it on. The cure, then, is not avoidance, medication, or such palliative strategies as deep muscle relaxation, mindfulness, or distraction, but a cognitive re-education. The person who suffers from panic attacks will need to come to believe that, while unpleasant, there is no danger from the initial experience of anxiety. That is the truth.
So, for those of you who experience panic attacks, know that the truth shall set you free. You need to reassure yourself that:
• What you experience to begin with is only anxiety, a painful experience to be sure, but one that is not dangerous and will pass. Furthermore, what goes on in your body is merely the predictable consequence of your autonomic nervous system stirred up. You can look this physiological process up on the Internet if you’d like so as to reassure yourself that it is not dangerous. So, what is happening to your body is unpleasant, but it is explainable and certainly not dangerous.
• You are not going to die, go irreparably insane, or lose control in some bizarre way. What you are experiencing is merely anxiety, pure and simple, and you will survive the unpleasantness of it. If you will let yourself have the anxiety without catastrophizing about it, it won’t have you. That is, you will gracefully lump it without going into panic.
• Finally, without panic, you can work to rid yourself of the original anxiety that started your whole ABC process. This is what I discussed in my December 26, 2017 blog, which you can go back and review if you’d like.
So, this process is what I used with Kristi, Brad, and Silvia to cure them of their panic attacks. I taught them the ABC’s of their panic, helped them ferret out their catastrophizing ways of thinking, reassured them that they were in no danger, showed them how to dispute the validity of these panic-inducing thought patterns, and helped them engrain new thoughts that told the truth of their safety. With hard work, they eliminated their panic attacks, as did all the others over the years that made the same effort as they did. So can you.
What I have just communicated tells the truth about the cause and cure of panic attacks. If you suffer from these gut-wrenching experiences, perhaps this blog will help you conquer them. If not, don’t hesitate to consult with a competent cognitive behavioral psychotherapist, preferably one who practices Rational Emotive Behavior Therapy as I do. He or she could help you get the job done.
Can you rid yourself of panic? I know you can. Will you? That’s up to you. In my next blog, I will teach you how to free yourself from one of the two varieties of depression—self-damning depression—by telling yourself the truth. In the meantime, be well, and live with passion.
Russell Grieger, Ph.D. is a licensed clinical psychologist in private practice in Charlottesville, Virginia. The author of several self-help books, all designed to empower people to create a life they love to live, he invites you to check out his new relationship happiness book, The Couples Therapy Companion; A Cognitive Behavior Workbook and his new motivation book, Developing Unrelenting Drive, Dedication, and Determination. Both can be found on Amazon. You may contact Dr. Grieger for questions or for more information at email@example.com