When I was a kid, I was terribly afraid of the dark. I still remember the feeling I had walking down the basement stairs of my grandparents’ house, or getting up in the middle of the night to go to the bathroom. My worst fear was of some indefinable something that lay beyond fear: Would I get so scared that I’d actually see something freaky? Could I in fact go crazy from terror, or even scare myself to death?
I hear echoes of this “fear of what’s beyond fear” in many of the anxiety conditions I treat, and most clearly in panic disorder. First, a quick description: Most of us at some point will have at least one panic attack, which is a sudden surge of fear along with physical symptoms, such as a racing heart, shortness of breath, or feeling faint. But having panic attacks does not indicate a disorder; one must also really fear having more panic attacks. Generally, one will worry that the panic signifies something terrible like “having a heart attack” or “going crazy.” Panic attacks become problematic when we’re so afraid of them that we alter our lives to avoid them. For example, one may stop using elevators, taking public transportation, or driving over bridges if these situations are tied to panic.
If you have ever experienced a panic attack, you know they are miserable: There’s a gripping fear, a sense of impending doom, and an overwhelming drive to escape the situation.
In addition to the experience itself, panic in Panic Disorder usually triggers a fear that something else—something beyond panic—is going to happen. We imagine that whatever it is will be qualitatively different from the panic alone, such as:
Panic does not cause these terrifying events. What is actually beyond panic? In the short term, just more panic. Inevitably, the body and mind stop generating the panic symptoms and the attack ends.
The best tested treatment for panic disorder—cognitive behavioral therapy—focuses on training the mind to understand that panic is just panic, no less and no more. With practice and hard work, we can move through our fear and our expectation of something worse than panic.
What makes panic overwhelming is what we imagine will happen. When we conquer our belief that panic is going to include something worse, we’re free to face the panic itself. People tend to find that they can deal with a panic attack when it is stripped of its most terrifying forecasts.
Perhaps many other things in life are similar to panic—things we could deal with as they are, but struggle with because we fear they will turn into more than we can handle. For example, we can deal with an awkward and dreaded conversation; it will just be awkward, no better and no worse. And we can face a busy work day on very little sleep; we will be tired at times, no more than that. Similarly, we can finish a tough workout; it will hurt, then it will be over.
Our minds repeatedly create ghosts that we treat as real, and that we believe will be more than we can manage. When we face our lives as they actually are, we find we are enough.