There is much written about anxiety attacks (proper name: panic attacks). Some is helpful, some not, the latter because it’s either commercially motivated or innocently misguided. I recently read an article that was probably well-meaning, but certainly misguided. It recommended distraction and avoidance, meaning distraction during the attack and avoidance of situations that trigger attacks. Both approaches might reduce panic in the immediate sense but would certainly make it worse in the longer term.
As a psychologist and practicing Cognitive Behavioural Therapy (CBT) and Acceptance Action Therapy (AAT) therapist, both cognitive-behavioural approaches, I’ve treated many clients suffering from panic. All were quickly cured. This is certainly one of the easiest psychological problems to resolve.
Independent advisory bodies such as the National Institute of Clinical Excellence (NICE), universally recommend cognitive-behavioural approaches as the treatment of choice for panic and other anxieties. In recent years treatment has been enhanced by combining traditional CBT with more modern acceptance-based approaches, such as AAT, ACT or Mindfullness.
The most effective treatment for any anxiety problem is a combination of acceptance, that is acceptance of both the anxiety symptoms and the trigger, and behavioural change. Acceptance is the opposite of resistance, where ‘resistance’ means having negative thoughts about something or wanting something to be different (those two definitions are effectively the same thing). Anxiety is always caused by resistance of the symptoms of anxiety and/or resistance of the trigger.
Panic always involves resisting panic. A fearful thought initiates the panic cycle. That fearful thought is often anticipation of panic. The fearful thought generates a release of adrenalin. Anxiety is often referred to as the fight-flight response. It developed during our evolution to increase our chances of survival under threat by helping us to fight or flee.
Physiological responses to adrenalin include an increased heart rate, to get more blood to the muscles to enable us to fight or flee, increased breathing, to get more oxygen to the muscles, perspiration to keep us cool, shutting down the digestive system, to release more blood to the muscles (reflected in a dry mouth or throat as adrenalin shuts down the saliva glands, or a desire to go to the toilet as the intestine relaxes) and tingling on the skin due to blood being diverted from the capillaries to the muscles and due to changes in carbon dioxide levels resulting from heavier breathing. Some people experience all these symptoms, others just some of them.
With panic the person experiencing the symptoms becomes fearful of the symptoms. Often this is because they know from experience that the symptoms will lead to panic. Fear of the symptoms results in more adrenalin being released. And so a vicious cycle of adrenalin and increasingly fearful thoughts is initiated, leading to panic.
These days, the body’s automatic adrenalin response to a fearful thought is usually unhelpful, since most fearful thoughts are no longer related to physical threats. So the fight-flight response is now largely an unwanted irritation.
AAT provides the understanding that anxiety, and the adrenalin that drives it, are harmless and the experience is bearable. AAT also provides tools to enhance our willingness to experience discomfort. These understandings and acceptance tools enable us to be willing to experience anxiety and to accept it.
Acceptance immediately diminishes the anxiety, since it interrupts the fear-adrenalin cycle. But more importantly it enables us to follow the CBT behavioural response of stopping avoiding, or escaping from, situations that generate panic. And this ultimately is the key to resolving the problem.
Most people naturally try to diminish or avoid panic, either through attempts at distraction or through avoiding, or escaping from, situations that trigger panic. Unfortunately all these actions reinforce our resistance of anxiety and prevent us from finding out that anxiety, like any other feeling, is harmless and bearable.
So the cure for panic is: stop using distraction, avoidance or escape as a means of controlling it, understand that it’s harmless and bearable, accept that there’s nothing wrong with experiencing panic, stay with it and watch the feelings rise, peak and subside as they always do. To speed up the cure, seek out situations where you’ve previously panicked.
And so join the thousands of others who have suffered from panic attacks and now no longer fear them, so they no longer arise.