Online sessions now available.Kristian S. Nibe - clinical psychologist and ISTDP Practitioner.
Panic attacks are episodes of intense and overwhelming anxiety. Approximately 20 % of the population have a panic attack during their lifetime. When the intense anxiety that characterizes panic attacks sets in, it usually is accompanied by thoughts centering around losing control, going crazy, having a heart attack, or dying. These thoughts repeat themselves at high intensity, and the person with the panic attack has great difficulty controlling them and regulating his panic and anxiety.
For the afflicted person the anxiety often feels so intense that he believes his last hour has come. He is unable to separate between his feelings, anxiety, and thoughts. He perceives them as they are one and the same thing, and he therefore becomes confused and afraid.
The panic-stricken person doesn’t understand that feelings, anxiety, and thoughts are three different processes happening separately in the brain and body. These three processes don’t have anything to do with fear. A panic attack doesn’t mean that you are afraid, it means that you have intense feelings in your body that you are not aware of. Read that last sentence again and let it sink in.
To know that there are three different processes happening simultaneously during a panic attack, rather than just one chaotic process, makes it easier to regain control and regulate anxiety. This can be illustrated with the Triangle of Conflict below, here with an example taken from my book Reconnect to your Core.
The Triangle of Conflict above shows that the first process that happens inside the brain during a panic attack is that a underlying feeling gets triggered due to a thought or perception of the environment/relationship. Our primary feelings are anger, sadness, joy, guilt, or disgust. These feelings activate the body physically as the figures below illustrate.
The second psychological process follows a split second after a feeling has been activated, and this is the anxiety (i.e. panic, muscle tension, nervousness, stress) which tries to cover up the underlying feeling(s).
To summarize; a panic attack indicates that the underlying feeling(s) are too intense for defense mechanisms to cope with.
To illustrate; anger ranges on the continuum from bothered, to annoyed, to irritated, to anger, to rage. A person might not get access to a feeling from the unconscious mind because he learned early in life that the feeling can be painful and create uncomfortable emotional experiences. If that is the case, then that person will feel anxiety/panic rather than the feeling itself.
The intensity of the underlying feeling determines how much anxiety/panic is needed in order to cover up the feeling. This means that a person that is annoyed will experience tension or nervousness, while a person who is angry or filled with rage will experience strong anxiety or panic.
If unaware of this anxiety mechanism, it is likely that a person will interpret the panic attack as fear and believe that one is afraid during the panic attack, rather than understand that unconscious feelings are present in the body. This error in perception is understandable since the person experiences panic rather than the feeling.
It can be of great help to know that anxiety is not the same as fear. To know that anxiety is feelings in the body one is unaware of rather than something one needs to fear calms the person down significantly. That knowledge alone can enable reflection rather than fear when anxiety sets in. It is of great help to not become afraid of anxiety when it arrives, but instead become able to explore and try to understand what kinds of feelings that might have been activated in the body given the context of the situation and/or relationship dynamics.
The third process that happens during a panic attack is that thoughts starts increase in intensity, negativity, fearfulness and worry. Typical thought patterns during a panic attack entails death and dying, having a heart attack, losing control, or going crazy.
None of these thoughts are “real” in the sense that they can’t predict the future. Our bodies are designed to tolerate anxiety. Anxiety is just the wordless muscle tension in the body that covers up feelings. This wordless muscle tension doesn’t mean the thought: “I’m going to lose control.”, that is just a thought based on the assumption that anxiety means fear which subsequently results in passivity and helplessness. Furthermore, the belief that anxiety means fear blocks awareness of the underlying feelings present in the body. That is why a thought that predicts a worst-case scenario (i.e. a worry) is called a defense mechanism. Defense mechanisms defends the person from his own feelings. They defend the panic-stricken person from getting to know and feel underlying feelings since that person is busy worrying about whether he is losing control, rather than exploring (and expressing) his own feelings.
It would be better and healthier if the person learned to regulate his anxiety, explored his feelings, and gained control of and distance to his thoughts.
How to overcome panic attacks.
People that want help to overcome their panic attacks often say that their panic sets in suddenly and without any forewarning. However, this is most often not the case. Usually the person has spent a considerable amount of time being at unease, nervous, worried, and anxious before panic sets in. Unfortunately, the person has ignored this bodily activation and instead focused on his worrying thoughts or distracted himself through some other activity. However, by becoming aware of and paying attention to internal processes it is possible to detect anxiety before it turns into panic.
In order to overcome panic attacks, it is therefore necessary to learn to listen to the body when it changes from a relaxed to a tense state. Therefore, rather than ignoring what happens in the body it is important to become aware of what feelings are present in order to prevent anxiety and panic from occurring.
Ignoring feelings, the belief that one is afraid, distractions such as alcohol or cell phones, excessive worrying and worst-case scenario thinking, inability to regulate anxiety, lack of knowledge regarding what anxiety really is, resistance towards sharing feelings with others, judging the anxiety and interpreting it to mean weakness or failure, in addition to getting trapped in a loop where one becomes afraid of the anxiety (so-called “Anxiety for the anxiety”), characterizes nearly everyone suffering from panic attacks. The good news is that it is possible to overcome panic attacks if one is motivated to make change and dedicate oneself to the healing process.
Panic attacks and defense mechanisms.
A key defense mechanism most people with panic anxiety employs is the “need” to escape the situation they are in. Since physical symptoms during panic attacks are so strong, pervasive and uncomfortable, many people believe that they are having a heart attack or that they are losing control. This often results in the worry that one will experience a new panic attack later (i.e. anxiety for the anxiety). The worry especially centers around whether panic will happen in a place where help isn’t available and/or where it’s difficult to hide or escape without embarrassment.
This is the reason many people experience panic attacks at work, in meetings, during presentations, in tunnels/trains/bus/elevators/planes, at the movies/theaters/classrooms, while they’re home alone, or alone in the woods or hiking in the mountains. All these situations have in common that the defense mechanism “withdrawal” is not readily available, and that is why anxiety increases in intensity during these situations. Left defenseless, the ego doesn’t know how it’s going to solve a situation it usually would have solved by withdrawing from the situation or by going passive, therefore it “freaks out” by activating the anxiety mechanism.
Panic attacks usually reach their climax ten minutes after their onset, and seldom they last longer than thirty minutes. Regarding most people’s biggest nightmare, introduction rounds at work, the anxiety subsides immediately once they have been able to hark out their name and title, and many people seek help because they can’t understand why the body is reacting so intensely because of the apparent small task of stating their name in public.
Often clients report that the panic attack lasted “the whole weekend”, but after probing for specifics, it is revealed that the panic hasn’t been equally intense the entire weekend, but rather it has varied in intensity. Often what drives such a prolonged panic attack is the “anxiety for the anxiety”, which means that the person has become afraid of the anxiety and not known how to regulate it.
Armed with knowledge regarding how to regulate anxiety one can avoid the anxiety becoming too overwhelming in intensity, so that it no longer feels as if one is losing control. With this ability it is possible to explore unconscious feelings and rid oneself of destructive defense mechanisms that maintain anxiety, symptoms, and dysfunctional behavioral patterns. This is how to overcome and get rid of anxiety once and for all.
Online consultations available.
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Consultations are available for either 45 minutes or 90 minutes, and are conducted by video either through Skype or appear.in. Alternatively I also offer sessions through chat/e-mail.
The price per 45 minute consultation is 160 Euro. The price for a 90 minute consultation is 300 Euro.
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