Panic Attacks, Phobias and Fear
By Danny Hickling BSc. Hons. (Couns.) MBACP UKCP
Panic attacks are an unpleasant frightening but harmless set of sensations when the body becomes overly anxious and goes into panic mode after being ‘triggered’ by a singular or multiple sensations or thoughts.
They are often described by sufferers as coming from nowhere, and having no pattern to them but there will often be at least one trigger which at first may seem identifiable to the sufferer of the attack.
Symptoms commonly include
Rapid heart rate.
Feeling sick or churning stomach.
Feeling dizzy or disorientated.
Pins and needles
Sweating and sensations of hot flushes or chills
Weak legs and arms
Thoughts commonly include
I am having a heart attack
I am going to die
I am going mad
I need to get away or flee from the situation
Worrying that people will see you
Although the common fears are “there is something wrong with my body or mind” what is happening here is a natural process, which in effect is our mind and body trying to keep us safe and away from harm.
This response is called the ‘fight flight response’ and has been bred into us as a beneficial instinct because it allowed human kind to survive their natural lifetime and has allowed mankind to evolve successfully over millions of years.
Although we are gifted with large brains which allow us to theorise, reason and empathise, in everyday life we can calculate how much the shopping will come to, weigh up the options of where to go out to tonight or contemplate the vastness of space but this capability to think deeply can take time, so this part of the brain isn’t all that useful when split second can get in the way of survival. Often there is no time for reasoning when split second life saving choices have to be made Evolution has ensured that in a split second any of the senses can witness a signal that means danger, screeching brakes, a fast approaching train and in an instant a part of our brain the Amygdala registers this as signal of Danger. Cleverly the Amygdala continually has data added to it throughout life and accesses stimuli at any given moment against the implicit memories it holds to see if what is happening around us is perceived as safe or unsafe. if we’re listening to Abba’s mama Mia as a child and a car hit us and we broke our leg, the chances are the Amygdala will remember this fact and set off the alarm bells in our nervous system when this song plays again!
For the vast part of our lives in modern society we have no use for this fight or flight response, however it will help us in heightening our senses if we suddenly find we have taken a wrong turn and walked into the wrong part of town late at night or can alert us to characters that ‘give us the creeps’ . However, it can leave us frozen in fear felt in past events and intrude into our everyday normal existence. At other times deep existential fears such as our fear of death will instinctively install fears in us such as fear of heights.
Existential fears are unavoidable fears connected with existence and living the commonest of these fears is fear of dying which its believed can manifest itself in direct reminders such as hospitals but also in more indirect situations such as fear of heights or enclosed spaces.
Where a fear is associated with a particular object person place or event such as the dentist or enclosed spaces it is often called a phobia, phobias often lead us to avoid the catalyst or trigger such as the dentist, exposure to the dentist will often lead to the fear or anxiety being replicated and if the experience is a bad one can in some cases if the trigger can’t be escaped lead to a panic attack. If this happens the expectation of a future panic attack will often lead to avoidance of the dentist all together, this can however be changed by future experiences.
In the moment of a panic attack or intense feelings of fear a number of techniques may help
This may sound patronising because breathing is easy, right? Well yes we might be breathing but when we are feeling tense we tend to breath too rapidly and too shallowly this contributes to the symptoms of both Anxiety and a panic attack..
The good news is breathing and mood are closely interlinked.. Slow down our breathing and our bodies and minds will follow suit!!! Deep breathing sends a message to our through the parasynthetic nervous system to our mind and body that its safe to relax!!
The trick is a simple one and it starts with a simple thing that you will have forgotten to do..
BREATHE RIGHT OUT!!!
Breathe out slowly through your mouth until your lungs feel empty.. This will make room for the next important stage..
BREATHE IN!!! But slowly…. And pull your stomach this will let the breath slowly fill your lungs.. But keep it slow…..
Then when you have breathed in to a comfortable point hold it, just for a moment or however long feels comfortable to you, then let the air flow out again… Always make your out breath is a little longer than your in breath.
You might choose to count in your head for the first few breaths, the timing is up to you as we all have different sized lungs but try to keep it slower than what you have been used to..
Out through the mouth for 1 2 3 4 5 6
In through the nose for 1 2 3 4
Keep this simple breathing cycle going for 6 or 8 cycles and the body should start to slow down.. At this point its ok to just let you breathing flow in a relaxed way..
It has been understood in recent years that our brains and body are hard wired to touch, this response is called self soothing, this is why our response to stress is often to clasp our hands to our face, to put our fingers to our mouth or fiddle with our hair or ears.
A hand on the heart has a particularly powerful effect. Neurons in this area respond – calming the nervous system down – this is a handy tip to remember when you are feeling that you may be getting the first signs of a panic attack.
RIDE IT OUT
If the trigger to your panic is logically harmless, and the phobia crept into your life without an initial traumatic event being responsible for it :then one option is to try to resist the temptation to avoid the trigger of your phobia!
If you have a phobia about walking over big bridges that has just started to occur it might seem easier to walk a different way to work that avoids the need to walk over a big bridge. But to avoid the immediate stimuli (a bridge) might seem a simple solution at first; but the risk in doing this is, if you don’t stand up to, and ride out the initial fear the phobia often extends itself into other areas of life, next its smaller bridges such as foot bridges or underpasses. I know it sounds insurmountable but a journey of a thousand miles starts with a single step.
Often the fear of the bridge can be your fear of the symptoms the fear creates in crossing the bridge and not of the bridge itself. Panic attacks peak after around 10 minutes to half an hour of occurring : they may appear to last forever but they do not! Many people who are able to realise that they do pass by even when the presence of the trigger of the panic is still present, find after the experience, that the trigger no longer holds the same power or has such an intense effect on their bodies anymore.
If you choose to ride the experience out many people find having a supportive friend with you who will be there with you throughout the experience can help, if you choose this option choose someone who is unlikely to panic at your own symptoms but someone how is calm but most importantly is patient so won’t expect you to just ‘snap out of it’ .
If this method seems too intense for you, milder exposure with small at first but ever increasing exposure to the trigger of your panic can be achieved in what is called exposure therapy within our sessions.
Exercise not only stimulates Serotonin, the body’s natural feel good drug, but this in turn reduces Cortisol levels that have a damaging effect on the body. There is also a growing awareness that nature is especially good at soothing to our minds and nervous system. So why not combine the two! Take brisk walks ideally out in green spots such as woods the beach or if you live in a city the local parks the exercise stimulates your body into creating Serotonin and the walk often creates positive distractions and a greater sense of wellbeing. Some Counsellors including myself use ‘Walk Talk Therapy’ to help utilise these two aspects of walking to speed up the process within therapy sessions.
Counselling can give us space to examine these feelings. The very act of talking of a fear often begins to take the power out of the fear, this combined with breathing or visualisation techniques can halt the vicious circle of anxiety associated with phobias and further break the pattern down that can exist between the fear being faced and the panic attack that used to follow up this exposure.
Psychotherapeutic Techniques such as Eye Movement Therapies ( EMI and EMDR ), Cognitive Behavioural Therapies (CBT) and Hypnotherapy may be used in sessions to further break the association between the trigger of a panic attack or fear and the associated thoughts and physical feelings that used to accompany it. The process may involve conscious reasoning in sessions such as with CBT or involve deeper unconscious processes such as with Hypnotherapy and Eye Movement therapies
If you still require help after reading this article yo are welcome to contact me for further details about arranging a counselling session through my website or Facebook pages
Please feel free to watch the video below on other peoples experiences with their panicky feelings.