Understanding Panic Disorder & Agoraphobia

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Understanding Panic

Panic is perhaps the most intense and the most challenging of all human emotions.  What is panic, and how can we best understand it?

Panic comes from the "fight-or-flight" response that all of us have and that has been key to our survival as a species.  In prehistoric times, when a saber-toothed tiger or neighboring cannibal tribe wanted to have us for dinner, the fight-or-flight response kicked in.  Instantly, we would have superhuman strength and speed, to either fight or flee.

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Today, the stresses we face are very different from what they were in prehistoric times.  Sometimes, our fight-or-flight response gets triggered when there is no actual threat to our survival.  With no external, life-threatening danger to focus on, bodily sensations and scary thoughts can spiral into a panic attack.

It’s helpful to think of our fight-or-flight response as having two parts.  The first part is an internal alarm.  A great analogy is a fire alarm bell.  A fire alarm is loud, scary and very unpleasant, but the alarm itself is never dangerous.  In fact, the fire alarm is designed to insure our protection and survival in the event of an actual fire.

Once our internal alarm bell gets triggered, the second part of our fight-or-flight response kicks in – we  instinctively search for the danger.  We need to know instantly what kind of danger we are facing, in order to know whether to fight, flee or climb a tree!  A great way to think of this part of our survival response is a huge, round clock with only one hand, in the shape of a huge POINTER.  The POINTER spins around at top speed, locating the danger, so that you can instantly respond and save yourself from great peril.

But what happens when your internal alarm is a false alarm?  The POINTER spins around wildly, desperately trying to locate the danger, in order to save you.  But there aren't any tigers or cannibals around.  The only thing unusual is what's going on in your own body – sensations that relate to the activation of the fight-or-flight response.  So the POINTER, with no other place to go, points inside, to those strange and strong sensations.

All of these sensations are completely harmless.  In fact, the body is mobilizing for heroic action.  If you were really facing a tiger or a cannibal, you wouldn't notice these sensations – you’d be too busy fighting or fleeing.  But with no external danger, your POINTER focuses on these strange sensations – they are the only thing unusual that's going on.

And yes, the sensations are unusual.  The fight-or-flight response doesn’t often get turned on.  In fact, the first time you experienced a panic attack may have been the first time your fight-or-flight response was triggered without a real, external emergency to focus on.  So, yes, the sensations are unusual.  And completely harmless.

Fast on the heels of the strange sensations, the scary thoughts come in.  "What if I'm going crazy?”, “What if I’m having a heart attack?”, etc., etc.  Your POINTER has found a "danger".  And this “danger”, as convincing as it seems, is composed only of sensations, each of which is completely harmless and scary thoughts, each of which is completely untrue.  

In fact, these scary thoughts are just about the most false thoughts the world has ever seen.  They are less likely to happen than the sun not rising tomorrow.  They are even less likely to happen than the Cubs winning the World Series.

Let’s take one of the most popular scary thoughts as an example:  “What if I’m going crazy?”  

With all the millions of people experiencing tens of millions of panic attacks, there is not a single case of anyone ever going crazy from a panic attack.  Not ever.  Psychotic disorders develop  gradually over a period of many years, and do not arise from panic attacks.  Psychosis has to do with losing touch with reality.  This couldn’t be further from the experience of the panic sufferer, who is super-attuned to reality.

So, how do these completely false, scary thoughts arise?

Again, let’s take the example of “What if I’m going crazy?”

Now, we all have a vocabulary that includes the scary thought of going crazy.  Cultural myths about people “going mad” run very deep.  We've seen more than enough horror movies, from an early age.  We have plenty of images in our brains of psychopathic killers, snake pit asylums and padded cells.  So, when our POINTER is spinning around, desperately trying to locate a danger, the best it can find might be: "Maybe these strange sensations mean I’m going crazy!”

Panic is a fascinating and very odd emotion.  But remember, the fight-or-flight response resides in a very old part of the human brain.  Prehistoric times were very, uhh, colorful.  Without our survival  response, we wouldn't be here today.  And in giving us the gift of our fight-or-flight response, our Creator was more concerned with ensuring our protection than with avoiding false alarms.

The most sensitive among us are the ones who get to experience the false alarms.  We can feel victimized, or we can use the experience to learn and grow in some extraordinary ways.

Understanding Panic Disorder

 


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