Disclaimer: If you notice yourself experiencing what you think are panic attacks, it is always best to visit your Doctor (GP) as a first stop to make sure these symptoms are not caused by an underlying health condition. Once your doctor gives you a clean bill of health, they might refer you to a therapist for panic attacks.
What is a panic attack?
Panic attacks are a heightened form of anxiety. They can be an unbearably overwhelming experience. Heart racing, a tightness in your chest, hands tingling, feeling like you just can’t catch a breath.
It’s no wonder that many people end up in the emergency room for fear that they are having a heart attack. When a panic attack shows up, it can feel like something is going terribly wrong with our bodies.
What is happening when we have a panic attack?
We humans have evolved to avoid things that are unpleasant, dangerous, and painful. If we think back to ourselves as cave people on the savannah, avoiding dangerous things meant that we would not become another creatures lunch!
We not only avoid painful things outside our body, we are also wired to avoid unpleasant experiences inside our body as well. In Acceptance and Commitment Therapy (ACT) we call this process experiential avoidance.
Experiential avoidance is something we all do, myself included! I don’t want to feel shame or have my mind tell me I’m a failure so I don’t go for that promotion at work. I don’t want to feel the fear and embarrassment that would come if the cute girl at the coffee shop rejects me, so I won’t go ask her out on a date.
When we are struggling with a panic attack, our minds see our racing heart, tightness in our chest, and shortness of breath as an alarm signal that something is wrong. Our mind might start telling us I am dying, I am having a heart attack!
Of course, our mind is just trying to help us and keep us safe, however a cycle of panic has now begun. Our racing heart is now pounding even faster, our chest feels even tighter, and we start grasping for the next breath.
In psychology we say that panic attacks are anxiety about anxiety. When anxiety shows up, it is natural to have the physical sensations described above. Our minds however can start seeing these physical sensations as a very real and dangerous threat. Just like we would a lion on the savannah! We naturally try to get rid of anxiety, and doing so creates panic.
How are panic attacks treated?
So how are panic attacks treated in therapy? A therapist will help you identify what triggers your panic attack. This would include physical sensations (for e.g. your heart rate increasing), what your mind is saying (your thoughts), what feelings show up in your body, and in what situations a panic attack is more likely to occur.
You might have already guessed, if trying to get rid of anxiety is what causes a panic attack, would it make sense to practice the opposite of trying to get rid of it? Yep! That’s exactly what we do!
In therapy we call this skill willingness. Willingness means practicing making room for what feelings and bodily sensations are showing up moment to moment. A big part of therapy for panic attacks is about building this skill.
Once this skill is practiced, it would then be put to use in what we call interoceptive exposure (currently the best evidenced based method for treating panic attacks). Interoceptive exposure means you and your therapist would gradually expose yourselves to the feared physical sensations. That could be dizziness, a racing heart, shortness of breath, nausea, or a tightness in your throat.
This could be done by both of you running up and down on the spot, rapid deep breathing, spinning yourself in a chair, or breathing through a straw to name a few.
If this sounds scary to you, you’re right, it is scary! Taking a step like this marks a profound act of courage. It is scary, and possible! A former first lady of the U.S. said it best:
“You gain strength, courage, and confidence by every experience in which you really stop to look fear in the face. You must do the thing which you think you cannot do.”– Eleanor Roosevelt