I used to have panic attacks - but not any more

on Thursday, 23 August 2012. Posted in N21 Experts

EVERYTHING YOU NEED TO KNOW ABOUT PANIC ATTACKS

by Christine Hill from Optimum Success Hypnotherapy North London www.optimumsuccess.co.uk 
 
What are Panic Attacks?

A Panic Attack is a discrete period of intense fear or discomfort with typical symptoms (such as accelerated heart rate, sweating, trembling, tingling, hyperventilation, light-headedness, dizziness....) which develop abruptly and reach a peak within 10 minutes. A Panic Attack is commonly a one-off occurrence experienced during a highly stressful incident and although unpleasant, it is harmless and soon passes without any further consequences.
 
Clients that come for treatment are those who are experiencing recurrent and unexpected Panic Attacks. The persistent concern about having additional attacks is beginning to interfere with their life and holds them back from doing the things that are important to them.
 
What causes unexpected Panic Attacks?

An important premise from psychology is that ‘all behaviour is purposeful’. Although you may not be consciously aware of what has caused this unwelcome bodily response and accompanying thoughts and emotions, the unconscious mind, which stores all your long term memories, has learnt something from your own experiences that activates this response. Your unconscious mind knows precisely the reason for the response, but you are not consciously aware of it.  
At the conscious level there does not seem to be any rational explanation. As panic is a fear response, it means that your unconscious mind has learnt that something is a threat to your safety. If this was an accurate perception and you were in genuine physical danger, the stressor hormones that you are now producing would be the perfect response to act quickly to increase your strength and energy to avoid the danger or protect yourself. However, as there is no physical danger, for example you are just shopping in the supermarket or sitting in the cinema, then the learning is faulty – it is a misinterpretation. 
 
At your conscious rational level you desperately want to go shopping and you are telling yourself that you are perfectly safe, but that is overridden by a message from your unconscious mind that is making you feel fearful, with a strong desire to avoid the situation. Another premise from psychology is that ‘the information in your unconscious mind will always take precedence over that in your conscious mind, which is where your willpower resides’. If you try to achieve something with your willpower which conflicts with your unconscious programming, your unconscious mind will always win in the long-run. This is particularly true of panic, or the fight or flight response, which is an involuntary response under the control of the unconscious mind.
 
Who gets them?

We are all innate learners. We don’t need to go to class to learn; we are always learning. Given the right conditions, babies naturally learn to walk and talk. For that reason any one of us could potentially mistakenly learn an inappropriate fear response to something. 
 
Fortunately most of our learnings are well adapted, appropriate and beneficial. Typically, the mal-adaptive response of recurrent Panic Attacks begins to be learnt during a repeated or prolonged period of high stress and anxiety, when the unconscious mind identifies an object, situation or process in the environment at the time, as a threat to your safety. 
 
Because we learn by recognising similarities and ‘patterns,’ panic attacks can ‘spread’ from one situation to another. The unconscious ‘sees’ a pattern that was previously associated with panic, and assumes that it is appropriate to panic again.
Because this ‘pattern match’ has to be approximate, mistakes can be made and an apparently inexplicable re-triggering of the panic response can occur. For example, after having felt highly stressed due to bereavement and work pressures while seated on a train at a rectangular table next to the window, the client’s unconscious mind subsequently interpreted sitting in a restaurant at a rectangular table by the window as traffic goes by, as a similar and therefore dangerous situation, and re-triggered the fear response. This can lead to a ‘fear of the unknown’ and ‘fear of having another panic’.  Trying to predict and possibly avoid situations in which the feared response might occur again, can reinforce the faulty learning.
 
Is it a question of coping with it, or can you get over it and take back control?

You can absolutely get over it. People experiencing panic attacks often find it difficult to imagine being panic-free and resign themselves to avoiding feared situations, or using coping strategies of their own design such as taking someone with them, planning an emergency escape route or other safety precautions. Some of the coping strategies clients opt for can actually be counter-productive, but it is certainly true that there are some very effective coping strategies. 
I really want to encourage anyone currently experiencing panic attacks and say again. ‘Yes, you CAN take back control. With the disciplined application of some effective techniques that address the faulty learning at the unconscious level, you can be free of panic attacks forever.’  This is because of another premise of psychology which states that ‘anything which can be learned can be unlearnt and something new learned in its place’.  Appropriate coping techniques will enable you to create a relaxation response to override or reduce the panic. However removing the faulty learning or programming as well will replace the panic response with a neutral response. Once completed thoroughly, the change is enduring due to another handy law of the mind: ‘the unconscious mind will always respond to the most recent learning’. 
 
How does the condition develop? Can the condition clear up spontaneously?

If you think about that law of the mind: ‘the unconscious mind will always respond to the most recent learning’, you will come to a rather unsettling conclusion. If you respond to that urge to leave the supermarket without getting your shopping and then feel relief, what has your unconscious mind just learnt? If you worry whether you will panic in the cinema and decide not to go, and feel relieved, what have you learnt? If you continue to repeat these types of learning it is natural that the condition will worsen. If you feel safer when you avoid something, it seems to prove that it was indeed dangerous, and every time you do it, the ‘danger’ learning is being reinforced.  
The condition can only ‘clear up’ if you do something different; learn something new to de-condition, or neutralise, the unconscious panic response.
 
How does Hypnotherapy help?

The faulty learning is held at the unconscious level and new learning at this level is something that hypnosis can achieve more easily and often rapidly, as it enables you to access your unconscious mind. During hypnosis you will be guided to re-educate the unconscious mind so that it understands that the situations that currently trigger your panic attacks are not actually dangerous.
 
Reducing the overall level of anxiety by addressing other sources of stress is also required.  If anxiety levels are persistently high, it will take only a small increase to tip over into panic. It can be the proverbial straw that breaks the camel’s back. Hypnotherapy uses many techniques designed to reduce stress through new learning and by reconnecting you with your inner strengths and your natural ability to relax. Good ongoing relaxation levels will guard against any further faulty fear-learning in the future.
 
Therapy will involve 3 steps:
1. Learning to create a relaxation response through breathing techniques
2. Learning to deepen that relaxation
3. Re-programming the unconscious mind not to fear the panic-inducing object, situation or process.
 
What about self-help techniques – are they successful? 

Relaxation techniques, together with some Positive Thinking exercises can be learned using self-help books and CDs and that can be quite successful. If your best efforts on your own are not working, get professional help from a Hypnotherapist or Neuro Linguistic Programming (NLP) Practitioner. It is essential that you use a technique to re-programme the unconscious mind. With the right help and techniques, even long-standing conditions can be resolved.
 
The most important thing is to ensure that your habitual breathing style supports the relaxation response. During a panic attack, when the fight or flight response is activated by the autonomic nervous system, the breathing pattern changes to increase the amount of oxygen available to the big muscles to fuel the surge of strength and energy required to act. If there is no physical threat and you are not using this extra energy, you experience all the symptoms of hyperventilating (over-breathing). 
 
Although it can feel as if you are not getting enough oxygen, the opposite is true. The symptoms are caused by too much oxygen. To use this oxygen (to extract it from your blood), your body needs a certain amount of Carbon Dioxide (CO2).When you hyperventilate, you do not give your body long enough to retain CO2, and so your body cannot use the oxygen you have. This causes you to feel as if you are short of air, when actually you have too much.
 
Hyperventilation responds very well to the following technique. If you practice this daily, hyperventilating should cease to be a problem very quickly. It will also reduce your overall stress level and give you much more control over panic.
In order to activate the relaxation response you need to practice a specific type of breathing, not into your chest, but deep into your stomach or diaphragm which is below your chest. Diaphragmatic breathing means using the big diaphragm muscle at the base of the lungs to draw in the air (stomach expands, not the chest). The out-breath must be twice as long as the in-breath (ratio of about 1:2). This causes stimulation of the part of your nervous system responsible for relaxation. This is a basic law of biology and if you breathe in this way then your body will have no choice but to relax. It may take a few minutes but the body will respond regardless of what your mind is thinking. 
 
Doing this regularly causes your general anxiety level to come down. You may also find that you begin to breathe this way automatically if you feel anxious. Regular relaxation actually starts to inhibit the production of stress hormones in the body so it actually becomes harder and harder to panic. As you become more generally relaxed the ‘baseline’ of arousal from which you are starting lowers. It actually becomes harder to get stressed!
 
How to do Diaphragmatic Ratio Breathing
•  Place one hand on your diaphragm which is located underneath the bottom of your ribcage, and the other hand on your upper chest.
•  Inhale through your nose for the count of 4 so that you feel your stomach rise under your hand. Ensure your chest and shoulders remain as still as possible.
•  Pause briefly, then exhale through your nose for the count of 8. Feel your stomach pulling in towards your lower back as your hand sinks down. . You can hold for a couple of seconds at the bottom of the out breath if that’s comfortable for you.
•  Repeat a few times until you feel more relaxed and then allow your breathing to settle into its own natural rhythm. You will have set the pace for a more relaxed breathing style that will now continue all by itself.
 
As you practice this technique for a few minutes, several times a day, you will begin to breathe like this automatically with a new habit of breathing deeply in this ratio of 1:2. After a while you will find that you no longer need to check with your hands or count the numbers.
 
What is the one most important thing to know about recurrent Panic Attacks?

There is no need to suffer. Don’t just cope with it, or tranquilise it – resolve it.  Sort it out sooner rather than later! Take back control and hear yourself saying ‘I used to have panic attacks – but not anymore’

A panic attack is commonly a one-off occurrence experienced during a highly stressful incident and although unpleasant, it is harmless and soon passes without any further consequences.

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