Panic Attack Or "I Almost Died, And They Tell Me About Some Kind Of Head"

2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43

In this article on panic attack, I will make two points. The first is on the recognition of the panic attack itself and the behavior after it (therefore, there will be many statements from clients, starting with the headline), and the second - on a brief description of the work, so that there is an understanding of what to expect from psychotherapy.

A panic attack is simply an unreasonable, short, acute attack of fear of dying or going insane, accompanied by a storm of bodily symptoms. Clients usually come at a time that can be called "I have already had a doctor's appointment, but I don't want to see a psychiatrist." When the ambulance was already called, the diagnosis of the heart, blood vessels, adrenal glands, thyroid gland was done, the VSD was diagnosed, "all the little things, they didn't find anything serious."

It is understandable, the state is functional, i.e. when "sausage", there is pressure, and arrhythmia, and hypoxia, but when they get to the doctor, the crisis has already passed and left no traces. Meanwhile, these attacks continue to bother, although all the obvious safety measures have been taken (places, situations and circumstances in which the attacks took place, the person diligently tries to avoid). The suspicion that "something is there with the brain" scares the prospect of ending up with a psychiatrist who will offer pharmacological treatment, "but I don't want to give up yet."

Then the client comes to the psychotherapist with the words “This cannot go on any longer. I'm not some kind of nutcase. I want to live as before, ride the subway, leave the house, not be afraid of traffic jams, crowds and ride the elevator (everyone has their own). I'm tired of these restrictions, seizures and the expectation that it will cover again. " In the bag for this case "sedatives" are in store, in the head are prepared affirmations "I am calm, I am safe", and the request "to open the window wider, otherwise there is nothing to breathe."

Since the body of a city dweller has been under stress for a long time, the first panic attack usually occurs in a "quite routine situation" and the causal relationship "accumulated stress - the body's reaction in the form of panic" does not occur. But the “scene” and selective fixation on the symptoms (lack of air, palpitations, dizziness and loss of vision clarity, cold sweat) are easily combined as a cause and effect and are marked with the conclusion “That's it! I'm finished!"

It should be said that during a panic attack, a person behaves in a way that he could not afford in his ordinary life. ASKS for help, SHARES his FEARS, asks for advice from his CLOSE, is looking for a specialist for YOURSELF, loses CONTROL and surrenders to EMOTIONS. Here it is the luxury of involuntary release of tension, which is "impermissible" for a modern person. The triumph of the biological over the social. A kind of revenge.

Evolutionarily, emotions and violent bodily reactions were necessary not so much to enrich the inner world with experiences as to move the body from its place of survival. Our nervous system is created and well-sharpened for solving external practical problems: situations, stimuli and conflicts used to require a quick motor response. Now the stimuli and conflicts are mostly internal and in the motionless cultural body all the same massacres, runaways and persecutions, displaced from the field of consciousness to the bodily level, are conserved.

The work begins with the "materiel": explanations of what is happening at this moment in the body, how the autonomic nervous system works, how the head is involved and how this panic attack (consider such a stupid emotional discharge) releases the accumulated "static electricity" that the client has forgotten how to throw off in other ways, "we are adults, educated people and know how to control ourselves."Moreover, often chronic stress and tension are perceived by the person himself as composure, concentration and purposefulness. And the fear of losing control of oneself even more twists the knob of the regulator of vegetative manifestations to the maximum.

Sometimes it is faster and easier to show how the body and the autonomic nervous system work right on the "debriefing", on the experienced panic attack. It becomes clear that the thought of a grandmother's stroke with the subsequent paralysis added oil to the fire, attempts to breathe "deeply" only led to dizziness, but intuitive findings in the form of urgently telling someone about what he felt in the body and long exhalations helped …

Analysis of the "first aid kit" also clarifies the picture. It turns out that either "light" sedatives or "heavy artillery" of psychotropic or tranquilizers (valocordin, corvalol, phenazepam) helped. Both those and others had an effect on the course of mental processes, and not on the heart, blood vessels and lungs. The question is often asked here: “Is there a drug. In order NOT to COOL yourself, so that Scary thoughts - STOP, and everyone else - PASS. " I must say right away that there are no such electoral ones.

The next task is to reduce the fear of an expected attack and open the connection (trigger situation - fear of an attack - panic). Often through an attempt to voluntarily intensify the symptom and call it outside of a dangerous situation. In parallel with this, there is a training in the skills of self-regulation and self-help during an attack.

These activities can be attributed to education, prevention and symptomatic treatment. The reason for this state of affairs lies deeper, in repressed emotional reactions and internal conflict. Finding what conflicts with what and organizing a constructive dialogue between the parties is more difficult. This material is supplanted and sensitively guarded by psychological defenses. That is why the client firmly believes in the danger and seriousness of his bodily ailment and runs away from psychotherapy like the devil from incense, coming already with a bearded history of the issue, at a time when the quality of life and relationships with loved ones begin to suffer. For example: a mother cannot take a child out of school alone, and “for the company” no one agrees to walk or it is difficult to drive a car because of fear of dying alone in a traffic jam, but you have to go.

I will not describe in detail the part related to finding and resolving an internal conflict. Since the beginning of the last century, this topical issue has captured the minds of the Great Beings, starting with the works of I. P. Pavlov and Z. Freud, walked the red line through the history of all neurophysiology, psychology and psychotherapy. Different approaches offer different methods, but they have the same essence. Detect this conflict and resolve it.

In conclusion, I will say that dealing with a panic attack is first and foremost work. Vegetative conditioned reflexes instead of the person himself will not be changed, cognitive errors - no one will correct for you. There is no magic pill, although sometimes pharmacotherapy is indispensable. The drugs make it possible to create a "therapeutic window" and tweak the brain biochemistry to a state of neuroplasticity. By themselves, they will not restructure your experience or change neural connections.

And remember - this request is targeted. If the doctors did not find anything "interesting" for them, you should see a psychotherapist. He has a place to roam. Otherwise, you can become a hostage to your illness.