Psychotherapy For Panic Attacks

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

What is today called the term "panic attacks" just a few years ago bore the "names" better known to you - vegetative-vascular dystonia with a crisis course, cardioneurosis, neurocirculatory dystonia. Familiar words? Previously, they were listed as chronic diseases and could not be completely cured. And all why? Because doctors could not find the true organic causes of this disease.

Relatively recently, this topic began to be intensively studied by psychotherapists as a result of experience and the fixation of an individual in it at a particular moment in life. This has fundamentally changed the clinical view of the diagnosis and treatment of panic attacks.

In this article, I will give you a brief understanding of the essence of panic in various approaches and techniques, and at the end I will offer my own point of view, based on which I work with this problem.

How to recognize panic attacks?

The ICD-10 offers a list of "mandatory" symptoms on the basis of which a diagnosis is made.

In order to speak with confidence about panic disorder, a person must regularly observe at least 4 of the following symptoms:

1. Tachycardia (heart palpitations);
2. Increased sweating;
3. Chills;
4. Feeling of internal trembling and externally fixed tremor (trembling of the limbs);
5. Shortness of breath, feeling of acute shortness of breath;
6. Discomfort and pain in the region of the heart and / or along the entire left side of the chest;
7. Derealization - a sudden feeling of unreality of the surrounding world;
8. Depersonalization - the feeling of observing oneself as if from the outside;
9. Fear of losing your mind or losing control of your actions, thoughts and feelings;
10. Fear of death;
11. Tingling sensations, numbness, internal pressure in the limbs;
12. Sleep disorders such as insomnia;
13. Confusion of thoughts.

Symptoms highlighted in red are essential companions to panic attacks. If you notice a combination of these symptoms in yourself, you can consult with a psychotherapist in order to understand the nature of this condition and get rid of it.

Causes of Panic Attacks

Different approaches focus on different mechanisms, each of which is right in its own right and has a place to be. Knowing what each approach is focused on allows you to find the psychotherapist of the necessary direction.

I offer you a short excursion into the views of the main directions:

CBT (cognitive behavioral therapy)

This direction is recognized as the most effective in teaching the patient to cope with attacks of panic attacks. CBT views panic attacks as a consequence of a person's severe, catastrophic fantasies with no real precedent.

Behavioral theory views the person subject to these attacks as highly sensitive, somatising experiences. This means that the psychological state is transferred to the bodily sensation and is amplified by it.

Cognitive theory considers the cause of panic attacks as a misinterpretation of one's own feelings (as carrying a threat to life).

Psychodynamic therapy (psychoanalysis and its varieties)

Followers of the teachings of the great Sigmund Freud consider fear and its extreme severity - a panic attack - as an external manifestation of the strongest intrapersonal conflict. Specifically, Z. Freud spoke about the conflict between morality and repressed drives.

More modern psychoanalysts have extended this to the conflict of needs and feelings. For example, once suppressed fear, guilt, aggression, which oppose attitudes and upbringing, can cause anxiety, which later becomes panic disorder.

Transactional Analysis (in which I work)

This direction considers the personality as a triune structure of the so-called. ego states. These are the ego states of the Child, Parent and Adult. A child is a person's own experience in childhood with all accompanying emotions, feelings and experiences.

Panic attacks are a fixation of personality in the Child's highly traumatic experience. When a trigger situation arises, a person can “fall through” into a childish state and react in the way that was relevant at that age period in those traumatic conditions.

Systemic systemic therapy

In this case, we are faced with panic attacks as a consequence of the violation of interaction in the family. Thus, it is not a human disease, but a family disease. The internal tension generated by the discord in relationships comes out in this way.

The methods of correction must include psychotherapy for the whole family.

Gestalt therapy

This method is aimed at working with emotional states, needs and desires. Blocking needs and desires can lead to an accumulation of feelings of dissatisfaction, which in turn leads to a panic attack.

What is happening at the physiological level?

Physiology is the understanding of the body's functioning under normal or atypical conditions. Understanding the physiology of panic attacks is very important in order not to discount the significance of the problem, but to fully understand it.

There are several stages:

• Anxiety (thoughts and feelings of anxiety).
• Activation of the release of catecholamines (in other words, adrenaline).
• Constriction of blood vessels (they have a muscular membrane, which contracts under the action of adrenaline).
• Increased pressure (as a result of vasoconstriction).
• Tachycardia and rapid breathing (also a reaction to catecholamines).
• An increase in the amount of pure oxygen and a decrease in the amount of carbon dioxide in the blood.
• Dizziness (occurs due to an increase in the amount of oxygen and increased breathing).
• Disorientation in oneself and in space (after all this it is really difficult to maintain composure).

As you can see, the system works "automatically", in the process there really is no threat to life. But the triggered response mechanism increases the feeling of anxiety.

Psychotherapy in the treatment of panic attacks

For the features and schemes of drug therapy, you can contact a neurologist or psychiatrist (do not be afraid, this does not mean that you are mentally ill).

I invite you to get acquainted with the methods of treating panic disorder in psychotherapists of different directions.

CBT

This method has a seven-step treatment regimen. Among the wide arsenal of techniques, the following are most often used:

• self-observation diaries - recording your thoughts, feelings, actions in various situations, accompanied by anxiety and seizures;
• training in correct breathing techniques and meditation techniques;
• training in muscle relaxation techniques;
• deep work with the root causes of fear and anxiety.

Psychoanalysis

Usually work in psychoanalysis is very deep, I would even say a fundamental study of the personality and the identification of those very inner conflicts. This therapy gives more lasting results, but takes longer.

However, at every stage of psychotherapy, positive changes will occur.

Transactional Analysis

In this approach, therapy will take place through deep and very careful work on finding traumatic fixation in childhood, identifying unmet needs at that time, cultivating a sense of basic safety and eliminating the "fall" into an uncontrolled childhood state.

In terms of duration, work in TA with panic attacks also surpasses CBT, but like psychoanalysis, it affects not only the sphere of trauma, but all spheres of life. Persistent and profound life changes take time.

Hypnosis

Various hypnotic techniques work with deep subconscious structures. Classical hypnosis offers a number of guidelines for getting rid of panic attacks. A softer Ericksonian works on the sphere of internal conflict.

TOP (body-oriented approach)

In this case, the psychotherapist works with bodily sensations and teaches a person to hear his body and respond to its needs. Jacobson relaxation (muscle relaxation) and various breathing techniques are used.

DPDH (eye movement desensitization and recycling)

A very subtle method based on simulating eye movement during REM sleep. This technique allows you to activate natural restorative mental processes and stabilize the emotional state. There are very few competent therapists of this method.

Knowing the main directions can be very productive in treating panic attacks. Today, high-quality and deep psychotherapy allows you to completely get rid of this problem and live a high-quality, fulfilling life.

As for my personal views on this problem, I am convinced that a panic attack is a "learned" reaction on a subconscious level. Most likely, in a non-standard situation from early experience, the child considered the reaction of others as "my life is in danger" and recorded for himself the fear of death as a normal reaction to such situations. Of course, genetics, living conditions, personality traits, and the danger of the situation itself play a role here. But my theory is supported by the fact that not all people with a childhood experience of dangerous situations develop panic disorder. If the surrounding people, especially significant people, reacted adequately to the situation and the child did not grow up in an anxious family, the risk of developing a disorder is very small.

For you, dear readers, I propose to draw your own conclusions. If you have a desire or need to get advice on the topic of panic attacks from you or your loved ones - sign up!