2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
By this point, I have been working with panic attacks for 10 years and have helped over 400 people recover. From time to time I put into an article what I tell my clients. This is my third article on panic attacks, the first two can be read here and here. This article will focus on the psychological mechanism of panic attacks, and I will give examples of real clients.
It may seem strange to some, but we almost always cope with panic attacks without medication. And even when medication is needed, my clients give it up pretty quickly when they learn psychological ways to manage their panic. In my experience, it's not just the panic attack itself that causes the greatest difficulty in quitting drugs, but also the fear of waiting: clients are afraid that an attack will occur and they will not be able to cope with it. Therefore, non-drug methods of seizure relief are, of course, very valuable. It is important to master and apply them in order to remove both the panic itself and the excruciating fear of waiting.
To master such methods, you need to understand the mechanism of occurrence of a panic attack. Partly I write about this in the previous article "Where do fears, phobias, panic attacks come from?" And in this one we will talk about deferred reactions.
What is a delayed reaction?
In principle, everything is simple here:
- A person does not show his emotion (anxiety, fear, panic) at the moment when it arises. Because of this, he does not seem to "feel the emotion", suppresses it. Sometimes he himself does not even notice that he is emotional, but his reaction is stored in the unconscious.
- Much later, this emotion manifests itself, but this has nothing to do with the actual situation.
Short examples of delayed reactions
Two tourists went skiing to the forest in winter and met a bear there. They got scared and ran away. On the way, one of them caught a ski on a stone and broke it, so he had to run away on one. This made them even more frightened. In the train, they were silent about what happened. When they came home, both developed diarrhea. Why? Because there was no time to go to the toilet in the forest, they saved lives, and at home, in a safe situation, you can relax, experiencing fear as a symptom.
Mom was walking with the child, the child ran out onto the road and got into a dangerous situation, the driver braked at the last moment, all the participants were terribly frightened. At first everything was fine, my mother took her son and took him home, but already at home she began to shake and freeze. It turns out that her fear manifested itself in a completely safe situation, much later than the danger passed.
That is, at the moment of strong fear, a person can unconsciously postpone his reaction for the time being. Perhaps he does not notice it, perhaps he is ashamed (inconvenient) to manifest it immediately, sometimes it seems dangerous, inappropriate, or it happens for some other reason. Most importantly, you need to understand that this is an unconscious process, a person does not suppress his emotion on purpose, not in a controlled manner, not on purpose, but, as a rule, he does not even understand that he is doing it.
That is, when a client with panic attacks comes to a psychologist, it completely sincerely seems to him that everything is fine in his life, there is nothing to be afraid of, there are no worries, only for some reason, panic attacks periodically arise from "it is not clear from what", but everything is fine … And in order to be cured, he needs to be aware of his anxiety. That is, to understand what he is really afraid of. As soon as he does this, he will be able to refuse medications, because the incomprehensible attacks of panic will pass, and the fears will become quite understandable. It is extremely difficult to do this without a psychologist, because the client does not know where to start and “where to dig”.
Of course, this is only half of the work, then we deal with real (explainable) fear. But even the very realization that panic does not come "out of nowhere", but is caused by completely rational reasons, greatly facilitates the condition. This is best understood from the following picture.
In the upper picture, we are afraid to go only in one direction, because there is danger, but the rest of life is quite accessible to us. At the bottom - we are afraid of everything in general, because danger is seen everywhere. Likewise, with panic attacks: when a person does not know when and where he will be "covered", why it is happening and what is the reason, a painful expectation of panic arises, it begins to seem that danger lies in wait everywhere. It is clear that the danger is imaginary, but the panic is quite real. In therapy, when we find real fear, the panic "about everything in the world" (with which it is completely unclear what to do) disappears, and there is only one real reason to be afraid, with which:
a) easier to handle, b) you can continue to work.
I think it's time to give examples of real clients. (Of course, they gave their consent.)
Example 1
A 22-year-old woman, the last year of the institute, lives with a boyfriend, getting ready for the wedding. Panic attacks are almost daily, started 2 months ago. She cannot answer the question of what terrible happened 2 months ago, but after asking her, I found out that at about the same time the young man made her an offer, which she accepted.
At first glance, the event is joyful, no one would associate it with panic attacks, because we are looking for a reason for panic, something terrible. However, the client herself has very conflicting feelings about the upcoming wedding. 3 months ago, she found out about the betrayal, was very worried, thought about parting or not, the guy repented and promised that this would not happen again, and in the end they decided to keep the relationship. In this situation, the guy proposes to her, and she agrees, although the situation of treason has not yet been lived through, trust has not been restored, the resentment is still there. The client herself thinks that the guy does it more out of guilt than out of a desire to marry, as if he is trying to atone for betrayal by this. Of course, she had concerns about the reliability of such a marriage, but she also cannot refuse. And it's scary to agree, and to refuse - too.
There was another interesting symptom, she did not have panic attacks in the presence of a guy. And if a panic attack happened, she called him, he came to her and the attack quickly passed in his presence. It was as if she was unconsciously testing his reliability, as if she was testing him. Will you help me when I need it? Can I count on you at a difficult moment? Can i trust you? Won't you leave me? All these fears receded the moment he arrived, abandoning all his affairs for her.
Why doesn't she talk to her boyfriend about the situation and postpone the wedding for a few months, since she's so bad, you say? Because she deliberately forgave him completely and wants to marry him. The problem is that the client is not aware of these fears. She is unconsciously afraid, and anxiety on the principle of a delayed reaction is realized in the form of periodic attacks of panic. The client was able to notice her fears only in psychotherapeutic work. An interesting point was that as soon as she spoke to her boyfriend and postponed the wedding, the panic attacks instantly disappeared.
Example 2
Male, 26 years old, panic attacks started two weeks ago. He can't remember anything terrible, but he says that he received a job offer that he dreamed of. However, as we found out, there are many fears associated with this proposal. The fact is that the company offers him to move to another city. But this means completely changing his social circle, and he makes new contacts with difficulty, and most importantly, he is afraid to tell his girlfriend and parents about it. It is not known how the girl will react, it is not clear whether she will agree to move with him. He also cannot leave his parents in his city, he perceives this as a betrayal in relation to them.
He does not dare to talk with his relatives, the date of the move is approaching, and he is already inclined to not go anywhere. Losing a good offer is also scary. As a result, he is caught between two fears, which accumulate and, in the form of a delayed reaction, result in panic attacks. Moreover, he says that, perhaps, he will remain in the city, since he now has panic attacks, and it is risky to go to the capital in such a state. That is, the symptom also brings a secondary benefit: by referring to it, you can avoid responsibility for the decision and thus not decide anything. This happens completely unconsciously.
Accordingly, the panic attacks passed as soon as he was able to talk to his loved ones.
Example 3
Client, 27 years old, married for 7 years, no children. In addition to panic attacks (from 17 years old), there are many other fears from childhood: fear of heights, fear of a negative assessment, fear of the dark, cannot stay alone in an apartment, fear of disapproval of others, fear of strangers, fear of making mistakes (he checks documents many times at work, because of this, it misses the deadline), fear of going to an unfamiliar place alone, walking along an unfamiliar street, fear of turning to a psychologist (although … well, almost everyone has this fear J). She is very dependent on her mother and husband, she needs a leading partner in everything, who will confirm the correctness of her actions.
All these fears, as we found out, had one reason. This is raising an overly anxious mom. Mom was afraid and still fears for her daughter. All conversations with mom are only about no matter how something happens, that everything needs to be done correctly, otherwise there will be something bad, etc. As a result, the daughter simply does not know that it is different, that you can live without being afraid of every rustle, that you can perform your own actions without looking back at your mother or another leader. With all this, she sincerely believes that her mother is the ideal parent for her and the relationship with her mother is excellent, because she has never seen other options.
Panic attacks began at the moment when the client met a guy (whom she later married) and began to do things that she could not tell her mother about. She was trapped between two fears. If you do it your own way, it’s scary without a mother’s leadership role. And if you do as your mother says, then there should be no guy at all, you need to think about studying, and from sex they become pregnant, become infected with HIV and die. As a result of internal conflict, the client is unable to make any decision, appears in a sense of a dead end, constant fear with which nothing can be done, and ultimately in panic attacks.
Panic attacks passed when the client learned to support herself in doing her own way, in an adult way, without looking back at her mother. That is, to live your life without asking permission.
Let's combine what is common in all these examples, and then the mechanism of seizures will become clear. Panic attacks occur when a person is caught between two strong unconscious fears and cannot make a choice. Fears accumulate and, according to the principle of a delayed reaction, result in panic attacks. In other words, panic attacks occur when there is a strong unconscious fear that cannot be avoided.
It becomes clear why panic attacks often occur in connection with serious life changes: moving, entering and graduating from a university, first sex, marriage, pregnancy, childbirth, leaving maternity leave, divorce, job change, death of loved ones. All of these (or other) events can carry the most powerful fear associated with change, even if many of them are perceived as joyful.
Understanding the mechanism of panic attacks, one can find psychological cure tools and refuse drug treatment. Even after reading this article, you will most likely need the help of a psychologist trained to deal with panic attacks. But if we understand this mechanism, then we will save time.
Alexander Musikhin
Psychologist, psychotherapist, writer
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