In the fast-paced and often stressful reality we live in , panic attacks are quite common. Around 4% of the general population will experience a panic attack at some point in their lives, with women being twice as likely as men. In this article, we will discuss a paradoxical, yet very effective approach to panic attacks.
What is a Panic Attack?
A panic attack is an anxiety reaction, a surge of intense fear and discomfort with several physical symptoms, that usually peaks within ten minutes, with at least 4 of the following symptoms being present:
Heart palpitations
Sweating
Shaking or trembling
Breathlessness / shortness of breath
Feelings of choking
Chest pain / discomfort
Nausea or abdominal distress
Dizziness, unsteady feeling, feeling lightheaded, feeling like you are about to faint
Derealization (feeling as if you are detached from reality, as if what you are experiencing is not really real) and/or depersonalization (being detached from the Self, feeling as if you are not really You)
Chills or feeling hot
Numbness or tingling sensations
Fear of losing control or going crazy
Fear of dying
Recurrent and unpredictable panic attacks, accompanied by persistent anxiety that more panic attacks may occur, anxiety about the cognitive and/or physical consequences of the panic attack (e.g. the individual is afraid they will lose control or will “go crazy”, or that they can actually suffer a heart attack), as well as a significant change of the behaviour of the individual related to the panic attacks, would signify the diagnosis of panic disorder.
Panic as the Enemy
Even if you’ve never had a panic attack, it is not difficult at all to conceptualize just how frightening, discomforting and terrible it must feel.
Panic disorder develops as a “fear of fear”; you ultimately become so frightened by this actually normal, but exaggerated , anxiety response.
Slowly but surely, panic becomes the enemy. And when we are at war, we fight our enemies. You desperately want to defeat the panic attack. Another way to confront an enemy is by escaping them- by distracting ourselves or fleeing the situation completely.
Yet unfortunately, the more you fight these symptoms directly, the more they fight you back and grow even stronger. We may unwillingly strengthen the power of panic by trying to counteract the unpleasant symptoms.
We may develop safety behaviours, that are essentially avoidant behaviours. For instance, someone that may feel a panic attack approaching while they are in the cinema, may actively choose to sit near the exit of the room, so that they can escape the room quickly just in case their sensations escalate into a panic attack.
One of the necessary steps in therapy is dropping all of these safety behaviours. The most popular therapeutic approach for panic is cognitive-behavioural therapy. Among others, the therapy goals are distinguishing and subsequently challenging beliefs about panic (e.g. that a panic attack means impending death), recognizing the different coping behaviours that the person has developed, exploring the triggers and anxiety history of the person, developing different relaxation techniques, such as abdominal breathing, distraction, mindfulness, and thinking positive thoughts to replace the ones that accompany the panic sensations etc.
For some people, all the above methods work great. There are others, however, for whom the panic attacks become even worse than they were before… For example, it may feel almost impossible to apply deep breathing when you’re in the middle of a panic attack- exactly because you are hyperventilating, and attempting to inhale deeply may feel as if you’re choking even more…
White Bears Don’t Disappear...
In a previous article, we have talked about the White Bear Effect: Thought suppression doesn’t work. When we try to actively suppress and fight against negative thoughts, they actually backfire and become more resilient and intense.
There is the rationale that all of the above-mentioned techniques, such as challenging negative thoughts, distraction, thinking positively etc- trigger the White Bear effect, thus making panic more prominent. Think about it symbolically: Your enemy grows bigger as you’re desperately trying to fight him, and he runs after you fiercely when you try to escape him…
What if I told you that, instead of trying to counteract your panic symptoms, an effective alternative is to actually surrender to them, accept them, and accentuate them even more- even bring them on by yourself?
It may sound crazy, but this paradox approach to panic, that involves the flooding technique, actually works wonders for many people that could not cope with the more traditional strategies.
The Paradox Approach to Panic: Surrender!
Panic is this monster that you constantly feed and make bigger in your mind because of your fear.
When it approaches you next time, would you try to just let go of the power struggle, and surrender?
This surely sounds illogical, since it is contrary to the physiological response of Fight or Flight, when encountering a threat. This approach actually means going against our basic instincts!
If you stop fighting panic, it will eventually disappear. You just need to give up the struggle, courageously!
If you suffer from panic attacks, the above may understandably sound like terrible advice.
It is based on the idea that Resistance is Futile and Meaningless.
Your panic feeds on your resistance to it; this is how fear grows into a monster that you think you have no power over.
So when you stop resisting, you will eventually realize that you can outlive this monster.
Like Dr Claire Weekes suggests in her book ”Simple, effective treatment of agoraphobia”, there are 4 important steps to take when confronted with an impeding panic attack:
Face the symptoms- do not avoid them
Accept what is happening instead of trying to suss it away
Float with your feelings – do not tense
Let time pass- do not be impatient
Moreover, she emphasizes that the best way is that the individual gradually learns to pass through panic- not run away from it.
Flooding Panic
Taking it a step further is the use of Flooding. Flooding is a technique originated in behaviour therapy and it is based on the concept of desensitization.
You shouldn’t just surrender to your panic, but next time you feel a panic attack approaching, just try to bring it on with bigger force. Attempt to amplify all of your symptoms, try to give yourself a full-blown, out of proportions, majestic and incredible panic attack.
Yes, you read it right. This is sound psychological advice.
KEEP CALM AND JUST SURRENDER TO PANIC!
Feeling your heartbeat increasing? Great- focus on it; can you make it go wild?
Shortness of breath? Fantastic- take short shallow breaths instead of trying to breathe slowly and deeply, make yourself hyperventilate as much as you can.
Dizziness? Fabulous- could you focus on being even more dizzy?
Take each of your panic sensations one by one, and amplify it. Let your panic consume you.
Why though…?
The explanation is actually simple.
Panic is fear of fear, fear of losing control.
By surrendering to your symptoms, by actively making them more intense, what you are essentially doing is you give up control.
What happens instead?
You actually gain control, by giving it up!
That is exactly why it is called the Paradox.
When you consciously attempt to amplify your symptoms, you essentially bring them under voluntary control.
What happens is that you actually show yourself that you CAN win over panic. Therefore, you effectively prove that your fears are ungrounded.
You shift your attitude, take full responsibility for your symptoms, and thereby disconfirm all those very catastrophic cognitions that something terrible will happen, such as “I will die”, “I will loose all control”, “I may be going crazy” etc. These beliefs actually maintain and feed the vicious circle of panic.
Similarly, you can provoke your panic symptoms during a calm state. You can practice increasing your breathing rate and the rest of the anxiety sensations, when you are completely calm or just slightly feel a sign of anxiety. However, it is recommended to do this in a therapeutic setting, in the presence and guidance of your therapist, if you haven’t tried it before.
Acceptance as the Solution
As a conclusion, applying the Paradox approach to panic means Accepting and Embracing Panic.
Think of your panicky fear as a Wild Beast to be tamed, not fought against!
The use of humor and metaphors can greatly help in this approach. Can you be the King of Hyperventilation, or the Queen of Panic?
No matter what specific elements you want to add to your Paradox, it is worthwhile to remember that it is all about changing your perspective.
Stop fighting , drop resistance, give up the struggle, work together with your panic instead of against it- and you’re the Winner.
The results may surprise you!