Panic Attacks

Panic attacks are sudden rushes of fear and dread, usually accompanied by sweating, increased heart rate, shortness of breath, dizziness, nausea, trembling, choking, sensations of unreality, chest discomfort, hot flashes or chills, fears of going crazy, or fears of dying. Panic attacks are not the result of a physical condition, such as a heart attack or too much alcohol. Generally the episode lasts about ten minutes. Sometimes a precipitating event has occurred that traumatized the individual having a baby, moving to a new city, leaving a job, starting a new job, or recent loss of a loved one), making her more vulnerable to fears about bodily symptoms along with a predisposition to unhealthy, unproductive thinking patterns.

Ten to twelve percent of the population has a panic attack once during a given year. Panic attacks are common. More women than men suffer from panic attacks, and the average age that a woman seeks help is age thirty-four. Some of the precipitating environments for panic episodes are malls, elevators, theaters, freeways, walking alone, or being away from one’s customary environment.

Examples of the distorted thinking of those who have panic attacks include interpreting an increased heart rate as a heart attack, blurred vision as impending blindness, or breathlessness as suffocation. One can see that the panicked person tends to think in extremes, overgeneralizing to an alarming degree. CBT helps the troubled individual decatastrophize the situ-ation, bringing symptoms into a realistic context.

CBT offers help for those who suffer from alarming panic episodes.

Some helpful techniques include re-education about the true nature of physical symptoms and their relative degree of danger, breathing and relaxation work, gradual exposure to the feared situation with support, and gradual increased exposure to the feared physical sensations. With practice, the person learns that the situations and sensations are not life-threatening.

According to Professor William Sanderson of Hofstra University, New York, the majority of panic-disordered patients who commit to a course of treatment of Cognitive Behavioral Therapy significantly improve their symptoms.

Exposure to Extinction

Extinction is one of the terms from classical conditioning, referring to the result of repeated exposure to a particular stimulus until it is no longer “rewarding” or has no particular effect. Imagine that you are interested in speaking in a foreign language but are terrified of saying something wrong and causing a dire result-people not understanding you or, worse yet, laughing uproariously at you. You might tailor a course of actions to counter this particular deep-seated anxiety in the following way:

•   Listen to tapes in the foreign language.
•   Watch subtitled films in the foreign language.
•   Listen to music in the foreign language.
•   Use practice tapes that pause, giving you a chance to imitate and answer.
•   Find a store where the clerk speaks the desired language. Visit frequently and say simple things such as, “Good afternoon,” “Thank you,” or “How much is this?”
•   Go to an ethnic restaurant and order in the new language.
•   Take a trip to a country where you must speak the language in order to take care of all the arrangements-travel, hotel, directions, financial transactions, etc.

If you are able to follow this course of action from beginning to end, you will certainly find that you are no longer afraid of making mistakes with the new language. You become so intent on communicating, even imperfectly, your distress. Facing the originating incident and the emotions of that time (completely appropriate for a scared child brings it all out in the open, and miraculously, the out-of-control emotions subside.

Types of Anxieties

Some of your deep-seated fears may have to do with your basic worth as a person. Were you defined as a child in terms of your accomplishments?

If that is the case, you might have a shaky sense of individual value, apart from achievements, status, and material worth. Other types of anxieties may hinge around where you ft in the social scheme of things. If there was emotional or verbal abuse in the family of origin, the adult often is uncertain in social situations, whether in groups or interacting intimately, one on one with another person. The old anxieties of the child come to the forefront, and the natural reaction is to withdraw. It will take practice to accept that you have a great deal of worth, simply for being a human being, and that others will find you quite pleasant and acceptable, unlike the emotionally battered situation of the family of origin.

Louise Hay suggests the following affirmation for a person troubled with anxiety: “I love and approve of myself, and I trust the process of life. I am safe.” You might want to say to yourself, “I am confident in a wide array of human experiences. I can adapt to a variety of people in different situations.”

Social Anxiety

What are some of the signs of social anxiety? In his book, The Cognitive Behavioral Workbook for Anxiety, psychologist William Knaus lists the following indicators of social anxieties:

•   Feeling self-conscious
•   Fear of evaluation and judgment
•   Expecting others won’t like you
• Feeling confused, unable to think clearly or speak with others
•   Difficulty making small talk
•   Fear of authority figures
•   Hiding when the doorbell rings
•   Frequent blushing or sweating in the presence of others
•   Avoidance of public speaking

Social anxieties can beso debilitating that people resort to drugs or alcohol in order to ease the way with others, even a little bit. Social anxiety is highly prevalent in the United States, with upward of about 11 million Americans feeling petrified in social situations. Some people escape with workaholism or other obsessive activity-anything to avoid interacting with others.

Social Fear Inventory

Knaus suggests that people with social phobias fine-tune their awareness of the specific situations and self-talk that goes on before the dreaded event. For example, you might journal sentences such as the following that occur to you as you increase your awareness of what it is that is actually so scary, and then rate them in some manner as weak to very strong:

1.   “I am nervous when I meet people I don’t know.”
2.   “I have little of interest to offer to others.”
3.   “People probably won’t like me very much.”
4.   “If people knew the real me, they would be horrified.”
5.   “I’m not good at casual conversation.”
6.   “I am afraid of looking ridiculous when among others.”
7.   “I’m embarrassed when I’m the center of attention.”
8.   “I don’t like eating alone in restaurants.”
9.   “I’m self-conscious about my appearance.”
10.     “I have to think hard about what I will say before I can speak to others.”