One of the most common reasons I hear for someone reaching out to me for therapy is panic attacks. Whether terrified by one, painful panic attack or crippled by ongoing, even frequent attacks, patients come to my therapy office frightened and confused.
Commonly (though not always) the story goes like this: “I don’t understand it. Everything in my life was going just fine and all of a sudden…” And then I hear the details. Sometimes there’s freezing up. Often there’s an increased heart rate or shortness of breath. For some there’s constant crying while for others there’s a complete inability to cry. The common feature for those who seek therapy for panic attacks is, well, panic–an overwhelming sense that something is very, very wrong.
Whether the panic attack seems consistent with whatever else is going on in the patient’s life, it is here (the patient’s life) where we first begin our exploration in therapy of why panic attacks are happening and, more importantly, how to prevent these panic attacks from taking place again.
In the short-term, however, it’s helpful to have some tools for dealing with the attacks when they do happen. In therapy our strategy will include moving quickly once a panic attack is recognized (and of course we work in therapy on getting better at seeing the panic attacks coming), changing the environment, re-organizing some of the distorted thinking that goes with the attacks, and changing how we respond both physically and emotionally. Ideally other people can be involved, either before the panic attack gets going, or once it has started in order to shorten or minimize the severity of the attack.
The most successful work in therapy to address panic attacks involves exploring the context in which the attacks are taking place (also known as your life). This therapeutic work involves looking at what’s going on that’s causing anxiety, fear and stress (usually the substance of the panic) but also looking at what protective factors are in place to prevent these challenges from leading to panic attacks. In the course of our therapy to explore the panic attacks, more often than not we discover that there’s not enough in place by way of sharing, shaping, guidance and direction with regard to the these sources of stress. When individuals try to deal with stress on their own, without a context with which to build with it and give it to others to be shared, panic attacks are one likely result.
Group therapy and panic attacks
While I’ve never seen a patient have a panic attack during a group therapy session, I have seen many patients re-organize their relationship with panic attacks and eliminate them from their lives as a result of working to include their therapy group in the attacks themselves. How? Sometimes it’s as practical as having group members to call when the panic begins, or to check in during particularly stressful times (and usually knowing that you can call is the most helpful part). In other instances we see just how powerful the group can be in seeing things that we can’t–like pointing out the things we do that may produce panic that we might not even be aware of.
The reality, whether it feels like it or not, is that panic attacks don’t just fall out of the sky. They are one of the countless things human beings are capable of creating. They come from you. The solution? Create a life with more meaningful relationships, where stress and anxiety play a smaller and smaller roles.