“Everything that happens once can never happen again. But everything that happens twice will surely happen a third time”.
Paulo Coelho, The Alchemist
Panic disorder is an extremely debilitating condition. Many sufferers report symptoms of heart palpitations and hyperventilation, the fear of being out of control and an impending sense of doom.
For many sufferers, panic attacks may be triggered by elevators or airplanes, traffic jams or movie theaters. Others are triggered by shortness of breath – whether through exercise, humidity or being in a stuffy, confined space with lots of other people.
Most sufferers are extremely embarrassed about their panic attacks and wish they could “just get control of themselves”. Many have undergone excruciating treatment using a systematic desensitization approach which involves gradually exposing the sufferer to what they most fear – with limited results.
Rather than a set of random, unexplained symptoms, Jane believes that panic attacks are triggered by subtle cues that look like, smell like, sound like or feel like a life-threatening situation to which the sufferer has been exposed before – not once, but twice.
The brain is usually very good at dealing with a one-time traumatic event – particularly if it occurs when we are young – and is usually able to tuck it away as an isolated experience that is unlikely to happen again.
Should a similar experience occur later in life, however, the brain suddenly kicks into overdrive, recognizing that the same experience could occur again and again and being ultra-sensitive to any cues that may resemble either of the previous events. Often the sufferer has no idea what the original event may have been; in many cases it may have been something that occurred pre-natally or pre-verbally and is stored as “lived experience” in the limbic system but there is no explicit memory of the event. Other times there may be knowledge or explicit memory of the underlying event, but the sufferer has never connected it with the panic attacks.
A common example is in the case of an infant who stops breathing. Panic usually ensues – not only for the caregivers but for the infant herself as she fights to stay alive. While the caregivers may remember the event and become especially vigilant and anxious, the infant may grow up to be largely unaffected – that is, until being smothered by an elder sibling in a game of rough and tumble at age 7, or running out of breath on the sports field at age 11. Both events could trigger a panic attack – where the body recognizes the cues as being similar to those it felt when it stopped breathing as a baby – but the child usually has no idea what the root cause might be. To make matters worse, nobody else connects the two events either, and the child is labelled as anxious, sensitive or otherwise unpredictable. Not surprisingly, the child grows up perpetually fearing another attack – not only because stopping breathing is so terrifying, but because it’s embarrassing and everyone else is often puzzled and unsympathetic.
By the time the child grows up to get on an airplane as an adult, they’re the one having the meltdown as soon as the door is closed, delaying the plane and inciting impatient glares and tuts from all the other passengers. Most simply stop flying, avoid driving on freeways, or always take the stairs – and may often be labelled as controlling or neurotic by others around them. But when flying, driving and elevators are impossible to avoid, sufferers have no choice but to seek help.
Treating panic disorder
Jane uses a combination of Thought Field Therapy and EMDR Therapy to treat panic disorder. The beauty of EMDR is that the sufferer doesn’t have to know which events might be triggering the panic attack – rather, EMDR will find them.
She starts by taking a thorough developmental history, paying careful attention to issues of prenatal, birth or preverbal trauma, which sometimes highlights possible areas where the original trauma may have occurred. She will also ask the sufferer about the most recent panic attack, and using that as an entry point, will ask the client to float back to any times when the body may have felt the same way before.
By building a chronological list of contributing events, Jane will use EMDR to target the first, worst and most recent events of panic, before using a Future Template technique to target future events where panic could potentially occur.
The crucial ingredient, however, is teaching clients to have compassion for themselves, and engendering a sense of wonder at the body’s amazing ability to keep us safe.