A person experiencing a panic attack feels an undeniable wave of fear for no particular reason. The individual’s heart begins to beat rapidly, his chest aches, and he finds it increasingly difficult to breathe; the point at which the individual believes that he is having a heart attack and will die if he does not receive proper intervention.

One patient defined his symptoms this way: I am very afraid; Every time I start going out I get this horrible feeling in the pit of my stomach, and I’m afraid that another panic attack is coming or that some other terrible unknown thing is going to happen to me or someone in my family.”

Panic attacks generally don’t last more than a few minutes, but they can be the most distressing condition a human being can experience. People who experienced one attack will have others. Those who experience repeated attacks or feel increased anxiety about having another attack are considered to have developed panic disorder.

Panic disorders are a serious health problem in the United States. Recent studies concluded that around three million people will experience panic attacks at some point in their lives. The symptom is strikingly different from other types of anxiety. Panic attacks are very sudden and often unexpected, seemingly unprovoked, and often disabling.

Panic attacks can occur at any time, even during sleep. An attack often peaks within ten minutes, but some symptoms can last much longer.

What causes panic attacks? And how are panic disorders treated?

One approach to understanding the cause of panic disorder is that the normal body Alarm system The mental and physical mechanisms that allow a person to react to a threat tend to activate unnecessarily when there is no real danger in the immediate environment. Most medical studies cannot explain exactly why this happens.

However, several psychological studies have shown that the root cause of panic disorder can begin on the emotional or physical level, or both. The feeling of heightened anxiety always begins with a trigger that starts the struggle gold flight limbic system response. For example, at the first hint of apparent danger, your brain chemistry, blood hormones, and cellular metabolism kick into action.

When you have a chronic anxiety disorder over time, your anxiety symptoms may be triggered by less and less severe events because the limbic system has become sensitized to react in highly panic manner.

For example, if you were constantly yelled at as a child; As an adult, he may feel anxious whenever there is the possibility of a confrontation with an authority figure; and he can go to extreme measures to avoid such a confrontation, even in a situation as benign as refusing a simple request from a family member or any authority figure. At this point, his conscious mind has lost track of the connection between his current feeling and his past emotional experience. Now you have no idea why you feel panic about something so insignificant.

past emotional experience

Early emotional experiences are the birthplace for the development of panic disorders. The experience may have been early childhood trauma, such as death of a parent, divorce, child abuse, constant criticism, abandonment, deprivation, or a highly emotional family social environment; very anxious parents, including alcoholic and drug-addicted parents.

Childhood is a time of little power and control. When bad things happen to children, their coping mechanisms are not fully developed; they are unable to process what happened in a healthy way and move on. In a very real sense, these adverse childhood experiences are trapped deep within. As adults, those hidden issues often surface as anxiety symptoms. It can be difficult to connect what triggers your panic state with your past experiences; but there is always a link.

Past experience has taught me that you should not attempt to treat panic disorder unless you are willing to approach it from many sides; this approach can be time consuming and emotionally intensive, which conventional practitioners all too often tend to avoid. Instead, antidepressants are given as candy to scare patients and soothe their physical symptoms. However, no matter what type of panic symptoms you are experiencing, you must address the emotional component if symptom reduction is to be achieved.

treatment mode

There is a wide variety of treatments available for panic disorders, including various psychopharmacologically effective interventions and specific forms of psychotherapy. Psychotherapy for panic disorder is as important as pharmacological intervention. Several studies show that the combination of medication and psychotherapeutic treatment for panic disorder is more effective than either intervention alone.

Cognitive Behavioral Therapy (CBT) is widely accepted as the superior form of psychotherapy. CBT is designed to help people with panic disorder identify and decrease irrational thoughts and behaviors that reinforce panic symptoms.

Psychodynamic psychotherapy is another form of intervention that is rarely mentioned as an appropriate treatment for panic disorder. In fact, many therapists strongly reject the idea of ​​using psychodynamic techniques as an intervention to reduce symptoms associated with panic disorder.

What sets psychodynamic therapists apart from the rest is their ability to recognize an indisputable fact: Panic states can symptomatically appear identical even though they arise from a neurotic condition or of a manic depressive state.

Clinical research indicated that panic states of the neurotic type should be treated only with psychotherapy; and manic-depressive states must be treated with one of the many effective antidepressant drugs. Proper differential diagnosis is the superhighway to symptom reduction for all psychological disorders, including panic disorder.

Treatment of panic disorder with psychodynamic techniques

although studies have shown the efficacy of cognitive-behavioral and psychopharmacological treatments; many patients do not respond positively to these interventions or have had persistent or recurrent symptoms. Given the high costs and the recurrence of panic disorder, there is a need to explore treatment options.

Psychoanalytic techniques are commonly used to treat panic disorder, but have rarely been exposed to the rigor of scientific research procedures. Such a study would highlight and describe the psychoanalytic concepts involved in understanding panic disorder. While at the same time proposing a more “client-friendly” psychodynamic psychotherapy for panic disorder called panic focused psychodynamic psychotherapy.

The potential benefit of this form of therapy is based on the belief that panic patients have a psychological vulnerability to panic disorder associated with personality disturbances, relationship problems, difficulties in tolerating and defining internal emotional experiences, and unconscious conflicts. about separation, anger and sexuality. Psychodynamic psychotherapy focuses more, but not exclusively, on these impairments than other therapies, including psychopharmacology, potentially reducing vulnerability to symptom recurrence.

unconscious emotions

According to psychoanalytic theory, panic symptoms are based, at least in part, on fantasies and unconscious affects. In fact, both clinical observation and research suggest that panic sufferers have special difficulties with angry feelings and fantasies, such as desires for revenge. These desires often pose a threat to important loved ones, especially those to whom we are closely attached; thus triggering a panic attack.

Patients are often unaware of the power of these affects and the vengeful fantasies that accompany them. Becoming aware of these negative aspects of mental life, making them conscious, and making them less threatening are important components of psychodynamic psychotherapy.

Conclusion

Since panic disorder continues to be a major health problem in the United States, it is important to continue to develop an effective approach to its treatment. Panic-focused psychodynamic psychotherapy will be a useful alternative or adjunct to the cognitive-behavioral approach and medication. Psychodynamic therapy addresses intrapsychic conflicts, defense mechanisms, and developmental issues that are unlikely to be addressed by other therapeutic methods.

The psychodynamic approach also addresses the psychological factors that lead to vulnerability to recurrence of the panic state or other difficulties related to a panic disorder. A full randomized controlled trial should shed more light on the effectiveness of panic-focused psychodynamic psychotherapy.