After experiencing a terrifying event a few weeks ago, Ann Marie was referred to me by her doctor. She had been standing in her local shop when suddenly this incredible feeling of doom came over her.

Feeling that she was going to die, her husband rushed her to the nearest hospital where they eventually told her that she was having a panic attack. Unfortunately, this continued to happen, so her GP gave her my name.

Psychotherapy is all about helping people understand why they are feeling the way they are and, more importantly, what they need to change.

To do this, I show people how to look at their thinking and to become like a car stuck in first gear. By slowing right down and taking one thought at a time, reasons as to why we feel the way we do suddenly become much clearer.

Ann Marie’s experience

I asked Ann Marie to walk me through what had happened to her in the shop that day.

“I was standing in the fridge section getting some milk when I felt this enormous feeling of panic come over me. I just felt that I had to get out of there.” She started.

“So, what were you afraid was going to happen,” I queried?

“I felt that if I didn’t get out of there, I was going to die.”

“And what did you think was going to kill you?” I asked her finally.

At this, Ann Marie was stumped. While she had believed at the time that she was about to die, her own intelligence had figured out that obviously she hadn’t. But if she didn’t die, then what was all the panic about – pardon the pun! Or, more precisely, what did she think was going to kill her?

The fear of fear itself

Feelings are not caused by what happens to us but by what we say to ourselves about what’s happened. Thinking that something makes us feel a certain way is not correct. It’s what we say to ourselves about things that causes our feelings.

In the shop, for some reason, Ann Marie suddenly felt anxious. This could have been over anything at all. However, in this instance, instead of just feeling anxious, she believed that the physical symptoms of the anxiety itself were going to kill her.

Of course, she then did what any of us would do in the circumstances, she tried to protect herself by trying to get rid of the anxious feelings. Taking deep breaths, getting out of the shop to protect herself etc.

I gradually teased out what was going on in her life

Unfortunately, the more she tried to get rid of the feelings, the worse they got. A bit like when you get a song in your head and the more you try to stop singing it, the more you sing it.

The same happens with panic attacks. The more you try to avoid them, the more you reinforce that they are dangerous (which they are not) and it is trying to avoid this danger that triggers the panic attack. Like everyone who has panic attacks, Ann Marie didn’t realise that she was getting anxious about being anxious.

By getting rid of the panic attacks, we were able to focus on what was happening in Ann Marie’s life that was causing the original anxiety

Ann Marie and I gradually teased out what was going on in her life. By focusing on what she could do when they occurred, Ann Marie was able to switch them off.

Once the panic attacks subsided, we were then able to look at what might have brought them on. Remember, there were two anxieties going on. By getting rid of the panic attacks, we were able to focus on what was happening in Ann Marie’s life that was causing the original anxiety.

But that’s another story.

The panicky feelings will only go away when you take away the danger you believe you are in. And you can only do this by changing your behaviour when you experience one. You must behave in a way that reinforces that feelings are not dangerous.

Let the feelings wash over you like a wave. They’re not in the least bit dangerous. It’s just your body thinking that the adrenaline reaction is dangerous to you. All the sensations are your body doing exactly what is says on the tin.

Try to observe each symptom as it occurs and understand its purpose:

If you sit it out, your brain will eventually realise that there is no danger and will switch off the adrenaline reaction after a few minutes.

Feelings can be very distressing but are not dangerous in the least. However, if you can’t convince yourself of this, try to be precise as to what the actual danger is. The more precise you try to be, the more vague your brain will get in relation to the danger. Once you realise you cannot identify an actual danger, your brain will turn off the panic attack.

Our brain has one purpose: to protect us. Like a radar, it continually scans our environment looking for potential dangers. When it sees a potential danger, our brain does exactly what it is supposed to do – it gets us up the nearest tree and out of danger.

It does this by releasing adrenaline into our blood stream which triggers our “fight or flight” reaction.

This adrenaline causes our hearts to race, increases our breathing and every nerve ending starts to tremor as we get ready to jump out of the way of danger.

However, in a panic attack, there are two anxieties going on:

We are feeling anxious about something in our lives.

The more we try to get rid of the anxiety, the more anxious we get

Instead of just feeling anxious, we attach danger to the actual adrenaline symptoms of anxiety.

Because we believe that we are going to die or go mad, we try to save ourselves by trying to get rid of the anxiety. The more we try to get rid of the anxiety, the more anxious we get. This then causes the panic attack. Why? Well, imagine if I told you that thinking of pink elephants would kill you, you’d end up doing nothing but thinking of pink elephants. Because we don’t realise that there are two anxieties going on, we only see one. As a result, we can’t pinpoint the actual danger because we don’t realise that it’s the actual anxiety itself that we think is dangerous. As a result, our brain can’t switch off the adrenaline reaction because it keeps thinking that the danger is imminent. And it is this simple error that can result in people having panic attacks for years.

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