Strategies For Overcoming Panic Attacks
by Deborah A. Rogers with No Comment
Trauma is a mental or physical injury that can affect us on all levels. It can make us feel lost and unsure of how to reclaim our sense of self. This occurs from emotional or physical abuse, from discrimination or neglect, or from an injury or illness. Events and circumstances may be different, and people may be different, but I believe that a resulting interlocking link between people in such circumstances is fear.
Lack of control over past, painful medical experiences that led to excruciating complications of a paralyzed leg and foot, a broken back, torn dural tube, spinal fluid leaking, and a spinal Staph. infection causing horrific pain and continuous muscle spasms, left me feeling victimized and fearing a lack of control over current and future events. I formed a core fear associated with the false belief that I could not protect my body nor myself. The possibility of being threatened again and having little or no control over the outcome was terrifying. I became hyper-vigilent, always on guard for any possible threats that were similar to those of the past. Pain, a touch on my back, my hyper-aroused state, past memories, an image, a doctor or medical treatment, and needles all triggered a conditioned reaction of terror and panic.
Babette Rothschild states that “The fear . . . once felt to an external threat becomes anxiety generated from within”. I became more and more petrified, catastrophizing that some new trauma was going to happen to me and lead to more pain. Exaggerated fears magnified. I worried that a simple Lidocaine injection in my mid-back would paralyze both my legs, or that I would one day simply awake with both legs paralyzed. I worried that I would get hit by a car because I too slowly limped across the street with my cane. I worried that my bones had become so weak they would crumble and my spine would collapse.
Past trauma combined with ongoing, bombarding pain signals, exasperating stress from trying to cope, and swelling terror from my inability to control the pain created a state of hyper-arousal that grew beyond self-control. My emotions had accumulated so many dimensions and layers that they developed an eerie power of their own, making it harder and harder for me to find my own sense of inner power.
Months of physical pain and emotional turmoil finally took their toll and manifested into panic attacks. The panic attacks were not picky; driving, sitting, standing, it did not matter. When pain suddenly increased, someone touched my back and its scar, when I looked at a medical appointment on my calendar, walked into a hospital, suddenly I was overtaken with a sense of doom. I would gasp for air as my heart raced, and I felt trapped and as if I were going to die. The pain, fear, and traumatic memories that came to life during the panic attacks stimulated even more pain, emotions, and flashbacks, further assaulting my nervous system and mental faculties
I did not understand what was happening to me. . . until one day.
I had been in the kitchen, well past my 10-minute standing tolerance, stirring the chocolate chip cookie dough mix in the bowl when suddenly my body’s alarm starting screeching, alerting me that I had stood too long and my body could no longer handle it. Instantly I lay down on the floor, trying to relax my body, decrease the pain, but the pain would not stop, and the alarm grew louder and louder. I tried to breathe, but could not. Terror overtook me as I lay on the floor like a fish out of water gulping for air. Suddenly, as if to escape my reality, my mind dissociated, pushing me outside of myself into some sort of dual awareness. In a flash, I was looking down at this girl lying on the floor. I watched her struggle to stop suffocating from her own hyperventilating. Exactly then I realized that that girl was me, and these horrific events I had been having must be panic attacks.
Self-compassion overcame me. Gently I reached my arms around and tightly held myself, calming myself. Then, I imagined myself sitting barefoot on the soft grass under a willow tree. It was the willow tree from my Grandmother’s back yard. I would sit under there as a child, feeling so safe and protected, enthralled by the long branches that umbrellaed me, gracefully swaying and dancing in the breeze. I am safe, I told myself as I hugged myself tighter.
From this experience, although I still felt unsafe in my body and my environment, I started learning what I could do to begin overcoming panic attacks.
My Strategies For Overcoming Panic Attacks
My mind’s respite was sitting under a willow tree on top of a hill. Surrounding the tree and myself, I allowed my mind to spontaneously create whatever it needed to feel a sense of peace. I closed my eyes. Amidst the raucous of thoughts and the blackness of terror, a beautiful, colorful, lush garden of greenery and flowers painted itself into a reality I could not resist. A sparkling stream of fresh water skipped by me. Following to where it began, I looked at the waterfall coming from the mountaintops, which touched the yellow rays of the sun. I felt the warmth from the sun, the gentle breeze on my cheek, the velvet grass I lay upon, the freedom of my surroundings. I smelled the grass, the flowers. This was my safe place. No one could enter it unless I gave permission, and I could come here anytime for as long I wanted.
Finally I had found somewhere safe, where pain and despair did not exist. Creating this feeling of safety over and over again when it was most needed, gradually created a reality of feeling safe within not only my mind, but my body. As soon as the pain became unbearable, I employed my safe place technique. Over and over I practiced and soon it became an automatic coping technique that initiated without effort.
Over time, as visualizing my safe place instantly brought me comfort, it also enabled me to become more aware of my physiological responses related to the panic attacks.
2. Breathing
Too hyper-aroused from panic to talk myself into calmness, my safe place mentally energized and empowered me to physically alter my breathing in a way that would calm myself. During panic and anxiety attacks, higher cognitive functions are inhibited by memories, emotions, and protective defense mechanisms. Breathing is a function of the brain stem (the lower brain), where survival, heart rate, and alertness are controlled. By actively controlling my breathing, I was able to directly control my level of alertness and hyper-arousal. Concentration on my breath slowly passing into my lungs for the count of four and then exhaling out for the count of eight brought my attention back to my body, away from the flashbacks and internal madness. I attended to the breath. I felt it. I visualized the breath to be waves of an ocean moving in and out of my being.
– I also discovered that exhaling out of pursed lips, instead of my nose, slowed my breathing and forced me to take more expansive inhalations, stopping me from hyperventilating. –
Focus on my breath started bringing relief to my terror-stricken system, literally allowing it to catch a breath and slow down. Sometimes while focusing on my breath, I became creative and visualized air as a light green wave coming into my lungs and floating down into my lower abdomen, filling it with an imagined feeling of calm warmth. As I exhaled, the color slowly drifted back up and out of my mouth. This helped me to move my attention from the surface of my body to within my body, and to maintain my attention for longer periods of time.
Gradually I learned that a feeling of shortness of breath was my cue to immediately focus on my breathing until I was in safe harbor.
Such a deep focus on my breathing anchored me back into my body and decreased my reactivity to pain and my emotions. Attending to my breathing became a conditioned response I could instantly employ, along with my safe place image, as a means to decrease my panic. The concentration it took to sense and to control my breathing was incredibly difficult to maintain, yet it was also magnificently reassuring. Yes, I was getting air! I really could breathe after all! This brought a heightened sense of self-control and self-reliance.
Next, I learned what to do when my panic was so pronounced that I could not calm myself. I gave myself a physical cue of safety by hugging and holding myself and then chanting a soft “Shhhh” with each exhalation because it triggered a calm remembrance of my mother soothing me when I was sick as a child. But I also noticed something else. Shhhh became a mantra that my mind could focus on instead of being in its frenzy of uncontrollable thoughts.
As time and practice progressed, I began examining the crust of each emotion and thought. I tried not to judge my emotions and thoughts as bad or good. I had to get past the judgments of them to get past the fear they created.
3. Emotions
I discovered that I could focus more easily and specifically on my emotions by investigating them immediately after the panic attacks, when I felt calmer and safer. Imagining myself back in the scenario, I tried to sense what emotions I had felt, their intensity, and from what they stemmed. I tried to determine how my present emotions were influenced by past emotions, attending to the emotional layers.
I continuously asked:
What was happening before the panic attack?
What led me to react this way and feel fear?
What other emotions did I feel? Why? From where do they stem?
4. Thoughts
As I grew more centered, I grew more conscious of my thoughts.
1. First, I wrote down my scattered thoughts: ”I can’t take this!”; “No one’s around. What if I need to go to the emergency room?”; “I felt something. Was that a spasm or is my spinal fluid leaking again? What if my spinal fluid is leaking again?”; “Does this pain mean that I need another surgery? I can’t handle another surgery!”; “Does anyone out there care?”; “I am so alone.”
My thoughts were onrushing fears manifested.
2. From identifying my thoughts, I discovered they were inflamed with unending dread, spawned either from my actual past medical experiences or from an unending series of self-inflicted, catastrophic what if questions.
3. I began to recognize negative thoughts had fueled more panic, which in turn stimulated more negative thoughts.
4. Actively, I started changing my thoughts to calming and positive affirmations, such as, “I’ll be okay; I know this will pass.”; “Pain is just a sensation; it is not harming me.”; “I am strong; I will get through this.”; “I am safe.”
– I talked myself into confidence balanced with determination to take back control. –
Gradually, increased self-awareness furnished an increased sense of control and safety of being in my body. Now my psyche was able to relax, and fear of pain started decreasing. I was coming back from pain and panic.