Have you ever had a panic attack? If so perhaps you are now afraid to be in the same place where you had it for fear of having another one. For example, if you had a panic attack in the grocery store, do you avoid going to the grocery store for fear of having another panic attack? Then maybe you had a panic attack while driving, so you no longer want to drive. Notice too that as you avoid these places for fear of another one, your life now gets smaller and smaller.
The interesting thing is, the location is not what brought on your panic attack. It’s a simple matter of classical conditioning that is making you feel like the place you are afraid of is what will cause your next panic attack.
Classical conditioning
Have you ever heard of the experiment by Pavlov (a Russian scientist) and his dogs? It comes down to a stimulus and a response (reflex). In his experiment his hypothesis was that when he brought food (stimulus) out to his dogs that they would salivate (response). What he saw was that the dogs would begin to salivate when they heard the footsteps of the person bringing the food. He found that the food itself or the presence of the feeder led to the same response.
He then went one step further and only fed the dogs after a bell was rung. The dogs were no longer fed when the person first came into the room. What he saw was that the dogs did not salivate when the feeder walked into the room, only just after hearing the bell. Because the food was paired with a neutral stimulus (the bell), which would not normally lead to salivation, the dogs began to salivate.
This is why people have panic attacks in situations that do not normally lead to panic. Using our example above, being in a grocery store (neutral stimulus) does not cause panic (reflex). Because someone did have a panic attack in the grocery store, they associate the grocery store with panic. The grocery store is the neutral stimulus, just like the bell.
How to get rid of your panic attack
You may think, OK so we know what causes it. More importantly how do we get rid of it? This goes back to the original experiment. To uncondition the salivation response, they rang the bell and did not feed the dogs. At first they still had the salivation response, however over time when the bell ringing did not mean they were getting food, they stopped salivating when the bell was rung.
The way that applies to you is you need to go to the grocery store over and over again to get over your fear of panic. This isn’t to say that you won’t feel anxiety when you go to the store. As a matter of fact, you will have a lot of anxiety the first time you go back. However, your anxiety will decrease the more you do it.
Anxiety is normal
Remember too that we are wired for anxiety, thus we will never be able to get rid of all anxiety. This is adaptive. Perhaps you have heard of our fight or flight instinct. When we are faced with bodily harm or death, we go into fight or flight mode. This helps keep us alive. It is instinctual. Our heart rate and breathing rate increase, digestion slows down, blood goes to our limbs. This is all to prepare you to save your life. However, when someone has a panic attack, their body goes into fight or flight mode. Our nervous system doesn’t know if there is a saber tooth tiger running after us, or we are imagining some terrible scenario in our mind. It reacts in the same way.
Treatment is about new learning-basically rewiring your brain. Or as explained above, we need to uncondition the learned response that is maladaptive. A common treatment is called exposure and response prevention, which helps you confront what you are afraid of vs. avoid it. The avoidance is what maintains the anxiety.
If you or someone you love suffers from panic attacks, therapy can help. Please give me a call at 713-304-6554.
Take care,
Debbie
