Panic, Phobias and Post-Traumatic Stress


 

The brain has an emotional alarm system designed to keep us safe. When people suffer panic attacks, phobias or post-traumatic stress, it is because the system has gone into overdrive.

 

What happens is this. There is a small, structure in the brain, known as the amygdala (Greek for almond, which is its shape), which has access to our emotional memories and learned responses. It evolved in the distant past and its job is to match new circumstances to what is already in the store and alert us to anything that previously represented a risk and might do so again. In the distant past, this might have been a movement or flash of colour that could have signified an approaching predator. The amygdala would then have triggered changes to help the body get ready to fight or flee the danger – pounding heart, racing pulse, quick, shallow breathing, etc.

 

Now imagine this. A young woman, who has had a highly stressful day, is waiting in a long supermarket queue, worrying whether she’ll be out of the shop in time to catch the bus to school to collect her little girl. It is one pressure too many. The amygdala responds as if she is under threat and she starts to feel her heart pounding strangely and her breathing quickens. She becomes terrified that she is having a heart attack and that makes the symptoms escalate – her palms sweat; her chest feels as if it is bursting and she struggles to breathe. Soon she feels overwhelmed and may collapse or run out of the shop. The amygdala, fearful that this could happen again, files away the fact that there were bright lights and lots of people queuing when the ‘threat’ occurred. Then, when the woman is queuing in the post office the next day, the bright lights and queue may be sufficient for the over-vigilant amygdala to trigger another panic attack to deal with the new ‘threat’.

 

Phobias start the same way – the amygdala makes associations with what was going on when a person first felt threatened, not all of which may be relevant. So, while it is understandable that someone who is attacked by a strange dog may well develop a fear of dogs generally, it could equally be the case that someone develops a fear of broken glass because, on a previous occasion, when they had had a panic attack, there was broken glass lying near to where they collapsed. Agoraphobia develops when someone is too frightened of panic attacks even to leave the house.

 

In the case of post-traumatic stress, someone who was in the back seat of a car when a collision occurred may find it frightening to travel in the back seat again but there may be other, unconscious, connections with the accident too, such as the smell of petrol. So the person may experience seemingly inexplicable panic when filling up their own car with petrol.

 

Fortunately, in the pragmatic approach we can work in a variety of ways to help deal with many of these circumstances. For example, if a traumatic memory is causing panic attacks, phobias or post-traumatic stress, we may use a powerful, painless visualisation procedure, known as the rewind technique, to take the emotion out of the memory and enable the memory of the event to be stored away as history, instead of one that continues to intrude on the present. The memory remains, and always will remain, a deeply unpleasant one but no longer one that is emotionally arousing. This method can work swiftly and reliably, sometimes even in the most extreme of cases.

 

Pragmatic Therapy integrates the human givens approach with established evidence-based treatments approved by the National Institute for Health and Clinical Excellence (NICE). Special thanks to Denise Winn, Editor of the Human Givens Journal, for her assistance with the self-help articles on this website.