How I Understand My 'Panic Process' as a Therapist With a Panic Disorder

Although it’s been three years since my last full blown panic attack, my mind remains littered by debris. When I make plans to go out with my wife or plan an activity with my children, fear of an attack tries to jail me. These days I am a bit more able to barrel through fear and allow reality to stomp the lies my brain tells me. However, because healing from panic disorder is a process, hurdles remain. I sometimes feel flurries, but they are usually rebuffed by a combination of my medication and deep breathing. I still carry a safety pack of snacks and water whenever I travel by car and public transportation remains out of the question, although it won’t be this way forever. Because panic disorder plants doubt grenades in my brain, my pride related to remission of attacks is sullied by internal accusations I am not pushing myself out of my safety zones fast enough. Sometimes my inner critic refuses to give me a break.

I have recently started examining triggers and although mine are singular to me, I imagine others experience them. My attacks have all begun with a physical sensation in my digestive tract. My attacks usually happen while driving. I’ve been blessed to never have been hindered by attacks in my home, nor have I ever been woken up by panic’s grip. Still, my third panic attack of approximately ten full-blown ones scarred me and the world I used to explore with reckless abandon has gotten somewhat smaller.

For reasons known only to my disorder, subtle changes in bodily sensation sets off my alarm. I have never felt chest pain or shortness of breath, nor have I experienced depersonalization or derealization. My symptom is overwhelming nausea, followed by intense fear I will be publicly humiliated by spilling the contents of my stomach or colon for all the world to see.

Panic attack is the ignition of our body’s fight, flight or freeze response. I imagine if my attacks are triggered by sensations in my digestive tract, followed by mortification as a result of the world pointing its finger and laughing, therein lives my perceived danger. The moment panic strikes, I am compelled to flee until I reach bed or bowl where I am confined for days. Panic is never pretty. Once confined, my process of establishing safe distances from home begins.

My experiences have led me to question my perceptions of humanity and myself. It seems clear I lack faith no one will offer to help me if I am in distress. My mind has convinced me the masses will run, be disgusted or stare as if I am a freak. It seems unreasonable to think no one will help, but my roots grew in toxic soil. My mother spent years hospitalized with major depressive disorder and my father struggled to keep my home from unraveling. Constant turmoil left no room for hugs, affirmations or support. I believe my adult self believes if my own family was unavailable, strangers won’t be either.

Introspection also revealed my stringent use of intellectualization as a defense mechanism. I have a history of being afraid to be wrong. I loathe the phrase, “I don’t know” and I hyper-focus on self-image. I am also deathly afraid to be made fun of and I am sensitive to criticism. It seems if panic is going to thrive anywhere, it is going to thrive in a person wound too tightly. Recently, I have focused on letting myself be the butt of a friendly joke. I admit flaw and I am liberated by admitting I don’t know everything. Admitting weakness is how I outed myself as a therapist with panic disorder in the first place and it is a decision that is freeing me from the inside of my own mind.

In recent weeks, I have begun the practice of acknowledging physical sensations and trying my best to let them be what they are. If I feel a rumble in my gut, I note the change and it goes away. If anxiety brings about slight nausea, I note it, remind myself I am not in danger and it helps. Whatever glitches I feel in my body, I am certain millions of others are experiencing the same thing. I have seen people vomit in public and while the thought terrifies me, I have ever pointed a finger and laughed, nor I have seen anyone else engage in such mockery either. My wife always reminds me bodily functions happen to everyone and it is a thought that helps keep me centered. When I think about ways to counter fear of humiliation, I imagine myself  announcing to everyone I might have a panic attack and my insides might explode. I suspect should I just put it out there and destroy the stigma, fear will recede. It is a strategy I am moving closer to employing as I unravel the mystery of my illness. As more and more people hear about my experiences, my shame recedes and I move forward.

I don’t suspect these strategies will work for everyone, but I hope there are some out there who will relate to lack of trust and use of defense mechanisms to compensate for insecurities as root causes. Gaining our freedom from panic disorder is a process that begins with a look inside. As with any enemy, in order to vanquish it, we must get to know the process of our disorder intimately. Although it is not who we are, it is part of us and with most any part of us, there is hope of gaining understanding and mastery.

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Thinkstock photo via Victor_Tongdee.