Dr Perpetua Neo

"Do I expose myself to panic attacks?"

Yesterday I read a post in a woman’s group asking about whether one should immerse themselves in a panic attack, otherwise known as ‘exposure’. As someone who has had experienced and treated panic attacks, this is a topic close to my heart.

Exposure is taking that step forward with your chin-up and telling the scary person who just threatened to hit you, to try it if she dares to. Even if your heart is slamming away, your breathing is shallow, you’re doing it. Because you know she’s merely threatening you, and if you face that fear, she’ll melt away like the Wicked Witch of the West.

It’s useful for facing the things that petrify us.

I’ve done it on myself- with raw meat- so I could cook for my cat. I remember how much I wanted to gag, and how I fainted on my first trip to the wet market at 3 years old. I’ve done it with clients. We worked with spiders, dead rats and dogs.

Whilst facing your fears is useful, when it comes to panic attacks, we need to ask ourselves, “What is that main fear?”.

What is that main thought in your head when you have a panic attack.

If it’s “I’m going to die” or “I’m going to have a heart attack”, then yes, exposure will help you. Before then, knowing the science behind it- that you won’t die or have a heart attack– is key.

We often think that our fear levels or our heart activity will shoot up sky-high. And thus, we want our panic attack to stop, so the catastrophic outcome we fear won’t happen. When we realise that our emotional system can regulate itself and our fear levels will plateau, panic attacks become less of a scary monster.

So, if you’re going to expose yourself to panic attacks, make sure you know you won’t die or have a heart attack. Or you’ll feel like the sailors on Columbus’ ship, sailing over the horizon, believing that they were going to die. Because back then, we thought the world was flat.

Not all exposure exercises are equal

Even then, consider your personal and public safety on where you’re planning to do your exposure exercise. If it’s whilst driving, that’s like driving after taking a tablet that induces drowsiness. You’re not sure what will happen. Don’t.

Why? When you have your panic attack, it isn’t all in your mind. People who tell you that have never experienced one, or aren’t very considerate of what you’re going through.

The physical sensations are real. The heat at the back of your neck. Your quivering muscles. Your mind overwhelming you with thoughts of the worst case scenarios. They’re undeniably real. They’re measurable if you strap yourself up to medical devices. But you’ve got nothing to prove to anyone.

In the case of facing panic attacks, it isn’t just walking forward in the face of a threat to dissolve the illusion of fear.

There are real things triggering your panic attacks- perhaps a hypersensitivity to heat whilst in enclosed spaces, or a fear of being trapped and laughed at by others. Sure, you didn’t always have panic attacks all your life, and it’s probably something relatively recent that makes you wonder “What has changed” and “Is there something wrong with me?”. Your fear is a muscle, and this muscle has become so well-fed that it jumps into Panic Attack Mode instantly.

“I need to escape” & “I cannot handle it”

So, if the main belief is about “I need to escape” or “I cannot handle it”, then don’t do exposure. All the times you’ve managed to calm yourself down, all the times you’ve escaped from the clutches of the panic attack- you’ve done it. You’re still alive.

You spend your days knowing that whilst you’re still hypersensitive to panic attacks- because that Fear Muscle is on autopilot- you’re vulnerable. You’re still living your life. You’re brave.

Everytime you berate yourself for being ‘useless’, ‘stupid’ or ‘worthless’ for having your panic attack, you increase your stress levels. When we suppress our fears and our stress, they need an outlet to escape. Enter, more panic attacks.

You aren’t less of a human for having panic attacks. In fact, clinical psychologist and UCL lecturer Ali Modaresi once said this:–

“If you’ve not experienced a panic attack or depression by late 20s or early 30s, it means that you are not doing enough, and have not fully experienced the complex and overwhelming world out there.”

Please remember that.

How about some gentleness instead?

Instead, can you come back home to yourself, rather than be lost in your mind. Can you breathe in deeply for seven counts, feeling your lungs and chest expand, slowly but surely. Then, breathe out deeply for eleven counts, feeling your lungs and chest fall, and your belly empty. Feel the way the breath enters and leaves your nose.

I know you might be distracted by your mind, telling you that danger lurks everywhere.

It’s okay, simply come home to your breath. Come home to yourself.

Last consider this, what fears or stressors in your life are you trying hard to suppress? Fear exists for a reason– to warn us to fight or take flight. Sometimes, however, we freeze. And at other times, we’re too quick to bury it, it morphs into something deeper. Which are released at the seemingly-strangest times as pure unadulterated rage, shame and panic.

Here, Zen Master Thich Nhat Hanh’s advice works marvels.

“So the practice is not to fight or suppress the feeling, but rather to cradle it with a lot of tenderness. When a mother embraces her child, that energy of tenderness begins to penetrate into the body of the child. Even if the mother doesn’t understand at first why the child is suffering and she needs some time to find out what the difficulty is, just her act of taking the child into her arms with tenderness can already bring relief. If we can recognise and cradle the suffering while we breathe mindfully, there is relief already.”

If you can’t envision cradling a child, envision cradling a pet.

You have that space of warmth, compassion and love inside you.

Panic attacks can make us doubt ourselves and feel as though the future is extremely uncertain. Trust your ability to take care of yourself and come home to yourself.

Want to heal from your panic attacks for good? To take that train, plane or never fear before speaking at a meeting again? Say hello for your free Chemistry Call or go here to read more about my signature 8-week program for treating panic attacks.

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