These mental processes (also known as neuroses and complexes) can be driven by distorted ways of thinking about ourselves and the world, counterproductive beliefs, unprocessed traumas or other losses, or unresolved conflicts between who we are and who we think we should be. These processes can be modified if we put in the work to identify them, decide they are not helpful, and move toward new internal approaches. Seeing our symptoms as alarm bells and not something inherently wrong with us allows us to, without guilt, shame, or blame, realize that our "stuff" needs our focused attention. Once that stuff has our openhearted attention, we can then take corrective action. This action is seldom easy, which is why we come together as a group. Doing "the work" alone is infinitely more difficult than tackling such an imposing project together.
We shared the thoughts that have accompanied our individual attacks, as well as the associated attitudes, beliefs, and feelings that reside with us before and after. Many of us had had the same fearful thoughts the first time a severe panic attack had visited: "Oh my God! What's wrong with me?!" "Is this a heart attack?!" "Will I stop breathing?!" "Am I going to die?!" "Am I going to crash my car?!" We also had had many of the common thoughts following our first attack. "Will this happen again?" "When?" "How can I know when it might come?" "How can I avoid these things?"
As I've said, the way to permanently protect ourselves from anxious symptoms such as panic is to go deep into ourselves do a lot of challenging work. One reason this is so important is that the "thoughts" that spawn panic are often unconscious. This is why panic attacks can feel spontaneous. "I wasn't even worried when it came!" is a common comment. Well, there's worry that you know about and there's worry that's been repressed. Worry, anger, resentment, fear, and other negative emotions only gain power when they're buried. Digging down to those time bombs and defusing them takes time and effort. But what can we do right here, right now, in this moment?
Thankfully there are things we can do to make panic easier to deal with as it happens or threatens to happen. Our therapy group put our heads together and came up with a list of short-term, in-the-moment strategies which have been helpful for us. This list is not exhaustive and perhaps you've tried something else that has been useful. If so, please share it with us! Here is our list:
This is so simple, it feels like a trick. Taking a few slow, deep breaths is better than any medicine for calming yourself down. Every cell in our body uses oxygen as fuel. More fuel means higher function for each of those cells. And the cells we're wanting to help here are the neurons that create our thoughts and that run throughout our body. Feel the stress in your mind and in your body lower as you breathe. Hey, but don't overdo it! One of our members recommends breathing into a paper if hyperventilating is a problem for you. All things in moderation, even deep, cleansing breaths!
CHALLENGE YOUR THOUGHTS
Panic attacks sometimes come out of the blue, with no noticeable warning, but they can also follow self-defeating thoughts. Some examples are:
I can't do this.
I'm not good enough.
I'm going to blow it.
I'm a loser.
I'm a hopeless case.
Life is too hard.
Challenging these thoughts is as simple as turning them on their head. Tell yourself that these automatic thoughts are of no use to you and that the opposite is as likely to be the truth. Remind yourself that there are people who believe in you. They would never say such things about you, just as you would speak generously of them. You don't have to get corny with your self-affirmations. Just get real.
An alternative to challenging thoughts is to let them go. Our thoughts, both pleasant and upsetting ones float in and out of our conscious minds and a rapid rate. We are thinking machines and sometimes operate like factories churning out thoughts. We try and sell these over-abundant products to ourselves at any price. They roll off the production line in rapid succession. Mindfulness is like being a very choosy customer. We don't need to buy every thought that's offered. In fact, we don't even need to touch it. We can let the thoughts just roll on by. We can observe them, but when we're mindful, we don't let any one thought occupy us for long. We observe it, we don't judge it, and we let it go. The conveyor belt taketh away just as well as it giveth. To foster calm, decide to be mindful and let those thoughts go.
A number of members mentioned accepting the current reality, without fighting it, as a strategy. The interior dialog might go something like, "I'm getting that feeling. My heart is doing that thing and my anxiety is building. I'm afraid I'm going to panic. But I can handle it. I will breathe and be calm in spite of my fear. I will not die from this, this will pass as it always has." Acceptance works for a lot of stuff. Victor Frankl wrote that the concentration camp prisoners who survived their ordeal the best were the ones who made up their minds to accept their plight as a reality to be dealt with.
We've all felt the benefits is a brisk walk, a jog, a run, swim, or a bike ride for giving us a more relaxed outlook. Is it because our bodies are distracted by physical exertion so it doesn't bother with the mental kind? Is it because using our muscles to raise our heart rate puts to good use any excess stress hormones (cortisol and adrenaline) we've produced unnecessarily? Is it because exercise raises our seritonin and endorphin levels? (Seritonin is our mood-stabilizing neurotransmitter and endorphins [there are more than 20 kinds] are the neurotransmitters that act as our own natural pain-killers and sedatives.) I don't know, but the result speak for themselves.
This is one you might not have heard of. But it works. Take a deep breath right now and give it a try if you don't believe me. Close your eyes and put one palm over the occipital lobes of your brain (you'll find them under those two bony protuberances at the back of your skull). This is where a lot of memories are stored. Put the other palm over your frontal lobes (they're those giant brain structures in the front of the skull where our executive functions are processed). Now breath slowly and just hold that pose. Keep your eyes closed and just think about calmness. You don't have to think about calmness, but the feeling of the hands on these parts of our head will kind of take over. Is there energy being exchanged? Absorbed? I don't know. But when we tried this on Wednesday, the group liked the feeling we got a lot.
SLEEP ON IT
It's not practical to take a nap during a panic attack (though some group members reported waking up in a panic at times), but good sleep hygiene was cited as a way to ward off high levels of anxiety. Bad sleep is closely correlated with anxiety symptoms. Once we get into a bad sleep cycle it can be come a self-fulfilling prophesy, so the sooner we attend to healthy sleep practices the better. There are just as many ways to sleep well as there are to sleep poorly. Try everything and don't let yourself get into a counterproductive rut. You'll notice the difference all day.
This is another tool that is more strategic than tactical, but try it. Journaling about the things that bother us, the things we see as obstacles in our lives, and the things we want to accomplish is a time-tested way to get to know yourself better. And knowing yourself—as weird or alien or scary as it may sound—is a good way to understand what's really going on. Your panic didn't come from no where, even if it feels that way. Journaling can be a soothing way to make friends with that frightened, anxious person inside whom you've maybe been avoiding.
The emergency first aid tricks above can be used whenever you feel panic rising in you. (And the last two are good for before and after.) Instead of feeling helpless in the face of an impending attack, tell yourself that you have tools at your disposal, and that using them will be just what you need for now. You can do it. You are definitely good enough. You've done plenty of hard things before. This is just another one. You're going to be okay!