8 Things Your Psychologist Doesn't Know That You Can Use To Stop Panic

Once a panic attack has started, you can’t help yourself. All those tips about stopping a panic attack are useless. What you are about to learn will stop panic before it can start. You can keep panic from happening again. The first step is to understand the processes involved.

1. As the amygdala monitors what is going on, it is sometimes triggered to release stress hormones.

What triggers it? The amygdala is genetically programmed to release stress hormones when it senses anything unfamiliar or unexpected. Though such things sometimes mean danger, they may be benign. Your high-level thinker and decision-maker— I call it your Inner-CEO — needs to figure it out. We’ll get to that in a moment.

In addition to its genetic programming, the amygdala learns to react to things associated with trauma experience. In most traumatic situations, we are unable to escape. Thus places where escape is blocked — elevators, bridges, tunnels, high places, MRIs — can trigger the release of stress hormones based on learning.

You don’t need your amygdala to react in these situations. Can you teach your amygdala to not react to them? Maybe. Maybe not. According to amygdala expert Joseph LeDoux, the amygdala has two sets of memory cells.

• Plastic Memory Cells. The plastic memory cells are quick learners. The first time a trauma happens, they learn to react to every associated with the traumatic experience. But when those things are experienced and no trauma takes place, the plastic memory cells relearn and no longer react.
• Storage Memory Cells. The storage memory cells are slow learners. The first time a trauma happens, they make no connections. But if the trauma is repeated, then the storage cells connect the things up. Let’s say you were repeatedly assaulted and could not escape. The storage cells will connect being unable to escape and danger. The storage cells will also associate arousal (rapid heart rate, rapid breathing rate, sweatiness, tension, overwhelm) with danger.

Once storage memory cells learn to react, they may never stop reacting to something no matter how many times nothing bad happens when exposed to it. This is why exposure therapy may not produce results.

2. Stress hormones activate the sympathetic nervous system (SNS).

When stress hormones are released, your SNS goes into the fight or flight mode. The SNS increases your heart rate and breathing rate to send more energy to your muscles. It reroutes your digestive system’s blood supply to your muscles. It increases perspiration so evaporation will pre-cool your body. If what the amygdala is reacting to turns out to be a threat, you are ready to take action.

3. Stress hormones cause alarm.

Do you really need to take action? Is your amygdala reacting to danger or something benign? Your Inner-CEO’s high-level thinking needs to figure it out, so the stress hormones cause feelings of alarm to grab its attention.

4. Intense feelings of alarm need to be down-regulated.

Alarm overwhelms your Inner-CEO. It can’t function until alarm is down-regulated to curiosity That’s a big shift. But your Inner-CEO can function only when it is cool, calm, and collected.

5. Our down-regulation system.

We have a down-regulating system: the parasympathetic nervous system (PNS). The prefix “para” means against. When activated, the parasympathetic system produces down-regulation that fights against the up-regulation being caused by the sympathetic system. When fully activated, the parasympathetic system overrides the sympathetic system and restores your Inner-CEO’s ability to function. Many of us lack the mental programming needed to adequately activate the PNS.

6. How down-regulation is activated.

• Dependent Activation Is Inborn

According to neurological researcher Stephen Porges, we are genetically programmed to be calmed by the face, voice quality, and body-language/touch of a person who accepts us. These signals, unconsciously transmitted and unconsciously received, activate the PNS.

This is why we are comfortable with people who, instead of judging us, criticizing us, or giving us advice, accept us. Even if stressed, the right person makes us calmer.

But what can activate the PNS if we are alone? What allows us to control anxiety and panic independently?

• Independent Activation Can Be Developed

A child who is consistently responded to expects to be responded to. When alarmed, the child expects the caregiver’s face to appear, their voice to be heard, and their touch felt. The child’s imagination of the caregiver’s face, voice, and touch activates the PNS and calms the child before the caregiver arrives. As this scenario is repeated, it establishes a program in the child’s mind that attachment theorists call an “internal working model of secure attachment”.

A fully developed internal working model is like an app. When alarm takes place, it elicits a memory of the caregiver. The memory of the caregiver activates the PNS. The PNS down-regulates alarm thereby freeing the Inner-CEO’s high-level thinking to determine whether danger exists, and what, if anything, needs to be done.

If action needs to be taken, your Inner-CEO plans what to do. At the moment your Inner-CEO commits to a plan of action, it’s a “done deal.” The Inner-CEO signals the amygdala to terminate the release of stress hormones.

If your Inner-CEO determines there is no danger, that is also a “done deal.” The amygdala is signaled to stop releasing stress hormones.

Either way, your Inner-CEO resolves the matter and ends the release of stress hormones. Panic does not develop.

7. Without down-regulation, panic may develop.

If you do not have an “internal model of secure attachment” that can activate your PNS, alarm persists. Continued alarm overwhelms your Inner-CEO. It is unable to determine whether what the amygdala is reacting to is real or imaginary. So, better safe than sorry, an overwhelmed Inner-CEO deals with imaginary threats as though they were life-threatening.

Let’s go back to what LeDoux learned about the amygdala’s memory system. If a person has experienced trauma once, the plastic memory cells learn to react to things associated with the event, But if the trauma is a brief one-time event, the plastic cells re-learn and stop reacting.

The story is different with repeated trauma or a traumatic experience went on for some time.

• The storage cells learn to react to the inability to escape. Thus bridges, tunnels, high places, airliners, MRIs, etc. are associated with danger and feel unsafe.
• The storage cells learn to react to feelings of arousal. Thus rapid heart rate, rapid breathing rate, sweatiness, and tension mean danger.

If your Inner-CEO is overloaded by feelings of alarm, these feelings serve to “prove” an imaginary danger is real. Overwhelmed, your Inner-CEO can’t develop a strategy to combat the danger or to escape the danger. With no control and no escape, the situation is hopeless, and panic takes place.

8 How to make sure automatic down-regulation takes place and panic is prevented.

The difference between panic and no panic is down-regulation. Psychologists often make the mistake of thinking panic is due to irrational thoughts when the problem is inability to down-regulate alarm caused by thoughts

• When alarm is down-regulated, Executive Function determines whether a threat exists and what, if anything, needs to be done.
• When alarm is not down-regulated, Executive Function is (a.) unable to recognize an imagined threat isn’t real, (b.) can’t fight imagination off and (c.) can’t get imagination to go away; in other words, can’t escape it.

Down-regulation of alarm depends upon activation of the parasympathetic nervous system. Activation of the parasympathetic system depends on an app, an adequate internal working model of secure attachment. According to research, only about 60% of us develop secure attachment. This means about 40% of us did not have a relationship with our caregivers that promoted development of the app needed to automatically calm us down following stress hormone release.

If you don’t have a panic-stopping app you can give it to yourself now. The steps that develop it are detailed in my book. You can read a lengthy sample at this link.

This COVID-19 pandemic has produced some unique reasons for anxiety, claustrophobia, and panic. These are addressed in my book which you can sample at this link.

The development of this app was made possible by a convergence of neuroscience (Stephen Porges) with attachment theory (John Bowlby) and Object Relations Theory (Fairbairn, Klein, Guntrip, and others) and in my “lab” at 30,000 feet where I worked with people who had been unable to fly due to panic.