Panic Attacks Archives - Embodied Living

In order to help with the symptoms of trauma we need to think of the trauma response as being an accelerator. I often remind my clients that trauma is something our body does. Our body has floored the accelerator pedal (so to speak) and we have forgotten that we even have a brake.

Trauma as undischarged energy

Trauma is our body’s natural response to an unnatural situation. Think of the tiny mouse who gets pounced on by the cat. Suddenly it is trapped in sharp jaws and knows it might die. A huge surge of energy rushes through its body as accelerator hormones are released that pump blood and expand lung capacity. It is like a nuclear bomb went off inside its body. This energy prepares the mouse to flee at the first opportunity (or fight if this was a larger animal). The moment the cat drops the mouse it runs faster than it ever has to survive. And the energy bomb is dissipated. The ‘hyper-arousal’ of trauma has served its purpose.

Fall asleep

Sometimes something else happens. When released from the jaws of hell, the mouse looks like it is dead. The animal feigns death. This is less well known side of the trauma response – ‘to fall asleep’. Many animals do this as a survival mechanism. It lies on the floor completely dead. The cat walks away. But the moment the mouse senses a millimetre of safety, it springs up and races off. However, if you were to watch closer, for longer, at some point you would see the little creature jerk and throw itself around in a strange sort of way. This is the mouse discharging the energy of the trauma response. This discharge means the mouse can get back to its normal life with no lasting after effects from the nuclear bomb which has just gone off inside of it.

Symptoms of undischarged trauma

Humans are often not so fortunate. Our natural instincts can be interrupted by our logic and our higher mind. Practically, this means that we are often left with the symptoms of undischarged trauma in our bodies that stay with us long after the traumatising event. In fact, they may lie dormant, but only until another trauma event triggers this energy again.

Diagram: (Levine, Ogden, Siegel)

This diagram is commonly used to help us understand heightened brain/body reactions during adversity. The dotted lines show a healthy nervous system. This being one which is able to self-regulate and maintain an arousal level (following a difficult event) that is within manageable or normal levels. When we experience trauma, this can induce a heightened energetic response in our system (as described above) and can mean that our ability to self-regulate is compromised. This is more likely to be the case if we have had earlier trauma, including disruptions in our early attachment needs.



From Hyper to hypo

This response to trauma pushes us into one of two states, which we will inevitably fluctuate between. Hyperarousal (the ‘stuck on’ position) is where our sympathetic nervous system is in charge and is characterised by an excessive energy response. This will present itself in symptoms of anxiety, panic, fear, hypervigilance and emotional flooding. We may feel rage or anger, restless and hyperactive and it will be difficult to eat, sleep or concentrate.

However, human beings cannot maintain this state for too long. Our system takes over and plunges us into the exhausted state of hypo arousal. This is where the parasympathetic nervous system takes over and in particular the dorsal vagal complex of the vagus nerve. Effectively this is the equivalent of the animal’s ‘feign death’ mode. Here we will feel depressed and tired, have more feelings of negativity and worthlessness, feel disoriented and disconnected. A sense of flatness or numbness will take over and we won’t feel like doing anything, we may also sleep a lot. Indeed we may even feel we don’t have a future. We are, in effect, emotionally dead.

Fluctuating between extremes

Again, our bodies won’t let us stay here too long. So we may be driven to risky (even suicidal) behaviour to feel alive again.

What I often find is that people often find one state more intolerable than the other, and therefore have more of a default position of ‘switched on’ or ‘switched off’. It goes without saying that both of these extremes are confusing and disturbing to us, and to those around us. People say ‘I feel like I am going mad’, they feel messed up and long to be normal. It is a chaotic state. Of course, this layer of shame doesn’t help.

Understanding the energetic response

Nevertheless, understanding the science behind this response helps to understand the disturbing nature of these symptoms. It is vital to learn to build resources in our self that will help us to manage the chaotic nature of undischarged trauma. This will help to protect us (and others) from further harm.

Risky behaviour increases with the trauma response

Without learning how to ‘self-regulate’ we will be at risk from taking actions that somehow help us manage these states but cause us more problems. We may take an overdose if we are so frightened by the thought of carrying on with these symptoms. We may smoke or drink more to help alleviate some of the distress, or become addicted to some other process or substance. These are more risky ways of managing the post-traumatic symptoms that lead to more shame, which will only feed the cycle.

Taking refuge in our self

Our body, and unconscious mind, already have all the resources within them to help us self-regulate the trauma response and find safety. By learning, or being reminded about, the resources we have within we can find and apply the brake on trauma. We can learn when to apply the accelerator and when to use the brake to steer our self into safety.

Applying the brake and the accelerator

Whilst there are different techniques to use for the hyper state and the hypo state, there is one that can work well for either. There is a muscle inside the middle of our body, which attaches to the heart via a central tendon, and also links up with the ventral vagal complex of the vagus nerve. In short, this muscle helps to engage the newest branch of the parasympathetic nervous system – the ‘smart vagus’ – the self-regulation centre. This muscle is the diaphragm, the primary muscle of respiration.

However we cannot just breathe our way out of trauma we have to do it in a very specific way. If we can learn to breathe using the full range (25-30 cm ) of our diaphragm, through our nostrils at a rate of around five breaths a minute (that is a 12 sec breath in and out) we can find a balance point between the brake and the accelerator. For this balance, certainly to begin with, there should be no pauses at the end of the inhalation or exhalation, just a smooth flowing of in-breath into out-breath. Like an undulating wave. It is from here that we can reach coherence and begin to find ‘normal’ again.

A simple practice to achieve coherence and balance

I usually teach my clients to reach this state in a number of steps. But I usually start by teaching them to find and engage with their diaphragm.

The following is a simple practice and the best way to do this:

Listen to a podcast of the practice here.

  1. Lie on the floor on your front with your body in a straight line. (it is important that you lie on a hard surface rather than a bed).
  2. Bend your arms at your elbows and rest your forehead or side of your face on your hands.
  3. Make sure you allow a few moments to get as comfortable as possible here.
  4. Make sure your mouth is closed, lips together, and you are breathing through your nostrils.
  5. Be aware of your body lying on the floor and the contact between your body and the floor.
  6. Become aware of your breathing, and notice your abdomen pushing into the floor as you breathe in. It releases as you breathe out.
  7. Keep your awareness on this feeling of your belly pushing into the floor as you breathe.
  8. After a few minutes, you can start to exaggerate this movement and push your belly even more into the floor by drawing deeper breaths. (if at any point you feel uncomfortable or have dizziness stop for a moment and come back to the practice later).
  9. Continue this practice for as long you can. And repeat every day if possible for a while.


Changing default habits

Remember that the trauma response is a habit that our body has gotten into when it is triggered. You can begin to change any pattern if you practice the new resourceful behaviour for a minimum 20 minutes for a minimum of 21 days (I usually say a month, continuously, with Sunday off!). This is like restoring your mobile phone to its factory default settings. You remember to breathe how you were born to breathe. You take the first step at re-connecting with the resources within that are your human heritage as an embodied being.

This article was first published on Counselling Directory.

I estimate that one in every 10 people who come to me are suffering from panic attacks. They think they are going mad and berate themselves for feeling out of control. Yet panic attacks are not what you think. They are a stimulus-response circuit that your body has learnt. I have suffered from them myself. It limits lives, even ruins lives if left to run without help for long enough, becoming a panic disorder.

The symptoms include: feeling of faintness (or actually fainting), lightheadedness, chest pains, rapid breathing, rapid heartbeat, numbness, sweating, tingling feeling on the fingers, nausea, hot flashes, trembling or shaking, abdominal pains. A feeling that you are about to have a heart attack or die. People can feel like they are about to vomit, or have diarrhoea. Symptoms vary from person to person, but they are very frightening.

Who gets panic attacks?

Panic attacks can happen to anyone. Many of us may have had one or two in our lives, and overcome them. When panic attacks become a problem, it is usually in people with less self acceptance/ self like, they tend to dissapprove or dislike themselves. Maybe an underlying, limiting belief about self such as “I’m worthless” keeps them unconsciously wishing to punish themselves or self sabotage any attempts at changing it.

What are panic attacks?

They are not phobias, as phobias are a fear of something specific and identifiable outside of yourself, removal of which stops the symptoms of fear. But if you fear fainting in a public space or making a public spectacle of yourself in certain situations then your fear is a fear of panicking and is internally generated, caused by your own thoughts: “What if I faint? I’ll make such a fool of myself. What will others think of me?”

Panic attacks become inconsistent, their occurrence depending on a number of different circumstances, unpredictable and we don’t know why it happens or how you learned it. They always start with some event in childhood where we lost control of our bodies, usually due to illness, and fainted, were sick or had diarrhoea. This leaves us with a very negative emotional experience linked to a time and place. It is this memory of time and place linked with emotion, that becomes an unconscious pattern outside of our conscious control. And explains why they can be so scary.

What can be done?

Many people believe that, because they have had panic attacks for a while and have not been able to do anything about it, they are stuck with them and can’t change. But, whilst the change may not be immediate, and the person needs to put some effort in to change, panic attacks can be treated and life can return to normal. In Embodied Living therapy here are some of the processes that I look at to help people:

  • education about the process of panic attacking
  • assess hyperventilation/breathing and retrain breathing
  • teach relaxation skills
  • teach thinking skills and identify the trigger thought and learn to change/stop it
  • identify the ‘dandelion root’ of limiting belief or event from early life and re-solution that
  • develop witness mind to teach person to dissasociate and keep out of the panic
  • install resources to help with managing emotional state and control the sympathetic nervous system: anchoring, resourceful self, cognitive distraction, SWISH, timeline intervention and memory resolution,
  • tasking and practicing controlled exposure with resources
  • building identity – ideal self – to build a more resourceful, resilient self this can have a huge impact on eradicating the panic attacks and helping people achieve their fully potential

Panic attacks are disabling and can have a significant effect on limiting people’s lives. In a recent post on panic disorder, I looked at the underlying sympathetic nervous system response and how yoga and mindfulness practices can help. From a psychotherapeutic perspective, I find that when people have some education about the process of panic attacking and some awareness of the process, they can start to let go of some of the fear. The very nature of panic attacks is similar to phobias, but the fear is of fear itself: the fear of having a panic attack becomes the phobic response. So by educating people as to the nature of the process, fear starts to loosen.


The Process of Panic Attacks

Panic attacks are the body’s learnt or conditioned response  to a stimulus and is classical conditioning. However, when the body does something really well, it leaves it all to the unconscious mind, which by its very nature we can’t change without a little help. The original stimulus is often an event, perhaps an illness, where we lose control and experience some particular strong, negative emotions for the first time (fear, terror, panic, etc). We often can’t even remember the original ‘event’ but nevertheless, the body remembers it! These powerful emotions get ‘remembered’ by the body, the memory of that event in terms of the ‘felt sense’ of it, get stored in the body as a response.

Then, at a later date, some other (non related) event (stimulus) then gets associated with the response of panic (that response which has been remembered by the body).  Thereby a ‘limiting decision’ is made by the unconscious mind (body-mind) to make the connection between the new stimulus and the panic response.  The negative emotions of the panic attack build up and work together in a vicious cycle of anger, fear and blame. As well as the fear of having a panic attack (because we cannot control it), there can be anger that we feel at our self for doing it, sadness that we can’t control ourselves or will lose face or friends, guilt that we can’t solve the problem ourselves.


Thoughts Make the Problem Worse

When the limiting decision made by the unconscious mind to make the connection between the new stimulus and the conditioned response, the beliefs and thoughts that the person has about the situation make the negative feeling experience much worse – ‘it’s not normal’, ‘it’s not right’, ‘i’m  abnormal’, ‘I’m rubbish’ , ‘If anyone finds out I’ll lose everyone’, ‘I’m going to throw up/lose control in front of everyone’, ‘I’m going to die!’


How to Treat Panic Attacks

The process of treating panic attacks, involves giving the unconscious mind more choice and flexibility to help it ‘undo’ the stimulus-response that has been ‘learnt’. In my work using neuro-linguistic psychotherapy, I follow a process that broadly can be summarised as:

  1. Identify the triggering thought and emotions and/or limiting belief
  2. Identify the first panic attack – the time when the stimulus-response and limiting decision was made
  3. Use search anchor (with safety anchor and kept dissociated) or similar to find first event – where the root fear was experienced
  4. Clear out the negative emotions that act as a ‘glue’ binding the response in place  – anger, sadness, fear, guilt
  5. Then clear out the limiting belief or treat as a phobia

Contact me at Embodied Living for help on resolving your panic attacks.

So What Lies Beneath Panic Disorder/Attacks?

Rather than a ‘mental disorder’ this is a disorder of our system. A fault in the operating system, like a virus on the hard drive. It is a product of living in a chronic emergency mode of attention: the sympathetic nervous system is in permanent overdrive. Like a car that has the accelerator stuck to the floor. Sometimes this chronic engagement in the ‘fear, flight or fight’ mode is the ‘system’s’ way of keeping fearful or high-intensity memories and feelings at bay. And often the cause of panic attacks is routed in a highly stressful or traumatic event.

When the accelerator is stuck to the floor like this, we live in a state of chronic narrow focused attention. Our brain is in overdrive, with high intensity thoughts that are one tracked, tunnel vision thinking, focused on the fear. Our body is flooded with the stress hormones of cortisol, noradrenaline etc which shut down non-essential blood supply, such as that to higher regions of the brain. So we are actually less able to think ‘big picture’ and therefore less able to problem solve and put things in perspective. And this narrow focus keeps us in the high state of anxiety; we literally can’t see the wood for the trees.

“Anxiety is the state of twentieth-century man.” ~ Norman Mailer

If this is true, perhaps panic disorder is its 21st century progeny? Panic attacks are horrible: they come on suddenly, for no apparent cause, characterised by a severe fear that can peak within 10 mins. This is accompanied by symptoms such as excessive sweating, nausea, disturbing thoughts about harming oneself or others, fear of loss of control or that you are becoming insane.

For me, the Edvard Munch painting ‘The Scream’ – pictured right – epitomises this condition, which both men and women suffer and which can have a negative effect on a person’s life. Many sufferers struggle with this condition for many years, and can give up hope of ever getting better or refuse to believe their condition is treatable. In many ways this is understandable, when this disorder has you in its grip, it is a very scary place to be.

Nevertheless, this is the most treatable mental disorder. And treatment is very effective. When I am working with my clients, regardless of what condition they have, I tell them ‘it won’t last’. Of course, I know they will get better, but often people experience rapid changes in a session or two, and can get very ‘attached’ to this change. And of course, such change indicates that ‘the system’ is learning. Whilst changes do happen quickly, it is important that people know that the system has a mind of its own that needs time and practice to make lasting change. Otherwise, they will too easily become disheartened.


But the nervous system is very malleable and these chronic symptoms can be reversed. In order to release the long-held anxiety we need to educate our system into moving into a softer, more ‘open focused’ way of being. This involves sedating the sympathetic nervous system and tonifying the parasympathetic nervous system.

Embodied Living works initially on the somatic mind, using practices such as:

  • yin yoga and yoga therapy – calming, nurturing and supportive practices
    breath work – re-educating the breathing system
  • self-hypnosis and deep relaxation techniques
  • mindfulness-based practices such as Open Focus and antar mouna – to help us shift our style of attention
  • biofeedback – using heart rate variability and brain wave monitoring to coach the system into coherence

Once our body-mind and physiology have normalised, and the system is more in balance, we can then work on the cognitive mind. By working with NLP and cognitive behaviour techniques we can learn to change our thinking. And psychotherapy can also help us to understand the emotional causes of anxiety.