Dear Alistair

I have been experiencing sudden attacks of anxiety recently, when my heart starts to pound, I become a bit shaky, and sometimes I actually fear that I might faint. I consulted my GP who suggested that I am having “panic attacks” and that they are nothing to worry about. He prescribed some anti-anxiety medication for me to take when I am starting to feel anxious. I don’t want to become dependent on this medication and want to know if psychological therapy is another way to stop these attacks from happening?

It certainly does sound as though you have been experiencing panic attacks. These are part and parcel of what is termed Panic disorder. It is different from the normal fear and anxiety reactions to stressful events in our lives. It is a debilitating condition that generally strikes without reason or warning. The numerous physical symptoms are horrible enough but, over time, a person with panic disorder will often develop a constant fear of having another panic attack, which can then have a very negative effect on daily functioning and general quality of life.

So, can panic attacks can be prevented through psychological therapy (also termed ‘psychotherapy’). The answer is a definite “Yes”. A very effective approach, used by some psychologists, is termed mindfulness therapy. This approach often includes teaching the individual various relaxation techniques such as breathing ‘retraining’ which may help you during an attack.
Mindfulness Therapy is a lot more than just a collection of relaxation techniques however. It teaches you to how engage with the anxiety and/or feelings of panic in a counter-intuitive, but highly effective, manner! For example, you are taught how to “sit” with your anxiety and panic. This means that you learn to hold the emotion in your awareness without reacting to the emotion in the “normal” way, which is usually to try to push it away and/or to get rid of it.

At the core of panic disorder you will inevitably find a number of common thoughts and/or beliefs that trigger the panic attacks. In the Mindfulness Therapy approach, we realize that the problem is not simply with the content of our thoughts or beliefs, but with the emotional energy that gives such power to the negative thoughts. Thus the emphasis is on finding ways to change this emotional energy, allowing it to discharge and resolve itself. Then all that remains is an “empty thought” which ceases to have any particular meaning or power to cause anxiety or suffering.

This fundamental change in relationship from being carried away by the powerful emotion to one of being able to observe the emotion as an object, which we hold in our awareness is pivotal. The negative thoughts and beliefs lose intensity (and their power over you.)

In terms of the outlook for people with Panic Disorder, with appropriate treatment, nearly 90% of people with panic disorder can find relief. Without treatment, however, panic disorder can have serious consequences and can severely impair quality of life. I admit to being completely biased, but would strongly encourage you to consider the psychotherapeutic options!