Dear Dr. Norquist:
I know you’ve written about panic attacks before, but I can’t remember what you said. I feel panic-y whenever I have to drive on the highway. I had a near accident two years ago (not my fault, by the way), and now my heart pounds uncontrollably and I start to panic whenever I try to drive on the highway. As you can imagine, this really limits where I can go. What can I do about it?
Dr. Norquist responds:
The panic you experience is a normal reaction to a near accident. The shot of adrenaline provided by your body to handle this threat to your survival has the side effect of a racing, pounding heartbeat. In an effort to protect you from future danger, your brain has associated driving on the highway with a survival threat – hence your body’s continued panic when you drive on highways. The way out of this dilemma is to slowly but surely give your brain many positive experiences with driving on the highway. I know this isn’t easy to do after a panic attack but it is essential so that your mental, emotional, and physical world is not constricted.
Trying to control your symptoms traps the anxiety within you. So, start by just allowing the panic sensations to arise within you while you watch them, as if from a distance. Panic comes in a wave because the adrenaline takes a minute or so to dissipate throughout the body. Could you practice just observing this wave (watching it rise and then pass)? An attitude of curiosity will be useful here as you observe your bodily sensations. This becomes easier with practice.
Your overall goal is to redirect your brain’s focus – to jar it into a different neural pathway. There are many ways of doing this, for example, humming or singing, reciting a poem, praying, or even counting backward from 100. Decide ahead of time which option(s) you will use. Another option is to concentrate on a focal point. Staring at something long enough actually triggers a relaxation response. In staring, you switch from thinking to observing, further reinforcing the relaxation response. You could also focus on your breathing. Try counting to four as you breathe in, holding your breath for four counts, then releasing it slowly to a count of eight. While focusing on your breathing, imagine yourself in your favorite “safe place.” This is a mental way of letting your brain know that it’s safe to relax. Take some time in creating the perfect safe place for yourself. You can make it just the way you like it. Play with the sounds, the images, the smells, and the physical sensations until your safe place is perfect for you. The more you practice all of these techniques, the more effective they become.
(Dr. Sallie Norquist is a licensed psychologist (NJ #2371) in private practice and is director of Chaitanya Counseling Services, a center for upliftment and enlivenment, in Hoboken.)
Dr. Norquist and the staff of Chaitanya invite you to write them at Chaitanya Counseling Services, 51 Newark St., Suite 202, Hoboken, NJ 07030 or www.chaitanya.com or by e-mail at drnorquist@chaitanya.com, or by fax at (201) 656-4700. Questions can address various topics, including relationships, life’s stresses, difficulties, mysteries and dilemmas, as well as questions related to managing stress or alternative ways of understanding health-related concerns. 2010 Chaitanya Counseling Services