Anxiety affects all human beings. Anxiety is adaptive as it tells us when there is danger and helps us to survive in emergencies. This “fight or flight” response kicks in when there is a threat and helps us to get out of the way or, at times, to fight that threat. Social psychological research tells us that a moderate amount of anxiety is adaptive in performance situations. Too much or to little anxiety is actually associated with poorer performance. However, some individuals experience anxiety when there is no actual threat. It’s as if the “fight or flight” system is going off when there is no actual danger. When this occurs, individuals can experience many uncomfortable physical sensations such as rapid heartbeat, sweating, blushing, and nausea. The mind may come up with thoughts such as “I am going to die,” “I am out of control,” and “I’m having a heart attack.”
When the emergency response system goes off and there is no danger and no medical problem, it is a panic attack. Individuals with panic disorder experience panic attacks that are sudden, out of the blue and are typically accompanied by physical symptoms such as racing heartbeat, chest pain, dizziness, and tingling sensations. Many individuals with panic disorder initially end up in the emergency room as they think they are having a heart attack or some other dangerous medical problem. Once medical causes are ruled out, cognitive behavior therapy comes into play.
Cognitive Behavior Therapy for panic involves several steps. The first step is to teach the individual about panic attacks and educate them about the symptoms. The next step is to teach the client to respond differently to the panic attacks and other anxious sensations. The therapist can actually induce symptoms of panic in the therapy office and help the individual to remain calm and sit with the distress. Finally, the client can start engaging in important aspects of life that they were avoiding due to fear of having a panic attack.
Cognitive Behavior Therapy is a highly effective form of therapy for panic and usually requires between 10 and 20 sessions. A concept from Zen Buddhism called Radical Acceptance is one of the most helpful skills that client may learns as part of the treatment. Marsha Linehan developed a type of CBT called Dialectical Behavior Therapy. One of the skills she developed is called Radical Acceptance. Many other cognitive therapists have also talked about acceptance as a skill.
Panic attacks (and many other issues) tend to fall under the spell of “What you resist, persists.” This idea tell us that that when we struggle with something, want it to just go away, and feel that it’s absolutely awful, it makes the problem worse. Similarly, there is the adage “What you don’t want is what you will have.” Radical Acceptance teaches us to let go of fighting with our pain. Radical Acceptance teaches individuals with panic attacks to work with and accept the anxiety, rather than to fight it. Ironically, acceptance often leads to decreased anxiety.
Radical Acceptance does not mean surrendering, enjoying or wanting more pain. Rather, it’s an attitude of “it is what it is.” It means acceptance of reality just as it is. When I work with clients with insomnia, we discuss Radical Acceptance of being awake in the middle of the night. Having difficulty sleeping tends to be associated with anxiety about sleep. Radical Acceptance does not mean we don’t still employ strategies to get back to sleep. But, it means that we work towards more helpful self-talk such as “Well, I’m up” (it is what it is) rather than ”This is so awful, I will never sleep again.”
So, whether you struggle with panic attacks, insomnia, or are just sitting in traffic and feeling anxious about missing your meeting, think of the idea of Radical Acceptance. Drop the rope of your struggle with reality, remind yourself that “it is what it is” and take a breath.
If you’re looking for expert and compassionate therapists in the Denver, Colorado, area, please contact CBT Denver online or call our office at 303-355-5133 to schedule your appointment.