Q: Hello Dr. Neuman. I read your latest post on psychology today “Beyond Panic Disorder: A Way of Living”. In it you mention imagination as an amplifier of anxiety. When having a full blown panic attack( heart pulperations, tight chest, swelling of the head, foaming of the mouth, ice cold hands, stiffness of the muscles, difficulty breathing, and thoughts of not making it) how do you control the imagination that is telling and showing you more then what is true, happening?
Thank you, Scott Bernard
A: You may be illustrating the effects of imagination. Panic attacks do not cause foaming at the mouth or swelling of the head.
The way to counteract irrational or exaggerated fears is by experiencing reality. For example, a child who hears the monster under her bed needs to be encouraged to look under the bed. If she is very afraid, she may need someone to be standing next to her when she does this. If she repeatedly hears the monster, or sees its shadow against a chair, she needs to look under the bed repeatedly. The reason why adults to not worry about monsters under the bed is that long experience has taught us there is no such thing.
Similarly, panicky patients need to remain in the phobic situation–while they are having a panic attack–long enough for the panic attack to recede, as it always does. If a patient has a really terrible panic attack without running away, he, or she, will discover that the panic attack does not cause loss of control or physical dissolution. If that person can repeat that experience ten or twelve times, the condition is usually cured–although a brief panic attack will still recur at increasing intervals for a time–but without frightening the patient.
– Dr. Neuman