'The fear of fear' is what one individual said to me.
"All I do now is to fear the fear of panic and that is adding a whole load of anxiety to me, that I just don't need".
For those who experience panic attacks, there is a real desire for many not to think about the 'fear of fear'. Yet, this is what their ruminations and thoughts latch onto. Which is why exploring how individuals have coped with previous anxiety producing situations is key, so that they start to reflect on their resilience and their ability to cope with panic in the future. Yet, the word 'coping' does not fully describe the reality, that those who have panic disorder, should be supported in working through the panic events so that they can see that the anxiety process reduces over a short period of time, that they have got through it and that previous coping mechanisms that they have employed do not have to re-engaged with.
Previous coping strategies may in fact be perpetuating the fear and thereby the panic and anxiety itself.
So talking through how anxiety is not harmful is important as part of the psycho-education process. As is the need to normalise anxiety - that it is a natural body reaction used to defend us and that those who have anxiety and panic attacks, have an over-sensitive and over-reactive sympathetic nervous system. Reducing the 'fear of fear' is therefore important which has a knock on effect of reducing thoughts and feelings that the individual is somehow 'faulty' or 'significantly different' than the general population.
Another way of anchoring clients who ruminate and who reflect on the past, is to help them to catch themselves and be mindful when they start to go into the ruminatory cognitive process. Staying in the present and the 'here and now' and noticing 5 things around them, is a useful way of anchoring them in the present moment, helping them to engage with the world around them and with nature itself. It is anxiety reducing and helps to make people feel that they are part of something larger and wider than them. This process is one of a number of tools to help sufferers of panic attacks to slowly build a mindset that accepts and lives with mental flexibility, rather than the inflexibility of mindset that anxiety creates.
Lastly, breathing techniques, and learning to let thoughts 'come and go' - much like leaves on a stream, are other useful tools that people with anxiety and panic attacks can use. These are all mechanisms that I use within my therapy sessions with clients.
