Panic Disorder – The Mind in Conflict

An individual experiencing a panic attack feels an undeniable wave of fear for no particular reason at all. The individual heart begins to beat rapidly, his chest hurt and it become increasingly more difficult to breathe; at which time the individual believes he is having a heart attack and will die if he does not receive proper intervention.

One patient defined his symptoms in this way: I am so afraid; every time I start to go out I get that awful feeling in the pit of my stomach, and I am terrified that another panic attack is coming or that some other unknown terrible thing is going to happen to me or someone in my family.”

Panic attack generally last no more than a few minutes, but it can be the most distressing condition that a human being can experience. Individuals who experienced one attack will have others. Those who experience repeated attacks, or feels heightened anxiety about having another attack are considered to have developed panic disorder.

Panic disorders are a serious health problem in the United States. Recent studies concluded that about three million people will experience panic attacks at some time during their lives. The symptom is strikingly different from other types of anxiety. Panic attacks are very sudden and often unexpected, seemingly unprovoked, and are often disabling.

Panic attack can occur at any time, even during sleep. An attack often peaks within ten minutes, but some symptoms may last much longer.

What causes panic attacks: And how do you treat panic disorders?

One approach to understanding the cause of panic disorder is that the body’s normal alarm system the mental and physical mechanisms that allows a person to react to a threat, tends to be triggered unnecessarily, when there is no real danger in the immediate environment. Most medical studies are unable to explain exactly why this happens.

However, several psychological studies have showed, the root cause of panic disorder may begins on the emotional level or the physical side, or it could be both. The feeling of heightened-anxiety always begins with a trigger that initiates the fight or flight response from the limbic system. For example, the first hint of apparent danger your brain chemistry, blood hormones, and cellular metabolism all goes into action.

When you have a chronic anxiety disorder over time your anxiety symptoms may be triggered by less and less serious events because the limbic system has been sensitized to react in a highly panicky manner.

For example, if as a child you were constantly yelled at; as an adult you may feel anxious whenever there is potential for confrontation with an authority figure; and you may go to extreme measures to avoid such confrontation, even in a situation as benign as refusing a simple request by a family member or anyone of authority figure. At this point your conscious mind has lost track of the connection between your current feeling and your past emotional experience. You now have no idea why you are feeling panicky about something of so little significant.

Past emotional experience

Early emotional experiences are the birthplace for the development of panic disorders. The experience may had been early childhood trauma, such as the death of a parent, divorce, child abuse, constant criticism, abandonment, deprivation, or a highly emotional family social environment; highly anxious parents, including alcoholic and drug addicted parents.

Childhood is a time of little power and control. When bad things happen to children their coping mechanisms are not fully developed; they are unable to process what had happened in a health way and move on. In a very real sense, these adverse childhood experiences are trapped deep within. As an adults, those hidden issues often surface as anxiety symptoms. It may be difficult to connect what is triggering your panic state to your past experiences; but there is always a link.

Past experience have taught me that you shouldn’t attempt to treat panic disorder unless you are willing to address it from many sides; this approach can be time-consuming and emotional-intensive work, which conventional practitioners, too often, tends to avoid. Instead, anti-depressants are given out like candy to panic patients to calm their physical symptoms. However, it doesn’t matter what type of panic symptoms you are experiencing you must address the emotional component if symptom reduction is to be achieved.

Mode of treatments

There are a wide variety of treatments available for panic disorders, including several effective psycho pharmacology interventions, and specific forms of psychotherapy. Psychotherapy for panic disorder is equally important as drug intervention. Several studies shows that the combination of medication and psychotherapy treatment for panic disorder is more effective than either intervention alone.

Cognitive Behavioral Therapy (CBT) is widely accepted as the superior form of psychotherapy. CBT is designed to help those with panic disorder identify and decrease the irrational thoughts and behaviors that reinforce panic symptoms.

Psycho dynamic psychotherapy is another form of intervention that is seldom mentioned as an appropriate treatment for panic disorder. In fact, many therapist strongly reject the idea of using psycho dynamic techniques as an intervention to reduce the symptoms associated with panic disorder.

What set psycho dynamic therapists apart from the rest is their ability to recognize one indisputable fact: Panic states may, symptomatically, appear to be identical weather they are produce from a neurotic condition or from a manic-depressive state.

Clinical research indicated that neurotic type of panic states should be treated solely with psychotherapy; and manic-depressive states are to be treated with one of the many effective anti-depressive drugs. Proper differential diagnosis is the super-highway to symptom reduction for all psychological disorders, including panic disorder.

Treating panic disorder with psycho dynamic techniques

although studies have shown the effectiveness of cognitive-behavioral and psycho pharmacological treatments; many patients fail to respond positively to these interventions or have had persistence or recurrence of symptoms. Given the high costs and reappearance of panic disorder;there is a need to explore treatment options.

Psychoanalytic techniques are commonly used to treat panic disorder but have rarely been exposed to the rigor of scientific research procedures. Such a study would highlight and describe the psychoanalytic concepts involved in understanding panic disorder. While at the same time proposes a more “client-friendly” psycho dynamic psychotherapy for panic disorder called panic-focused psycho dynamic psychotherapy.

The potential benefit of this form of therapy is based on the belief that panic patients have a psychological vulnerability to panic disorder associated with personality disturbances, relationship problems, difficulties tolerating and defining inner emotional experiences, and unconscious conflicts about separation, anger and sexuality. Psycho dynamic psychotherapy focuses more, but not exclusively, on these impairments than other therapies, including psycho pharmacology, potentially reducing vulnerability to symptoms recurrence.

Unconscious emotions

According to psychoanalytic theory, panic symptoms are based at least in part on unconscious fantasies and affects In fact, both clinical and research observation suggests that panic patients have special difficulties with anger feelings and fantasies, such as wishes for revenge. These wishes often represent a threat to important love ones, especially those we have a close attachment to; therefore triggering a panic attack.

Patients are often unaware of the power of these affects and the revengeful fantasies that accompany them. Becoming aware, by bring them to consciousness, of these negative aspect of mental life and render them less threatening are important components of psycho dynamic psychotherapy.


Since panic disorder remains a major health problem in the United States it is important to continue to develop effective approach to its treatment. Panic-focused psycho dynamic psychotherapy will be a useful alternative or adjunct to cognitive-behavioral approach and medication. Psycho dynamic therapy addresses intra-psychic conflicts, defense mechanisms, and developmental issues not likely to be focused on in other therapeutic methods

Psycho dynamic approach also affect psychological factors that lead to vulnerability to recurrence panic state, or other difficulties connected with a panic disorder. A complete and randomized controlled trial should shed further light on the effectiveness of panic-focused psycho dynamic psychotherapy.