[lit-ideas] Re: Tune and Turn Off - Panic Attacks
- From: "Andy Amago" <aamago@xxxxxxxxxxxxx>
- To: lit-ideas@xxxxxxxxxxxxx
- Date: Sat, 6 May 2006 12:39:04 -0400
> [Original Message]
> From: Donal McEvoy <donalmcevoyuk@xxxxxxxxxxx>
> To: <lit-ideas@xxxxxxxxxxxxx>
> Date: 5/6/2006 11:12:36 AM
> Subject: [lit-ideas] Re: Tune and Turn Off - Panic Attacks
>
> The story of panic attacks:-
> 1. Before David Clark?s work, the prevailing orthodoxy was that panic
attacks
> are primarily ?biological? rather than ?psychological? because:-
> a) they can be induced biologically (using sodium lactate infusions, for
> example).
They can/are induced by poor breathing techniques. Taking an extra breath
every X number of breaths will induce a panic attack. Sit on the edge of
your bed and breath quickly and shallowly and you'll have a panic attack.
The breathing changes (if I remember correctly) the acid/base balance of
the blood (lactate sounds like a base). The point, however, is there's an
unconscious psychological need to induce the panic in one's self through
shallow breathing.
> b) apparent heritability: more than half of sufferers have relatives with
> some anxiety disorder or alcoholism; and if one of two identical twins has
> panic attacks then 31 % of co-twins has them whereas if one of two
fraternal
> twins has them none of the co-twins are so afflicted.
Thinking patterns are also inherited. How something manifests depends on
any number of family/society/personal chemistry variables. That it's there
to manifest in the first place is the problem.
> c) specific brain functions appear to be involved with sufferers showing
> abnormalities in brain chemistry and abnormal blood flow and oxygen use in
> the relevant parts of their brain.
As Monsanto or Dupont says, without chemistry life itself would be
impossible. Everything is chemistry. But does the behavior or the
chemistry come first? Psychologists will say the behavior/thinking/lack of
appropriate emoting come first. Insurance companies won't pay for
expensive therapy, but they will pay for short visits to a psychiatrist for
drugs, which, sort of, change chemistry without addressing underlying
problems.
> d) drugs can dampen and even eliminate panic attacks.
>
Right. So does alcohol, and opiates and meth, and even cigarettes,
separate and apart from the glam that advertising gives cigarettes.
Gambling too churns out feel-good brain chemicals that become addicting.
> 2. Clark turned this on its head; he argued ? what if an apparent symptom
of
> a panic attack (feelings of morbid dread, of having a heart attack, of
being
> about to faint etc. ? in general terms, a catastrophic interpretation of
> bodily sensations) was actually their root cause?
>
Another way of saying, if I worry about having a panic attack, I don't have
to worry about [fill in the blank].
> 3. This theory fits the biological findings well:
> a) sodium lactate makes the heart race creating an initial bodily
sensation
> that it is then interpreted catastrophically.
> b) panic may be partially heritable because having a particularly
noticeable
> bodily sensation (e.g. palpitations) is heritable not because panicking is
> itself heritable.
> c) specific brain areas are activated not as a cause but as a symptom of
> panic.
> d) drugs relieve panic by quelling the unpleasant bodily sensations that
> provoke a catastrophic reaction.
>
All chicken and egg problems.
> 4. Clark and a fellow researcher, Paul Salkovskis, did further experiments
> that showed:
> a) persons with anxiety disorders are quicker to see the catastrophic
ending
> of a sentence than ?normals? (showing they have a catastrophic way of
> interpreting).
> b) persons prone to panic attacks, but not ?normals? or recovered panic
> patients, can have panics induced by reading aloud word pairs such as
> ?breathlessness-suffocation?.
>
Another way of saying that panic prone people are more fearful than
non-panic prone people. That's why the first two years of life are so
critically important. Don't pay attention to that child while he's crying
(or other seemingly innocuous parental responses) and risk forming all
sorts of fear imprints. Add to that spankings, especially with belts and
other things, parents screaming at each other and at them, needed to please
a parent, etc. etc. and there's plenty in the unconscious that's fearful.
> 5. Clark also helped develop a new cognitive therapy for panic attacks
that
> appeared highly effective ? more effective and less dangerous than drug
> treatment. It involves explaining the physiological mechanics of a panic
> attack ? for example, that though a person might feel about to faint this
> could only in fact happen if their blood pressure dropped but during an
> attack blood pressure shoots up; the feeling of faintness is due to a
small
> drop of oxygen to the brain caused by blood being diverted to the muscles
> away from the brain as part of a ?fight-or-flight- response to perceived
> danger.
>
Therefore, psychological options are effective. The person still has the
panic attack to focus his life around, but it's manageable. Win/win.
> 6. The success of this therapy nevertheless does not show the cause of
panic
> attacks is cognitive. Clark?s simple and devastating differential
prediction
> is as follows. Panic-patients were given an infusion of lactate and?Oh
god,
> I?ve forgotten it again.
>
Yes, we practice the art of medicine ...
> Donal
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