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Panic attacks and traumatic stress may be helped with mindfulness psychotherapy

Sally* is a 50 year old woman who came to see me in Surry Hills after a month of having severe panic attacks. These started first thing in the morning. She experienced shortness of breath, tightness in her chest, racing heart, trembling hands and legs, nervous sensations in the belly, irregular breathing and a sense of suffocation and impending doom. Often there would be no trigger for these panic symptoms. They would be intense for around 30 mins then would persist in varying degrees all throughout the day.

These panic feelings were impacting her ability to work effectively and maintain a social life. Sally often thought during these panic attacks that she was “going crazy” and perhaps there was “something deeply wrong with her”.

Ordinarily, Sally was a highly competent, robust individual who had never really experienced any severe anxiety or panic symptoms. However, she had just been through a major life change – she had relocated to Sydney from overseas after leaving a highly traumatic and abusive relationship. This relationship involved experiences of feeling a combination of complete overwhelm, helplessness and fear. One of the coping strategies she had adopted was to “keep going and push through” with a focus on action- oriented outcomes.

There was also a past history of accumulated grief from her recent mother’s and her late husband’s deaths, which she admitted was still unprocessed within her. She was holding traumatic stress in her body.

Sally was interested in helping herself as much as she could. Although she came to see me as a GP, she did not want to use medication unless it was absolutely necessary; she preferred to turn to mindfulness psychotherapy to help her.

Mindfulness psychotherapy may be healing

Through our weekly sessions together, she learnt how to use mindfulness to slow things down and observe her internal experiences without getting completely hijacked by them. She learnt to build and discover resources within her body and mind that helped her panic symptoms. By understanding and learning how to calm her internal world Sally felt empowered to then begin processing and integrating her previous ‘undigested’ memories and feelings.

This process allowed her to make sense of what has been senseless before and to regard the feelings in her body as useful information rather than something to be avoided.

Sally now experiences significantly less anxiety. More importantly when the waves of anxiety do arise, Sally now can work with her internal states, rather than let them escalate into full-blown panic as it had before. Mindfulness psychotherapy has allowed her to witness her thoughts and feeling and get a gauge on how they impact on her body. By working directly with and navigating the information held within her body, Sally now draws upon “safe” places, both inside and outside the body to regulate her arousal and bring her back into the present moment.

She reports feeling less reactive and acting less automatically and can now make decisions based on choice.

How does mindfulness psychotherapy help panic attacks and traumatic stress?

Sally’s panic attacks were a reflection of traumatic stress stored and held within the body. As a whole, our bodies are highly intelligent systems, equipped for stress and even trauma. When there is a perceived threat, our bodies will instinctually activate our “flight/fight/freeze” mode to take action and respond to danger. This then leads to a complex biochemical cascade within our bodies that orients us for survival.

Ordinarily, we can usually cope with great stress for a period of time as long as it is temporary and/or we can make sense of what has happened to us. However, when we are faced with trauma, this survival response becomes frozen and our bodies are unable to discharge all the pent up energy. We keep re-living what has happened, even when there is no obvious threat – it’s like a bad tape that keeps playing over and over again, without an option to pause or stop. So by using mindfulness to slow down, we begin to examine more carefully what is happening and to take in new information that would otherwise have never been noticed or would have been dismissed. We learn to develop a new language for reporting on our own internal experiences and finally begin to get to know intimately our emotions, thoughts and beliefs that held us captive for so long.

* Name has been changed

This case study is for educational purposes only. Results may vary due to individual circumstances.

Dr Marie Paek – General Medical Practice, Mindfulness Psychotherapy

For more information see:
www.hakomiinstitute.com
www.hakomi.com.au