Until now, panic attacks have been a problem without a consistently viable solution. The Anxiety and Depression Association of America reports that 6 million Americans have a panic disorder, but the most commonly used therapy, cognitive behavioral therapy (CBT), only stops panic in one out of seven people, and the drugs that are often prescribed to treat panic are highly addictive.
When author Tom Bunn was an airline captain, he began a quest that lasted many years: to find a solution that would help fearful fliers control their panic. He started a fear-of-flying course, went to graduate school, and became a licensed therapist. He attended one postgraduate training institute after another and experimented with different methods until he finally discovered a solution that works, which he shares in Panic Free: The Ten-Day Program to End Panic, Anxiety, and Claustrophobia.
Panic Free offers readers a step-by-step solution for training the brain to stop panic before it starts. We hope you’ll enjoy this excerpt from the book.
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If you have struggled with panic and found no relief, I know the frustration. As an airline pilot, I tried for years to help fearful fliers control panic, using every known method. Nothing worked.
After years of experimentation, I stumbled on a solution. Since then, every client who has learned this new way to manage anxiety has been able to control panic when flying. Though our principal aim was to control panic in the air, clients reported an unexpected benefit: they were free from panic on the ground as well. This approach changed their lives. It can change yours, too. This book can lead you to a future free from panic and claustrophobia.
This breakthrough, like many important discoveries, took place accidentally after years of searching for a solution. The search began in 1980 at Pan Am, where I was a pilot and volunteered to help with the airline’s fear-of-flying course. The pilot who led the course told participants they could conquer their fear of flying by letting go of control and by using breathing exercises to stay relaxed. The course ended with a “graduation flight.” Some participants got through the flight all right, but others panicked despite diligently performing their breathing exercises. The pilot in charge believed his advice was adequate. Unable to fault them on their breathing exercises, he told them, “You didn’t let go.”
Panic is an awful experience. Being blamed by people who don’t understand makes it worse. It was distressing to watch this scenario play out in course after course. The suffering — and my powerlessness to relieve it — set me on a quest. I set up a fear-of-flying course of my own, called SOAR. It included every known technique for combating panic. Some techniques came from mental health professionals; some came from panic sufferers. Each technique was helpful to some people in some ways. But all these techniques put together still weren’t enough to help every participant control panic.
The search continued. I went to graduate school, became a licensed therapist, and attended one postgraduate training institute after another. I studied Gestalt therapy, neuro-linguistic programming, psychodynamic psychotherapy, Ericksonian hypnosis, and cognitive behavioral therapy. Again, various aspects of these therapies helped some clients, but not all.
Cognitive behavioral therapy (CBT) was a new and seemingly promising approach. It is based on the idea that what we feel is caused by what we think. Therefore, to control our feelings, we must learn to control our thoughts. I developed new CBT-based techniques for clients to use on their flights. These new tools worked for some clients, but they did not work for those whose panic developed rapidly. For them, the slightest movement of the plane was like a spark that quickly turned into a wildfire. Emotion instantly overcame them. Even while using the breathing techniques I had taught them, they went straight into full-blown panic.
Looking back, there are two obvious reasons why CBT could not help these clients. First, though it’s true that panic can be caused by thoughts, it can also erupt with no conscious thought at all. Second, whether panic is triggered consciously or unconsciously, the real issue is something else: inability to regulate the intensity of feelings. Normally, intensity is regulated by unconscious processes. If these processes fail, imaginary threats can escalate quickly into the belief that life-threatening dangers exist. If escape is not immediately at hand, a person feels trapped, and panic results. CBT did not address the lack of unconscious regulation.
We can think of regulation as working like the thermostat in a home, which is supposed to keep the ambient temperature in a comfortable range. The thermostat does this job without our needing to think about it. We may not know how it works, but we know it isn’t working right if the room temperature soars to one hundred degrees. Similarly, your emotional thermostat is supposed to work without your needing to think about it. When you panic, something has gone wrong with that thermostat.
Which takes us back to the snag with cognitive behavioral therapy. Cognition is a conscious process, but the regulation of arousal — arousal being how revved up we are — is an unconscious process. CBT does not engage the unconscious part of the brain where regulation of arousal should take place. You probably know the old joke about the drunk looking for his keys. Though he lost them elsewhere, he’s looking for them under a lamppost because “that’s where the light is.” Unfortunately, when looking for the keys to unlock panic, I was like the drunk. I was looking not where the action was — where the processes of arousal regulation were taking place — but where the conscious processes were observable. It didn’t work. To find a solution to panic, I had to do what the drunk needed to do: leave the lamppost and grope around in the dark. I needed to stop looking at processes I could observe and start finding ways to understand and manage processes I couldn’t observe.
If a technique could be devised to control panic, it would have to work the way regulation is supposed to work: automatically and unconsciously. Once panic starts to develop, what a person does consciously — which is to say, cognitively — is unlikely to help. If we believe something life-threatening is happening, and there is no possible way to escape it, we panic. If, however, we can examine our thinking and see that the life-threatening thing is not actually happening, we won’t panic. CBT trains people to stop and examine their thinking. If they can do that, they can prevent panic. But in a state of near panic, most people are simply incapable of rational thought. Under stress, imagination takes over, and a situation that is not life-threatening is experienced as life-threatening. That is the first factor that causes panic. The second is the conviction that this situation, truly believed to be life-threatening, cannot be escaped. The person’s cognitive abilities desert them. As a client told me, “If you asked my name, I couldn’t tell you.” Someone in this state can’t examine what is going on in their mind skillfully enough to recognize its inaccuracy.
The therapist Jerilyn Ross was also looking for a way to help clients control panic that did not rely on cognition. She came up with a technique she called “thought stopping.” She instructed clients to wear a rubber band on one wrist and to snap it every time an anxiety-provoking thought entered their mind. She believed that the association of pain with the anxiety-provoking thoughts would inhibit the thoughts and keep them from causing panic.
Though this reasoning made sense, the idea of self-inflicted pain didn’t sit well with me. Instead of thought stopping, I tried thought redirection. I trained my fear-of-flying clients to bring a positive memory to mind each time an anxiety-provoking thought arose. For example, I taught an athlete to automatically shift anxious thoughts about flying to her memory of running the New York marathon. In her case, thought redirection worked. I taught a young man to redirect thoughts of flying to the moment he proposed to his wife. He did fine. So did several clients who redirected thoughts of flying to memories of making their wedding vows. But overall, the results were hit or miss. For some clients, this technique was helpful. For others, it did nothing at all.
One day, I was teaching thought redirection to a new client, the mother of a small baby. I asked her to name a powerful, positive experience she could use to shift her anxiety-producing thoughts. She said, “Nursing my baby.” I thought to myself, “You’ve got to be crazy. You’re going to get on the plane and think you’ll never see your child again.” Fortunately, I kept my thoughts to myself and went along with her idea. To my amazement, when she reported back, she said the flight had gone perfectly. She did not experience a single ripple of anxiety!
In the months that followed, a few more mothers chose to redirect anxiety-producing thoughts to nursing. They, too, reported complete success. Had we stumbled on a key to the problem? If so, what was it? Why did a memory of nursing a baby work better than a memory of running a marathon, scoring the winning goal, or graduating from college?
It soon became clear that these exceptional results were not due to thought redirection. Research by Sue Carter, Kerstin Uvnäs Moberg, and others has found that mothers produce oxytocin during nursing, and that oxytocin inhibits the release of the stress hormones that give rise to feelings of fear, claustrophobia, and panic. When my clients redirected their thoughts from their fear of flying to their memories of nursing, flying actually became associated with nursing, and being on the plane triggered the release of oxytocin, which blocked the stress hormones.
Nature inhibits the release of stress hormones to prioritize the child’s needs for nourishment. Suppose a new mother is nursing her child when she gets a call that relatives are on the way over to see the new baby. The house is a mess. Will the relatives understand it is impossible to keep up with housework when there is a new baby? Or will they criticize her? If the mother becomes anxious about their visit, she might stop nursing and clean the house. The baby would not get proper nourishment. Nature takes care of that problem. Though things that need to be done come to mind, oxytocin prevents the release of stress hormones so that she feels no anxiety to stop nursing and prepare for the arrival of the relatives.
Since I stumbled on this discovery, I’ve been able to help several thousand formerly anxious fliers control panic by linking flying to one or more of the ways nature causes us to produce oxytocin. This is an amazing result, because no environment is more problematic for panic sufferers than being high above the earth, with no control of the situation and no means of escaping it. It’s easy for them to persuade themselves that their fear is rational. After all, planes do crash. Turbulence can make a plane shake so hard that it may feel as though it’s about to fall out of the sky.
This special panic-inducing environment became the lab in which my clients and I developed advanced methods to control panic. The oxytocin link was only the first discovery. I knew that redirecting thoughts about flying to memories of getting engaged or saying wedding vows could be effective in controlling anxiety, but why? It is because in these special moments, the brain and the body are signaled to override the effects of stress hormones. This gave us two ways to control fear, panic, and claustrophobia. The first prevents the release of stress hormones; the second overrides their effects.
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Tom Bunn, LCSW, is the author of Panic Free: The 10-Day Program to End Panic, Anxiety, and Claustrophobia, which is the result of his many years addressing flight panic in his role as an airline pilot. He is also a licensed therapist, a regular contributor to Psychology Today, and a former U.S. Air Force captain who flew the Air Force’s first supersonic jet fighter, the F-100. Find out more about his work online at www.panicfree.net.
Excerpted from the book Panic Free. Copyright © 2019 by Tom Bunn.