by Anita Frankel, M.A., M.F.T.

Panic is our stress response on steroids. Literally.

When we are suddenly confronted with our vulnerability in the face of danger, our thoughts trigger the lower brain to begin a cascade of activity which prepares us to fight or flee. It’s not subtle. There is a quick release of steroid hormones and a rush of adrenalin, which make our heart beat faster, our breathing shallower, and our palms sweaty. Blood vessels constrict in some areas and dilate in others, to bring more blood, and hence more oxygen, to the major muscles. One of the areas with a reduction in blood flow is the brain itself. As the visceral activity proceeds, the physical tension and the loss of equilibrium give our oxygen-starved mind more reason to keep pressing the panic button.

We call this self-reinforcing conversation between mind and body the Stress Response. It evolved as a survival tool for mammals, and protected our Stone Age ancestors who had to flight or flee from fierce creatures. It also became useful for competing with other humans for scarce resources, and for arousing a fighting spirit in warriors. The first guided missiles were wooden clubs hurled in fear.

For those of us living in more peaceful and prosperous circumstances, the threats to our well-being are more complicated. Our sense of safety often involves the presumption that we are seen by others as deserving of respect, that our needs are legitimate, and that our ideas are worthy of consideration, no matter how we stumble to express them. And so the anticipation of falling outside the circle of respect, of becoming socially “unprotected,” is a thought that can feed the Stone Age machinery of alarm.

Once the Stress Response cascade begins in full, it becomes very difficult to think of alternatives to Fight or Flight. We are disconnected from everything that is not happening to us NOW. Our self-talk becomes part of a self-reinforcing loop. Eventually, as the evidence of imminent danger becomes less compelling to our conscious mind, our animal brain ceases sending panic signals, and the body, exhausted, relaxes.

And yet, precisely because the stress response is a looped conversation, we have some power to change its direction before it spins out of control. If we can change the self-talk early enough, and introduce some different instructions to the body, we can cool down the cascade, and even reverse it. We call this the Relaxation Response.

Training the Brain

In my practice, I often suggest relaxation and guided imagery exercises for clients who are seeking ways to manage stress. Before introducing exercises, we hold some unhurried conversations to learn what kinds of past events have led to feelings of helplessness, and what present situations trigger the mind-body cascade.

We try to identify the expanded choices and strengths which they have as an adult, in comparison to the state of vulnerability and helplessness earlier in life. Getting clarity about one’s process under stress can itself be a calming event for many people.

After those preparatory sessions, I invite my client to stretch out comfortably, and we record a guided relaxation exercise. I might begin by giving instructions for tensing and relaxing muscles, and for changing the rhythm of one’s breathing. These things “remind” the body that we can take conscious control over processes which are usually autonomous. If the mind is distracted by thoughts of problems to solve, or deadlines to meet, I suggest imagery to put all problem-solving thoughts aside, to permit oneself the pleasure of No Tasks.

As the mind and body become more accustomed to the relaxed state, I may integrate one or more messages from our conversations. I might also suggest that my client have a silent conversation with an imaginary “Inner Advisor” about a given stressor. It’s often useful for clients to tap into their own store of knowledge, with their own language and imagery. The Therapist is not the only therapist in the room.

If a client has come for help with a particular problem, such as stage fright, we can spend some time in conversation to deconstruct the episodes into a step-by-step progression. Then we can record some “desensitization” exercises, visualizing the stressful situations and making use of the relaxation techniques that we’ve been practicing.

With some consistent practice, it is possible to dial down the alarm that arouses panic in us, and confront with more calm and confidence the challenges in our lives.

Anita Frankel practices in the Beverly Hills/Los Angeles area and is a member of the Independent Psychotherapy Network. She can be contacted at 323-661-0297 or