Andrew looks a bit ashen as he sits in your office. It’s his first session for help with a panic disorder that he’s managed on his own thus far in his life. But his new position at work requires him to travel. It’s not that he’s afraid of planes crashing, he tells you, it’s just that he’s afraid his panic might hit him while he’s in the air. “What if I’m sitting next to a colleague?” he asks. “Or what if TSA thinks I’m nuts, but I’m really just having a panic attack?”
According to Margaret Wehrenberg—anxiety treatment specialist and author of The 10 Best-Ever Anxiety Management Techniques—when it comes to clients with panic disorders, the first thing to discern is what they’re doing to avoid panic. “The problem with avoidance,” Margaret says in this video clip, “is it works. If you can avoid what you don’t want to do because you’re afraid you’ll be scared, you won’t be scared. So you get reinforced for avoidance. I want to know what my clients are avoiding.”
A key element in her approach is getting people to understand how their brain is overreacting and then teaching them ways to “stop panic when it’s underway and how to calm down the fear that they’re feeling.” But that begins with clients cognitively realizing there’s not a real threat. As she says, “They feel like there’s a real threat, but there isn’t. So that’s why understanding the amygdala and its reaction can be helpful.” Watch the video clip.
Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.
Margaret Wehrenberg, PsyD, is a clinical psychologist, author, and international trainer. Margaret blogs on depression and anxiety for Psychology Today. She has written nine books on the topic of managing anxiety depression, and her most recent book is Pandemic Anxiety: Fear. Stress, and Loss in Traumatic Times.