Can This 6-Second Trick Prevent a Panic Attack?

Anyone who has ever experienced a panic attack knows how hellish it feels. A panic attack is the feeling of extreme anxiety taking over your entire body. On average, they can last around 20-30 minutes. However, some people can remain in a state of panic for days. Symptoms of a panic attack include hyperventilation, a sense of danger, rapid heart rate, chills, hot flashes, nausea, abdominal cramping, dizziness, numbness, and trembling or shaking. 

Human beings are physically programmed to either fight, run (flight), or avoid (freeze) when faced with danger. You can see how this biological wiring leads to the survival of the individual and the species. This was necessary for survival in the "caveman days," however, this is not the case presently. Nowadays, this biological programming is rarely needed but is often activated.

For example, this response was activated hundreds of years ago when a lion was going to attack you and your family. You would either survive the attack by freezing, fighting, or fleeing. You would experience an immediate rush of adrenaline and pick one of three F’s to handle the situation. Currently, people will have this same response activation, but to situations that are not actually dangerous.

For example, a high school student receives a letter in the mail from the admissions department of the college that he really wants to attend. The student is staring at the envelope not knowing if he will find a rejection or an invitation to the institution inside. Immediately, that fight/flight/freeze reaction consumes him and adrenaline begins to kick in while he is opening the envelope. Clearly, an unopened envelope in your hand is not the same as a vicious lion chasing you, yet the physical sensation feels the same. Why would that be the case? We have created a society where we have something I call “associated fears.” An associated fear is when we associate the fear of not having a career and not making money, and being homeless and hungry with getting rejected from college. So, the envelope is "not just an envelope" anymore, it may become "the way in which I will starve to death." This is why our primal reflexes get activated and we feel “danger.” 

An OCD sufferer can live in this dysfunctional pattern almost all the time. If the OCD is severe enough, the sufferer can often live in a state of freeze/flight. Notice that I left out the fight response. The fight response is one that an OCD sufferer ceases to use. In fact, when chased by a humongous and scary lion, most would not choose the fight response. Yet it is that natural response that is the needed behavioral treatment for anxiety and OCD. 

My six-second “trick” is one of the 10 strategies in the interruption phase of my RIP-R therapy. I call this strategy “drama.” Drama is a way to trick your body into believing that you picked the fight response in order to deal with “danger.” Here is how it works: You begin by imagining the worst-case scenario and then you have to physically respond to it like an actor who is completely overacting. Picture Jim Carey in the movie Liar Liar. In the film, he uses his body and his movements in an over-the-top way to express himself. 

In the case of the high school boy who is nervous to open the envelope from the college admissions office, he would imagine the absolute worst case—he does not get in, therefore, he never, ever, ever has a career, and he winds up homeless and then he dies. Next, he has to “dramatize” it or “physically act it out.” So, he might throw himself to the floor, curl up in fetal position, and begin crying and screaming, “Why me? Why me? My life is over! Goodbye cruel world!” There is no “too much” with this strategy. I once had a client go into a shower with all her clothes, shoes, jewelry, and makeup on. She fell to the shower floor with the water running all over her as she cried in hysterics on purpose. She not only avoided doing any compulsive behaviors, but she prevented a horrible panic attack. This approach has a very “get it before it gets you” feel. You are behaviorally fighting the danger. 

This technique is quick, powerful, and highly effective. The caveat is you need to use it almost every time you get a triggering thought that creates a sensation of danger. The next time you feel a threat coming on, get ready, set, action!

By Ilisa Kaufman, Psy.D.