Ep 63 - Taming Fear and Panic using EMDR
White knuckling, shaking in my boots, shaking like a leaf, scared stiff, hairs standing on end, wound up, highly strung… can you guess what we are talking about today? These are all beautiful descriptive terms for the way the body responds to the emotion of fear. Otherwise know as dread, or panic, terror, fright, worry, trepidation, anxiety. One of THE most common presentations to your local psychology practice. And of course fear, at its most strong presentation, panic or terror, lies at the very heart and centre of PTSD and CPTSD, which are my bread and butter. Most people get PTSD or its complex cousin CPTSD from a time or times when they have been literally scared out of their wits. When the fear has been too much to cope with, and their brains have momentarily gone a bit off line and neglected to process that particular memory in the normal way, so those events become stuck the trauma centre of the brain and keep activating the amygdala to keep on generating the fear, long after the threat has passed.
Fear is very adaptive - of course we need it, to help keep ourselves safe. We have needed fear since time began, and I could safely say that all animals experience fear and also, have a similar fear response in the body. It is an instant, not premeditated, instantaneous response to a life threatening situation, and what our bodies do in that moment is to pump a whole lot of adrenalin, cortisol and other hormones around our body to help the muscles work, to run away fast, to help our eyes see better and our pupils dilate, help us hear better by focussing on the registers of high frequency noises (like screaming) and low frequency noises (like lions roaring) , and tune our unnecessary middle range noises (like the human voice), to stop digestion and other unnecessary bodily processes. Even the hairs standing on end have a function - to make us look bigger (like a cat). So all of the physical feelings of fear have a very definite function. But of course feel awful. Who wants to sweat and palpitate and feel muscles tense and mouth dry up? It’s necessary if we are in that immediate threat, but why do we need to feel that every day, when we are in ordinary circumstances? If we hadn’t had trauma, we wouldn’t, if we hadn’t been exposed to very scary events, then in everyday life we would feel calm and settled and easy. But as a result of the original event, lets say a car crash, our brain registers that memory and all the details around it, to be frighting circumstance - our brains learn that the car, the steering wheel, the road, a red traffic light, a right hand turn, whatever the triggers may be, our brains learn that they are frightening things, and they get sort of stuck in the pathways of the brain with that red flag label of ‘scary’ so then we respond immediately to those triggers, We have no control over this, the trigger is lightening fast, instant. It bypasses the thinking brain, the planning frontal cortex and all those executive functions and immediately allows the release of all those fear hormones and the feeling of fear in the body then takes hold and takes a bit of time to resolve and settle. What we do in EMDR is to effectively retrain the brain that those triggers, the traffic light, the right turn etc, are not actually scary. As we are processing the memory, with the bilateral stimulation, the brain is able to allow those memories and triggers to be reallocated in to the long term memory systems, to be in effect re-filed as not scary, not needing attention, just like reallocating non -urgent to our emails in our inboxes. We kind of take the red flag off the memory. And having done that, there is no amygdala response, we don’t flood with adrenalin, and we can stay feeling safe and calm. So in this car crash example, we might process the event, all the details of the event, the outcome of the event, all the individual triggers, and once we have done that, often the fear dissipates and resolves.
And what about when we are fearful of fear itself? This is the classic panic attack sequence, actually. We become fearful of our bodies, fearful of our own brains response to the event. How panic attacks start is usually because we feel afraid, we show all the symptoms of fear, shaking, heart racing, nausea, dry mouth, feeling scared, and then that state makes things worse for us in some way - maybe we get teased for looking scared, maybe we get beaten for freezing up, maybe someone yells at us for being a wimp or not helping the situation. So then we interpret that as our state of fear in our body being a dangerous thing, as it contributed to being abused further in some way. So let me give you an example. Maybe a young person is on a train for the first time. Maybe they have experienced some difficult family situations and already have the belief that the world isn’t safe. Maybe they are a bit anxious because they don’t know when to get off, and they are with their friends who have all done it before. So when this young person shows some anxiety “oh no , I’m going to miss my stop”, and all their friends laugh at them, then they learn that anxiety is not acceptable, that if they show anxiety they will be publicly humiliated, and shamed in front of the group, so the next time they get on a train, they still feel anxious, maybe more anxious, and when they notice the anxiety showing up in their body, they notice the fear, then they get more afraid, they are afraid of their own fear, thinking, last time i was in this situation things got very bad, very humiliating, and this all snowballs and they can’t express it (for fear of humiliation), they try to keep in under wraps and finally it gets so big they start hyperventilating, they are stuck on the train, can’t get off, they start crying and gasping, and have a full blown panic attack. Awful to experience. And what they learn is that trains aren’t safe, that feeling anxiety in the body is going to lead to a panic attack, and that they have no control over their fear. Then very likely they will decide to take the bus instead of the train, even if it takes an extra hour to get home, just to avoid that feeling of fear, and avoid the possibility of it taking over and escalating in to a panic attack.
So EMDR treatment for anxiety or for panic attacks is actually very simple. We look at the underlying reasons for not feeling safe - looking for difficult early experiences, then we look for how the anxiety turned in to panic attacks, maybe the first panic attack, and process those experiences, look for some of the bad times they had a panic attack, process those, look for some of the triggers for the panic attack - the train, or the right hand turn, or the sign of the car door, we may need to process those. We may even look for the internal triggers - the feeling of being short of breath or breathing hard, or the feeling of sweaty palms, and process those, so there is no longer the fear of ones own body. We might process some future fears, and help the client feel stronger and more capable in life generally.
Simple right? Well, like all answers, nothing is all black or white. Depending on the amount of trauma a person has experienced, it may take a little longer, or be a bit shorter than others. And sometimes the feeling of fear is so awful and has so many bad memories, that we can’t just jump in and do the EMDR straight away, we may need to build some confidence in being able to sit with the fear for long enough to do the work.
And I can just hear people asking - but I get panic attacks and I never had trauma? And my answer to that would be, there is usually trauma, big T or little t, and it needs the skill of the therapist to help tease out those underlying factors and sensitivities.
But my overall message is this - having fear every day does not have to define the rest of your life. It is treatable, there is help, and if something I have said resonates with you or your experience, please go and find a local EMDR therapist - there are plenty of great therapists around, very likely one in your local area.
If you are an EMDR therapist and want to chat to me about anything you have heard today or on another podcast, please reach out for Consultation, I will post a link in the show notes, or email me at [email protected]
I hope this has been helpful to you, I will talk to you again next week, in the meantime take good care, bye for now.
