According to the DSM 5 (Diagnostic and Statistical Manual of Mental Disorders): “Panic attack is a sudden start of a brief period of time of intense discomfort , anxiety or fear, added by somatic or cognitive symptoms[1] (…)”. While “(…)panic disorder is the occurrence of repetitive panic attacks , usually followed by fear of future attacks or behavioral changes in order to avoid situations that might trigger the attacks. Diagnosis is clinical.(…)”
Continuing the previous Posts, for PA[2], panic attacks and disorders aren’t just quantitatively distinct. Panic attacks might be defined as periods of loss of reference. They are instants of sudden and violent horror in the face of danger, which trigger disproportionate behaviors (…)[3]. They are not at random. Loss of reference is associated with identity’s loss. If, for instance, John has panic attacks[4] every time he has to fly somewhere (aerophobia) it is necessary to investigate conflicts in the cause of phobia. Let’s say they lie on a conflicting memory linked to an oppressive atmosphere from childhood. John may practice behaviors to deal with panic attacks in trips (flights) and develop, on the other hand, claustrophobia or chronic breathing crisis – both replacing symptoms linked to the ‘lack of breath”. This is how the unsolved oppression is discharged in the body. Or Joseph, in another example, might find well succeeded strategies to deal with tics that happen in stressful situations (for example, at meetings of company he works for) and start, in turn, to stammer in similar situations (both discharge mechanisms associated with internal ambivalent /hesitant atmospheres). We have to search for the background of anguish and, when it is detected, we are able to track down “history of the symptoms. Once the person is aware of the original conflict it will , then, be worked out in psychological sphere and stop to be discharged in the body. By then, it is the right time to expose themselves, counting on psychotherapy’s support, to situations that used to trigger phobic or anxious behaviors before. It is , actually, the same strategy used for sexual identity blocks. The difference is to understand which anguish lies in at the root of symptom. Panic disorder, in turn, is defined by the “loss of ground”. Although behaviors might sound as disproportionate to real danger, they are proportionate to the loss of “psychological ground”[5]. It is not by chance that potential panic attacks that might indicate possible panic disorders in late adolescence (transition to adult’s life) start insinuating in puberty. This is the stage when children’ identities are changing and “psychological grounds” in this phase, are vulnerable by nature. In adulthood, situations that might trigger panic disorders are associated with the abrupt interruption of life direction: loss of jobs, of dear people (from family, in short, roles or conditions that used to define person’s identity (psychological ground) before. As in panic attacks, the strategy is to investigate the background of anguish, in order to reach the conflict in the origin of symptom. Both panic attacks and Panic disorder mix the three kind of anguishes: neurotic anguish- threaten atmospheres that are disproportionate to reality-, existential anguish- regarding direction or purpose to life and circumstantial anguish– brought by embarrassment and the limits the symptoms impose.
To be continued in the next Post
[1]DSM5- [2] PA is the initials for Psychodramatic Analysis , my methodological reference [3] Infopedia.pt [4] The names are not patients ‘real names. Similarities with real cases are coincidence. [5]For more details see: Post 2- Ego versus Identity, in: Essay 6-Cultural influences on Identity. In: www.ceciliapsicologa.org. Post 4- Sexual energy and ambivalences and Post 5- Existential Anguish . In: Essay 5- Anguish and Adolescence. In: www.ceciliapsicologa.org. Chapter VIII-Video 1- Emotional instability in Adolescence. In Talking about psychology with Cecilia Leite. In: YouTube
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