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Panic Attacks and Panic Disorder-A Prevention Model

by Dr. Blumberg on February 8, 2011

Panic Disorder and Emotional Stuffing

Panic attack sufferers tend to hold in their emotions. Oftentimes, they associate emotional expression with loss of control and signs of weakness. They tend to avoid conflict and confrontation in significant relationships for fear of hurting other’s feelings.  They are also prone to excessive worry about the safety and well-being of their family and friends and can be especially sensitive to loss and separation.

How do you respond to conflict and confrontation?

Four Key Features of the Pre Panic Personality Profile

  • Over accomodator, people pleaser, skirting conflict?
  • Peace maker, thinking, “Don’t rock the boat”
  • Excessive worry about what people think, fearing that others will be mad at them.
  • Wracked with excessive guilt, worrying that they are responsible for other’s hurt feelings

Minimization as an Emotional Management Style

If you fit the Pre Panic Personality Profile, you may be sensitized to ongoing conflict in relationships and worry excessively about losing people you care about.  To avoid a confrontation, minimization (“No Big Deal”) is one common method of managing upsetting emotions (e.g. anger and irritation) when faced with an argument in a significant relationship.  While you may be able to block out upsetting events in your mind temporarily, emotional reactions to chronic conflict can gradually build up inside of you.  Physical symptoms of stress (e.g. headaches) can emerge as a delayed response to blocked emotions.  Then a sudden surge of stress-related symptoms like heat waves and shakiness can seem to strike suddenly “Out of the Blue.”

Schachter and Singer’s Two-Factor Theory of Emotions

In 1962, Schachter and Singer introduced the Two-Factor Theory of Emotions.  They proposed that to feel a full emotional reaction two components must be present at the same time.   You must recognize the (1) emotional conflict situation that is upsetting you.  At the same moment, you must feel (2) strong physical sensations of arousal.  When you connect continual critical comments from a significant other with heat waves, then you feel “burnt up inside.” If you block out the emotional context of continual criticism, you can be left with sudden heat waves for no apparent reason.

Many Panic Attack Victims Do Not See the Link between Stressful Life Events and their First Panic Attack

Research studies demonstrate a relationship between Stressful Life Events and the Onset of the First Panic Attack.

Two of the Most Common Stressful Life Events Associated With the Onset of the First Panic Attack

  • Interpersonal Conflict In An Ongoing Relationship ( e.g. work, marriage, dating, family)
  • Loss/Separation and Illness of a Loved One

Most panic attack sufferers do not report any triggering event that preceded the onset of the first panic attack. Panic Attack Victims, often, describe the first attack as coming “Out of the Blue.” Why?

Three Factors That Contribute to A Disconnect between the First Panic Attack and the Core Triggering Event

  • The core stressful event, like chronic conflict in a relationship, can be an ongoing background stressor and does not stand out in the forefront as an immediate precipitant. The cumulative effects of one more minor argument does not appear to be central to the surge of panic.  The argument blends into the backdrop of stress and does not stand out as significant trigger for panic attack symptoms.
  • Thoughts and emotions stirred by memories of previous conflict and anticipation of future conflict are fleeting. Time may have elapsed since the last actual confrontation.  Fleeting upsetting and painful thoughts, memories and feelings of past conflicts can be quickly blocked from awareness.  The panic attack symptoms seem to appear without a context.
  • Minimization as an emotional management style diminishes the significance of the core trigger, the chronic conflict situation.

Why Is It So Important To Make the Link Between the Core Trigger and the Onset of the First Panic Attack?

If the Pre Panic Person recognized the build-up of chronic stress as directly related to the onset of panic attack symptoms, the symptoms would occur in a natural normal emotional context. The mystery of why am I feeling heat waves and heart pounding would be removed.  The stress-related symptoms would become part of an emotional response to the chronic stressor.  The Pre Panic Person would be less likely to misinterpret the normal physical feeling of heart pounding as a sign of a heart attack.  A new emotional management system would be developed to effectively express feeling of anger and sadness. Theoretically, this discovery of the Missing link between the core triggering stressor and the stress-related symptoms could prevent the development of panic disorder.

The ideas in this blog are developed from Dr. Blumberg’s panicLINK Program.  PanicLINK is a comprehensive, twelve session, four phase, multi-media educational program on panic disorder. The material in this Blog and the panicLINK Program are copyright protected by Out of the Blue Network, LLC. No permission is granted to reproduce this blog for commercial purposes. For more information about the panicLINK Program, connect at

* This educational information should always be used in consultation with your doctor to confirm a diagnosis and review available treatments for panic disorder.

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