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What is the Root Cause of My Panic Attacks?

by Dr. Blumberg on May 3, 2011

The Psychological Basis of Panic Disorder

What Does My Personality Style Have to Do with Panic Attacks?

The People Pleasing Personality

  • Are you an over accommodator?
  • Do you bend over backwards to make others happy?
  • Do you constantly fear that other people will be mad at you?
  • Do you avoid conflict and confrontation?
  • Are you “always there” for others?
  • Do you over identify with the pain and suffering of loved ones and friends?
  • Do you feel guilty and overly responsible for other’s hurt feelings?
  • When a friend or family member is upset, do you feel you are the cause and become overly apologetic?
  • Do you focus on the needs and feelings of others so much that you stifle and neglect your own needs and feelings?

What Is The Core Fear Underlying The People Pleasing Personality Style?

  • Do you worry excessively about people rejecting or criticizing you?
  • Do you become preoccupied with the possibility of separation or loss of a loved one?
  • Do you dread the idea of abandonment and coping alone?
  • Do you associate speaking up and self-expression with conflict and confrontation and the possible loss of a significant relationship?
  • Do you tend to minimize and make light of your genuine feelings of resentment that may be smoldering inside you?
  • Are you uncomfortable with feeling strong emotions of anger or sadness?
  • Do you view the display of negative emotions as a sign of weakness and loss of control?

How Do You Process and Manage Your Emotions of Anger and Sadness? Are You An Emotional Stuffer?

  • Do you hold in your emotions to be strong for others?
  • Do you stuff, stifle and bottle up emotions?
  • Are you a giver “to a fault” in your relationships and rarely say no to other’s requests or wishes?
  • Do you view emotional expression as a sign of weakness?
  • Do you focus so much on meeting the needs of others that you sometimes lose touch with your own emotional reactions?
  • Do you associate emotional expression with fears of losing control of your feelings?
  • Do you tend to over commit and feel obligated or trapped in interpersonal relationships?
  • Do you sometimes feel physical stress building up in your body e.g. tension headaches?

Panic Disorder, Emotional Suppression and Alexithymia

In 1962, Schachter and Singer proposed the two-factor theory of emotions.  These highly regarded researchers held that two factors must be present simultaneously for emotional expression.  You must first feel physiological arousal like heart pounding, rapid breathing, overheating.  Secondly, you might identify the emotional context or circumstance that triggers the arousal.

“Hot Under the Collar”, But You Deny the Emotional Context

The One Factor Theory of Emotional Management in Panic Disorder: Blocked Emotions

A friend has been taking advantage of you repeatedly throughout your relationship. There is a build-up of underlying unexpressed resentment.  You use minimization and emotional stuffing to block out the feelings of resentment. You rationalize that it is no big deal to help out the friend in need again.  You feel heat for no apparent reason and fail to recognize that you are burnt up inside.  Researchers have identified a personality trait termed alexithymia.  Alexithymic individuals do not identify, label or express their emotions. They only feel the bodily sensations of emotional arousal without recognizing or feeling the full emotion.  A body of research has shown elevated alexithymia levels for panic disorder sufferers.  Panic disorder victims feel the physical symptoms of an emotion e.g. heat, but fail to identify the emotional context that triggered the emotion-based symptom.

Emotional Stuffing: Anger and “Out of the Blue” heat waves

As Panic prone individuals we are so focused on satisfying the needs of others that we often suppress our own needs and feelings.  To avoid the possibility of disapproval, we can use minimization or even denial of our feelings to buffer and protect ourselves from labeling and identifying unacceptable or uncomfortable emotions. Emotional stuffing occurs with both feelings of anger and feelings of sadness associated with loss.

The Core Emotional Trigger Is One of Four Panic Attack Triggers

Panic disorder sufferers encounter four triggers for panic attacks. The core emotional trigger activates your first panic attack “Out of the Blue” and also is the underlying trigger for relapses in panic disorder, after living panic free for months or years. Discovery and mastery of your core emotional trigger is the key to living a panic free lifestyle.

The ideas expressed 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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