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Key points
- Panic can take place when the parasympathetic nervous system fails to limit hyperarousal caused by the sympathetic nervous system.
- When stressed, parasympathetic nervous system response is needed for us to separate what we imagine is happening from what is really happening.
- The thought of an emotionally and physically safe person can calm the parasympathetic nervous system.
- Though we can tolerate the thought of "being" dead, the thought of going through the process of dying may terrify us.
Thirty-five thousand feet in a thunderstorm is a great lab for studying panic attacks. Turbulence powerful enough to make a person believe their plane will fall out of the sky is a potent panic causer. The person is not in control. They are unable to escape, And, in turbulence, they believe they are about to die.
Panic: The Unimaginable Terror Of Imagining You Are About To Die
It's interesting that fearful fliers say the problem is not being dead; the problem is getting dead. When the plane is in turbulence, they "just know" they are about to die. After the flight they understand the belief they were about to die was an illusion. Yet, the experience is so intolerable that it changes their life. Some become unable to fly due to fear that the experience will happen again. Some continue to fly but with great dread that they will feel that again.
When stress hormones are released, our sympathetic nervous system revs us up in case it turns out that we need to run or to fight. To determine whether we need to run or fight - or whether this is a false alarm - we need to be able to think clearly. We need to identify the cause of the stress hormone release. We need to determine whether the cause is a threat or a false alarm. To think clearly enough to do that, the parasympathetic nervous system must limit the sympathetic nervous system. Why? Because we can't think clearly if we are too revved up. In the case of a person who has panic attacks, their parasympathetic nervous system is not limiting their sympathetic nervous system well enough to for them to recognize that what is happening in their imagination is not what is happening in reality.
Terra firma is fine. Aer non firma isn't.
A person who lacks adequate operation of the parasympathetic nervous system depends on being in control or being able to escape to prevent panic. On their own two feet, if something is interesting they can approach it and examine it. If something is unsettling, they can distance from it. When lifted off their feet, their basic way of regulating emotion is taken away from them by the plane.
To make up for this loss, they may try to pretend they are not in the air, but elsewhere, such as on a beach. But when the plane starts shaking, the beach fantasy falls apart. Beaches don't shake. In turbulence an excessive amount of stress hormones is released. The amygdala regards dropping as falling. Every drop causes it to release stress hormones. As the stress hormones build up, panic takes place in a person whose parasympathetic nervous system does not activate and prevent hyperarousal due to the sympathetic nervous system activity caused by excessive stress hormones.
A Special Memory Can Control Panic
Years ago, I found that certain memories can control in-flight panic, When a memory of getting engaged or of saying wedding vows is linked to thoughts of flying in turbulence, in-flight panic is controlled. But why? How could such a simple memory have such power? I really didn't know.
Years later I stumbled on the answer. Neuroscientist Stephen Porges had discovered that a person who is safe to be with, physically and emotionally, unconsciously transmits signals indicating that safety. In the presence of a person who is transmitting safety signals, our parasympathetic nervous system is activated. It then blocks the revving up activity of the sympathetic nervous system. Feelings of fight or flight if present, are neutralized. We are caused - by these unconsciously sent and unconsciously received signals - to feel safe.
This means we can, by establishing links between the presence or the memory of a "safe" person and the challenging moments of flight, neutralize the fight or flight feelings triggered by the release of stress hormones, even in turbulence.
This also means links between such a person and challenging situations in day-to-day life can control panic. For example, panic on bridges, in tunnels, in elevators, in MRIs, etc. can easily be controlled by linking various moments in the challenging situation to the presence - or the memory - of a calming person.
