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The key quality of pathological anxiety is that it is out of proportion to any actual threat. Why do people endanger their health by being extremely anxious in this way? One possibility is that a fight-or-flight response is inappropriately triggered.
When attacked by a predator, a prey animal either runs away, or evades detection by staying put. The fight-or-flight response revs up metabolism and tones muscles in preparation for vigorous activity and it is shared by most, or all mammals. Panic attacks have several similarities.
Symptoms of Panic
People who suffer from panic attacks also experience rapid heartbeat, heavy breathing, and sweating, responses that are designed for the vigorous movements of escape from predators, or self defense. When questioned, panic attack sufferers report fears that are consistent with a predator attack.
Most report that they fear a loss of control that is exactly what happens to prey when trapped in the fangs or claws of a predator. The other common apprehension is fear of dying.
Panic attacks look like inappropriate triggering of fight-or-flight responses by objectively non threatening situations. Why does that happen? What might sufferers do for themselves so as to relieve the problem?
Inappropriate Triggering of Panic
One interpretation of panic attacks is that they are not caused by misinterpretation of actual threats so much as misreading of bodily cues such that normal variation in breathing, or pulse rate, gets falsely interpreted as an emergency response.
When this happens, the individual becomes unduly alarmed producing a positive feedback effect whereby physiological arousal is increased up to the point that a real fight-or-flight reaction gets triggered.
Clinical Techniques for Anxiety Reduction
Most cognitive techniques for treating anxiety involve some recognition by the sufferer that their subjective state–including physiological arousal–is out of proportion to any current threat in the environment. In reality there are no dangerous predators around. We are also unlikely to suddenly lose control over ourselves, especially if that did not happen in similar contexts in the past. Victims of panic attacks are very unlikely to die of anxiety either.
Yet, simply being aware of the fact that a person is far more agitated than they need to be is quite unlikely to resolve the problem. For that, the individual must resort to some technique for bringing down their physiological arousal level. Effective techniques include relaxation training where the subject is taught to relax different parts of the body using suggestions that they are “heavy and warm,” sensations associated with low physiological arousal of a relaxed state.
The high prevalence of anxiety disorders as a class raise the question of whether humans can be categorized as very anxious and jumpy like most game animals or whether we can be credited with the sang froid of a top predator.
Why Can't People just Chill Out (Like the Predators We Are)
Although some predators are themselves vulnerable to predation–particularly when they are immature and defenseless–most convey an impression of being extremely laid back. Many, from domestic cats to lions, spend much of their day asleep.
Although indigenous humans relied on predation for a substantial portion of their food, it seems that we are emotionally closer to being prey than predator. This could reflect the vulnerability of the human body to predator attacks thanks to our thin, comparatively hairless skin and lack of natural weapons, such as horns, tusks, sharp teeth or powerful claws.
Given our inherent vulnerability to predator attacks, it is clear that ancestors who panicked easily were more likely to survive and propagate their jumpiness to subsequent generations.
Consistent with this notion, one finds that a person's stress reaction is genetically heritable with a correlation of .61 for identical twins reared apart (1).
If most people are easily panicked by the threat of a large predator, and many of us develop irrational fear of snakes, or insects, severely disabling panic attacks are rare (at around one person in thirty compared to one in five for relatives of sufferers, 1).
What to Do
Reading between the lines, it seems likely that people with panic attacks may have an unusually strong genetic predisposition for launching a fight-or-flight response. Knowing that is not going to solve the problem. It does, however, suggest that one novel way of coping with the problem could involve desensitization to wild animals.
The reasoning is that if wild animals were the most likely trigger for fight-or-flight responses amongst indigenous people, then learning to cope with that specific primal threat might help people to gain control over their panic reactions in other situations.
Fortunately, techniques for coping with irrational animal fears through participant modeling are well worked out and quite successful (2).
Sources
1 Plomin, R. (1990). Nature and nurture. Pacific grove, CA: Brooks/Cole.
2 Seligman, M. E. P. (1993). What you can change and what you can’t. New York: Fawcett Columbine.
