Rachel was sitting on her settee doing nothing. All of a sudden she felt an overwhelming feeling of dread. Her heart started beating rapidly and she felt very hot. She couldn’t think of anything that had made her feel like this.

It’s not unusual to have such feelings ‘out of the blue’ and be unable to say what caused it. When it happened Rachel often searched the Internet for an answer. She found many authoritative sites that confirmed her symptoms were panic. On the Royal College of Psychiatrists’ site she read that; panic is a sudden surge of intense anxiety that can come out of nowhere; anxiety, panic and phobias could be caused by her genes, her life experiences or some drugs.

All the sites said much the same thing. None put the person back at the centre of their experience. None suggested that when we’re anxious we’re actually doing something; i.e., we’re essentially wondering how things will work out for us; we’re making predictions and wanting some outcomes and not others.

From an evolutionary point of view, it would make no sense at all to panic when there is no threat. This suggests that somewhere in the background of our panic we have to be sensing danger. In fact, evolution has equipped us with an impressive ability to react instantly even before we are aware of what danger we have perceived. Our startle response is another more everyday example of a similar process. It allows us to react instantly to loud noises or sudden movements. Our panic response is similar although the things we panic about are more complex such as threats to our health, relationships, jobs, etc.

Many years ago I met a man who had been on a business trip to Bogota. One day Bob was sitting in a bar with his business contacts. Outside the street was busy and there were lots of parked cars. Unbeknown to anyone, one car was packed with explosives. When it exploded one of Bob’s business contacts was killed.

Bob eventually returned home. As far as he was concerned he had coped with the incident as well as anyone could. He returned to work and was able to carry on with his life. Then some six months later he was working in his garden. It was a warm summer’s day and the sky was clear. Suddenly, literally ‘out of the blue’, there was a loud crack of thunder. Bob described himself as ‘falling to pieces’.

This was a dramatic example of the sort of instantaneous thinking that we are all capable of in the right circumstances.

Normally our startle response might kick in if there is a sudden clap of thunder. Bob’s reaction was much more intense. Somewhere in his background thinking the thunder had ‘reminded’ Bob of the bomb blast. However, he didn’t recognise this connection. Instead, he was worried by the intensity of his reaction. Just like Rachel he wondered what might be wrong with him.

Clearly how we understand an episode of panic is very important. If we ignore the fact that behind every panic there must be some instantaneous anxious thinking, we will focus instead on how we feel. What conclusions we draw will depend on what physical signs we notice. Eg if our heart races, we are having a heart attack; if our throat tightens, we are choking; if our chest feels tight, we are unable to breathe; if we become light headed or have a pain in our head, we have a brain tumour; if our legs feel weak, it is MS or some other debilitating disease. If we interpret our panic in any of these ways we simply add more anxiety to the panic. Also, it is logical and almost guaranteed, that we’ll want to monitor our sensations more closely. We’ll be wary of any early signs of panic in the future. We can trap ourselves in a self-fulfilling prophecy and become afraid of fear itself.

The Royal College of Psychiatrists’ site claims that “anxiety disorders affect 1 in 10 people”. That so many people fall into these same patterns of thinking might be telling only how the culture has come to understand panic and anxiety.

What we all need to know about panic
1.We are largely unconscious creatures; we do all sorts of complex things without being aware of the thinking necessary to do them. Reading is a good everyday example of this; anxiety is another.
2.Everyone can experience an episode of panic simply because everyone has many things that are important to them.
3.Feelings of anxiety and panic can come on instantly without us knowing what we are thinking. It helps if we can stop and think about what issues or situations we might be concerned about.
4.Anxiety produces a lot of physical effects and if we focus only on how it feels we are likely to entertain all sorts of ideas about what is wrong with us. The most common are about physical illness, losing control and going mad. If we take them seriously these big ideas only add to our anxiety.
5.Anxiety and panic are impressive evidence of the complexity and sophistication of our thinking. It has been honed over thousands of years by evolution to enable us to respond quickly to situations that matter to us.
6. Most Internet sites focus on symptoms and encourage us to diagnose ourselves and seek help. We need to wonder why they don’t explain the ordinary and natural psychological processes involved in anxiety and panic. Since knowledge is power, some might say this represents a transfer of knowledge and skills from ordinary people to those who then become ‘experts’.