seemingly unheeded conversations. Even when the attacks are less frequent
and intense, and shorter—signs that they’re managing them better—panicky
people still view them as grim reminders that the disorder is still there.
This is especially true of people like Jane, who have been on medications
that made the panic go away, and to whom mild euphoria is their internal
standard for relief. You’ll have to keep pointing out progress even if your
words are ignored, at least for the moment. Be patient. If you repeat the
message enough, panicky people will take it in, and one day see it as their
own idea rather than yours. That’s when it will begin to work. As you can
see, very good therapy is sometimes very slow and very mundane.
Blame as an Obstacle
You’ve probably noticed that though I try to organize treatment of fear dis-
orders into steps and stages, I seem to be jumping back and forth in my
expositions and anecdotes. In every chapter, we’ve covered material that
could fit into each of the therapeutic steps, but not in any particular order.
My only defense is that life is like that too, a perpetual game of Twister,
even at the physiological level. Your amygdala can be in one stage and
your hippocampus in another, with your heart right in between. The steps
I list indicate the direction of flow. Sometimes the process of healing is
disturbed by swirls and eddies, but if things keep moving, eventually people
will be all right.
Which brings me to the psychological equivalent of the Hoover
Dam: blame.
Blaming stops forward movement. It doesn’t matter whether people
blame themselves or somebody else. Blame is blame. Mindlessly fighting
back is no better at curing fear than running away.
Though you may feel that you’re being supportive, you can do harm
by siding with someone you care about against mean old spiders, idiots
who run stop signs, doctors who can’t find the real problem, or even sexual
abusers who probably should be in jail. Blaming, at best, diverts the energy
needed to get better; it diverts it toward getting someone back. At worst it
can convince a person that getting someone back will get them better.
Sometimes in the course of healing, people with fear disorders go
through a stage of blaming. This is especially true in PTSD as they begin
to realize that what they feel is the result of something that happened, not
anything they did, chose, or even permitted. The relief feels so good that
116 ❧Explosions into Fear