What’s happening is called the fight or flight response. At the physio-
logical level, Jane’s panic attack is caused by gratuitous activation of the
autonomic arousal system that protects her from physical danger. You’re
probably familiar with this system both from your reading and from per-
sonal experience. You know what it’s like to feel a sudden rush of adrenaline
on hearing a loud noise. Immediately, everything changes. Your heart
pounds, your muscles tense, your senses frantically scan for the source of
the sound. If you see real danger, your body is already primed to get away
as quickly as possible. If, on the other hand, you discover that the noise is
nothing to be alarmed about, the alarm system shuts down. The adrenaline
in your bloodstream takes a while to wear off, but in a few minutes you’re
back to normal. This is how the fight or flight response has worked since
the days when it protected your ancestors from saber-toothed tigers. It’s
one of the main reasons they lived long enough to become ancestors.
Jane panics because her fight or flight system is not working correctly.
It switches on for no reason. As she walks through the mall, her body gives
her a sudden but needless jolt of adrenaline. It feels just the same as the
jolt in response to a loud noise, but it has no external cause. Jane’s heart
speeds up, her muscles tense, and she scans the environment for a danger
to fight or flee. She finds nothing, but this makes the situation worse, not
better. Her brain, seeing no outside danger, looks inward to the physical
signs of arousal, thinking they are the cause of her fear rather than its
result. She convinces herself she’s having a heart attack, which in this day
and age is considerably more perilous than the threat of tigers.
The first time this happens, there’s no way Jane can know whether
it’s a real heart attack or merely panic. Nor would you know, if you were
with her. You need to get a medical opinion quickly. Your own fight or
flight response will help you dash to a phone to dial 911.
Panic attacks are usually recurrent, however, so there’s a good chance
that on this trip to the mall both you and Jane know that she’s experienc-
ing a panic attack, not a real threat to her life. But knowing that there’s no
danger doesn’t necessarily help either of you to deal with the situation more
effectively. Human brains are not programmed to deal differently with
imaginary dangers, so you’re both likely to follow the same patterns of
thought and action as if you were in the presence of a real threat. This all
but ensures that Jane will have more and bigger panic attacks in the future.
10 ❧Emotional Explosions