a representation of her internal state. Generally, when people say they
have a phobia, they’re asking for external accommodation rather than trying
to grapple with what’s going on inside themselves. I’m feeling claustro-
phobicmeansLet me out of here.
Reframing allows her to begin thinkingabout the experience of panic
rather than just experiencingit. You want her to recognize that she’s hav-
ing a panic attack, which is a normal physical response to danger that
occurs in a situation that isn’t really dangerous. You might say something like
I did: “You’re having a panic attack. Your body is so full of adrenaline that it’s
hard to think straight. Taking deep breaths will slow your mind down enough
so you’ll start feeling better.” Blaming adrenaline is often a good tactic
because people know that its effects are temporary. Also, when you’re trying
to induce psychological movement, it’s always more effective to talk about
where you want people to go rather than where they’re coming from. More
calmis always better than less afraid. The sympathetic system only knows
from running away; the parasympathetic at least has a destination.
Panic happens in an unendurable, interminable, and inescapable pres-
ent. You need to remind panicky people that what they’re going through has
the dimensions of normal experience. That is: It happens with a certain
frequency, it lasts a certain length of time, and then it abates. Escape comes
from living through it rather than running away. To stimulate this line of
thought, ask questions like: Have you ever had an attack like this before?
How long did it last? What helped you feel better? You want to set up the
expectation that things will get better soon if she just hangs in there.
“I got locked in a closet when I was a little girl. It was dark and I
couldn’t get out.” The woman’s breathing is becoming ragged.
“I screamed and screamed, but nobody came. I couldn’t breathe.
I thought I’d—”
“Okay, take a deep breath,” I say once more. “Good. Hold
it while I count to five.”INTERRUPT ESCALATIONS. People in the midst of an emotional explo-
sion do not get better by getting things off their chest. Talking about how
bad they feel or where their fear comes from only makes them feel worse.
Don’t be afraid to interrupt. It doesn’t help to stand by politely letting peo-
ple work themselves up when you’re trying to calm them down. This rule
Basic Calming Technique ❧ 63