ger of a symptom, let a doctor decide. If the person has had several different
symptom patterns diagnosed as panic, consider delaying a call to the doctor,
and instead proceed with the calming, explaining, and reassuring. It helps to
have agreed on a panic plan in advance, so both of you know what to expect.
Phobic Explosions into Flight
Everything I’ve said about panic disorder applies also to phobia. Fear is
fear, whether or not you know what you’re afraid of. Phobic people rarely
have panic attacks, unless they are surprised by their feared object or they
find themselves in a situation that doesn’t allow escape. In those cases, the
calming sequence and explaining how physical symptoms are the result
of fear may be helpful.
Most of the time phobic people avoid explosions into fear by staying
away or running away. You won’t be able to stop a phobic person from run-
ning, nor should you try. Your goal should be to try and keep them from
running so far that they never have to encounter anything frightening.
The process ofgeneralizationis the most insidious enemy in the fight
against fear because frightened people tend to avoid not only what they
fear, but anything that reminds them of what they fear—and then any-
thing that reminds them of what reminds them. To help phobics, we must
teach them to recognize gradations of fear, encourage them to run only
to the place where they can just barely tolerate the internal sensations,
then calm them down and help them to move closer. The process is called
desensitization, and we’ll discuss it more fully in the next chapter.
PTSD, Explosions into Numbness and Nightmares
People with PTSD are on the alert 24–7, even in their sleep. Day and night,
they are stalked by graphic, real-time, mind-bending, gut-wrenching
reenactments of the most traumatic moments of their lives. No wonder
they feel depleted and numb!
There is pretty good evidence that PTSD is a disorder of memory.
Psychological trauma affects the physiological processes through which
the brain stores information.
Memory is a devilishly complex operation, involving areas all over
the brain. Rather than listing the theories about how memory works, let
me direct your attention to its final product.
Explosions into Fear ❧ 79