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The Fight or Flight Response
by Mark Sichel, LCSW

Do you recall a time when you've been in danger, or feared that you could be in danger? Do you remember how the adrenalin pumped through your body, and how you quickly you went into action? Your heart likely beat rapidly and your breath became faster. This is a primitive response called the "Fight or Flight" response. It is an inborn genetic response which helps us to protect ourselves throughout our lives. The surge of adrenalin gives us the strength we need to either get the heck out of there, or stand our ground and fight off the danger. The fight/flight response is one of survival.

You might recognize the description of someone in fight/flight mode if you suffer from panic attacks. People having panic attacks experience the same physical symptoms as a person in immediate physical danger. Panic attacks are a type of fight/flight response. Once this response "kicks in," we tend to perceive anything and everything around us as a potential threat to our safety. When we are in fight/flight mode, our brain chemistry is altered. The part of the brain which controls our rational thoughts is bypassed, and we move right into "attack" or "run" mode (For a more in-depth description of the physical effects of fear and panic read The Biochemistry of Panic).

Medical emergencies, building evacuations, and automobile accidents are all situations in which the fight/flight response would be likely to kick in. This makes sense. There are obvious, immediate, potential threats to your physical being in all of those scenarios. Why then do people having panic attacks go into fight/flight mode? Often a panic attack will seemingly come "out of the blue," with no external threats or dangers that are immediately obvious.

It is precisely the fact that there is no obvious source of danger that intensifies the fear of a person about to have a panic attack. The danger feels almost palpable, and yet it is invisible. If something is invisible, how do you decide whether to flee or fight? How can we run from danger when we don't know what, where or who it is? How can we fight when we don't know what we're fighting? This is the psychological birth of a panic attack: a fight/flight response with nowhere to fly and no one to fight, given our unawareness of the enemy. Whatever is scaring you is going on in your unconscious.

The unconscious was discovered by Freud in the 1920's and has become a widely accepted fact in our culture. The problem that many people have in understanding the unconscious, is that we have no visible proof of it. We are relegated to understanding it by looking at our dreams, fantasies, slips of the tongue, and behaviors, which occur without conscious thought. Interestingly, our unconscious often wants things contradictory to what we consciously think we want.

None of us want to have panic attacks, yet they occur. Generally the danger lurking in our unconscious, has to do with feelings, wishes, and ideas which we feel will put us into danger. The danger is not a physical one, but it is just as real to us. These "lurkers" in the recesses of our minds set off a complicated set of emotional and physical reactions within us.

For example, a young man harboring enormous rage at authority figures gets into a conflict with his boss. He is aware of being mad at his boss, but becomes very frightened of the strength of his feeling. When he goes into therapy for his panic attacks, and begins to look at his dreams, he realizes the strength of his anger is a great deal more than he ever thought it could be. Overtime he comes to accept the rage as just a feeling, and he realizes that he has the controls to not act on this feeling. His panic diminishes. The "lurker," in this case, was his own fury.

In another instance, a popular movie released in 1978, "An Unmarried Woman," told the story of a woman's struggles following her divorce. In one memorable scene, the woman, played by Jill Clayburgh, has a panic attack in Bloomingdale's. She asks the circle of on-lookers if anyone has a valium. What we can extrapolate from her behavior is that the fear of not being taken care of was her "lurker," given that the outcome of the panic attack was that she was able to be taken care of at that moment.

So, if you have panic attacks, what are your "lurkers?" What triggers your fear? The danger may seem invisible, but you are actually reacting to something that is very real in your unconscious. When you can pinpoint what is triggering your fear, you will be better equipped to conquer your panic attacks.

If you would like to continue the Panic Disorder lessons, read The Domino Effect to learn how to prevent isolated panic attacks from turning into full-blown phobias.

If you would like to start at the beginning of the Panic Disorder lessons, please read What to Expect When You are Diagnosed with a Panic Disorder.

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