Let’s say you were walking down a hiking trail that you’ve been down many times before and you know very well. It’s a very nice spring day and everything seems right with the world and you are thoroughly enjoying your hike. There are many sounds in the area such as an occasional rock falling, tree branches rubbing together, the wind whistling through the leaves and trees, etc. You feel very comfortable and relaxed because you’ve been here many times before. You turn a corner on the hiking trail and suddenly there before is a giant grizzly bear. You, of course, panic in reaction to meeting this grizzly bear, but luckily managed to escape this encounter and survive unharmed.
The next day you return to the same hiking trail and take the same route you took the day before. Now consider how you will evaluate the various sounds, noises, smells, etc. that you encounter this day as compared to the day before. The day before when a rock fell in the distance you hardly even noticed; you might have barely even heard the sound and since it meant nothing to you it caused no anxiety. Today, however, after having met the grizzly bear the day before the sound of a rock falling takes on a whole new meaning. Now, because you think the rock falling might signal the reappearance of the grizzly bear you become very anxious and may even panic. The various noises that didn’t bother you the day before now all become potential signals that the grizzly bear might be on the horizon.
Perhaps you can already see the application of this story to anxiety disorders. The grizzly bear might be a panic attack and the sound of the rock falling might be your heart going faster. So prior to your first panic attack your heart rate might increase for various reasons such as climbing stairs, drinking coffee, or any other number of possible reasons. But prior to the first panic attack these sensations didn’t bother you much because they meant nothing to you and you weren’t afraid of them. However, during your first panic attack you are keenly aware of your heart beating very rapidly and have come to associate a rapid heart rate with the terrible ” grizzly bear” or panic attack. So now when your heart goes faster you become afraid of it because you think it means the impending arrival of this feared event, a panic attack. But the sensation is the same as it was the day before the panic attack; your heart rate goes just as fast now as it did then but the meaning of the sensation has changed dramatically. And, in fact, your entire demeanor may have changed from one of relaxed and casual to suddenly “on alert”. The radar has been turned on and you are scanning for signs of danger. Sensations that before the panic attack were harmless now have taken on a much more sinister and dangerous tone to you. Much like somebody who is walking down a dark alley and is on alert scanning for any danger coming out of the shadows you are on alert watching for any danger signs of the impending arrival of a panic attack.
When you behave like this you are much more likely to notice sensations that otherwise you simply would’ve overlooked completely. Let’s again return to the example of your heart rate. Before a panic attack your heart rate might have gone up for a variety of reasons, but you wouldn’t pay attention because you didn’t think a rapid heart rate was dangerous; after the panic attack you are keenly aware of your heart rate and are constantly paying attention to it because now you think it could be a potential signal of a coming panic attack. This is one of the ways in which panic attacks gets perpetuated. Because we are on alert for signs of a coming panic attack. And we think that ” normal” sensations now are potential signals of danger, we are constantly encountering what we think are indications of a coming panic attack.
Robert W. McLellarn, PhD