2.5 The role of emotion processing
Up to now you have been learning about the cognitive model of panic, which seeks to understand how thoughts (e.g. catastrophic misinterpretations) and behaviours (e.g. avoidance) can make panic worse.
Another theory is that the way people respond to their emotions may also be key in panic disorder (Baker, 2011). This theory suggests that people who experience panic disorder are prone to the following:
- trying to control their emotions by bottling them up or suppressing them
- not expressing (in words or actions) or sharing with others their feelings
- focusing on the bodily feelings associated with an emotion rather than the emotion itself
- having trouble labelling emotions
- not connecting emotions with the events that cause them.
Baker argues that this pattern of dealing with emotions is evidence of a difficulty with processing emotions. He also argues that this type of emotion processing often leads to the very first panic attack that a person experiences because this pattern of (not) dealing with emotion leads a person to fail to notice when they are becoming seriously stressed:
Stress, often undetected by the person and occurring months before the first panic, can build up to a level where a panic attack is easily triggered. In explaining this to patients during psychological therapy, I compare it to water building up behind a dam. The water rises bit by bit over the months, and the pressure mounts all the time. At a certain point, the pressure becomes too much, and the dam suddenly gives way. Huge columns of water burst through the fractured dam, causing devastation to the land beyond. Panic is like this: sudden and devastating. Unknown to the sufferer, the pressure has been building up for weeks and months. The panic attack appears to be sudden, but it really is not.
One value of this emotional processing deficit model of panic is that it implies a pathway to remedy panic disorder – learning better emotional processing strategies. The next section explores this further, focusing on what help is available for panic disorder.