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Questions & Answers:
Spontaneous Panic Attacks
Q. I have what you have said
are spontaneous panic attacks. They just happen any time any where
and they can also wake me up at night. But my therapist tells me
that 'spontaneous' panic attacks is just one particular theory
amongst others. He believes this theory is wrong and thinks that I
must have some sort of phobia that I am not recognizing. He also
says my night attacks are a result of having a nightmare. I know
what I experience, but now I am beginning to become confused and I
am beginning to doubt my own experience. After all my therapist is
an expert.
A. There was definitely some opposition to the three
'Panic Attack' categories in the Diagnostic and Statistical Manual
Number Four (DSM 4)when it was released in 1994. This manual, is as
it says, is the diagnostic manual for diagnosis of Mental Disorders
which is used by the American Psychiatric Association. Some
therapists did question the validity of these categories, primarily
because it appeared to be at odds with their own particular schools
of thought and the therapies they provide. Irrespective of the other
varying theories about Panic Attacks, the DSM 4 is correct. My own
experience of Panic Disorder and the thousands of people I have
spoken with over the years show that this type of attack is very
real and without doubt does happen. Not only is there the personal
experience of so many of us who have this type of attack, the
research and the subsequent release of the DSM 4 confirms the
scientific validity of these attacks.
The sleep research also confirms that this type of attack is not
a result of dreams or nightmares but occurs at the change of
consciousness from dreaming sleep to deep sleep or from deep sleep
back to dreaming sleep. Many people also report it occurs as they
begin to enter the first stages sleep or as they begin to wake up.
Even though the attacks do occur for no apparent external reason,
Cognitive Behavioral Therapy is the one therapy that has been proven
Internationally to be the most successful long term therapy. I would
suggest you discuss your concerns in detail with your therapist. If
your therapist does not agree with your experience and is not
prepared to work with you on that basis then you may wish to
consider changing therapists. Your recovery must be your number one
priority. Trying to fit your experience into a model that does not
recognize the latest scientific research and diagnostic criteria is
going to mean an unnecessary and costly uphill battle in your
recovery.
The 1994 edition of the DSM 4 (Diagnostic & Statistical
Manual, American Psychiatric Association) now shows that Panic
Disorder is not a Phobic Response and people are not afraid of
situations or places but are frightened of having a spontaneous
panic attack. A conclusion we agree with without reservation.
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