by Joseph Precker

“Dear Dr. Precker:

“I am a mature, happily married man with an important position in a major international company. This is my second marriage—my wife is Japanese and a wonderful person. With all my good fortune, I find myself feeling more and more threatened by almost everything. I hate being stuck in traffic. I find it almost impossible to get on crowded trains (those crowds make me feel I cannot breathe! When­ever I have to go overseas (and my job requires fre­quent air travel), I almost have to force myself to get on the plane.

“I carry a small bottle of whisky with me at all times. A slug of whisky often makes it possible for me to take the next step. I also have tranquilizers with me, and take a few before going into meetings. While they calm me down a bit, they also get in the way of my thinking clearly and speaking up effec­tively.

“My wife is very supportive, and she’ll often drive me to work or to the airport—or even travel with me. Her presence reassures me, and her help means a great deal to me. But how can I get rid of these panicky feelings? I’m afraid I’m going to break down at the office one of these days. Then what will I do?”

Dear Panic-Stricken:

You’d be surprised how frequent the symptoms you mention are seen in practice. I’ve dealt with a whole array of people, from the housewife who can scarcely get out of the house, even for routine shop­ping (who would be labelled, if you care for labels, as agoraphobic), to the schoolgirl or boy who panics each day on the way to school, to the top-level execu­tive—or even ambassador—who seems to have everything, yet uses up lots of energy trying to hide the panic . . .

What common characteristics do I find among these seemingly different people, in very different life situations? I’ll quickly outline some of the major similarities I have found.

1) Great concern over being evaluated. And the more successful they are (high grades, important titles, large salaries), the more they fear that next time around, everyone will see them fall flat on their face!

2) Related to the above, something that’s been called “the imposter syndrome.” According to a va­riety of research studies, it is surprising how many high-achievers secretly feel that they are “imposters,” and that they’ll be uncovered at any moment. (And most of these people are hard-working, effective people who have earned their place in their com­pany or in their profession, and are definitely not “imposters.”)

3) Many people with panic attacks have strong ambivalent feelings about their work or their life positions. They may love it (in part, at least) on the one hand, but hate it—even fear it—on the other.

4) Many sufferers from panic feel they are not truly deserving of the high position they have ob­tained. Inability to be “perfect,” lack of a degree, achievement greater than those older and more expe­rienced are all attitudes they express, or which are slowly revealed in working with them.

5) Often the person capable of being panic-stricken is not very capable of intimate relations. They often have no one they can talk to honestly about their feelings, their fears, their panics—not even their lovers or spouses. They often fear they will reveal too much and then they’ll lose the only support they have. Too often, the victim of panic doesn’t even know how to be “intimate” with themselves! That is, their concerns are frequently out of conscious awareness, and they “don’t know” what they feel, nor why they feel as they do … often, their memories for early events may be very sketchy—or lacking altogether.

6) Frequently enough, the sufferer has a friend, a teacher, a spouse, a lover, a boss who, in their honest and sincere attempts to help these people, are really helping to perpetrate the panics by providing them with “secondary gains,” such as attention, relief from certain duties or responsibilities, treating them like children (driving the to work, for example), taking over some of their chores, coddling them, etc. While warm support is very important, it is essential that the person be expected to “carry on,” as the capable adults they usually are.

What can be done to reduce, and to eliminate, these panics? Quite a number of things:

1) Assist the person in realizing that whenever they’ve been evaluated, they’ve almost always been evaluated positively.

2) Help them to realize their achievements are real, they are not imposters, and many life-situations require at least some “acting.”

3) Lead them to explore whether their life-posi­tion in work, marriage, community is what they re­ally want to do. Even kings have wanted to be watchmakers. Even advertising executives have felt better as farmers or innkeepers.

4) Usually, a panic-sufferer has had one or more critical parents who led them to think that nothing they did was “perfect enough” or even “good enough.” These phantoms need to be faced and exorcised.

5) The sufferer must learn intimacy—first with self, then with spouse, lover, friends. A mature psy­chotherapist can help in this process.

6) Those who care for the sufferer must be very tactful in giving support, yet not “babying” the per­son.

Finally, the person needs assistance in realizing that they can take control of their own lives … often a psychotherapist is in order. Good luck!

Image: sebra /