Having had panic disorder for 15 years, I've come across some of the worst writing by supposed 'experts' on the topic of panic and anxiety disorders. What makes them terrible articles is that they mention words or phrases that will automatically cause a person with panic attacks to hit the back button on their browser, slam a book shut, or even go as far as to cancel all future appointments with a doctor or counselor.
If you want your article to be read, or your speech to be absorbed, then never use trigger words or phrases.
What Are Triggers?
A person with panic attacks, as you should know, has triggers. A trigger is a thing that sets off a panic attack, often called an anxiety attack. The list of triggers is different for each and every person, and the cumulative list of known triggers grows by the second. (For an idea of just what triggers an individual's panic attacks, take a look at the free-to-contribute-to list at http://66.206.11.19/bellatango/triggersreview.asp)
You will find everything from "a cloudy day" to "wide desolate streets" as triggers.
However, there are some very common trigger words and phrases that I can assure you that you are better off avoiding if you would like to impart your wisdom.
People with panic attacks are terrified. One of the reasons is that they feel as if they are out of control of their own body. They try to rationalize what could possibly be making them feel the way that they physically feel. They feel their heart beating and are terrified that they have heart disease, or get tension headaches from perpetually tensed up shoulders and believe they must have a brain tumor.
You get the idea.
Here is a sampling of those words and phrases to definitely avoid in the preliminary stages of talking, or writing, to someone with panic disorder:
Heart (or anything negative dealing with the heart), heart attack, stroke, brain, tumor, cancer, die, death, suicide, mention of someone dying young, EKG, MRI, Cat Scan, hemorrhage, insane, kill, crazy, and ambulance.
This should give you an idea of what not to say or write. When I say, "don't use the word brain" - I really mean that. Not even in an offhand remark such as "these people aren't using their brains - what are they thinking!"
When I say, "don't use the word crazy" - I really mean that as well. Do not even allude to it. If you are a practitioner who is working with a patient on their panic attacks, please be certain that you do not just blurt this word out in the first session. If the patient is that uncomfortable with it further into treatment then naturally you want to address the issue, but you definitely don't want to scare them off, never to be seen by you again, by your casual remark of "You'd be crazy not to wear a jacket today!" or some such thing.
So What Can You Say?
You want to maintain readership, or if you are speaking, to continue having listening audience (even if it's only of one person.) That is your goal. You want the person to feel comfortable with you, and believe wholeheartedly that you are a compassionate person. Aim for trust. If you can achieve this then your audience is going to benefit from you, and continue coming back for more essays, to buy more things from you, to pay you more for another session of your time.
Just be aware of what you are saying. Scour your writing for mention of anything that might be an obvious trigger. If you find one, rewrite the section. It's worth it.
If you are a person, a caregiver, who talks to people with panic attacks, then just be sensible. Think before you talk. Remember that you are dealing with someone who probably had to muster up every bit of courage just to get to your office, and most likely has spent the last few days with racing thoughts about the meeting you are having. It may only be 55 minutes for you, but to a person with panic disorder it can be an event that is prepared for a week or more ahead of time - so of course by the time they get to you they are emotionally exhausted. They are emotionally raw. They have done all of this in an effort to garner some priceless understanding and relief, the very least you can do is not use any of the trigger words, causing them unease or panic.
Things To Avoid Doing
After moving to a new city a few years ago, I realized that it was time to confront my severe driving phobia. I lived in a very busy metropolitan area, and so it was nearly impossible to find an appointment with a psychologist, which is what I was hoping to see. It would have been three months before I could get in to see one, so I opted instead to see a Clinical Social Worker (CSW.)
I was nervous about the meeting, but hopeful that she could help me. I thought about the appointment a lot before the actual day. When I got to her office the first thing I saw was a clock on her bookshelf. It was somewhat of an optical illusion in that it looked like a flashing banner of light that just hung in the air between two 6" tall posts. The flashing, strobe light effect was horrible. It made me very anxious, and I could not find a position to sit in that afforded me the luxury of not having the red flashing light visible in the peripheral vision.
I never made another appointment with her again, and suffered with my driving phobia much longer.
Here are a few more hints to make a person with panic attacks more comfortable, and more likely to benefit from your meeting:
No flashing anything is a good start. No flourescent lighting. This is a panic trigger for many people. Keep your books with scary titles like "The Diseased Mind" out of direct line of sight. Put away any pictures or plastic models of hearts or brains.
Another thing to consider is the stationary you use; pens, paper, sticky notes, etc. As you are probably aware, and if you aren't you should be, people with panic attacks take in everything - they don't miss much, and they often have a higher level of intelligence than the average person.
If they see that you are writing a prescription for - let's say - Lexapro, using a Lexapro pen, while looking up at your Lexapro wall clock/calendar to recall the date, they are very likely to assume that you are simply dispensing the 'drug of the month', that you are getting a kick-back, and didn't really listen to what - they feel - was a heart-wrenching talk about their panic attack situation.
Sure, it's fine to take the free goodies that the pharmaceutical companies give you - but take them home or give them to your office staff to take home. Buy yourself a nice wall clock, a nice pen for yourself, a ton of plain ballpoint pens for your office staff, and some inexpensive plain paper, because honestly? You'll look like a sell-out, and will very likely not have a very good relationship with your patient from that first impression onward.
These tips on trigger words and actions are just the tip of the iceberg. You simply have to think on the level of the person that you are trying to work with. Where is THEIR mind? Sit where they sit and look around and try to think as they think. See what they are going to see. What could you change?
As I said earlier, the further into treatment your patient gets the more comfortable they should be with these trigger words and situations, and of course, if they aren't - then a time will come to address them. The first few meetings, and especially the very first meeting, is definitely not the time for that.
People with panic disorder don't have to be handled as if they are completely fragile. They are anything but! They face sheer terror often on a daily basis, and get up again the next day to face the world again. If they were in a race they'd finish right along with everyone else - only they'd do it carrying a 50 pound bag of sand on their backs.
So, it isn't my intention to suggest that you coddle people with panic attacks - instead, just be sensitive to their triggers so that they have a chance to benefit from what you have to offer.
By following the simple suggestions in this article you will be using your time and resources more effectively, and the person with panic attacks will be more receptive to you. It's a win-win situation.
Elizabeth Stafford http://www.bellatango.com