by Marina Angeli
Several years of work with patients suffering Panic Disorder have convinced me that flower therapy, when combined with psychotherapy, can result not just in an almost immediate relief from symptoms with no need for chemical medication, but also in a fast and profound treatment of the underlying emotional causes of this problem.
In our days, many people are suffering from the so-called Panic Disorder. Panic disorder is characterized by spontaneous, unexpected panic attacks. The typical picture of a panic attack is that of a person who, all of a sudden, experiences symptoms such as tachycardia, dyspnea, palpitations and sweating. The symptoms increase rapidly during a period of 5-10 minutes. Symptoms may feel as life threatening and the great fear that arises because of them can result in a further worsening of the situation. Panic attacks most typically occur in closed-in places, in a crowded bus for example or in any sort of place from where the person could not get out immediately, although such crises may happen anywhere at any time. The crises last usually only for 20-30 minutes to a maximum of one hour, and during them sufferers experience great fear and anxiety. Soon after the first 1-2 episodes, they develop a great fear and apprehension about having similar crises. They suffer because of this fear and usually try to change their habits and life style in ways that make them 'feel safe'.
More often than not, they start to avoid going out in the public, unless accompanied by someone they know well, for the fear of a sudden panic attack, which would expose them publicly. This is known as 'agoraphobia', and then we speak of 'Panic Disorder With Agoraphobia'. They may also develop claustrophobia, a situation in which the person avoids closed-in spaces or vehicles, such as tunnels, bridges, elevators, buses, trains or airplanes. If they make it to go to a theatre or cinema, they will try to have a seat next to the corridor and preferably near the exit, for the case they get into panic and want to leave the place immediately.
Typically, people who suffer panic attacks visit many physicians and have lots of medical examinations, always without pathological findings. One will meet them in the emergency rooms of hospitals at any hour of the day or the night, being reassured by the doctors that nothing is wrong with their heart, and that their health is perfectly all right. They will return home, only to come back to the doctor with another panic episode, a few hours, days or weeks, and rarely, months later.
Finally, their physicians tell them that their crises result from anxiety and that they should seek psychological treatment. It is at that point they start visiting a psychiatrist.
Conventional medicine usually treats Panic Attacks with antidepressants and/or mild tranquilizers. Alprazolam, a benzodiazepine with the commercial name 'Xanax', has been the drug of choice over the last years. Patients strongly depend on it and they usually take it on a regular basis to have their anxiety and fear temporarily appeased. According to the current conventional medical treatment of Panic Disorder: Once effective, pharmacological treatment should generally continue for 8-12 months. The available data indicate that panic disorder is a chronic, perhaps lifelong, condition that will recur when treatment is discontinued. Studies have reported that from 30 to 90 percent of successfully treated panic disorder patients relapse when their medication is discontinued. Various reports have concluded that cognitive and behavior therapies are superior to pharmacotherapy alone; other reports have concluded the opposite. (Kaplan & Sadock 'Synopsis of Psychiatry': Panic Disorder and Agoraphobia)
It took a long time of experimenting with different flower essences before 'a formula' that really works in panic attacks became obvious. In the beginning, my attention tended to be 'symptom oriented', focusing on the symptoms of fear and trying to have the fear relieved with flower essences. So I tried all essences concerning fears, like Mimulus, Aspen, Rock Rose, Rescue Remedy and more. To my surprise, they would make practically no difference, as people's emotional situation would not change to any considerable degree, nor did their psychosomatic symptoms. I knew from experience how effective flower essences concerning fears had proven to be. So, why had we no results here? If panic was the real issue, why did it not respond to the essences?
Soon, I tried to change perspective and hypothesize that, although panic attack sufferers insisted that excessive fear was their main, if not exclusive emotion during, as well as between the crises, fear might actually be the outer expression of a more complex emotional situation lying underneath, which could be responsible for the psychosomatic phenomena they had experienced. This might explain why flower essences for fears had proven inadequate to handle the fears and anxiety and to remove the agoraphobic reactions. Viewing panic attack as the effect rather than the cause might be necessary in trying to apply flower therapy in this problem. As a matter of fact, such questions as: 'How was the patients' life before the panic attacks? What led to such a level of anxiety? How is their life now, except for their symptoms?' became important.
The first step was to try to understand the emotional state of someone who has acquired so much an inner tension that he suddenly witnesses enormous anxiety exploding in his body. A number of essences started to appear as potentially useful. At first, the very 'explosive' nature of the symptoms seemed to be pointing towards Cherry Plum. The person was acting as if unable to tolerate the inner tension any longer, bursting out, the loss of control being expressed as a physical turmoil, an aimless intensification of body functions to a state of emergency. Many times the suffering person is literally feeling that s/he is going crazy. On the other hand, the fact that, such crises often occur in closed-in or crowded places, where the person has little or no control over staying of leaving immediately if s/he wishes, should perhaps be viewed as symbolizing a lack of control in the person's life. The restricting outer situations could just symbolically represent an inner state of emotional 'suffocation' and despair, where finally emotions get out of control, such as found in the negative Cherry Plum state.
Next, one could detect a tremendous impatience, during, but also, between the crises. The patients wanted to exit the closed-in space immediately. Their psychosomatic symptoms of tachychardia, dyspnea, etc., were all symptoms of emergency. Moreover, I noticed that these people were constantly in a state of impatience, though not aware of it. Impatience was their natural reaction to their intolerable inner tension and dissatisfaction, which, like in a volcano explosion, would find a way out and become released during the crises. So the next essence might well be the Impatiens.
The third striking thing in cases of panic attacks, was that the person never seemed to have the slightest idea about the cause of their problems. Being in such an emotional emergency, they still considered their problems entirely physical. They would visit practitioners of all medical specialties except psychiatrists or psychologists, they would come for therapy only when referred by their physicians, and even then, they were unable to make any correlation between their symptoms and their overall life situation. The idea of attempting a psychological interpretation never seemed to occur to them, not even when they were prompted to. They did not seem to think that a panic episode is not much likely to appear out of the blue, and that a high level of tension must have already been present in them, long before the onset of the physical symptoms. They could not understand themselves, and this increased their panic. I took this as an indication for Chestnut Bud.
Working with Panic Attacks sufferers, I noticed over time that they almost always were extrovert personalities, who tried to avoid their problems and to shift their attention to pleasant diversions for as long as they could. When panic attacks appeared, they kept their panic and anxiety to themselves or within the family and did their best to appear normal and even cheerful to the outside. All of them greatly suffered at the idea of having panic attacks in the presence of others, thus becoming agoraphobic. So, Agrimony was added to the formula.
With Cherry Plum promoting emotional differentiation and accelerating contact with the inner feeling life, with Chestnut Bud increasing awareness about the causes of personal difficulties, with the soothing effect of Impatiens and with Agrimony relaxing the need to hide negative emotions, people were now becoming able to look inside themselves and perceive a lot of what was going on within them. So, it was now possible to ask them questions such as: Is there any situation in your life where you feel trapped in or pressed by, a situation that causes you to feel about to explode? From what in your life you would like to escape from, to get rid of? Are there instances in your life where you feel as dependent, uncomfortable, powerless, suffocating, as in the panic episodes?
It always appeared that, in fact, patients had become increasingly dissatisfied with their lives, already for quite some time before the onset of symptoms. They found their life conditions intolerable, but felt unable and/or unjustified to change them. Such conditions always concerned close relationships, usually with family members, most often with parents, who were overprotective, over-caring, and at the same time, psychologically and in some cases even physically, very dependent on the patient. The panic attack sufferer typically was over-concerned about the loved ones, felt responsible for them, let him/herself be manipulated by them, felt overburdened by their problems and their attitudes towards him/her, but at the same time doubted his/her ability to cope without their help. In addition, some patients felt trapped in conditions such as a job they did not like, even an entire lifestyle, which did not suit them, but they could see no way how to change it.
Since worry about loved ones was the main reason they resigned from trying for the better in themselves, Red Chestnut was the next choice among the essences. Although the negative Red Chestnut state was not apparent in the initial stage, it became obvious when the patient was confronted with the need to take action and to do what he or she needed in order to change his/her life and be happy. They need me. How can I ignore them and do my own thing? Red Chestnut has proven a 'strategic' choice, as it opened the way for them to break free from dysfunctional patterns in relationships and thus, move towards health.