Prime Time Replay:


Raeann Dumont
on Coping with Panic, Anxiety, and Phobias



MsgId: *brain_storm(2)
Date: Fri Apr 18 22:04:34 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

Good evening, everyone, and welcome to another edition of Brainstorms! I'm your host, Rob Killheffer, Senior Editor at OMNI. Our guest tonight is Raeann Dumont, a specialist in the treatment of phobias and panic disorders, and the author of THE SKY IS FALLING: UNDERSTANDING AND COPING WITH PHOBIAS, PANIC, AND OBSESSIVE-COMPULSIVE DISORDERS. Welcome, Raeann.
MsgId: *brain_storm(3)
Date: Fri Apr 18 22:05:33 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Welcome to you, Rob!
MsgId: *brain_storm(4)
Date: Fri Apr 18 22:06:58 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

Thanks for joining us, Raeann. Let me ask you first a little about your background. You're a practicing psychotherapist, treating people with these disorders?
MsgId: *brain_storm(5)
Date: Fri Apr 18 22:08:06 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Yes, for about twenty years.
MsgId: *brain_storm(6)
Date: Fri Apr 18 22:09:12 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

From your experience, what brings on a phobia or panic disorder? Is it primarily linked to events in a person's life, or a chemical or anatomical problem in the brain -- or both?
MsgId: *brain_storm(7)
Date: Fri Apr 18 22:10:38 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Since I focused on the cognitive behavioral, generally what we find is a major change or stress or loss in a person's life that makes them feel vulnerable, that makes them feel the world is a dangerous place. It may be something that occurs where they have an initial panic attack that exaggerates their sense of vulnerability.
MsgId: *brain_storm(8)
Date: Fri Apr 18 22:12:56 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

Two weeks ago my guest was a specialist in anti-depressant medications, and we talked a little about the effects those drugs could have on panic and anxiety problems as well. What's your opinion of the efficacy of drug treatments for these disorders?
MsgId: *brain_storm(9)
Date: Fri Apr 18 22:15:13 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Current thinking in the field of panic disorder is that the combination of medication and cognitive behavioral therapy is probably the best for people who have a very serious problem. For people who have a lesser problem, generally we start with cognitive behavioral therapy, because there's no side effects there. If they don't show affects in a few months, then we may want to look at the medication. There are people who are looking for a solution to their panic disorder who aren't able to concentrate on the cognitive behavioral therapy because of their panic attacks and that person may be better off starting with the medication and then going into cognitive behavioral therapy.
MsgId: *brain_storm(10)
Date: Fri Apr 18 22:17:16 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

I want to ask you to describe some of the techniques of cognitive behavioral therapy, but first let me ask you: have you noticed any evidence that panic, phobias, or other related disorders are genetically linked -- do they run in families?
MsgId: *brain_storm(11)
Date: Fri Apr 18 22:19:37 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Yeah, there seems to be a definite link. One of the biggest studies on separated twins has been in, I believe, Sweden, and they find a much higher proportion of anxiety will run in twins, even separated twins, so the issue of a genetic connection there seems quite clear. That doesn't mean that if you have those jumping genes that you will spend the rest of your life with a panic attack, because anxiety disorders are probably one of the easiest to handle in the field, so the person doesn't have to go on with a panic disorder.
MsgId: *brain_storm(12)
Date: Fri Apr 18 22:22:27 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

And that brings us to the main question: exactly how you go about handling a panic disorder. What are the techniques of cognitive behavioral therapy, and why do they work so well?
MsgId: *brain_storm(13)
Date: Fri Apr 18 22:25:00 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Well, it's kind of two-pronged. First prong is the cognitive part, which is looking at the thinking the person is doing. A person who is phobic of elevators is telling himself something different than I'm telling him. He's saying this experience will be dangerous, so we want to know what he's thinking that it's dangerous. The other part is the behavioral and that means I actually go into the elevator with the person. A lot of times people are responding to a conditioned response, so every time they go into an elevator they get panicky, because they've done that for so long, so we want to decondition that response as well as rethink the danger issue -- why is this elevator dangerous when it isn't for so many others?
MsgId: *brain_storm(14)
Date: Fri Apr 18 22:26:32 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

So you actually accompany your patients during their panic-producing experiences? Is that a common technique for therapists treating panic or phobias?
MsgId: *brain_storm(15)
Date: Fri Apr 18 22:28:01 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

It's not nearly common enough, but it's certainly the most effective.
MsgId: *brain_storm(16)
Date: Fri Apr 18 22:29:11 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

About how long does it take for cognitive behavioral therapy to show some effect? And how much better do your patients get?
MsgId: *brain_storm(17)
Date: Fri Apr 18 22:32:30 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

First question, how long does it take - it's hard to say. If a person has not had it too long so their entire life isn't affected by the panic disorder, we look at one way of getting better. If they have their normal life and activies, all those things bode well. However, if they've had it a long time and their whole life is limited by it, and they don't have people who can work with them and limit it, it's going to be a long haul.

By and large, a person should expect to see some improvement within a couple of months to three months. At least they'll understand where it comes from and grasp the problems. In terms of "can they ever get over it," yes, they can. They may always have a "jumpier" reaction to things, but the catastrophic thinking and the whole assortment of physical sensations don't have to follow that initial jump and at that point, we pretty much consider the person over their panic disorder.

MsgId: *brain_storm(19)
Date: Fri Apr 18 22:34:54 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

How do you determine when someone is suffering from "panic disorder" or a "phobia," as opposed to just having normal (or somewhat higher than normal, but not pathological) levels of worry or anxiety? That is, where do you draw the line between someone who needs treatment and someone who just needs to lighten up?
MsgId: *brain_storm(20)
Date: Fri Apr 18 22:36:02 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Actually, I don't draw the line. If the person feels that their live is messed up by the problem, then they draw the line and then they will come in for help or therapy on the problem.
MsgId: *brain_storm(21)
Date: Fri Apr 18 22:38:06 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

That's interesting. Do you think there's been a rise in the frequency of panic, phobia, and anxiety disorders over the past couple of decades (or longer)? Is this, as some people think, a disease typical of our hectic, overstressed world?
MsgId: *brain_storm(22)
Date: Fri Apr 18 22:39:17 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

There's certainly been a rise in the recognition of it, it's hard to tell if there's been a rise in the actual condition because for so many years people didn't have a name for it, they didn't know what it was, and for a long time, there was a lot of secrecy. They didn't want to admit they had a problem.
MsgId: *brain_storm(23)
Date: Fri Apr 18 22:41:27 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

One thing I noticed in reading your book was a pattern in many of the case stories you told: most of them seemed to build up to their problem by a series of steps, first with a small amount of worry that doesn't interfere with their life; then more persistent anxiety that interferes a little but not so much they can't compensate; then deeper and more chronic obsessive worry that really begins to eat into their lives. It's like it sneaks up on them.
MsgId: *brain_storm(24)
Date: Fri Apr 18 22:44:07 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Yes, that often happens. The initial panic attack will give the person a sense of vulnerability and if they're under a lot of stress, it's hard to bounce back to that. But the glimpse of the panic attack, and the idea that the person is going to go crazy or die or something terrible is going to happen, stays in their mind and other stressors tend to happen and then it goes into a downward spiral in their mind.
MsgId: *brain_storm(25)
Date: Fri Apr 18 22:46:32 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

I'm going to go out on a limb here and tell you that I myself have suffered from an anxiety disorder for two and a half years. (I'm not angling for a free therapy session here, just wanting to introduce some questions that derive from my personal experience.) Most of the stories in your book showed people whose obsessions or phobias tended to be focused on some particular situation, place, or object -- cleanliness, bridges, snakes, whatever. My own experience has been somewhat different: I feel the anxiety in just about every situation, no matter what I'm doing. Certain things are more challenging and certain things are less, but all in all there's no single (or even multiple) focus of the fear. Have you encountered cases like that?
MsgId: *brain_storm(26)
Date: Fri Apr 18 22:48:57 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Many, many, many, many. That's generalized anxiety disorder and the majority of people I see generally have generalized anxiety disorder and they didn't appear in the book because it's so hard to describe the condition or the anxiety or the source of the anxiety. It's easier to describe the anxiety when it's a driving anxiety, or a washing phobia.
MsgId: *brain_storm(27)
Date: Fri Apr 18 22:49:58 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

So does the same sort of therapy work on cases like mine? I mean, you could hardly accompany me throughout my day, right?
MsgId: *brain_storm(28)
Date: Fri Apr 18 22:51:26 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Couldn't accompany you on your day, but what I have people do is keep a diary so they can identify the catastrophic thoughts that lead to the anxiety and then reality-test them.
MsgId: *brain_storm(29)
Date: Fri Apr 18 22:53:55 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

I know that there are many many hospitals, universities, and other institutions engaged in studies of panic/anxiety/phobias at the moment -- it seems to have become a pretty popular subject for research. What do you see emerging from all that study -- new forms of treatment? New insights? Or just increased validation of what we already know?
MsgId: *brain_storm(30)
Date: Fri Apr 18 22:56:54 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

I think we're seeing more insights in terms of identifying people earlier and encouraging teachers, for instance, to recognize children with panic disorder and arrange for help for them much earlier. Finding ways to reach people who still don't know what they have, because many people don't, they think they have some strange disease that has their heart racing and knees wobbling. So I think we'll certainly see newer and better medications coming out of it, although the cognitive behavioral therapy remain the most efficient ways to help it. But most of what we're seeing is better and faster identification so it doesn't become engrained in a person's life.
MsgId: *brain_storm(31)
Date: Fri Apr 18 22:58:22 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

When I first started to experience panic attacks and extreme anxiety, I had literally never heard of the condition -- and so it was much scarier since I had no framework into which I could place my experience. Even now I was a little hesitant to mention my own experience in this public forum. Do you think there's still a strong stigma attached to anxiety disorders, so that sufferers keep it to themselves when they could get help if they would speak out? Or is that changing quickly?
MsgId: *brain_storm(32)
Date: Fri Apr 18 23:01:52 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

There's still a lot of reluctance on the part of some people to admit they have an emotional problem and they will look for a physical source after all possibilities have been exhausted. It is disappearing, the reluctance to relate it as a problem, but not as quickly as I'd like to see it disappear all together.
MsgId: *brain_storm(33)
Date: Fri Apr 18 23:02:31 PDT 1997
From: Rob_Killheffer At: 38.254.181.13

We're just about out of time, so I want to thank you, Raeann, for appearing here on Brainstorms. I'm sure our audience learned a lot from our discussion -- and, for all who are looking for more information, check out Raeann Dumont's book, THE SKY IS FALLING: UNDERSTANDING AND COPING WITH PHOBIAS, PANIC, AND OBSESSIVE-COMPULSIVE DISORDERS. It's available in our OMNI Bookstore here on this site. Until next time, thanks for tuning in, and see you all next week!
MsgId: *brain_storm(34)
Date: Fri Apr 18 23:04:03 PDT 1997
From: Raeann_Dumont At: 207.172.56.102

Thank you for inviting me to your chatroom and I hope it has been helpful for your readers. Good night!


Home || Prime Time || Live Science || Machine Dreams || Project Open Book || SF-Fantasy-Horror
Continuum || Antimatter || Mind-Brain Lab || Interactive IQ || Gallery || OMNI Toons

Questions, comments and suggestions can be mailed to the webmaster.


Copyright (C) 1997 by Omni Publications International, Ltd. All Rights Reserved.