Therapists are humans too! (re-thinking panic attacks)
I am a therapist and on occasions I have panic attacks. In fact, I had one yesterday.
There. I've said it.
There seems to be some illogical assumption 'out there' that counsellors, psychotherapists and psychologists are somehow immune to the stuff of life because we've read some books, taken some exams and probed deeply into the understanding of what makes us humans tick.
But we are still human and as such vulnerable to stress, pain, fear, rejection and even the common cold. We are not all-knowing gurus sat on thrones in our clinical chambers. And just because we have been taught how to 'not take our work home' doesn't mean that we are somehow impervious to vicarious trauma or others' heartbreaking experiences. We are not supposed to be stone-wall, stone-cold clinical experts with the emotional sophistication of switching a kettle on and off.
We have lives filled with stuff, and we have our own stuff, too. It takes a certain kind of person to enter into the caring professions.
- Must have true empathy (not a sympathetic smile and nod).
- Pulling sickies not an option.
- Be able to compartmentalise your own life and worldly worries to get on with the job (and yet we admonish patients' repression...)
The latter approach appears to work reasonably well - for a time at least. But like a car driving in top gear for hundreds of miles, the petrol is eventually going to run out.
Welcome to the professional world of compassion fatigue. It's a bit of a shameful stigma to admit that to your peers and clients. 'Perhaps they're not cut out for the job... maybe they're not well-equipped to cope... are they mentally stable enough to work with clients...?' and the nonsense goes on.
Yesterday, after my tenth consecutive week of six-days-a-week working in private practice I had a very unexpected panic attack. It occurred directly after my final client of the week (oh, the power of the psyche) and started in my stomach - a dreadful nauseating sensation that my intestines were about to bleed open, with a toxic cold bleach-like feeling rushing up my spinal cord until it reached the top of my skull, burning in a concentrated spot then spreading out over the left of my brain and face. This jolt was not only terrifying and out-of-the-blue but left me dizzy from the head rush and completely out of sorts for hours. I remained relatively calm in the knowledge that I wasn't having a heart attack (or more specifically stroke as I thought) and that my body was simply reacting to an extreme hit of adrenalin pin-balling its way around my quiet and unassuming body.
I would like to dispel the myth right now that all panic attacks (or anxiety for that matter) have the slightest thing to do with worry. Prior to the coat-tugging of my central nervous system, I had just had a lovely lunch out with my boyfriend followed by a positive eureka-infused session with a wonderful client.
Let us strip away the rubbish out there about what anxiety is, and indeed put those 'Do these five things to beat anxiety!' in the bin. Helpful tips as they might be to some, your biological evolution and sympathetic nervous system will categorically not be re-set by eating a banana or taking a few deep breaths. We need to know our enemies. Here is one of them:
Let us call him Colonel Cortisol.
Under times of stress, cortisol (a steroid hormone manufactured in your adrenal glands) gets released into your bloodstream with an important mission of managing your metabolic response, focus and immune system. Thank you very much Col. Cortisol.
However TOO MUCH of the blighter - whether accumulated by over-exposure to environmental or psychological distress - will result in all sorts of central nervous malfunctions throwing your finely attuned system into disarray (think of it like Buckaroo if you will). Sleep, mood, stress, memory, general health and well-being - 'all buggered up' to coin the more intellectual and professional terminology.
There is of course more to this story than just cortisol running rampant and if we're being honest, science still isn't 100% clear on what they're all about. Theories about abnormal activity in the brain's amygdala (our emotional command centre) seem to be the favourite - personally I see it in terms of simple waves and energy:
Keep banging a gong and you're never going to get silence.
But let's just stop all the nonsense, shame and stigma. If you have a panic attack (most people will in their lives) it does not mean there's something wrong with you. If anything it proves you are actually a human being (and not an android or superhero) and that you need to take some form of action to help your body return to its natural state of balance and stability (homeostasis). This may well include talking therapies, life adjustments, yoga, laughter, music, medication, nutrition (actually Magnesium and Omega 3 are proven to decrease cortisol levels) or cuddling animals. Whatever works, works.
None of us are immune unless you've undergone some radical biological evolution of which we're yet to hear about, so let's normalise this and stop shaming those who struggle with these types of deeply unwanted and bloody unpleasant experiences.
For me, I take heed of this warning signal. I've been working super long hours and with a huge amount of stress in my personal life. I have refused to let it interfere with my work but the body is smart. Every pressure cooker needs a release valve.
And should this piece be met with raised eyebrows or under-breath whispers from any of my clinical peers, I offer these words of advice to you:
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About Stephanie Jones
Steph Jones is a BACP Registered Counsellor and Psychotherapist supporting clients at her private practice in Stockport, Cheshire. A former Executive Board Member of MIND Manchester, radio presenter, musician and journalist, Steph writes for a number of wellbeing publications and is working on a book. She lives with partner Mike and Ziggy the cat.