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The fear of insanity is the second most common fear. We all try to get control over what is happening to us and the harder we fight, the worse we get.

Trying to understand what is happening to us continually pushes us to the limits of our knowledge. We cannot find anything in our past experience that even comes close to what we are experiencing now, so many of us feel we are going insane.

We’re not, although it often feels like it. Some of the other symptoms we experience don’t help to break this fear; they usually add to it.

Dissociation

The role dissociation plays in anxiety disorders is now being examined. From what I have found over the years, the ability to dissociate is found in a large subgroup of people who experience spontaneous panic attacks. Dissociation can also be described as altered or discrete states of consciousness or trance states. Altered or trance states are found in many cultures. They can be an ‘accepted expression of cultural or religious experience in many societies’ (APA 1994). A leading expert in altered or discrete states, Dr Charles Tart (1972) comments that many other cultures, ‘believe that almost every normal adult has the ability to go into a trance state’.

Individuals in other societies induce trance states not only by meditation, but by fasting, sleep deprivation and other forms of physiological stress. For those of us who have the ability to dissociate, major stress can make us more vulnerable to dissociation, or the stress can be a cause of our not eating properly or of losing sleep, which in turn increases our vulnerability to dissociate.

The ability to dissociate is not harmful in itself, but our lack of understanding* of the phenomena can lead to acute anxiety and panic. Although some people with panic disorder report they are not frightened of these sensations, others are, and the fear contributes to the feeling of going insane or loss of control.

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The anger many of us feel can be used in a positive and constructive way. When we direct our anger towards the disorder instead of ourselves, it can be the ‘rocketship’ towards recovery. I will discuss this further in chapter five.

We can also use our anger to help bring about changes to the health care system. If we are being completely open with our doctor or therapist, and they don’t know or want to understand, then we need to find someone who does. In the past this was not easy, but the situation is changing and will continue to change if we break our silence.

While we may still not wish to tell employers and friends, there are still other things we can do. We can write letters to the governing bodies of the various health professions and to the local state and federal members of parliament. We can keep writing until we receive a satisfactory response. Local self-help groups or the Consumer Health Advocacy agencies in each state are also available for advice and support. Individually we live in silence. Together we can break it.

Most importantly, our anger must not prevent us from seeking help. Understanding why various therapies haven’t worked will help us understand what will.

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Paul

Paul sat on the side of the hospital bed. He was being discharged after a night in hospital for observation because he felt as if he were having a heart attack. The specialist had told him he had not had a heart attack, but a panic attack. Paul had tried to tell the specialist that of course he had panicked. He had felt terrible and thought he was going to die. Surely, he thought, it was normal to panic under those circumstances.

Julie

The end of Julie’s shift was in sight. Another hour and she could go home, but first she had to hand over to the nurses on afternoon shift. She felt her stomach tighten and her anxiety increase. Julie had never had problems talking in front of other people before but the thought of hand-over today terrified her. She remembered the last few weeks and how it had become increasingly difficult for her to appear ‘normal’. Julie had had her first panic attack at work. Although she knew what was wrong with her, she was having enormous difficulty trying to ‘pull herself together’. She couldn’t control what was happening to her. She knew the other nurses wouldn’t understand if they found out. Julie felt she couldn’t go to any of the doctors at the hospital where she worked, as she was frightened they would make her resign.

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Carolyn

It had been a long and difficult week. Carolyn was glad she now had some time to herself. She curled up on the lounge with a book she had been wanting to read. As she relaxed she felt the tension ease from her body and she felt herself drifting into sleep. Without warning, she felt a wave of incredible energy surge through her body. As it moved through her, her heart rate doubled, she had difficulty breathing, she felt lightheaded and dizzy, a wave of nausea swept over her and she began to perspire. She jumped up and ran outside to her husband. ‘Help me, something is happening to me, I don’t know what but something is very wrong.’

Alex

Alex disliked staff meetings and social get togethers and did what he could to avoid them. He felt more comfortable just doing his job and avoiding any personal interaction with other staff. Now the new owners of the business had arranged a dinner for all staff and their partners and, like it or not, Alex had to go. He had been feeling uncomfortable all day and he knew his anxiety levels were very high. As he and his wife sat down at their table the people next to them began to make conversation. His heart began to race, his breathing became short and shallow, he began to perspire heavily and his hands trembled violently. As he tried to control it, he thought to himself, I shouldn’t have come. This always happens every time I am in this situation.

Jessica

Jessica turned on the ignition of her car. She was feeling very anxious. Is it going to happen today? As she pulled out of her driveway she tried to rationalise with herself for the hundredth time. She wasn’t frightened of driving, in fact she used to enjoy driving before she began to have spontaneous panic attacks. But there was one set of traffic lights where she would sometimes have an attack. There was no pattern to it. Sometimes it happened, sometimes it didn’t. Sometimes she would have an attack after she had driven through the traffic lights; on other days there were no attacks at all. Someone had told her she was frightened of that particular intersection, but she thought that was ridiculous. She was frightened of the attacks and their unpredictable nature, it had nothing to do with the intersection.

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