Panic and Suffocation

The problems with breathing, the shortness of breath and panic in the face of suffocation are rampant among my patients. Most of it stems from real suffocation at birth where for many reasons there wasn’t enough oxygen for the newborn. The most frequent reason was the massive anesthesia given to the mother or heavy doses of painkillers which effectively shut down the neonate’s breathing. Even epidurals can cause the shutdown. The baby cannot catch its breath. And because of that there is a panic state as death approaches. It is the same panic that adults suffer from time to time; a state that seems to come out of nowhere. Anything that is suffocating, even a biology class or a crowded noisy restaurant can set it off. The breathing problems are part of the reaction syndrome to lack of air early on. It would seem that it all comes out of the blue but in reality it is a reaction. Nearly always a reaction since panic is not a natural state in us humans. The question is “a reaction to what?”. If only we therapists could get use to asking “to what?”. Instead, we often stop there and begin our regime of suppression with pills. We are suppressing memory, and access to ourselves and our feelings.

There is research into this subject that claims it happens when a trigger is set off erroneously. It is not erroneous. It is precise, albeit symbolic. The feeling is the same whether in a room with lowered oxygen or in a crowded noisy restaurant. What is most likely to trigger off panic is the feeling of being trapped, stuck and unable to escape. Being in a situation that evokes all that; being trapped at the DMV in an interminable line and when you get to the counter they tell you that you need to fill the papers better. Or worse, being trapped in a home with rules and discipline and no love. Or being trapped in a job that has no future and no “room to expand.” That is the compounding factor. There are many ramifications that ultimately trigger off the earlier imprints. Being in a car with windows closed can do it, or in a room that is very stuffy. All roads lead to Rome. Sometimes just a passing thought can trigger the panic and the person is not even aware of what that thought was.

There is real suffocation and often the compulsive sighing that goes along with it. I call it the “Jewish mother-in-law syndrome.” But what seems to happen is fluctuations in what is known as the PC02 and lactate. PC02 is an index of the partial pressure of carbon dioxide and tells us how much carbon dioxide is in the blood. When they are high there is also a higher level of lactate and the result is the physiology of panic.

And what is this trigger? Remember there are higher levels than the pure physiologic one. And each higher level represents the basic brainstem reaction in its own way. Each higher level of the brain adds a different quality to an experience. So the second-line feeling system adds emotional tone and images, while the neocortex puts it all to words. And it works in reverse. A certain emotional situation or certain words addressed to the person, a demand or an insult, can run down the chain and trigger off the original panic. The origin is so deep down and so remote as to make the reaction a mystery. With deep personal access it no longer is a mystery.

Thus, the imprint of suffocation changes the physiology toward panic. Deep breathing diminishes panic for the moment. As does primal because a session that includes heavy breathing and crying lowers the levels. Later on, it will be painkillers (opioides) that will suppress panic; yet it is the deregulated painkilling chemicals associated with the early suffocation at birth that are partly to blame.

I have discussed the compounding process elsewhere; a lack of love, an oppressive household, an overprotective, suffocating mother can all add to the symptom. A mother’s real love and affection early on can also diminish the force of panic attacks by raising the inhibitory/repressive chemicals in the brain. There is an important difference between a suffocating, over-protective mother and one that offers true love. I had a mother like that; she had a terror of her kids getting sick and her having to take care of them. So she watched over them all of the time, never giving them freedom to make a mistake, i.e., suffocation.

There was, and is, a window of healing. To achieve that now means traveling down the chain of pain to origins and opening the window again. Otherwise, we are only left with pushing down the panic which can go on for a lifetime. What makes it all worse is when the mother is distant and unloving with her baby. It is why some children go into panic as soon as they cannot see their mother. It triggers off, perhaps, the anoxia again. A lifetime of disordered breathing can be set off during this critical window. This may be due to affects on some brainstem structures such as the medulla. In short, breathing difficulties can be first line symptoms, which can only be treated by descending down the levels of consciousness to the first line.

Let’s not make the mistake of considering the panic syndrome a maladaptive response. It is perfectly adaptive and commensurate with the asphyxiation that went on at birth or before. It would be abnormal if there were no “abnormal response.” When someone shuts off our air we all get panicky. That means we have triggered off our alarm system; cortisol pours into the system as we get ready to flee. And what we are fleeing from? Our memory.

Don’t be mislead about taking pills or shots to push down the panic. Pushing it back is not the same as erasing it. It stays and gnaws away until other organs, not the least of which is the heart, cease to function properly.