Panic Attacks: Insights from David Powlison

Scared woman prayingLast week our church had the opportunity to host the NANC (National Association of Nouthetic Counselors) annual conference.  I thought it would be helpful to share a few insights about Panic Attacks from a workshop given by David Powlison.

Insight #1:  Vulnerability and Lack of Control is a central issue in the heart of those who experience panic attacks.

It helped me to think of panic attacks within the category of vulnerability.  It is true, of course, that we are all vulnerable to a great many things.  However, panic comes when we have a sense of heightened vulnerability.  It will never do to simply encourage someone to “pull it together” or “to minimize their sense of vulnerability.”  However, in the process of helping people who experience these debilitating attacks we want them to understand how their attacks begin with a sense of vulnerability and lack of control.

Insight #2:  Those who experience panic attacks need a larger worldview to process them.

It is unlikely that reason will simply move someone out of an attack.  However, at some point that person will need to have the ability to focus on the bigger picture.  The reality is that this life is full of real and genuine threats. It is true that those threats may result in some kind of pain in our lives.  However, the larger worldview is that God has communicated with us that “Do not be afraid … for I am with you.” In other words, God meets people in their fears and grants them the courage to function in a way that pleases him in the midst of that fear.  The psalmists often speak of real and genuine threats to their life and security, but find strength and solace in their relationship with God.

Insight #3:  Those who experience panic attacks need to view those attacks as informative rather than devastating.

Panic attacks are devastating.  Life feels like it is spiraling out of control.  The person living the attack seems to have no way out of it. They may feel hopeless and completely alone.  As long as these thoughts persist, the attacks will continue to be devastating.  But what happens if the person learns to see the attack as informative? What if the onslaught of an attack is like the “check engine” light of our car?  What happens if they begin to see the attack as a warning sign that their fears and vulnerability are taking God out of the picture?  It seems that if they can process these moments as an opportunity to run to the Lord, to seek his help, to cling to his promises then God will meet them in that fear and vulnerability.  God’s grace and help will come and the person will avoid the chaos.  The sense of danger may not disappear, but there is a confidence in the sense of danger that God is there.

As I listened to Powlison, something else struck me:  I could relate to people who have panic attacks.  Initially, I went to the session because I wanted to learn something about which I had no personal experience.  However, by the time he finished I had remembered one “panic type” moment in my life.  I was having a medical procedure done and the equipment being used gave me the sense that I was about to be confined and then crushed.  I began to hold my breath and I tightened my muscles.  The more I did, the more I began to spiral into the thoughts of confinement.  I did not have any reason to fear, the tests were completely safe.  But at that moment I could not simply convince myself of that.  In fact, the tests had to be stopped and the medical personnel put me into a room to relax.  It was not relaxing.  There was nothing about the whole situation that was relaxing.  However, I took the time to pray, to ask God for his help in the midst of my fear, and to strengthen me for the remainder of the task.  In other words, I needed a bigger worldview.  That is exactly what God did.  As they restarted their work, I felt the fear coming, but God met me in the fear and the tasks were completed.  While my attack was minimal and much less severe than those who experience panic attacks, it was a reminder that (1) I could relate to counselees who struggle here and (2) that God genuinely meets us in our fears and gives us the courage to live for him in the midst of those fears.

Sometimes “labels” can be intimidating.  The label seems to put the situation in an entirely different category and one to which we cannot relate.  However, as Powlison showed, we can identify with people.  We can guide them lovingly, gently, and with great compassion because we, like them, are susceptible to the same or similar things.  Let me encourage you to run to the Lord, deepen your worldview, see fear and trouble as an opportunity to identify struggles and as an opportunity to run to the Lord, and to live please to Christ in the midst of your struggles.

Rob Green
Pastor Rob Green oversees Faith Biblical Counseling Ministries. A seasoned counselor, Rob also teaches others how to counsel--through FBCM's training conferences and Faith Bible Seminary's MABC program.