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Counseling Those with Panic Attacks

Truth in Love 285

When counseling those who struggle with panic attacks, we must turn to the character of God.

Nov 16, 2020

Dale Johnson: Today, I am joined by one of our Board Members here at ACBC, Nathan Curry. Nathan lives here in the Kansas City area—he lives on the Kansas side, in Overland Park. He’s the Associate Pastor at Redeemer Presbyterian, a PCA church here in the area. He’s also the training center director at the Redeeming Grace Biblical Counseling Center, which is one of our Certified Training Centers at ACBC. We’re grateful for Nathan, his service on our Board and also the way he leads in biblical counseling, even at his own church. Nathan I’m so grateful that you’re here to talk about this, what I would consider to be a very important subject, that’s often even somewhat confusing or makes people curious about how we would deal with in biblical counseling. 

The way I want us to start, if we can, is to talk about panic attacks. Most people in the culture think about this in terms of inner fears that we have, or inner ways that we see anxiety flourishing, but also they describe it (partly because of the culture) by the way the body experiences those types of panic attacks. If we can, let’s start with that question. Let’s consider some of the inner man and outer man realities that people deal with in these things that we call panic attacks.

Nathan Currey: I think it’s really important that we not compartmentalize ourselves. We’re body and soul nexus put together. There are inner man issues that affect our soul and our spirit as we think biblically that way, but the outer man is a reality. We live in our bodies that God created for us. My go-to person on helping people with panic attacks is actually my wife—a wonderful resource for me in our family, but I remember back in the day a workshop that was at an Annual Conference. David Powlison did a workshop on helping people who experience panic attacks. He described these panic attacks as self-generated fear, such as panic, anxiety, and phobia. It’s an attack from within, it’s not grounded in something objective and realistic. Now, that doesn’t mean that it’s not in reality—that there isn’t something physical going on. But I think we all have these irrational fears sometimes. They may have a ground, a beginning in a legitimate concern, but then they start to take a life of their own. Then you start to get this outer man experience, where your heart’s pounding, your mind’s racing. You’ve got this hyper-vigilance going. Maybe you were trying to get to sleep and now that’s out of the question. These are real things, real experiences in the outer man. And they are related to the way that you think.

Dale Johnson: So many times when we think about panic attacks and people have these types of questions, I think it’s helpful that we distinguish between the inner man and outer man and how those things overlap—one driving the other, and how the outer man is influential on the inner man. Sometimes in biblical counseling we have a tendency to think, “Okay, now somebody’s dealing with a panic attack. How do we give them preventive measures in the future to not deal with panic attacks again?” And we’ll get to that, but I think it’s important also that we deal with these issues in the here-and-now. What are some of the things that we’re looking to accomplish when someone’s in the middle of a panic attack that they’re experiencing right now? What are some things that we can do to help? 

Nathan Currey: You know, as counselors we don’t always have that opportunity to be there right when that attack is going on, but many of us have the experience of one of our children going through a time of panic, going through this attack—usually around bedtime it would seem like these fears maybe start to crop in. When somebody is in the middle of a panic attack, don’t try and reason with them. I mean don’t try and rationalize and talk them out of it. A good example that I try to use with folks if they have a child that’s dealing with a panic attack or they have a loved one that’s dealing with that, in the middle of that panic attack they’re like a child, imagine your toddler, in the pool flailing around thinking they’re going to drown. I mean they may be in the shallow end. They may be just an inch away from touching the bottom of the pool, but they’re freaking out. They’re having this attack. Don’t stand on the side saying, “Oh honey, this is what you should do. That’s not right. You should think this way.” No! Jump in, get alongside them, and help them. 

I think one verse that helps to direct the triage of a situation is 1 Thessalonians 5:14, where not every problem is handled with the same approach. Admonish the idle, certainly. Is the person in the middle of a panic attack idle? No. Encourage the faint-hearted? Somewhat, but help the weak! Tn the middle of that panic attack, they’re weak and they need you to help. And then be patient with them all. 

Dale Johnson: That’s so helpful because sometimes when we see people experiencing something like that, we even feel paralyzed to some degree. Sometimes we feel like, “Well, I’m not the expert. How in the world can I help them?” Step in and just be with them—that’s a comfort in and of itself. As we think through this, obviously we want to be grounded in Scripture, so what are some of the passages of Scripture or scriptural truths that help us to address the issues that drive panic attacks?

Nathan Currey: I like to think of vertical verses to take us off of the horizontal plane of human existence to think, “What does God think of this situation? What should I be thinking?” Philippians 4:4-8 is kind of a go-to passage when it talks about not being anxious. In verse 6 it says do not be anxious about anything.

And sometimes you could take that as a command, “Don’t be anxious.” And it sounds crazy to tell somebody in the middle of a panic attack, “Don’t be anxious.” I think it was Ed Welch that said in his Running Scared book that it’s more of a concerned parent who says to their teenage driver, “Be careful out there.” Not, “Don’t be anxious.” In Philippians 4, I like to back up to verse 4 where it says, “Rejoice in the Lord always; again I will say, rejoice.”

Well, that’s hard enough to keep in mind and to do, but verse 5 says, “Let your reasonableness be known to everyone.” Well, if there’s something that defines a panic attack it’s unreasonable. They’re not thinking reasonably. How do we get grounded in reasonableness? “Let your reasonableness to be known to everyone. The Lord is at hand.”

I love that phrase “at hand.” Dale and I are doing this podcast and he’s not quite “at hand.” He’s a little far away from me. But the pen in front of me is at hand, this paper in front of me, my Bible’s at hand. That’s what we should convey to that person—that God is as close to them as what’s at hand. Then of course, “do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God.”

You may have a conversation with your counselee and you ask, “What have you done about your problem?” They respond, “I have prayed about it. I can’t get rid of this anxiety.” Well, prayer and supplication with thanksgiving is key because thanksgiving is thanking God for His faithfulness in the past. When we can thank God for His faithfulness in the past, what does that say about how He can handle the future? Well, obviously He’s going to be faithful in the future so we can trust Him.

I think, “the peace of God, which surpasses all understanding, will guard your hearts and your minds in Christ Jesus,” is a grounding. If Jesus is going to be that guard for, you can have a lot of hope, you can have a lot of courage to face the future. 

Dale Johnson: I think it also helps us to understand where the battle is. God, when we turn to Him, will guard our heart and our mind. I think that’s such a critical piece of that passage that helps us to understand. This is good, Nathan, to help us to think vertically and it helps to get our minds off of the circumstances, which are often deceiving and very convincing, but we’re called to walk by faith. In those moments, we’re walking by the things that we can see and the way we’re interpreting it in the moments around us. Now that we’ve talked about passages that should drive the way that we engage, what are some of the tools and techniques that we can give our counselees to think about future attacks and how to help prevent those?

Nathan Currey: It’s very tempting to just be in rescue mode, and to try and shape circumstances and to try and set up scenarios where there won’t be any problems. We’ll just keep things chill, keep things relaxed. Just keep the stressors out. Well, that’s not a tenable plan for the future. We need to train our minds and our thoughts, and that can be really hard. 

I said the go-to person for panic attacks is my wife to help to influence and to train with those vertical verses. I remember my oldest daughter had problems right around bedtime with these fears that would come in and these anxieties from the day that would just start to snowball and snowball. You start to combine that fear of not being able to fall asleep and then the concerns that were driving that. My wife made a packet of verses for her. She wrote out Psalm 34:4, “I sought the Lord, and he answered me and delivered me from all my fears,” and Psalm 56:3-4, “When I am afraid, I put my trust in you. In God, whose word I praise, in God I trust; I shall not be afraid. What can flesh do to me?” Getting those verses hidden in your heart, that’s where we’re guarded against sin. So flash cards or however you can put the Word of God into your heart. 

I think one of the things that’s quite often overlooked is Psalms, hymns, and spiritual songs. In Colossians 3:15 Paul says, “And let the peace of Christ rule in your hearts, to which indeed you were called in one body. And be thankful. 16 Let the word of Christ dwell in you richly, teaching and admonishing one another in all wisdom, singing psalms and hymns and spiritual songs, with thankfulness in your hearts to God.”

There’s something that God has designed about the Psalms, about music, to help us embrace and to internalize truths that are going to bring us peace, the peace of Christ. John Calvin called the Psalms a mirror of the soul. He said, “I have been accustomed to call this book, I think not inappropriately, ‘An Anatomy of all the Parts of the Soul;’ for there is not an emotion of which any one can be conscious that is not here represented as in a mirror.” The Psalms have it all for us. How many times was David afraid? How many times can we see that kind of panic and fear that he faced for things that were probably more substantial than what we face? 

David Powlison, back in 2008, did a conference on using the Psalms. Powlison said, “It is a challenge to rivet truth to the heart so that it becomes effective in producing an honest life and then honest worship.” I love that image—there’s something about music, the Psalms, that can rivet truth. That’s what we need when the panic hits because everything just goes blank. Everything goes away. We need truth that’s already been riveted. 

Dale Johnson: That’s so good. One final thing: I want to mention it because it you were right on the edge several times of describing resources. In this short time, we can’t cover the full gamut. We’re trying to to give some specific bits of truth that will help people to think thoroughly through this from a biblical perspective, but there are a lot of different resources that are out there. What are some of the things that our folks can read, if they’ve not been introduced to already, that would be helpful to guide them biblically thinking about some of these issues?

Nathan Currey: Yeah, I think it’s important for us to have a variety of tools in our toolbox to help people. One of those tools that I’ve gone to quite a bit is the little pamphlet by Jay Adams, “What to do When Fear Overcomes You.” I love giving that out and saying, “Underline ten statements that really impacted you and be ready to discuss those when you come back.” Ed Welch in his book Running Scared, I think that can really fit for people. Elyse Fitzpatrick wrote Overcoming Fear, Worry, and Anxiety. My go-to illustration that she talks about is a panic attack is like falling down the stairs. As you’re cascading down, you hit the bottom. We’ve got to get ready for the next time we have those stairs again, and as you’re falling, look to grab the handrail. When you grab the handrail a step earlier than you did before, you’re saving yourself from hitting rock bottom. I insert those vertical verses as a way of grabbing the handrail.

As I consider helping people in the midst of panic attacks, those fears that start to overcome, you want to gather a lot of data and hear what are the particular things that are afraid of, but because of the unreasonableness (quite often) of what those fears are, it’s not the thing. It’s not the fear. Obviously, we ought to be crying out to the Lord. We ought to be telling God about our fears all the time. I love what one pastor said, “At some point we have to stop telling God about our fears, and start telling our fears about our God.” Again, go vertical, because that’s where we’re going to find the guard for our hearts and minds. 

Dale Johnson: Yeah, that’s so helpful. I think our discussion today really brings down to earth that this is more common than we wish it was. This is a common thing that so many of us have have dealt with and struggled with throughout our lives. The Bible has answers for these problems. If we’ll just seek Him to understand how He understands these things, we will find peace. We will find hope. I’m so thankful for our discussion to get today, Nathan, and for you guiding us through how we think about these issues that can so overwhelm our life and make us feel like we lack any type of control. Thanks for guiding us through the Scriptures on this issue.

Nathan Currey: Thanks, Dale.