Where Re-aligning Her Coping Strategies Eliminated 17 Years of Panic Attacks

BRAINSCANS don’t lie. So when they consistently highlight an unpalatable clinical truth, this paper argues that all clinicians, whatever their speciality, need to update their everyday practice, lest iatrogenic harm increase. For several decades now, it has been shown that recalling trauma induces a transient ischaemic dysphasia – here linked with the twin clinical anomalies of flashbacks and re-traumatisation. Even tentative mention of past trauma can be followed by a marked paresis of Broca’s area, thereby significantly distorting speech. And since adequacy of verbal description is paramount in every clinical context, this problem is not confined to psychiatry. A case report is described in which severe panic attack symptoms occurred only after an abusive father had died. The unreality of fearing a deceased abuser is here correlated with the aforementioned trauma-induced speechlessness. The analogy of peanut allergy is introduced to indicate how applying sub-triggering doses can, in appropriate circumstances, be used to overcome either chemical or emotional hypersensitivities. Verbatim dialogue, and video, of a 40-year-old patient overcoming otherwise impenetrable emotional barriers to speech in this way, is outlined. Implications of these points not only for psychiatry, but more globally, are reviewed.