The control of anxiety, fear, and panic depends largely on an ability to reflect on ones own mental processes. Without reflective function, panic attacks can come "out of the blue." When panic comes, the person may believe he or she is having a heart attack. Yet, monitoring of persons troubled by panic attacks has shown that during the panic attack, the person's heart rate is no higher that at other times during the past hour when no panic was experienced.
What goes on physiologically during panic is not - as the person believes - is unique to panic. The same heart rate happened repeatedly in the hour prior but went unnoticed - and perhaps we should say, "unpanicked." For example, during the hour prior to the panic attack, the heart rate was frequently 110, but it was not noticed. Then, for whatever reason, a heart rate increase is noticed. Unexpectedly noticed, the increase shocks the person. Had the person been more mindful of their heart rate, they might simply think, "My heart rate is up again; I wonder why? Oh, well. It will go down again as it did before." But, the person who has not been mindful of what has been going on thinks, "My God! It's a heart attack!"
Beginning back in the 1960s, Australian Dr. Claire Weekes taught her clients that there are two types of fear: first fear and second fear. In first fear, feelings are produced by automatic unconscious processes. In second fear, feelings are exacerbated by thoughts the person has in reaction to first fear.
If we apply her thinking to the current research on panic, the person sets up panic by trying to not be mindful. They do not know heart rate increases are routine. Thus, when a heart rate increase breaks through their attempt to avoid mindfulness, the heart rate increase causes "first fear." Then, the person's reaction to first fear is "second fear," by thinking, "I'm having a heart attack," and causing more arousal.
If a person is more mindful, and more aware of inner feelings including heart rate, the more likely they are to become accustomed to changes in heart rate, and thus the more likely they are to avoid panic when heart rate changes.
Weekes advised that second fear is best managed by accepting - instead of reacting to - first fear. New research at the University of Utah shows that people who describe themselves as more mindful have more stable emotions and believe they have better control over their mood and behavior.
Mindfulness is also helpful when dealing with mild fear of flying. But for severe cases for fear of flying, help that controls "first fear" automatically is the best answer, for if there is no "first fear," there is no "second fear," to use Weekes' principle.