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Panic practice on a spin bike
A lifelong fear of flying
Kelly McGonigal refused to fly for most of her life. Even thinking about booking a ticket brought on panic attacks, and the idea of giving up control of her body on an airplane made her want to dissociate. When she decided she wanted to be able to fly, she asked where else she had felt what a plane makes her feel: a racing heart, sweat, and a desperate need to leave a space she could not leave.
The spin class
The answer was an indoor cycling class she had hated. The room was sweaty, the air was stale, her heart was pounding, and all she wanted was to get off the bike. She went back and practiced staying on, feeling everything she would feel on a plane, and told herself she was doing it to choose a life where she could get on planes.
What avoiding cost
Avoiding the feeling had not protected her from it. She was suffering as much by avoiding flights as she ever would by taking them. What she practiced on the bike was the physical courage to stay put through the pounding heart, the sweat, and the sense of being trapped, in service of something that mattered to her. That same part of her now gets on airplanes even when she does not want to.
Why does hard exercise feel like a panic attack?
Hard exercise and panic share the same body signals: a pounding heart, fast breathing, and sweat. Panic tends to take hold when those sensations are read as signs of danger rather than effort. Therapists who treat panic disorder use a method called interoceptive exposure, in which a person deliberately brings on those sensations, for example by spinning in a chair or running in place, until they stop feeling threatening. The approach grew out of the panic control treatment developed by psychologists David Barlow and Michelle Craske.
How does avoiding a fear keep it alive?
Each time a person avoids a feared situation, the relief that follows rewards the avoidance, and the fear is never tested against reality. Psychologist O. Hobart Mowrer proposed in 1947 that fear is learned by association and then maintained because escaping it brings relief. Exposure therapy works by letting a person meet the situation without the feared outcome, which builds new learning that competes with the old fear. Researchers call this extinction learning, and it leaves the original fear memory in place rather than erasing it.
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