第 1 章
When Panic Becomes Your Shadow
In a remote corner of Peru, I found myself with a puke bucket in hand, burning blisters on my ankle filled with kambo, a toxic secretion from the giant monkey frog. The violent purges from this Amazonian ritual were supposedly healing everything from addiction to Alzheimer's-but for me, they were a desperate attempt to cure the panic attacks that had secretly plagued me for two decades. The irony wasn't lost on me: as an ABC News correspondent who'd reported from war zones and natural disasters, I'd cultivated an image of fearlessness while battling an invisible enemy that struck during the most mundane moments of live television. This contradiction defined my life-a courageous coward who thrived in genuine danger but crumbled during calm broadcasts. What most viewers never realized when watching my on-air "brain short-circuits" was that they were witnessing panic attacks in real-time. Oprah Winfrey once called this book "a revelation" for its raw honesty about mental health, while The New York Times praised it as "a gripping exploration of the mind under siege." With over 25% of Americans experiencing panic attacks-experts suggest the real number approaches 50%-my journey through this hidden epidemic reveals the universal struggle between our primitive brains and modern lives.
第 2 章
The Anatomy of Terror
At his father's funeral in 1990, twelve-year-old Matt, numbed by shock and Xanax, repeatedly tells mourners "at least he'd lived a full life" about his father who died at 42 in a plane crash. Thirty years later, as Matt reaches the same age, he confronts the strange milestone of outliving his father, reflecting on how this belief had driven him to live urgently.
Panic attacks are sudden surges of intense fear, peaking within minutes with symptoms like heart palpitations and feelings of unreality. Unlike normal fear responses, panic occurs without actual threat. Dr. Michael Telch notes that peaks last under a minute, though sufferers perceive them as longer. Affecting about 5% of Americans, panic disorder is characterized by persistent fear of future attacks. The most common trigger is glossophobia, affecting three-quarters of people. About one-third of "cardiac" emergency room visits are actually panic attacks, with studies suggesting 28-50% of Americans will experience one in their lifetime, women twice as often as men.
At Williams College, Matt faced pressure from his Jewish mother to become "a prophet" - an activist for social justice. His college career culminated in a devastating panic attack during his senior thesis presentation. In those crucial moments, his heart raced, vision narrowed, and his turtleneck felt suffocating. Despite knowing his material on Turkish-Israeli relations, his mind went blank, his voice strained, and he finished the presentation drenched in sweat, unaware he'd experienced panic.
During panic, the brain's primitive systems override rational thought. The amygdala triggers fight-or-flight responses, while the hypothalamus initiates a cascade of hormonal reactions through the pituitary and adrenal glands. This instant response prepares the body for survival - dilating pupils, increasing sweat, and suspending non-essential functions like digestion.
Panic's history traces back to ancient times, with the term derived from the Greek god Pan. Initially associated with mass hysteria and weakness, particularly in women, understanding evolved slowly. The Civil War's "soldier's heart" (now PTSD) connected mental and physical symptoms, but panic disorder wasn't officially classified until 1980. Modern neuroscience, despite advances, still grapples with understanding the brain's complexity. Notably, Western societies report higher anxiety rates than developing nations, possibly due to weaker social networks.
第 3 章
The Secret Double Life
In 2016, I sought psychiatric help not for therapy but for medication to manage my increasingly unbearable panic attacks amid career pressures, family responsibilities, and financial betrayal. My history with medication began in 2003 after returning from Iraq, where I'd worked as a print reporter during the US invasion. Though I hadn't experienced direct trauma there, I fell into depression upon returning to Tel Aviv, rarely leaving my apartment. A psychiatrist prescribed Paxil, which I'd take, with brief interruptions, for the next eighteen years. My career ascended when I joined ABC News Radio in 2005, but I struggled with what I called "nerves" during broadcasts - actually panic attacks that made words vanish from the page and my voice crack. When I moved to Miami as ABC's correspondent, my panic persisted even as my career flourished. The 2010 BP oil spill became my unexpected breakthrough to television when Diane Sawyer requested me for her show, suddenly transforming me from a radio journalist to a TV mainstay. Ironically, my visible nervousness was interpreted as "energy" that "punched through" to viewers, earning me more assignments and higher-profile work. I discovered I performed best when physically moving during reports, which distracted me from my panic. For standard stationary reports, I'd hold myself so rigidly to avoid showing panic that I'd walk away with an aching back and sweat-soaked clothes, convinced my next appearance would expose me as a fraud.
Hiding my vulnerability required elaborate deception. Fearing I'd be seen as deadweight at the network if my panic was discovered, I developed rituals to manage it. In my early career, I'd fake naps to secretly meditate before live shots, a skill I'd reluctantly learned at twelve when my "post-hippie" parents enrolled me in transcendental meditation instead of sending me to summer camp. My coping mechanisms weren't always healthy - I periodically took up smoking, which seemed to calm my fidgetiness and, in my superstitious thinking, might somehow protect me from anxiety. This habit, combined with my coffee consumption, created a "perfect pee storm" as both are diuretics, leaving me constantly needing bathroom breaks during long drives to reporting locations. I developed other anti-panic tactics too: arriving just barely on time for live shots to avoid the anxiety-inducing wait (sometimes worrying my crew and control room), doing push-ups or jumping jacks before broadcasts (disguised as warming up or stretching), or engaging in non-stop chitchat until the very last second. Sometimes these tricks worked; often they failed, leaving me with a familiar "shame hangover" and fears that I might never overcome my on-air panic.
For years, I desperately searched for the right medication to control my panic attacks. After finding Paxil helpful for general anxiety but ineffective for panic, my psychiatrist and I tried various options: Klonopin (which I avoided after experiencing complete memory loss during a flight), Xanax (which I secretly took before broadcasts using elaborate concealment techniques), propranolol (helpful for physical symptoms but not racing thoughts), gabapentin (caused too much drowsiness), and even ADHD medications like Strattera (which caused insomnia and digestive issues) and Adderall (which helped focus but potentially worsened anxiety). Despite all these attempts, my panic seemed remarkably resistant to pharmaceutical intervention. I eventually realized there was no "magic pill" - partly because, as Anne Harrington notes in her book, most psychiatric medications were developed decades ago with little new research since the 1990s. While my job continued giving me purpose and a paycheck, I increasingly fantasized about either experiencing just one panic-free broadcast or quitting television entirely.
My fear that a panic attack would eventually cause my professional downfall was realized in January 2020 - though not directly through panic, but through a terrible reporting error about Kobe Bryant's death. After receiving a month-long suspension, news of my mistake spread globally, with hundreds of publications reporting on it. The social media response was venomous, creating the worst kind of name recognition. Despite the shame, I felt some relief that "the jig was up" - the professional collapse I had always feared had finally happened. Seeking escape from pitying glances, I retreated to Alaska, where I spent time with a family of sled dog breeders, finding therapy in manual labor and canine affection.
第 4 章
When Fear Becomes a Superpower
In mid-February 2020, during my suspension for the Kobe Bryant reporting error, I escaped to Alaska to stay with sled dog breeders. While hiking Mt. Healy trail in Denali National Park, I got lost in deep snow as daylight faded. Panic became my ally - triggering problem-solving that helped me fashion makeshift snowshoes from branches, ultimately leading me to safety. This experience taught me that fear wasn't always the enemy.
Back in LA, I struggled with shame and insomnia, obsessively tracking media coverage of my suspension. The social rejection I'd feared had materialized, exposing me as fallible rather than the confident reporter who braved combat zones. My mental state mirrored my experience after being detained in Venezuela in 2016. Facing this career crisis, I began researching panic attacks, consulting mental health professionals who explained them as mental tricks rather than serious ailments.
Stanford researcher Robert Sapolsky explained fear's evolutionary origins: adrenaline and cortisol have existed for 500 million years. While dinosaurs experienced immediate fear responses, apes developed the ability to "get scared sooner" through glucocorticoids, enabling advance threat recognition. Early hominins evolved abstract fear 5-7 million years ago, allowing preemptive action. This biological insurance policy enabled planning and symbolic thinking, though in recent millennia, our refined abstraction capabilities made imagined threats sometimes more damaging than real dangers.
Sapolsky's baboon studies reveal parallels with Western humans - both species, having abundant resources, create social and psychological stress. Like humans, baboons experience anxiety, particularly visible in lower-ranking members, though alpha males also suffer from defending their status. This chronic stress activation releases cortisol, causing various health problems from digestive issues to depression.
Darwin's concept of sexual selection helps explain how adaptive traits can become harmful, like peacocks' elaborate plumage. Human anxiety followed a similar pattern - evolution selected for enhanced planning abilities that also increased worry capacity. During catastrophes, the "better safe than sorry" mindset of anxious individuals provided survival advantages, ensuring these genes persisted despite their health impacts. While anxiety might eventually disappear through natural selection, this would take thousands of years.
第 5 章
The Tribal Roots of Panic
For our Paleolithic ancestors, life was far more violent and dangerous than today. Their relationship with fear was fundamentally different from ours, with countless lethal threats ranging from starvation and predators to rival tribes. Human fears can be divided into two broad categories: fear of physical harm (starvation, falling rocks, drowning, disease, predators) that offer immediate paths to death; and social fears, which though less direct, could be equally deadly in the long term. These social fears, particularly the fear of expulsion from one's tribe, were critical to survival since humans depended on group cooperation for protection, sustenance, and safety. Rejection from the tribe could be a death sentence, leaving one vulnerable to predators or starvation.
Evolutionary psychologists believe emotions preceded language, with early communication warning of threats through facial expressions and distress calls. Humans refined linguistic communication to convey complex ideas, which proved more valuable for survival than physical strength or speed. Our ability to transmit detailed information allowed for planning, anticipation, and coordination that gave humans tremendous advantages. Unlike other animals that abandon injured members, human groups protected each other, with cooperation extending beyond family to non-relatives. This social structure allowed humans to expend fewer calories meeting basic needs compared to other apes, eventually shedding muscle mass and bone density as cooperation replaced physical power. However, this system required enforcement mechanisms-those who didn't contribute faced shame, rejection, and potentially expulsion. Studies show our brains process social rejection as physical pain, explaining why fear of social rejection underlies many modern anxieties. This biological sensitivity to social evaluation is what makes us human, and why our bodies would prefer a thousand false alarms to missing a single important social cue.
When facing panic during live broadcasts, I worried not about the millions of viewers, but about the small "tribe" in the control room-the anchors, executives, and producers who could judge whether my reports strengthened or weakened the group. Each time I went on air, I was unconsciously trying to prove myself worthy of membership in this illustrious tribe. Even when I succeeded, which was 95% of the time, the constant pressure took a psychological toll. Understanding our evolution helped me realize these reactions weren't "foolish frights" as Plutarch described, but deeply ingrained survival mechanisms. Social rejection has been genetically reinforced as threatening as any predator, which is why our bodies sound countless false alarms rather than miss a real one. This revelation brought me enormous relief-my anxiety and panic weren't signs of being broken, but evidence my body was working exactly as designed. While I'd brokered an uneasy truce with my brain, I still needed to better calibrate my mind's smoke detector to journey toward the end of panic.
第 6 章
Breaking the Silence
In December 2020, after a humiliating panic attack during a live Covid vaccine broadcast, I found myself confiding in Cat, a fellow passenger on a Southwest flight. When she shared her daughter's struggles with emetophobia, I realized talking about panic could be powerful medicine. This moment sparked a journey of gradually opening up to others. To my surprise, each disclosure was met with acceptance rather than the judgment I'd feared. My producer Lissette casually mentioned her sister's similar experiences, while my boss Wendy Fisher showed only sympathy. With each conversation, I discovered how many people - from various walks of life - shared similar struggles.
The lack of organized support for panic attacks was striking. Mitch Prinstein, chief science officer at the American Psychological Association, confirmed that while AA has over 123,000 groups worldwide, panic attack support was virtually non-existent. This gap stemmed partly from insurance not covering group therapy and psychology's historical roots in Freudian secrecy. Though anxiety became more openly discussed by the 1990s, panic remained stigmatized and underdiagnosed.
I eventually found a virtual therapy group based in Brooklyn. Introducing myself as a TV correspondent with panic attacks felt liberating. The group revealed how others' lives were often more severely impacted - some completely isolated by fears of driving, shopping, or social interaction. We formed a supportive WhatsApp group, sharing victories and daily challenges.
Reuniting with Cat, I met her daughter Ayla, whose emetophobia (fear of vomiting) restricted her from activities like cruises, restaurants, and travel. Despite multiple pregnancy losses and adoption challenges, she showed remarkable resilience. During a recent crisis involving her daughter's school illness, Ayla managed her panic by reframing the situation and using medication when needed. While proud of my progress in destigmatizing panic, I wondered about the long-term physical impact of two decades of hormonal "car crashes." It was time to investigate deeper.
第 7 章
The Unexpected Health Report
After extensive research into anxiety's physical effects, I became alarmed about potential damage to my body. Studies showed chronic anxiety increases blood pressure and heart disease risk, damages digestive systems, and causes inflammatory disease. Most disturbing was learning that social rejection - which I experienced after panic attacks - increases premature death risk by 100%, more than smoking a pack of cigarettes daily. Convinced my decades of panic had ravaged my organs, I visited my doctor, Dr. Rabbani, requesting comprehensive testing. To my astonishment, when he called with results, his main concerns were trivial - slightly low sodium (requiring more pickles) and vitamin D levels. Everything else was normal, even my cortisol, which was actually on the low side of normal. I was "extremely healthy" despite years of multiple weekly panic attacks. This contradicted everything I'd read about anxiety's physical toll, leaving me both relieved and confused. Could my meditation practice, exercise, or diet have protected me?
Seeking further insight, I turned to Dr. Temple Grandin, a renowned animal behavior expert at Colorado State University. Our conversation began with whether animals experience panic (they do - cattle separated from their herd show similar symptoms to panicking humans), but quickly turned to Grandin's personal experience with panic attacks. Growing up with autism, once considered developmental "stunting," Grandin overcame tremendous challenges to become a celebrated scientist and public speaker. She revealed she'd suffered panic attacks in the 1980s, describing her nervous system as "hyped for living in a jungle with dangerous animals." After researching antidepressants, she convinced her doctor to prescribe desipramine, which she credits with saving her life and has taken for forty years. When I mentioned potentially going off my Paxil, Grandin was adamant: "If you have been on Paxil for more than fifteen years, I recommend not going off of it." She dismissed the notion that antidepressants shouldn't be "forever drugs," citing examples of people who suffered after discontinuing them.
Despite Grandin's warnings to stay on antidepressants, I was increasingly skeptical about SSRIs. A groundbreaking 2022 study in Molecular Psychiatry demolished the "chemical imbalance" theory of depression, finding "no convincing evidence that depression is associated with, or caused by, lower serotonin concentrations." The study suggested this misconception led to "lifelong dependence on these drugs." Psychiatrist Ellen Vora calls patients' dependence on antidepressants "the silent epidemic," describing a common pattern: patients start medication during stress, stabilize, then experience withdrawal symptoms when attempting to stop - which they misinterpret as proof they need the medication. "Nothing feels as good as scratching the itch of withdrawal with the withdrawn substance itself," she explained. Worse, Vora suggested antidepressants might actually trigger panic attacks through "interdose withdrawal" - when the body craves its next dose. Since I took Paxil in evenings after broadcasts, could I have been experiencing withdrawal during my on-air moments? Despite these concerns, conventional medications weren't solving my panic problem.
Beyond medication, nearly every anxiety specialist recommended cognitive behavioral therapy (CBT). Though practitioners insisted it was a "sledgehammer" treatment, their suggested exposure exercises couldn't replicate the high-stakes environment of a live broadcast with millions watching. Some suggested inadequate substitutes like running up stairs to raise my heart rate or speaking to store clerks, failing to understand I already speak to strangers professionally. Despite their insistence that panic was merely a mental distortion, I resisted conventional CBT, suspecting my panic might be a symptom of a larger malady. After listening to wellness podcasts featuring holistic practitioners like Ellen Vora, I realized there were approaches I hadn't tried - perhaps I needed something that could treat "the whole human," a salve that could seep into my core and heal me from within, rather than just topical solutions that couldn't penetrate the surface of my psyche.
第 8 章
The Psychedelic Path
Seeking new approaches for my panic, I reconnected with Lane Jaffe, a former high school athlete turned yoga teacher and breathwork practitioner. Despite initial skepticism about breathwork seeming too "woo-woo," my suspension from work freed up time to try his class at Venice's Sanctum studio. The technique involved rapid breathing-two big breaths in through the mouth, one out-creating deliberate hyperventilation. Within minutes, my body began shaking, hands curling into immobile "lobster claws" (caused by blood vessel constriction from oxygen deprivation), followed by overwhelming emotion and sobbing. Lane described seeing me like "a balloon that had filled up with so much air" finally decompressing. Though the relief lasted weeks, the pandemic ended in-person sessions, and I feared getting caught in an inescapable "gyre of grief and pain." Still, I recognized the truth-I had a "Hindenburg hovering within me" that needed addressing.
As I researched alternatives, psychedelics emerged as a promising treatment for anxiety and depression. My wife Daphna scheduled a "guided mushroom journey" with a psychedelic guide named Farah, who operates in Northern California. Unlike casual "microdosing" (taking a tenth of a psychedelic dose) that's become common in wellness circles, Daphna took a "heroic dose"-a term coined by ethnobotanist Terence McKenna for a dose that "flattens the most resistant ego." Despite psilocybin's increasing acceptance and decriminalization in some areas, Farah (not her real name) still operates underground, screening clients through detailed intake forms and preparatory conversations. My wife's friend had previously experienced profound healing with Farah through MDMA therapy, claiming it provided "more healing than years of therapy." Daphna's mushroom journey, while more sedate, revealed meaningful visions of a Mayan pyramid and a light-beaming lion that foretold her purpose: building a musical bridge between adult and child worlds-a vision she's since fulfilled. Inspired by her transformation, I decided to try it myself, despite the steep $1,500 price tag.
During my psychedelic journey with Farah, I received an unexpected 5.5 gram dose of mushrooms after my body resisted the initial amounts. Instead of uncovering pain, I experienced visions of strength-seeing myself inside granite mountains and ancient oak bark growing in time-lapse. Though Farah tried guiding me to confront my father's death, I remained too self-aware to fully surrender. The four-hour journey ended with fruit and conversation about the underground network of psychedelic guides-a movement I'd later discover harbored both healing potential and concerning allegations of abuse. Despite the $1,500 cash payment and my post-trip euphoria viewing vibrant spring landscapes, I left wondering if anything had truly changed in my brain's central processor.
第 9 章
Into the Amazon
Six months after my mushroom experience with Farah, I found myself at Puerto Maldonado airport, still haunted by recurring nightmares. In these dreams, I approached an abandoned house with darkness spilling from its door, encountering a paralyzing terror. These experiences suggested my panic attacks weren't the illness itself but symptoms of deeper trauma.
During our bus ride to the Sacred Valley, our group of twelve shared their stories. Brian, an ex-special operations medic, sought healing from childhood trauma. Pete, whom I'd misjudged, revealed his traumatic kidnapping in Costa Rica. Each of us carried our own version of that darkened room from my dreams, hoping ayahuasca would help us face our fears.
At the mudbrick compound, we were welcomed with traditional dancers and met our facilitators: Carolina and shamans Carlos and Misael. When asked about my intentions, I vaguely said "go where the medicine takes me," though privately hoping to connect with my deceased father and grandmother. Our preparation included fasting, tobacco snuff initiation, and a cleansing ritual of lemongrass tea.
The ayahuasca ceremonies proved challenging. The brew, made from Psychotria viridis and Banisteriopsis caapi, affected participants differently. While others experienced profound visions and emotional releases, I remained largely "blocked" despite taking multiple doses across several ceremonies. Even with triple doses, I experienced only minimal visual effects while others reported deep spiritual encounters.
During a Reiki session with Gloria, I unexpectedly found the emotional release that ayahuasca hadn't provided. When she pressed points on my wrist-symbolizing the father relationship-I broke down sobbing. The toad venom ceremony that followed brought me to a complete sensory shutdown before unleashing a torrent of grief I'd been holding back.
My final ayahuasca ceremony, despite an "ungodly" five doses, resulted mainly in physical distress rather than psychological breakthrough. Dr. Rick Strassman later explained that about 5% of people have natural resistance to certain psychedelics. Though I didn't achieve the profound visions I'd sought, the retreat proved valuable in unexpected ways. I maintained the dietary changes, remained off antidepressants, and most importantly, my panic attacks hadn't returned in over a year. Still, I wondered if a fuller psychedelic experience might have helped me process my deep well of grief more completely.
第 10 章
The Ketamine Experience
As the pandemic began, Matt discovered companies advertising mail-order ketamine lozenges for treating depression and anxiety. Though known as a party drug in his youth-warned about as a "cat tranquilizer" that could lead to a dreaded "K-hole"-ketamine is actually one of the world's most commonly used anesthetics. Unlike psychedelics such as psilocybin and LSD (Schedule I drugs), ketamine is classified as Schedule III, making it legally prescribable. It's valued in medicine for being fast-acting, inexpensive, and having a short half-life, and was notably used to sedate the Thai soccer team during their cave rescue in 2018, with the added benefit of causing amnesia about the potentially traumatic extraction.
After ayahuasca in Peru left me feeling in "remission" but not "cured" of panic, I still sought a full psychedelic system reboot. My brother-in-law connected me with Dr. Dan Gil, a psychologist incorporating ketamine into his practice. Unlike clinics offering mild doses, Gil favored strong psychedelic experiences-straight into the "K-hole" of high school legends. He invited me to join his upcoming retreat in Ojai, California, where ketamine would be sandwiched between therapy sessions. The legal status and scientific backing appealed to me, as did Gil's own positive experiences with the treatment. He worked with a Colorado psychiatrist named Mark Braunstein, whom Gil cryptically described as "interesting."
During my ketamine experience, I found myself in a terrifying void with just enough consciousness to know I existed but not who I was. This was the ego death psychedelic blogs describe. After minutes in this space, I managed to ask "Am I alive?" and Braunstein's voice responded affirmatively. When I asked if this was reality, he declared: "You are experiencing all of reality at once. This is full reality."
While ketamine felt like moving into "death space" with furniture, I kept seeking reassurance. My tears flowed freely as I clutched Gil's and Braunstein's hands for grounding. Eventually, the experience shifted - colors returned and I began narrating the trippy images passing through my consciousness. Unlike most patients who remain silent during ketamine sessions, I wouldn't stop talking, prompting Braunstein to ask me to focus on myself. I wept thinking about Daphna enduring a similar experience alone, without guidance. Despite being terrifying, I repeatedly told them this was "one of the most profound experiences of my life."
Unlike ayahuasca, ketamine offered psychedelic experience without bodily suffering. The playlist's lyrics became my mantra: "I release control / And surrender to the flow of love / That will heal me." Though cheesy, it worked effectively. Psychedelics transport you to a realm of awe where simple truths - needing love, releasing control, practicing self-forgiveness - appear as profound epiphanies, making their lessons more impactful. As Rick Strassman explained, they're "meaning-enhancing drugs" that sharpen our perception beyond normal reality. After touching the bottom of consciousness in my second journey, I approached my final session still seeking something specific - a mantra or insight I could carry forward to calm my anxiety.
For my final ketamine session, I told Braunstein I wanted a lasting message to calm my anxious mind. He cautioned this wasn't "ketamine's thing" - it provides themes of oneness and connectivity, not specific mantras. Braunstein announced, "I want you to die tonight - in your head," explaining that witnessing one's mortality is ketamine's peak experience. With an increased 105mg dose, I sank deep into the bed and found myself soaring over an Amazonian jungle before diving off a cliff. Instead of crashing, the earth rose to catch me - the ultimate psychedelic trust fall.
When I emerged, I described feeling "deep but not dead" yet comforted by this sense of safety. Braunstein shared his own decades-long battle with depression, admitting that despite experiencing the full range of psychedelics, healing requires ongoing work: "You don't just get better by taking a pill. Wellness is work." The image of earth rising to meet me became my talisman against future panic attacks.
The next morning, I connected with fellow retreat participant Neil Brown Jr., a successful actor who shared my struggle with panic attacks. His first episodes began in his mid-twenties as his career took off, leading to multiple ER visits before receiving a proper diagnosis. The unpredictability of attacks made him go "square" - avoiding all substances and trying various coping methods. Even after landing roles in shows like HBO's "Insecure," he experienced panic during table readings. Eventually, he began opening up about his condition to colleagues and sought treatment with Dr. Gil, who recommended ketamine therapy. Though neither of us considered ketamine a cure-all, we both felt increasingly free of panic.
第 11 章
The Journey Back to Balance
When reviewing my last on-air panic attack with Michael Telch, director of the University of Texas anxiety lab, what had felt catastrophic to me was barely noticeable to him. Despite losing his alcoholic mother at twelve, Telch had channeled his trauma into four decades of research and patient care, developing a "sledgehammer treatment" combining cognitive behavioral therapy with exposure therapy.
My panic questionnaires showed improvement from severe to clinically mild, following my abandonment of magical thinking, breathing rituals, and antidepressants, supported by psychedelics and grief processing.
Cognitive behavioral therapy (CBT) begins with psychoeducation, teaching patients that panic symptoms stem from catastrophic misinterpretations. The behavioral component involves exposure exercises and abandoning safety behaviors. In Telch's lab, I encountered his exposure therapy tools: tarantulas, a claustrophobia box, and the CO2 challenge - breathing 35% carbon dioxide to induce panic symptoms. When I tried it, I experienced physical discomfort without psychological panic.
Telch introduced me to Jake Becker, who had suffered debilitating panic attacks that began during a work presentation. His attacks escalated to dozen daily, centered on fear of visible sweating. After failed treatments elsewhere, including unhelpful medications, Becker found success with Telch's exposure therapy using yohimbine, an herbal extract that induces sweating.
The breakthrough came when a survey of 300 psychology students revealed sweating ranked low among social concerns. Becker developed an "ace in the hole" - acknowledging his sweating with humor: "Here comes that Becker sweat gene again, watch out." This simple strategy helped him overcome panic and later become a counselor himself.
However, my own recovery was tested when, while reporting, I experienced an unexpected panic attack while speaking to a homeowner - something that had never happened before. As my producer took over, I was shaken by this break in my eighteen-month panic-free streak, especially since talking to strangers had always been my strength. It left me questioning the effectiveness of all my previous treatment work.
第 12 章
Embracing the Full Human Experience
After my unexpected panic attack in the rental car, I was struck by the irony. My confidence had been shattered during what I'd always considered my strength: talking to people. By dinner, I'd shared my story with colleague Jeff, moving from despair to acceptance.
The next day brought news of the Uvalde school shooting. Despite my PTSD from covering previous massacres, I agreed to report from Texas, knowing ABC needed someone already there.
Months later, I visited Neil Brown Jr. at his "Pain Palace" gym. He shared how during his ketamine treatment, he'd experienced multiple mini-panics without physical symptoms - the fear existed only in his mind. Since then, he'd been panic-free.
Like Neil, I draw strength from my psychedelic experiences. These memories enhance my meditation practice, which my friend Dan Harris explains can encourage neuroplasticity similar to psychedelics, albeit more gradually. Harris emphasizes that self-compassion, rather than perfectionism, leads to better outcomes.
Maintaining wellness requires vigilance. Through my journey, I've learned to face what Ellen Vora calls "portals to pain" - those dark corners of the mind that psychedelics helped me approach. This newfound courage allowed me to access emotional depths even without substances. During a London trip, instead of suppressing my sadness, I allowed myself to cry for forty-five minutes.
Dr. Vora reframes crying as "free therapy" - the body's way of processing "unmetabolized grief." She notes our cultural tendency to stifle tears, despite crying's natural therapeutic benefits. Laughter, particularly at ourselves, is equally healing. As Vora wisely states, constant happiness isn't the goal; rather, it's experiencing the full spectrum of human emotions.
Standing outside Van Nuys Middle School for a live report, I noticed something remarkable - panic's absence. Despite all the typical triggers, I remained steady. Small adrenaline bumps came and went, but I was ready - not because I'd conquered panic forever, but because I'd learned to live with its possibility without fear.
