The approach to anxiety disorder in O.L.I. integrative psychodynamic psychotherapy: Eight types of panic attacks
Abstract
This paper explores the connection between various forms of anxiety and panic attacks and deficits in the development of core emotional competencies: neutralization, mentalization, object wholeness and object constancy, tolerance of ambivalence and frustration, will, and initiative. These competencies represent fundamental emotional processing and regulation capacities that enable individuals to cope with life’s challenges and the emotions they evoke. When underdeveloped, each of these competencies gives rise to a specific form of anxiety: a deficit in neutralization leads to anxiety related to emotional overload and loss of control; impaired mentalization is associated with social anxiety and misinterpretation of one's own and others' actions; a lack of object wholeness results in persecutory anxiety and fear of disillusionment or guilt when love and aggression are directed toward the same object; compromised object constancy underlies separation anxiety; low frustration tolerance manifests as anxiety in the face of unmet needs; insufficient ambivalence tolerance produces decisionmaking anxiety; a weakened will leads to anxiety around self-support and persistence; and deficits in initiative evoke fears of visibility, rivalry, and symbolic "castration anxiety." These distinct anxieties are frequently observed in clients suffering from one of the eight identified types of panic attacks. Identifying the specific fears associated with each underdeveloped emotional competency allows clinicians to detect areas of deficit and focus therapeutic work on unlocking and strengthening the relevant capacity, using targeted techniques outlined in the taxonomy of therapeutic goals within OLI Integrative Psychodynamic Psychotherapy.
Keywords: anxiety, emotional competencies, fear, panic attacks, integrative psychodynamic psychotherapy