Panic in Seattle

Eleven meticulously worked out cases studied over four days. Ten instances of Panic, each extended in a different direction, with an eleventh offered as a ‘limit’ to differentiate panic from what it is not (the latter, a case of Aether, presented with a symptomatic overlap but in the setting of a different ensemble: the thematic complex of the ‘Drugs’). Before the cases, Massimo outlined core aspects of Panic - not the common symptoms, although they find their place at a lower octave. After the cases, a thematic summary and a differentiation of another fourteen remedies. Mythology and etymology (Pan) each made their presence felt but the key was this: behind the material presented, the cases exemplifying aspects of the thematic complex called Panic, behind this was a map of almost mathematical precision. To explain this is not easy, but not to convey something of it would be to miss the point entirely …

Massimo's core aspects for Panic include a sudden encounter with the unknown (mysterious, uncontrollable), the locus of which is mapped onto (declared to be) a physical problem within the body. Panic, as Massimo differentiates, is not simply depersonalisation, or hysteria (the topic of Massimo's coming 2007 Seattle seminar), or hypochondria, neurosis, or paranoia - although each of these shares symptoms with the province of Panic. Only by going to the heart (and lungs …) of Panic can one find that which qualitatively distinguishes Panic from neighbouring provinces … And the heart of Panic involves this strategy of ‘making physical’ - and it also requires finding help and support problematic. An animal that cannot be tamed doesn't recognise humans as sources of possible support. A person who doesn't recognise humans as supportive, as possible helpers, may well have a fear of doctors (let alone psychotherapists) and, accordingly, has one of the constituent pieces of Panic. Now imagine these two aspects together - a set of physical symptoms given the utmost importance, framed as an uncontrollable, fearful mystery, alongside a fear of doctors …

Related to this are other traits: an immature development, with some dependency, and a dislike of internality, a refusal of psychic introspection, a lack of looking within - this latter refusal keeping the enemy unknown and ‘physical’ and the whole supplying a narrow, non-adaptive vision that maintains Panic as ‘the only option’. The patients who appear in Massimo's Panic cases suffer from what, to them, is an un-representable, indescribable but global ‘something’. As Massimo observes, both in the mythology and in the cases he has received, panic arises in the day, and ‘out of town,’ outside of one's comfort zone and safety limits, arising within daylight consciousness as the unthinkable, as that which cannot be assimilated. Why? Because, as the patient declares of this unforgettable yet un-assimilable event (say, a father running over one's pet dog while backing the car out of the garage), not only was the event different from the quotidian and ‘other’ (alter), it was classified as ‘too different’ - as ‘alien’ (alienus) - and so it stubbornly remains, filling one's memory full of the unswallowable outside. If something arises which we cannot integrate (to make whole, from in-tegrare), and if that something persists, then it remains nameless, feared and alien. It doesn't fit on the map, says the panicked patient. Would you like to re-draw your map? asks the doctor. No, comes the panicky reply, there is no psychological role for me to play - the problem is physical and we never had this conversation! (Diversion and forced change of subject, all altering the course of the consultation, are endemic to these cases: think of traffic flow, diverted away from a problem.)

From this follows Massimo's counsel to the practitioner - make yourself available and stay available - and the slow, arduous prognosis for complete cure of the panic-driven individual.

An example: Massimo presented a patient (female, age 44, nursery school teacher) whose cure involved life-changing (alter-ing!) measures. She expanded her map of self to include the aggressive instinct, gradually becoming a person no longer ‘the victim of her own emotions' but instead able to assert (aggressively, authoritatively) ’who she is.‘ The case was shepherded to these new pastures by Verbascum thapsus (in repeated Q potencies). Massimo reviewed the strong sense of anger and vexation he finds within the Scrophulariaceae, ranging from Digitalis (unexpressed anger) to Gratiola (physical violence). The limit presented by this case of Verbascum, however, was the limit of ’zero‘: her angry outburst had no effect on her surroundings, appearing ineffectual. Disempowered, her panic was then further fed by the instinctual, welling-up force of her own anger and aggression (present throughout the Scrophulariaceae family, but with more attendant panic in Verbascum). An aggressive instinct that pushes one aside, and a response from the environment declaring one's aggression of zero import - this combination undermines and diminishes the sense of self, and leads increasingly to withdrawal. Massimo notes an extreme lack of adaptability throughout this family (and, in particular, Verbascum’s lack of adaptation to temperature: physicals echo psyche).

This ‘disempowerment to zero’ was just one limit: there were others, each with supporting case, each with carefully defined variables, whether the complete overwhelm of Eros by Thanatos or the threat presented to one's careful construct of ‘control’ by some extraneous, alarming danger. There were no limits to the remedies Massimo presented - size, even the miniscule, appears not to frighten him at all! Fraxinus excelsior, Castanea vesca or Gunpowder is as likely to arise as Argentum muriaticum or Alumina phosphorica or, again, Limulus, Spongia or Carbo vegetabilis. And with new analytical tools (‘spotted pain’), re-readings (‘dwelling’), concepts (‘reduction’) and the support of a thematic map (‘Sea’, ‘Drugs’…) Massimo put a face to the faceless domain of panic.