As a patient of mine described it, «experiencing a panic attack can be an overwhelming and terrifying experience. It’s like suddenly being engulfed in a whirlwind of intense emotions and physical sensations, without any warning or control over what’s happening to me. The onset is often rapid, and it feels like my heart is pounding out of my chest, almost as if it might explode.

My breath becomes shallow and rapid, and I struggle to catch my breath, making me feel like I’m suffocating. It’s like my body is on high alert, and I’m convinced that something terrible is about to happen, even though I can’t pinpoint exactly what that something is. My mind races with anxious thoughts, and I find it nearly impossible to focus on anything else. It’s as if my thoughts are running wild, and I’m trapped inside this chaotic mental state.

Everything around me seems to blur, and I might feel detached from reality, almost like I’m living in a dream. At the same time, my senses become hypersensitive, making even the smallest sounds or movements feel overwhelming. The world becomes a frightening place, and I just want to escape from it all.

Physically, my body might tremble uncontrollably, and I might break out in a cold sweat. Nausea can also set in, adding to the discomfort and distress. It’s like a vicious cycle – the more my body reacts to the panic, the more terrified I become, which only fuels the symptoms even further.

The whole experience is utterly exhausting, both mentally and physically. After the panic attack subsides, I’m left feeling drained, as if I’ve just run a marathon. I might also feel embarrassed or ashamed, especially if the panic attack occurred in public, and I worry about others judging me for not being able to handle my emotions.

Overall, having a panic attack is an indescribable rollercoaster of fear, confusion, and desperation. It’s like being trapped in a storm of emotions and sensations, desperately seeking calm and safety amidst the chaos.»

Panic attacks are often unexpected episodes of intense fear with feelings of lack of control, discomfort, or terror, frequently associated with a sensation of dying. These episodes can appear for no reason or after a stressful situation, and usually evolve rapidly in a matter of 10 minutes or even less time. While the peak of intensity can be fairly quick to arrive, the average duration of a panic episode is between 5 and 20 minutes, sometimes lasting longer, even hours.

Although not all people experience it in the same way, the most common symptoms are palpitations (tachycardia), sweating, hand trembling, leg weakness, nausea, abdominal discomfort, dizziness, headache, chest tightness, choking sensation and suffocation. In more extreme cases, vomiting, fainting, or states of great confusion and depersonalization may occur. As in many cases it tends to occur unexpectedly, people have difficulty recognizing it as a symptom of anxiety and may think that they are suffering from a heart attack or other serious medical problem.

At a biological level, a panic attack is a «normal» response of our organism, but in an inconvenient situation. Let me explain, in an emergency situation or serious danger, our body launches the «Flight, Fight or Freeze Response». This means that, faced with a dangerous situation, our brain sets in motion a survival mechanism that involves the release of certain substances (mainly adrenaline and cortisol), which first activate our heart, causing it to beat faster (palpitations/tachycardia). This causes more oxygen to reach the muscles, which would allow us to run away or defend ourselves. At the same time, to supply the increased need for oxygen, our breathing becomes faster and/or deeper (hyperventilation). This mechanism also allows us to reinforce or protect some vital organs and respond better to the situation.

The problem with panic attacks is that the brain triggers this «fight, flight or block response» in situations where it is not really necessary, which deeply disconcerts us and causes us to feel as if we are going crazy or losing control.

A panic attack is like a «brain earthquake» so if it happens once, it can happen again. It is very likely that the panic episode itself is a symptom that we are going through a period of increased stress, which has our system hyperactivated. Therefore, it is highly recommended, on the one hand, to stop and think about what is going on in our lives and how we can reduce our stress level (self-care).

On the other hand, it is highly advisable to seek psychological and even psychiatric help, because if we do nothing and the stress level remains or worsens, the probability of further episodes rises. And if you are experiencing panic attacks frequently or they significantly affect your daily life, definitely see a mental health professional as soon as possible. Therapies such as Cognitive Behavioral Therapy (CBT) can be very effective in learning to manage panic attacks and anxiety.

Guillermo Gabarain Beristain is a Psychologist and Coach at SINEWS MTI with more than 15 years of experience, licensed in both Spain and the USA to practice as a psychologist, bilingual and with international experience. Trained in scientifically validated methodologies, such as Cognitive Behavioral Therapy, Solution Focused Therapy, Gottman Method of Couples Therapy, Crisis Prevention and Intervention, as well as in Humanistic and Systemic approaches. His main activity is focused on working with adults and couples, and he is specialized in the treatment of depression and anxiety disorders, complex grief, adjustment problems due to migration, substance use disorders and addictions, and couple problems.

Metaphors can be tremendously therapeutic; they help us to visualize, to take perspective, and to recognize, realize or understand aspects that we were not aware of. A metaphor, as understood by Friedrich Nietzsche and José Ortega y Gasset who defended its hermeneutic character, helps us to describe the perceived reality with symbolic language, which is more unifying and understandable by more people. The metaphor also connects brain impulses between our linguistic and visual neurons, which has a beneficial side effect, which is to «activate» memories, mental schemes, in other words, to generate new perspectives.

One of my favorite metaphors at a therapeutic level, which is more of a «theory» because of its extension, I call it the «Pressure Cooker Theory». Over the years, I have been formulating and adding concepts, variables and some scientific discoveries, which have made it more of a «theory» than a simple metaphor. My purpose in this article is to share this small resource, which I believe has been very useful in helping my clients understand the following questions:

To begin with, as many of you may have already guessed, the «pot» itself refers to or symbolizes our most precious and complex vital organ, the brain. The distinction of «pressurized» highlights the capacity of humans to harbor levels of pressure or stress, both of intrapsychic and environmental origin.

Historically, it all began with the Stress Theory of Hans Selye, a professor and researcher considered the «father of stress», not because he invented it, but because he described it from a biological perspective. According to Selye, stress is the response of our organism to the variations, changes and adversities of life, that is, our physiological responses of adaptation to the environment. In the face of situations that we perceive as adverse, in the face of threatening, unsolvable or uncertain situations, our brain sets in motion what Dr. Seyle called the General Adaptation Syndrome (GAS), and we will use an example to understand it better.

Imagine that for a moment you walk calmly out of your room and encounter a lion. Naturally, your brain attributes a dangerous note to the situation and consequently, your amygdala, your pituitary gland and your adrenergic glands go into overdrive and trigger the stress response. Basically, they release adrenaline and cortisol, which make your heart beat faster, so that more oxygen and nutrients reach your muscles and vital organs, so that if you have to run away or protect yourself, you do it more effectively. Furthermore, your breathing becomes faster and deeper, your stomach seems to close up, and other changes that we usually ignore because we have a lion in front of us.

But so far we have only talked about how an external stimulus can trigger this General Adaptation Syndrome, or stress response. The reality, however, is that as Robert M. Sapolsky explains in his book «Why Zebras Don’t Get Ulcers», our brain is an extraordinary organ, and is capable of carrying out very complicated cognitive processes and functions on a daily basis. In other words, it helps us survive. However, unlike some animals, such as zebras for example, the human brain can carry out these complex processes repetitively or inappropriately. And that is why these processes can sometimes do more harm than good, if we allow them.

It is worth noting that our body usually responds positively or in tune with environmental stimuli and without negative consequences: this is what we call «good stress». At other times, however, our organism is not able or does not know how to adapt to the environment, since the required responses are unknown, too intense or too prolonged and the demands exceed our adaptation strategies. This is what we call «bad stress» (stress, in general).

This question may seem a bit strange, but I think it can provide a very understandable and practical perspective. When a pressure cooker heats up, a lot of pressure is generated inside and consequently the valve opens releasing some of the steam and pressure. When this happens, the valve makes a noise that we all easily recognize, and we quickly run to lower the temperature so that the food does not burn or the pot explodes.

In the same way, our brain, when subjected to high stress loads, sends us «signals», but we often do not recognize them as such, and generally, we do not run quickly to lower the temperature. As I explain to my clients, these signals are gradual, they don’t come all at once, and everyone is different and our brains can give idiosyncratic signals.

If I may engage in some degree of self-disclosure, when my pot starts to get too hot, the first signals it sends me usually include sleep problems (more awakenings, the occasional nightmare). If I ignore the signals and continue business as usual, my pot increases the signals, and in addition to sleep problems, it sends me some headaches and lack of energy. If I still continue to ignore the signals, my pot keeps adding signals, and sends me a series of negative thoughts that make me doubt myself, what I do and who I am. Obviously, if I allow my pot to continue to run hotter and hotter without limit, this can result in increasingly serious and pernicious symptoms.

But, as I have said, each person has his or her own idiosyncrasies and must understand and know himself or herself, and know how his or her pot signals that the temperature is too high. Some people are more prone to anxiety or depression problems, others to appetite and eating problems, others tend to disorganization and lack of attention, others tend to paranoia or suspiciousness.

From my point of view, the important thing is firstly, to learn how your pot signals high temperature and pressure, and secondly, acknowledge and become accountable for recognizing these signals and taking care of lowering the temperature of the pot.

This question can give rise to an infinite number of strategies, which is not the purpose of this article. My purpose is to emphasize the developments that have been made from the field of Positive Psychology and Neuroscience on our ability to generate and manage mental stability and happiness – following our Pressure Cooker metaphor, how to lower the temperature of the pot and keep it as stable as possible.

From a neurobiological point of view, there are certain neurological processes in the brain that are associated to happiness. For example, there are some identifiable structures or nuclei in our brain (i.e., the nucleus accumbens, the tegmental-ventral area, and some areas of the orbitofrontal lobe, insula, medial prefrontal and cingulate) and a series of neurotransmitters, for example, dopamine and serotonin, that are associated with happiness, pleasure and satisfaction.

However, happiness is not a permanent state and cannot be achieved instantaneously. In the field of Positive Psychology and described by Dr. Martin Seligman in the PERMA model, happiness is considered to be a state of subjective well-being that arises from the experience of positive emotions, engagement in meaningful activities, and a sense of belonging and purpose in life.

It is important to remember that happiness is an ongoing process and not an end state. Maintaining the temperature of the pressure cooker is a constant responsibility of each person. Each of us, I believe, harbors the capacity to learn «what can warm your pot» (internal and external stressors), «how your pot signals to you that there is too much pressure» (psychological and somatic symptoms), and «what can you do to lower and regulate the temperature of the pot» (regulatory strategies). By practicing these strategies consistently, you can develop greater resilience and a more positive attitude toward life, which can contribute to a higher level of long-term happiness and well-being.

Guillermo Gabarain Beristain is a Psychologist and Coach at SINEWS MTI with more than 15 years of experience, licensed in both Spain and the USA to practice as a psychologist, bilingual and with international experience. Trained in scientifically validated methodologies, such as Cognitive Behavioral Therapy, Solution Focused Therapy, Gottman Method of Couples Therapy, Crisis Prevention and Intervention, as well as in Humanistic and Systemic approaches. His main activity is focused on working with adults and couples, and he is specialized in the treatment of depression and anxiety disorders, complex grief, adjustment problems due to migration, substance use disorders and addictions, and couple problems.

I would like to begin this article firstly, by unpacking the title of the article itself, paying attention to what each of its parts means to me. Without wishing to enter into a very sophisticated and philosophical debate, at least, I wish to allude to what I mean by «therapeutic power», «group therapy», and «addictions», before identifying the benefits of group therapy in the treatment of addictions.

So what do we mean by «therapeutic power»? I believe therapeutic power resides or is based primarily on the relationship that is established between the clients and the therapist. I believe that this relationship is very special for several reasons.

Finally, «addiction» remains to be defined. Addiction could be defined as the lack of control over the use, consumption or enjoyment of «something» to the point where it could be harmful to oneself. Addictions are most commonly associated with gambling, drugs, alcohol and smoking, but it is possible to be addicted to almost anything, including work, sex, the internet, shopping, etc. Being addicted to something means that not having it causes withdrawal symptoms or a «craving.» As this can be unpleasant, it is easier to continue having or doing it, and thus, the cycle is perpetuated.

Before explaining the characteristics of cannabis, its incidence, its effects and its complications, I would like to begin by relating a real case, since I have fortunately been dedicated to helping people with addictions for more than 10 years. If you use cannabis in any of its forms, I invite you to read it and express what you think. I don’t just want to describe in detail the hardships and negative consequences of cannabis use that this person suffered, but to describe the positive effects of stopping cannabis use. As a professional, this is what ultimately motivates me, and even still surprises me: to see the real potential of a person and how a drug can obscure it in such a way.

For this purpose, I introduce you to Mr. C, whose personal data and information will be omitted for confidentiality reasons. Like more and more teenagers, Mr. C started using cannabis early, at the age of 13. The first time was in the company of an older friend, who invited him to take a puff of a hashish joint. The first impression was positive, a few laughs and the feeling of doing something «grown-up». In a few months, the consumption became more and more frequent and high, and by the time he was 15 years old, he was smoking hashish and marijuana practically every day, an average of 2 or 3 joints a day. Of course, this consumption brought him some problems: conflicts with his parents, fights with other young people, some fines and even a trial for illegal drug possession.

Mr. C otherwise spent a «relatively» normal adolescence. He managed to finish junior high and high school with average grades and although he enjoyed history, and as a child he loved swimming, soccer and skiing, he spent virtually all of his adolescence sitting on the couch at home. In fact, his family teased that the couch had Mr. C’s deformity.

Around the time he was 20, Mr. C decided on his own volition to quit using hashish and marijuana, and to ask for help with it – this is where I come in. Undoubtedly, this cost him at first a few sleepless nights, some tough cravings (desire to use, anxiety, irritability, etc.) and having to stop hanging out with his friends, virtually all of whom were using as he had surrounded himself with «using buddies».

The more positive changes, perhaps less obvious to the naked eye, began to develop over the weeks and months. Mr. C, well known for his endless naps, his voracious hunger and his always astonishing quietness, began to change progressively. What until then seemed to be an acceptable but somewhat mediocre academic performance, turned into a genuine interest and motivation to study, learn and improve. In a few months, Mr. C became one of the most outstanding students in terms of intellectual and dialectical ability.

Likewise, Mr. C’s interests and activity level also showed significant changes, with Mr. C showing a greater motivation for self-care, physical exercise, and a more balanced diet. And to cap it all off, after several months of jaw-dropping improvements, Mr. C developed an interest in international travel, and during an extended stay in the Netherlands, established a very positive relationship.

Stopping the use of Cannabis ultimately allowed Mr. C to not only increase his performance capacity and daily activity, but perhaps more importantly, to learn about his own strengths, aptitudes and personality traits that were tarnished by the habitual use of this substance.

We may ask the question, what would things have been like, or what would Mr. C have accomplished or done, had he not used this substance during his teenage years? Like all «What if» questions, we will never know….

The question may lead us first of all to analyze the most notable effects of cannabis abuse. Without disdaining the therapeutic value, which exists and will also analyze, I will start by acknowledging the most notable and worrying risks of its abuse.

At the Neurological level, Cannabis mainly affects what we call the Endogenous Cannabinoid System in our brain. This area of our brain is in charge of regulating the functioning of our behavior, learning, gratification, appetite, pain and emotions, among others.

One of the most notable effects of cannabis abuse, for example, is what we call the «Amotivational Syndrome». This pattern refers to a combination of symptoms, including generalized lack of energy and activity, lack of motivation and initiative, tendency to drowsiness, altered short-term memory, and difficulties in concentration. This Amotivational Syndrome, which appears with more habitual and chronic consumption, is behind many of the problems in professional or academic performance, and certain tendencies to conflict.

Perhaps one of the most notable and dangerous risk of cannabis use, which I am still surprised by how unknown it is to a large part of the population, is the capacity to generate paranoid symptoms, panic attacks, and even psychotic outbreaks and schizophrenia. Of course, in these cases, the impact on the person’s life is very serious and the consequences can last for life or for a long period. I want to emphasize, that for these symptoms to occur it is not necessary to consume in an aberrant or chronic way, as there are cases of severe psychotic outbreaks after occasional consumption.

Other interesting facts about cannabis abuse:

In any case, not everything is negative with cannabis. Cannabis has been used since ancient times for very diverse purposes such as the use of its fibers for the production of fabrics and ropes, or the use as a food additive, making use of its oil and hemp seeds as a nutrient. It has also been used for its psychoactive properties for religious and/or recreational purposes, and occasionally to treat certain diseases. There is also evidence to support the medical use of THC to control nausea and vomiting, stimulate appetite and reduce pain. CBD can moderate the psychoactive effects of THC and has medicinal properties, for example, it reduces epileptic seizures. Several drugs containing cannabinoids have been authorized for marketing, such as ®Sativex, ®Marinol and Syndros, ®Cesamet and Canemes, and ®Epidiolex.