Sylvia was waiting for a bus at the end of a hot summer day. The buses were full and a crowd of commuters swarmed around her. As bus after bus passed them by, Sylvia began to wonder if she would ever get home. She also began to wonder why her breathing was so very shallow and rapid. She felt as though she would have to monitor each breath or her breathing might stop altogether. Her palms, she noticed, were both cold and clammy, and although the air was muggy she was now shivering slightly. More alarmed than bewildered, she started walking home rather than waiting a minute longer for a less-crowded bus. As she half-ran, half-walked, panic welled up. Her heart pounded and she feared that she would not make it home. Terror seemed to come in waves, each leaving her more exhausted than the last. She reached her door, but found that her hands were shaking so violently she could not use her keys. She stood by her door, desperate. Within minutes, however, the panic subsided, and she entered her apartment shaken and mystified.

Sylvia was suffering from a panic attack. Her fight, flight, or fright reaction seemed to come from nowhere. As in the case of Rosemary's headaches, the stress triggering Sylvia's reaction was also an internal conflict between a wish and a fear. Sylvia wished to break loose at the end of her work day but also feared that impulse. She had never tested the impulse, and had no idea where it would lead her. With professional help she came to accept her impulse and handle it realistically—and her panic attacks subsided.

The female-to-male ratio for anxiety disorders is a disturbing three to two. The reason for this is unclear, but part of it may lie in the way girls are raised in our society. According to J. H. Block's research, fathers in this culture emphasize achievement, self-assertion, aggressiveness, and self-aggrandizement in their sons, but expect their daughters to control these same qualities. Is it any wonder that women think of many of their impulses as "dangerous"? Is it any wonder that women see themselves as more fragile and vulnerable than men?

Anxiety attacks are best treated by professionals —psychiatrists, psychologists, and psychiatric social workers. Before, during, and after treatment, however, support systems are vital. So too is knowledge of crisis-intervention procedures, which can help until a professional is found. Read about these procedures in the last chapter of this book, and help others help themselves.

In addition to acute anxiety attacks, women seem to experience more general anxiety than men. Why? Perhaps it is because women are less likely to respond aggressively to stressful situations. Perhaps it is because women are presented with more anxietyprovoking situations and cultural messages that reduce their sense of control. Perhaps it is because women are more apt to notice and label fight, flight, and fright reactions as "anxiety." Perhaps it is because, until recently, girls and women have had fewer sports outlets for tension than boys and men have had. Perhaps it is because men may be less willing to admit that they are also anxious! Perhaps it is due to all the pressures that make up the Female Stress Syndrome.

*19\287\2*