What panic disorders may have to teach us about experiential education

What panic disorders may have to teach us about experiential education

Michaela Tralli QC’12 and Jim Stellar

We wrote a previous post together about how one can develop a passion for learning right in the classroom, like what can develop from experiences outside the classroom.  Now we are back with another “outside” perspective on experiential education, this time from the field of clinical psychology, a field MT hopes to enter.  We will focus here on the syndrome of panic disorders.

We all experience some level of stress and at times an episode of anxiety.  However, individuals who suffer from anxiety more often than not and who experience panic attacks as well could have Panic Disorder. According to the DSM IV, a panic attack is a discrete period of intense fear or discomfort, in which four or more of the following symptoms developed abruptly and reached a peak within 10 minutes time:  palpitations, pounding heart, or accelerated heart rate; sweating; trembling or shaking; sensations of shortness of breath or smothering; feeling of choking; chest pain or discomfort; nausea or abdominal distress; feeling dizzy, unsteady, lightheaded, or faint; derealization (feelings of unreality) or depersonalization (being detached from oneself); fear of losing control of going crazy; fear of dying; paresthesias, or numbness or tingling sensations; and chills or hot flushes.  In addition to experiencing four or more of the preceding symptoms, in order for a panic attack to fit into the DSM IV criteria, one must also experience recurrent unexpected Panic Attacks, and experience at least one of the attacks followed by one month or more of the following:  persistent concern about having additional attacks; worry about the implications of the attack or its consequences; or a significant change in behavior related to the attacks.   Symptoms may not qualify as Panic Disorder if they are due to direct physiological effects of a substance or a general medication condition.  Finally, Panic Attacks are not better accounted for by another mental disorder such as Social Phobia, Specific Phobia, Obsessive-Compulsive Disorder, Posttraumatic Stress Disorder, or Separation Anxiety Disorder. 

One of the rules of clinical psychology is that there is a continuum from the normal to the pathological condition with the pathological condition having the attribute that it interferes with normal functioning.  That means not only can we learn something about the pathological from the normal and the reverse as well.  That is the point of this blog. 

So, what can we learn about experiential education from panic disorders?  The answer may come from an interesting observation in a review paper of fMRI studies in the field of neuroeconomics by Naviqi et. al in 2006. In this work, researchers (e.g. Bechara et. al 2005) use something called the Iowa Gambling Task to study choice behavior.  In that task the subject (often with her/his head in an fMRI machine) picks from a deck of cards that sometimes gives money and sometimes takes it back.  The job of the subject is to select from among 4 decks, which one is the one to most favorably draw cards so that they end up making money in the end, i.e. the “good” cards net outweigh the “bad” cards.  The interesting part here is that well before the subject is comfortable with the choice the limbic system is already reacting with a mild stress response as the subject moves to take a card from one of the 4 decks.  It is almost as though the hidden, what some call fast-thinking, incognitio part of the brain already has detected the pattern before the statistically thinking, conscious, talking, voluntary part of the brain does.  We have used this division of the two types of thinking repeatedly in this blog to point out the fact that our decisions (like choice of a major/career in college) may depend upon that part of the brain too and the references are scattered over and easily found in the previous several blog posts.  By the way, this Bechara result does not occur if the subject has damage to the ventral portion of the medial prefrontal cortex, which is known to affect how people handle risk.

One more very old study is important before to review we return to the main point. In an experiment from the 1970s rats were placed on a platform in a chamber with a footshock grid below the platform.  When the rats stepped off the platform, they were given a footshock to make them afraid to step down.  Then they were given electroconvulsive shock immediately after the fear conditioning to erase the memory of the conditioning.  It appeared to do that as in a subsequent test the rats stepped off the platform (the footshock was turned off).  But something interesting happened.  The rats began to stop stepping off the platform.  It was as though their emotional systems remembered the footshock even though their cognitive systems did not and they just felt uncomfortable off the platform.  To us, this sounds like the Bechera study where the mild fear of losing money caused an emotional response in the human when they put their hand over the deck that they would later consciously learn to avoid.

Fear and fear conditioning is a big field and a great deal of studies in this area have been done.  Since much of conditioning is well known to be able to operate outside of consciousness, it should come as no surprise that we feel this is a good example of where one might incorporate learning from experience.  It could be obvious, such as the student who does an internship (hopefully paid) in a hospital and learns that he hates blood or another who works in a law firm and learns that she hates law before committing the time and money to go to law school.  It could be much more subtle as in the Bechera study above.  Often people come to college with preconceived notions about their careers (mom always wanted me to be an accountant), but do not get enough or the right kind of experience in the familiar classroom to know.  Suppose the accounting student is good with numbers.  Here is where a little experience working in the field would quite help.  They would know they did not like accounting from their sophomore years onward and make another choice that could be something about which they were passionate, something they loved.  Experiential education provides both the “carrot and the stick” possibilities. We tend to focus on the carrot because that is what we think we want, but in talking with older alumni from classical co-op schools, JS finds that many tell stories of finding what they did not want to do first and how that was their most important experience in college. 

Colleges and Universities should provide the “laboratory” of real world employment connected to a major to help students make this most important of all decisions – What do I want to do with my life? – before they lose the flexibility of the college years.