To help people with panic and related anxiety disorders, psychologists
typically ask patients to taper their caffeine use while they learn how to
respond appropriately to their own physiological reactions. At the Center for
Stress and Anxiety Disorders in Albany, N.Y., psychologist John Forsyth, PhD,
uses an approach known as cognitive-behavioral therapy. Gradually, patients
learn to interpret their symptoms. A fast-beating heart, they discover, is the
body's normal reaction to a stimulant like caffeine -- not a sign of an
impending heart attack.
But not all psychologists think that avoiding caffeine is a long-term cure.
Norman Schmidt, an associate professor of psychology at Ohio State University,
is one who actually prescribes coffee as part of treatment. The goal? To help
patients confront their fears head-on and learn to distinguish unfounded panic
from a real threat.
After teaching patients to recognize caffeine's effects, Schmidt has them
desensitize themselves by gradually increasing their consumption of caffeine
over the course of a month or two. Patients start with sips of soda, then work
up to a cup of coffee.
The final exam? A strong cup of coffee spiked with No-Doz. "They don't
feel great, but they learn they can have these feelings and nothing terrible
happens," says Schmidt. "We could tell them that over and over again,
but they've got to know it in their gut."
If patients ending treatment announce they still don't intend to drink
coffee, Schmidt knows they haven't overcome their unfounded fear. So there's
one more test they must pass. He tells them to down a triple espresso without
triggering a panic attack.
Says Schmidt: "We call it the 'Starbucks challenge.' "
Rebecca A. Clay is a writer based in Washington, D.C., whose articles have
also appeared in Psychology Today, Modern Maturity, and The