In the first part of this blog duology, we explored what is a panic attack, what usually provokes it and some basic tips about what to do about it. In this part, we will go into different techniques that help take control during these situations. It is important to note that though it is helpful to learn more and familiarise with the different techniques available, it is a good idea to work with a trained and full qualified therapist. 

CBT

One of the most used approaches for panic attacks is CBT or Cognitive Behavioural Techniques. CBT techniques and other types of counselling help the client change the way they perceive a frightening situation and find new ways to approach these challenges when they arise. Research indicates that CBT might affect the neural pathways that are responsible for panic attacks. The length and intensity of this approach varies according to client and the intensity of the symptoms. In simple terms your therapist will gradually help you learn ways to work through what triggers a panic attack (Reinecke, 2018).

Mindfulness

Other therapists might encourage you to explore mindfulness. This approach is backed by research that proposes that mindfulness helps reduce symptoms of panic attacks (Lim, Lee, Joon et al. 2018). The concept behind mindfulness is that the client learns to better manage their symptoms using their own thought processes and enables the client to be more in control and not let their thoughts take over. It is important to not let thoughts take over as it is when we stay rummaging over a particular thought or situation that anxiety increases.

Mindfulness can help ground you in the reality of what’s around you. Since panic attacks can cause a feeling of detachment or separation from reality, this can combat your panic attack as it’s approaching or actually happening.

A simple mindfulness exercise in these situations would involve slowing down, focusing your attention on the present and recognising that you are having a panic attack and then taking action by focusing your attention to the physical sensations you are familiar with like feeling the texture of your clothes with your hands or digging your feet into the ground. The goal is to focus on an objective that grounds you back to reality and stop you from being overwhelmed. 

Breathing techniques

Another technique frequently used in these situations is teaching a client to breathe using the diaphragm. During a panic attack, people often hyperventilate and research (Ma, Yue, Gong et al., 2017) shows that learning to breathe deeply will decrease your stress levels and improve your wellbeing. 

Breathing through your diaphragm is a very easy technique where you learn to breathe to the count of 4, hold it for 1 second and then release to the count of 4. The idea is to breathe in through your nose and fill your chest and lungs with air. If you are breathing correctly, you should be able to feel your stomach rising and falling if you had to put your hand below your chest.

Clients are encouraged to direct their thoughts to their breathing which usually slows down the arousal provoked by the panic attack and control the hyperventilation one often experiences during an attack. 

A final note 

Having frequent panic attacks on a long-term basis can have a very adverse effect on your wellbeing. If you experience panic attacks or worry about having a panic attack for more than a month, catch yourself changing your behaviour after an attack, or your concerns due to panic attacks are affecting your daily life and work it is recommended you seek immediate medical advice.

If you think that you can benefit from professional support on this issue you can reach out here.

Sonya Galea is a family therapist with Willingness Team. She works with families and couples experiencing couple relationship issues and parenting struggles.

References

Gotter, A. (2022, Jan 5). 12 ways to stop a Panic Attack. Healthline.com. Retrieved from https://www.healthline.com/health/how-to-stop-a-panic-attack

Lim, J.A., Lee, Y.I., Joon, H et al. (2018) Investigating effective treatment factors in brief cognitive behavioural therapy for panic disorders Medicine: September 2018 – Volume 97 – Issue 38 – p e12422 

Ma X, Yue ZQ, Gong ZQ, Zhang H, Duan NY, Shi YT, Wei GX, Li YF.(2017) The Effect of Diaphragmatic Breathing on Attention, Negative Affect and Stress in Healthy Adults. Front Psychol. 2017 Jun 6;8:874. doi: 10.3389/fpsyg.2017.00874. Published online 2017 Jun 6. doi: 10.3389/fpsyg.2017.00874

Raypole, C. Marcin A (2022, May 17) Cognitive Behavioral Therapy: What Is It and How does it work? Healthline.com. Retrieved from Cognitive Behavioral Therapy: What Is It and Who Can It Help? (healthline.com)

Reinecke, A., Thilo, K.V., Croft, A. et al.( 2018) Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety. Transl Psychiatry 8, 225 (2018). https://doi.org/10.1038/s41398-018-0277-5 retrieved from Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety | Translational Psychiatry (nature.com)