James P Krehbiel

Cognitive-Behavioral Therapy's Answer To Panic



Posted: Thursday, March 22, 2007

by
Krehbiel Counseling

People who suffer from panic attacks experience symptoms such as heart palpitations, sweating, loss of control, feelings of impending doom, disorientation, and feeling trapped. Although those who suffer from this disorder feel debilitated, it is one of the most manageable syndromes to treat through the use of cognitive-behavioral therapy.

When people first come for cognitive-behavioral therapy, they may indicate that they have received prior counseling, have made innumerable visits to doctors, and have been treated in emergency rooms for symptoms associated with their anxiety. Patients are usually desperate for answers to alleviate their on-going struggle with panic. Patients are relieved to know that their symptoms are treatable through the use of cognitive-behavioral therapy. Often, patients feel that they are going crazy, although they need to be reassured that having “crazy" feelings is a cognitive distortion and is vastly different from those who might be considered clinically crazy.

Most individuals know the time-frame when they first started experiencing panic attacks. There may have been triggering events that fostered the emergence of panic. The patient may be unable to make an association between the panic and a painful triggering experience. Factors such as a significant illness, job stress, family abuse/ trauma, losing a loved one, and lacking emotional expressiveness may create conditions ripe for panic. Once a panic attack erupts, further attacks usually follow if an individual is not aware of the cycle of self-defeating thinking and behavior which sustains the panic process.

The key to curtailing panic is to help people understand that it’s the secondary symptoms that keep the panic alive. In other words, it’s the “panic over the panic" that sustains the panic pattern. With cognitive-behavioral therapy, recovery involves educating the sufferer on ways to respond to their self-defeating thought processes during the onset of their attack. For example, let’s say that you are taking a mid-term exam during college. You open up the test booklet and immediately react by saying, “Oh my God, none of this material looks familiar; there’s no way that I can pass this test; if I flunk this test, I might fail this course for the semester; if my parents find out, there’s going to be hell to pay!" In contrast, you can learn to respond rationally by saying, “Wow, some of this stuff doesn’t look familiar; just take some deep breaths and relax; I guess I better survey the whole test, answer the questions that I can and then go back and work on the other one’s; I can tackle this test, I just need to relax and be patient!"

How one responds to panic determines whether it subsides. Those who fight with their panic by “awfulizing" about their symptoms, intensify their panic. They may say, “Oh my God, here come those unbearable feelings again – I feel like I’m going to die!" However those who accept their panic and respond rationally with thoughts like, “Here comes that panic again – just calm down and take those deep breaths and it will eventually subside. These feelings won’t last forever, they are time-limited – they’ll be gone soon."

Learning through cognitive-behavioral therapy to go “down stream" with panic is important to its eradication. Those who “catastrophize" about their symptoms intensify panic attacks. Learning to rationally respond to panic diminishes its effect. Trying to figure out what caused an individual’s panic is not necessary to treat it. What is essential is teaching those who suffer from panic to respond with positive self-talk.

People who experience panic attacks tend to feel ashamed of their problem. It is important for sufferers to understand that they are not alone – anxiety is apart of the human condition. Anxiety and panic is not unusual and those who experience it need to learn to be more open and expressive with all of their feelings. Sharing a wide range of emotions with those you can trust is essential to the healing process. Those who hide panic as a shame-based pattern set themselves up to repeat it. When those we trust are aware of our authentic self, which includes our vulnerability, our anxiety problems tend to fade in significance.

Paradoxical interventions can be helpful in dealing with panic disorder. Having a patient schedule a panic time and encouraging them to perseverate can bring humor and assist in breaking the panic cycle. A ruminating patient might be asked to conduct cardiovascular exercises during panic-related chest tightness to try to lighten the moment and break the cycle of suffering. Cognitive-behavioral therapy is a structured, pragmatic approach which assists people in addressing the symptoms of panic by learning to respond to the disorder with a positive approach to their thinking.

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer, and nationally certified cognitive-behavioral therapist practicing in Scottsdale , Arizona . His personal growth book, Stepping Out of the Bubble is available at www.booklocker.com . James can be reached at www.krehbielcounseling.com .

James P. Krehbiel, Ed.S., LPC, CCBT is an author, freelance writer and nationally certified cognitive-behavioral therapist practicing in Scottsdale, Arizona. He received his post-graduate counseling training at Northern Illinois University. James has taught Master's level classes in counselor education through Chapman University of California.  He specializes in working with patients who have depressive, anxiety, pain management and autistic spectrum disorders.  James has written numerous articles on a variety of counseling-related topics, all available via Google searches.  His first book, Stepping Out of the Bubble, is available at www.booklocker.com.  James is in the process of having his second work published which is entitled, It Never Was About You:  Saying Goodbye to the Magical Illusions of Childhood.  He can be reached through his new, contemporary website at www.krehbielcounseling.com. 
This Article has been viewed 264 times. (Not updated in real-time.)
Top-level comments on this article: (1 total)
» left by Nancy Zimmerman
 4 years 301 days ago.
Interesting, practical article. Any chance you would add a couple clear strategies for on-the-spot "going downstream" rather than catastrophising? The very last paragraph looked really interesting. Could you develop it a little more? (bearing in mind we are lay-people).
We want your comments! If you can read this, you don't have javascript enabled, so you can't use this comment system. Please enable javascript.