Cognitive behavioral therapy for panic attacks


When a person has a panic attack, he or she typically experiences the feeling of impending or current harm along with symptoms such as weakness, dizziness, sweaty palms or a pounding heart. According to the Diagnostic and Statistical Manual, 5th Edition, the “attack” can last anywhere from ten minutes to an hour, sometimes even longer. Panic attacks can cause serious problems for those dealing with them.

Symptoms of a panic attack

The symptoms of a panic disorder include recurrent, unexpected panic attacks followed by one month or more of persistent concern or worry about having another panic attack. The panicked person will worry about the potential harmful effects of the attack, including heart palpitations and fatigue. Additionally, this person might adopt significant maladaptive changes in behavior due to the attacks, such as avoiding people, places or things that bring up the internal thoughts or sensations that bring on the panic attack. Additional symptoms of a panic attack may include:

  • Numbness
  • Feeling flushed
  • Chills
  • Feelings of being smothered
  • Feelings of having a loss of control
  • Feelings of impending doom
  • Chest pains and breathing difficulties
  • Feeling weak or dizzy
  • A racing heart

Thankfully those who deal with panic attacks do have different options for treatment. After a visit with a doctor to get a proper diagnosis, one may have a range of choices for medications they can take to help this problem. However, medications are not the only treatment method for panic attacks. Cognitive Behavioral therapy is also a very helpful treatment for this anxiety disorder.

Cognitive behavioral therapy as treatment

A study done by Dr. David M. Clark in 1999 attests to cognitive behavioral therapy (CBT) being a very effective treatment for alleviating panic disorder. When an individual is having a panic attack, internal sensations and symptoms indicate impending physical or mental catastrophe. This misperception of thoughts generates a “feedback effect” in which anxiety, physical symptoms and negative thoughts reinforce each other.

Utilizing cognitive behavioral therapy can be extremely helpful for those people who have panic disorders. Since the primary thought patterns are based off of fear, CBT allows a person with a panic disorder to recognize the root of the fear, whether it be negative thoughts, situations or internal sensations.

According to Dr. Michael W. Otto, Ph.D. and Dr. Heather W. Murray, Ph.D., from Boston University, the following treatment modalities are highly beneficial for the patient suffering from panic disorder:

Exposure interventions

In an exposure intervention, the therapist works with the client to determine the hierarchy of feared situations. After the client recognizes and understands understands these fears, the therapist provides a logical reason for the patient to confront the feared situation while providing accurate expectations of what is more likely to happen. This process is repeated until the patient is able to express and truly understand what was learned and how they benefited from the exposure.

Interoceptive exposures

Interoceptive exposures will help a person with panic disorder become aware of their safety during an attack. In this process, the patient is repeatedly exposed to simulated sensations that happen as a result of the panic attack. Interoceptive exposures will help the patient recognize and accept that they are safe even while experiencing symptoms like racing heartbeat, dizziness, hyperventilation, trembling, numbness or any other internal physical sensation that they fear. After frequently repeating the exposure, the patient is able to learn that the internal sensations are not harmful.

Situational exposures

Situational exposures provide patients with a learning opportunity to examine negative predictions about feared outcomes of situational events. These exposures will help the patient increase their tolerance to the internal sensations that result from their fear of situations. In a situational exposure, a person that has panic attacks would intentionally surround themselves with a lot of people, if large groups of people would usually cause them to have a panic attack.  Another example of this could be intentionally going to see a person that would usually bring on thoughts, emotions or internal sensations of a panic attack.

Preventative treatment

  • Identifying risk factors – Learn how to identify what is causing anxiety, or feelings of panic
  • Psychoeducation – Through individual or group therapy, the patient can understand the disorder
  • Cognitive restructuring – Identifies and disputes faulty thinking and distorted thoughts
  • Instruction for in vivo exposure – Patient is directly exposed to the person, place, thing or situation that is being feared

A person who is experiencing panic attacks or has been diagnosed with a panic disorder needs to take treatment very seriously. A person experiencing panic attacks would greatly benefit from seeing a therapist. This can be done on an outpatient or inpatient basis. There are also various medications that can be prescribed if diagnosed with panic disorder. It is especially important to see a therapist or psychiatrist if seeking medication treatment.
To learn more about CBT or about treatment for panic attacks you can call 855-653-8178 for more information.

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