Understanding Panic Attacks And How To Prevent Them From Reoccurring

Making Sense of Panic Attacks: How CBT and Nervous System Regulation Can Help You Find Relief

As a therapist and coach, I work with many clients who experience panic attacks—those sudden, severe bursts of fear that seem to strike out of the blue. They can be scary, like your heart is about to jump out of your chest, you can't breathe, and you're going to lose control. And the worry that you'll experience another one may lead to constant anxiety, which can affect many areas of life.

I've seen how distressing panic attacks are, but the good news is that they can be controlled. I've helped many clients over the years identify the root cause of their panic, and I use therapeutic techniques, including Cognitive Behavioral Therapy (CBT) and Central Nervous System (CNS) regulation, to help them find long-lasting relief. These techniques can not only reduce panic attacks as and when they arise, but can also prevent them from occurring again.

What Are Panic Attacks?

Panic attacks can make your mind and body feel as though they are suddenly plunged into a state of turmoil. Common symptoms include:

• Racing heartbeat or palpitations

• Shortness of breath or chest tightness

• Dizziness or lightheadedness

• Trembling or shaking

• Nausea or upset stomach

• Feeling of detachment or "out of body" experience

• Feeling of impending doom or fear of losing control

I've had clients describe their panic attacks as though they were going to have a heart attack or something worse. It's not unusual for people to feel completely helpless when they have an attack. But I reassure them that panic attacks, while frightening, are not harmful. They're a response to intense stress, and there are ways of surviving them.

Insights from Claire Weekes: Facing the Panic

One of the most significant influences on my own management of panic is Claire Weekes, an innovating Australian General Practitioner and Health Writer who developed a successful method of managing panic and anxiety. Her approach was straightforward: face the panic, rather than fight it.

When I first heard about Weekes' work, I was immediately drawn to it because of the efficiency and simplicity of it. Weekes concentrated on non-resistance and acceptance in her book "Hope and Help for Your Nerves". Rather than trying to push panic away or fear it, she instructed individuals to meet it head-on with the understanding that the symptoms are harmless and temporary.

I often share the following wisdom with my clients: when you allow yourself to experience the pain without fighting it, you begin to remove its power. This technique reduces the intensity of the attack and, over time, builds confidence in your ability to manage the sensations.

Cognitive Behavioral Therapy (CBT) for Panic Attacks

In my therapy practice, one of the most effective treatments for panic attacks has been Cognitive Behavioral Therapy (CBT). CBT targets the negative thoughts and beliefs that have a tendency to lead to anxiety and panic. Through CBT, you learn to retranslate the thoughts that exacerbate your fear and substitute them with more rational, reassuring ones.

One of the most common cognitions in panic is catastrophizing—where your mind jumps to the very worst conclusion, like thinking you're going to die or pass out when you experience a panic attack. In CBT, I guide clients to observe this and challenge it by questioning them in the following way: "What evidence do I have that this is actually true?" "What's the worst that could happen, and how likely is that?"

Through techniques like cognitive restructuring, exposure, and relaxation training, clients are able to interrupt the panic cycle. I frequently work on exposure with clients, in which they gradually expose themselves to physical sensations that culminate in anxiety. This desensitizes them to these sensations over time, and panic attacks become less overwhelming.

Central Nervous System (CNS) Regulation: Calming Your Body's Response

One of the major components of panic attacks is the body's fight-or-flight reaction, which is controlled by the Central Nervous System (CNS). This physiological reaction, produced by stress or anxiety, can enhance panic attacks. The body releases hormones like adrenaline and cortisol, which enhance your heart rate, breathing, and other physical symptoms.

To counteract this, it's essential to regulate the nervous system. I help clients practice CNS regulation techniques that have the impact of calming the body and not letting the fight-or-flight response become overwhelming. These include:

• Deep breathing exercises: I teach clients to breathe deeply from the diaphragm, which activates the parasympathetic nervous system (the calming part of the CNS). Deep breathing slows down the heart rate and promotes relaxation.

• Grounding techniques: These help bring clients back to the present moment and can be especially useful during a panic attack. An easy grounding technique that you can use is the 5-4-3-2-1 exercise, whereby you engage all five senses to reconnect with your surroundings.

• Progressive muscle relaxation: This involves tensing and then relaxing different muscle groups to release physical tension and send the body the message that it is okay to relax.

• Mindfulness: Mindfulness increases your awareness of the sensations in your body, enabling you to identify panic symptoms when they are still at an early phase and you can treat them before they worsen. It also leads you to be present in the here and now, rather than wandering into the future with dread.

If practiced on a daily basis, these techniques recondition the body to react more successfully to stress, causing panic attacks to become both less frequent and less intense.

Preventing Panic Attacks from Reoccurring

While it is impossible to guarantee that panic attacks will never happen again, combining CBT and CNS regulation can dramatically reduce their intensity and frequency. As you build resilience with these tools, you come to trust that you can cope with anxiety and panic.

One thing that I remind clients of is that prevention is key. When you make these skills a regular part of your daily life—even when you are not panicked—you begin to train your body and mind to be calm in the face of stress. Regular practice of relaxation proficiency, grounding skills, and restructuring negative thoughts will bring a sense of control and peace in the long term.

Final Thoughts: You Don't Have to Do Panic Alone

If you've been suffering from panic attacks, you may feel isolated, but you need to understand that you don't need to deal with it alone. In my practice, I've seen many clients regain their confidence and control with a series of pragmatic techniques.

If you're ready to take the first step towards overcoming panic attacks, send me an email for global online therapy or Barcelona-based in-person therapy. We can construct an individualized strategy that suits you best and allows you to break the vicious cycle of panic.