What To Do When You Feel a Panic Attack Coming Part 2: The Shields
Leaving the Situation: This is one of the strongest coping techniques, but also can eventually lead to problems. Leaving a crowd, pulling over on the side of the road while driving, or avoiding vigorous exercise are examples of leaving the situation. These are effective coping techniques because they can frequently avert a panic attack. However, these techniques have the obvious drawback of encouraging agoraphobia (i.e. the avoidance of activities because of a fear of panic). I would say that leaving a situation is useful, but only if you are also engaging in a definitive treatment to help you gain mastery over panic disorder.
Relaxation Techniques: It's hard to stop thinking about something "cold turkey." It's easier to stop thinking about something if you replace your thoughts with something else. Relaxation and meditation techniques aim at getting you to stop thinking by giving you an effective distraction to replace your thoughts with. For example, many Buddhist forms of meditation replace your thoughts with a focus on repeated sounds and/or breathing. In addition, various visualization exercises replace your thoughts with vivid imagery. The relaxation techniques I have found to be most effective for panic attacks are 11-muscle relaxation with Abdominal Breathing, Sensation Focusing, and Permission Breath Counting, which are all cognitive-behavioral techniques. I never teach patients just one coping technique because different techniques seem to work for different people. Relaxation techniques initially may not be strong enough to stop a panic attack, but they become much more effective once you have started doing exposures.
Thought Restructuring: This coping technique teaches you ways to stop your anxiety by talking back to it. Thought restructuring is a type of journaling done on paper for 10 minutes a day for 1-2 weeks. After 1-2 weeks, I usually encourage my patients to stop talking back to their thoughts on paper and start doing it in their heads. Much like relaxation techniques, this is a cognitive behavioral therapy technique, it gets better with practice, and it becomes much more effective once you have started exposures.
Thoughts restructuring along with Relaxation Techniques eventually form the two most healthy and permanent parts of your "shield" because they can be used extensively without having the drawbacks of avoiding situations or relying on medications. However, these "shield" techniques are usually not strong enough alone to gain complete mastery over panic disorder, most patient need to do exposures.
Related Tags: panic attack, agoraphobia, panic, anxiety attack, panic disorder, exposure, cognitive behavioral
Visit http://www.PanicMastery.com to get a free pdf copy of Dr. Kiriakos' "The Worry Guide".
Lindsay Kiriakos, M.D., is a practicing Anxiety Disorder Specialist. Certified by The Academy of Cognitive Therapy for Cognitive Behavioral Therapy, he has compiled his years of experience in to the "Panic Mastery Course" which was specifically developed for people who suffer from Panic Attacks. You can contact Dr. Kiriakos by email.
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