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How does mindfulness-based cognitive therapy help panic attacks?

If left untreated, panic attacks can have a negative impact on your life, but with treatment, they can be managed, even stopped. Mindfulness-Based Cognitive Therapy (MBCT) is a mix of cognitive therapy and mindfulness practices. In this article, I shall explain how it works, how it helps regulate your emotions, and ultimately, how it helps manage your panic attacks.

What is Mindfulness-Based Cognitive Therapy (MBCT)?

Mindfulness-Based Cognitive Therapy (MBCT) is a talking therapy that combines mindfulness practices with cognitive therapy and helps you to understand and manage your thoughts and emotions. You would be forgiven for thinking that sounds just like CBT, but adding the mindfulness aspects encourages you to be more aware of your internal experiences, such as how you feel, or what sensations you feel in your body.

If you have panic attacks, you might not want to be more aware of the sensations in your body, and I understand that, as I had panic disorder, but I am also a psychologist who has worked with hundreds, possibly thousands of people with panic over the duration of my career, and I can testify that this awareness is a help. It is not frightening.

MBCT was developed by Zindel Segal, Mark Williams, and John Teasdale and was originally a group training program. over time, the model has been adapted to treat various mental health conditions, which include panic disorder, anxiety, and stress-related issues.

image shows what can control and what cannot control with words MBCT for panic and dr Elaine Ryan logo

Key points

It’s the mindfulness aspect that makes MBCT feel quite different from CBT. MBCT is about observing your thoughts and feelings, as opposed to then changing them in CBT.

Meditation features which really helps calms your over worked nervous system. Bodyscans, breathwork and guided meditation all feature heavily in MBCT.

Acceptance is another central aspect of the model. Aceept your thoughts as they are. No need to change them or work with them as in CBT, rather just accept them for what they are; just thoughts.

Does MBCT work?

Research supports the efficacy of MBCT for panic disorder. Several studies have shown significant reductions in panic symptoms following MBCT treatment.

In this Oxford University study it was found that MBCT reduced panic relapse rates suggesting that MBCT can provide long-term benefits for individuals with panic disorder.

MBCT has also been shown to improve emotional regulation. This can help individuals manage panic symptoms more effectively.

Client Profile:

  • Name: Aisling
  • Age: 34
  • Occupation: Homeworker
  • Presenting Problem: Panic attacks, characterized by sudden onset of intense fear, palpitations, sweating, trembling, and fear of losing control or dying.
  • Duration: 1 and a half year
  • Medical History: No significant medical conditions. History of generalized anxiety disorder.
  • Previous Treatments: Cognitive Behavioural Therapy (CBT), medication (SSRIs), with limited success.

Assessment

Initial Assessment: Aisling’s panic attacks began a year ago, coinciding with increased stress at work. She experiences panic attacks 2-3 times a week, often without any obvious trigger. She avoids situations where she fears a panic attack might occur, leading to increased isolation and functional impairment.

Clinical Measures:

  • Panic Disorder Severity Scale (PDSS): Score of 15, indicating moderate severity.
  • Generalized Anxiety Disorder 7-item (GAD-7): Score of 13, indicating moderate anxiety.
  • Beck Depression Inventory (BDI): Score of 10, indicating mild depression.

Treatment Plan

Treatment Approach: Mindfulness-Based Cognitive Therapy (MBCT) was chosen to help Sarah develop a non-judgmental awareness of her thoughts and bodily sensations, reduce avoidance behaviors, and decrease the frequency and intensity of her panic attacks.

Session Structure:

  • Duration: 8 weeks, 1 session per week, 90 minutes per session
  • Homework: Daily mindfulness practice (30 minutes), weekly reflective journaling

Goals:

  1. Reduce the frequency and severity of panic attacks.
  2. Improve Sarah’s ability to manage anxiety through mindfulness techniques.
  3. Decrease avoidance behaviors and improve overall quality of life.

Intervention

Week 1-2: Introduction to Mindfulness and Breathing Techniques

  • Session Activities:
    • Psychoeducation about the nature of panic attacks and the role of mindfulness in managing anxiety.
    • Introduction to mindful breathing and body scan exercises.
    • Homework: Daily practice of mindful breathing and body scan.

Week 3-4: Developing Mindful Awareness

  • Session Activities:
    • Guided mindfulness meditation focusing on present-moment awareness.
    • Discussions on how to observe thoughts and sensations without judgment.
    • Homework: Daily mindfulness meditation, journaling experiences.

Week 5-6: Mindfulness in Daily Life

  • Session Activities:
    • Techniques for integrating mindfulness into daily activities (e.g., mindful walking, eating).
    • Identifying and challenging cognitive distortions related to panic attacks.
    • Homework: Practice mindfulness in at least two daily activities, continue journaling.

Week 7-8: Relapse Prevention and Future Planning

  • Session Activities:
    • Developing a personalized mindfulness plan for maintaining progress.
    • Strategies for dealing with setbacks and preventing relapse.
    • Homework: Create a detailed plan for continued mindfulness practice post-treatment.

Outcomes

Post-Treatment Assessment:

  • PDSS: Score of 6, indicating mild severity.
  • GAD-7: Score of 5, indicating mild anxiety.
  • BDI: Score of 6, indicating minimal depression.

Client Feedback: Aisling reported a significant reduction in the frequency and intensity of her panic attacks. She felt more in control of her anxiety and was able to resume activities she had previously avoided. She expressed a high level of satisfaction with the mindfulness techniques and planned to continue practicing them.

Follow-Up: A 3-month follow-up showed sustained improvement, with no major panic attacks reported and continued use of mindfulness practices.

If you would like help with your panic attacks and would like to try MBCT, it is important to look for a qualified mental health professional that is not only expert in anxiety disorders, but is also trained in MBCT. Once you find your therapist and engage in therapy, for the best outcome it requires effort and practice on your part, outside of sessions with your therapist. This is the same for all models of therapy, success really depends on the work you put in outside of therapy.