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CBT for Panic Attacks – how does it work?

Written By Dr Elaine Ryan.

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Dr Ryan is a psychologist with over 20 years of experience. She specialises in OCD and anxiety-related conditions and worked in the NHS in the UK before setting up a private practice in Dublin. Dr Ryan obtained her PsychD from The University of Surrey and is a Member of The British Psychological Society, The UK Society for Behavioural Medicine and EuroPsy registered.

Cognitive behavioural therapy (CBT) is the recommended psychological treatment for panic attacks, and in this article, I want to explain what the model is and how it will help you with panic.

If you have already attended your local GP, you may have been referred for psychological therapy, specifically CBT. The reason you get referred for CBT is that it is a well-researched model of therapy and has been shown to be effective in helping people with panic attacks.

If you have not met with your GP, I urge you to do so, as there are other conditions with similar symptoms that need to be ruled out before getting a diagnosis of panic disorder. You need to know what you are dealing with first before seeking treatment. I have written about my personal experience of this recently as I now have a diagnosis of sleep apnea, which could well have been the start of my journey on the way to panic disorder.

I won’t go into detail explaining panic attacks as I have a guide to panic that you can read here and also a series of articles on panic that you can find here. This article discusses CBT which is a long term solution to panic, but if you are wanting to read up on different methods that help stop panic attacks, you can do so here.

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Cognitive Behavioural Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is a talking therapy that has been shown to be effective in helping people with panic attacks. It is based on the concept that our thoughts, feelings, and behaviours are interconnected and that changing how you think about things can lead to changes in feelings and behaviours.

CBT involves several key components:

  • Identifying and challenging negative thought patterns
  • Developing coping strategies and resilience
  • Exposure therapy to desensitize panic responses
  • Homework assignments to reinforce learning

CBT specifically targets the cognitive distortions associated with panic attacks. These distortions often involve catastrophic thinking, where you might misinterpret harmless bodily sensations as signs of something serious going wrong with you. By challenging these distortions, CBT can help reduce the intensity and frequency of panic attacks. I think I better give an example and that is all sounding a bit wordy!

Two people can have very different reactions based on their point of view. My example involves two people seeing a dog coming towards them.

  • Person 1 likes dogs and is not afraid of them and thinks to look at that lovely dog; they do not feel anxiety as the dog approaches and may stop to pet it.
  • Person 2 is afraid of dogs and thinks oh no this could bite me and they feel intense fear and as the dog approaches they sweat and try to get past it a quickly as possible.

The only difference in the behaviours is how both people thought about the dogs. That might not be the best example, but hopefully, it explains the concept a bit better.

CBT techniques used in treating panic attacks include:

  • Cognitive restructuring: This involves identifying and challenging irrational thoughts and beliefs.
  • Exposure therapy: This involves gradually and repeatedly facing feared situations until they no longer trigger panic.
  • Relaxation techniques: These can help manage physical symptoms of panic attacks, such as rapid heart rate and shortness of breath.

The first session

The first session is the assessment session where we check your suitability for therapy and suitability for the model. I (or another therapist) explains the model to you, how many sessions it will take and outline what will be involved. We basically are then coming up with a treatment plan.

The treatment plan typically involves a combination of cognitive restructuring, exposure therapy, and the development of coping strategies. Each of these components plays a crucial role in managing and reducing panic attacks.

Identifying and Challenging Negative Thought Patterns

A key part of CBT is identifying and challenging negative thought patterns. These patterns often involve catastrophic interpretations of bodily sensations or situations. For example, an individual might interpret a rapid heartbeat as a sign of an impending heart attack.

Through cognitive restructuring, the individual learns to challenge these irrational thoughts. They learn to replace them with more realistic and balanced thoughts. This can significantly reduce the intensity and frequency of panic attacks.

Exposure Therapy: Facing Fears in a Controlled Environment

Exposure therapy is another crucial component of CBT for panic attacks. This involves gradually and repeatedly facing feared situations or sensations in a controlled environment. The goal is to desensitize the individual’s panic response.

Over time, the individual learns that their feared outcomes are unlikely to occur. This can help reduce the fear and anxiety associated with these situations or sensations, thereby reducing the frequency of panic attacks.

Developing Coping Strategies and Building Resilience

Developing coping strategies and building resilience is another key aspect of CBT for panic attacks. This involves learning techniques to manage stress and anxiety, such as deep breathing exercises and progressive muscle relaxation.

In addition, individuals learn to develop a more resilient mindset. This involves learning to view challenges as opportunities for growth, rather than threats. This shift in mindset can help individuals better manage their panic attacks and improve their overall quality of life.

The Importance of Homework in CBT

Homework assignments are a crucial part of CBT for panic attacks. They provide the opportunity for individuals to apply the techniques learned in therapy to real-life situations. This helps to reinforce the skills and strategies learned, leading to more effective management of panic attacks.

Measuring the Effectiveness of CBT for Panic Attacks

The effectiveness of CBT for panic attacks is often measured through various tools. These include self-report questionnaires, clinician ratings, and physiological measures. These tools assess changes in the frequency and intensity of panic attacks, as well as improvements in quality of life.

Research has consistently shown that CBT is effective in reducing the symptoms of panic attacks. It has been found to be superior to other forms of therapy and medication in many cases. This is due to its focus on changing the underlying cognitive distortions that drive panic attacks.

Long-term Benefits and Maintenance Strategies

CBT for panic attacks not only reduces symptoms in the short term but also provides long-term benefits. It equips individuals with the skills and strategies to manage future panic attacks. Maintenance strategies, such as ongoing practice of CBT techniques and regular follow-ups, can help to prevent relapse and ensure long-term recovery.