I Very Helpful Protocol for Getting Out of a Panic Attack

I work with a lot of people with panic attacks. And probably the worse way someone can deal with their panic attack is by trying to get rid of it. Yes, you read that right.  Trying to get rid of your panic attack is probably one of the worse things you can do.  There is something worse than that I am sure, but I am not going to discuss that here, so work with me here, people. 

Why is the worst thing you can do is try to get rid of a panic attack? Well, to put it simply, what you resist, persist.  If you fight the panic attack, for instance, telling yourself “Oh no! I feel a panic attack coming on! How can I get rid of this?! Push it down, ignore it, go away!” Well, guess what that does? It increases anxiety.  Anxiety being the sensation of high arousal (i.e., being outside of your optimal arousal zone). 

So, one of the best things you can do with a panic attack is accept it.  But before I get into all that, let me just give you the formula:

1. Acknowledge/accept thoughts, feelings, and sensations that are happening. 
2. Validate: does this make sense? Make sense of what is happening. 
3. What catastrophic belief has been triggered? 
4. What is the truth? 
5. Willingness to do opposite action and value alignment – this is where the rubber meets the road.

So let’s break it down. 

1. Acknowledge/accept thoughts, feelings, and sensations that are happening. 

When I say acceptance, what I do not mean is concession.  Just lay there and let the panic attack have its way with you. No. Please do not do that, please. What I mean is willingness to acknowledge that what is happening is happening.  Specifically, through thoughts, feelings, and sensations.  For instance, say to yourself, “Okay, I am noticing sweat building up on my forehead. I am noticing thoughts that say ‘I am a loser.’ I feel hot and tense in my shoulders.” If you can do this, you have completed step one.  

2. Validate: does this make sense? Make sense of what is happening. 

Ninety percent of the time when I ask clients to do this in real time they say, “No it does not make sense, it is stupid that I do it.” And I typically say, “Okay, I understand you think that but really try to make sense of it.” After a bit of a back and forth, they say something like, “Well, yeah it makes sense that I feel this way because no one ever taught me how to regulate my emotions, and calling myself a loser was a way to isolate and avoid rejection that I endured. After all, if I could hurt myself first, at least I had control.” 

Now, this does not make things ALL BETTER, but it does help the individual slow down.  And a lot of the time they will tell me that they are experiencing a bit of a calming effect.  And this makes sense, right? If you are not fighting yourself, but accepting why you might feel the way you do, your nervous system follows. You sort of drop into that optimal arousal zone. Also if your whole life people had been pretty invalidating and for once with yourself you validate, well, it can be pretty impactful. 

Lastly, I am pretty strong on the notion that whatever we have a habit of doing, even the really destructive things, well, they all, yes all, have a payoff.  In other words, everything we do, we do it for a reason. Quick example, getting into a dysfunctional relationship by ignoring red flags, the payoff is in the short term you get a lot of validation that someone finds you attractive again. Obviously the consequences are something like all your clothes getting thrown out in the middle of the street.  Not a fun day. 

3. What catastrophic belief has been triggered? 

What is the belief about yourself that triggered the thoughts, feelings, and sensations? Quick aside, whenever you are feeling any sort of pain (i.e., tension, depression, anxiety, self-doubt, etc.) it is safe to say that there is a core belief about yourself, that you adopted from childhood, for survival, that is at work in the panic attack.  Or that fueled the thoughts, feelings, and sensations.  Let me write that again. Are you experiencing pain? A core belief is fueling that. So the question is what core belief is it?

Well, let me encourage you here, you are allowed to be generic, because it turns out your nervous system does not really speak English.  Sure it can have associations with English but it does not speak it directly. So, your goal here is simply to identify in English what your nervous system is believing based on making a guess.  So be generic.  For instance, it could be, “I can’t handle it”,“I am not enough”, “I am a loser”, “No one loves me, etc. etc. etc. Just get the jist of what generic core belief is most likely running you.  If you want to get a little more specific because it feels too generic, then ask yourself, “What does it mean about me that I can’t handle it?” And that might get to something that hits more of a nerve, which could be helpful.  But again not required. 

4. What is the truth? 

Okay so you identified the fuel, if you will.  The fuel being the core belief, it is running you, it is fueling the panic attack.  But what is the truth? Can you really not handle it? Well, you may feel like you can’t, but is it ABSOLUTELY true that you can’t handle it? The answer might be, “well, no, it is not absolutely true, it feels true, but it is also true that I can regulate myself, breathe, put my hand on my heart, feel my feet on the ground.” 

On paper the truth typically is something like you are not great at regulating, you are doing the best that you can, and you can improve, and there is something right now that could at least help you feel 10% better, not 100%, but 10%. So, while this is not fun, you can handle it, and you are. 

5. Willingness to do opposite action and value alignment – this is where the rubber meets the road.

This is an interesting one because a lot of the times clients try to fight their panic attacks and then jump right to this step (i.e., skip steps 1-4). This step is vital but if you skip the other steps it can really backfire.  This is because you have not acknowledged and accepted what is really going on; no identification. You have not validated yourself.  You have not examined your software program that is running you (i.e., core belief).  And you have not reality tested the truth. So then you are just going to force yourself to do positive things like breathing, walking, calling a friend, taking a bath.  Well, sure, this is better than not doing it, but a lot of the times it backfires, because you are forcing yourself versus choosing to do healthy things from a place of presence.  In short, you are forcing yourself to do regulating things while simultaneously still believing the very thing that is fueling the panic attack (i.e., I am not enough, everyone hates me, etc.).   

You need space, and that is what steps 1-4 do.  Now, it is appropriate to bring in the tool Opposite Action, that is, doing the things you don’t necessarily want to do, or have the habit of doing, but are good for you; kind of like eating your vegetables.  This is where breathing, going on a walk, painting, working on your goals, aligning yourself with your values – the list is endless – makes all the difference. This is where just do it can be most impactful because it is coming from a place of presence, not a place of panic. 

Okay, I think you get the point.