Therapy Tips

How to Control a Panic Attack

The most severe and debilitating type of distress that a socially anxious person suffers is the panic or anxiety attack. These attacks manifest themselves in two ways: as a wave of free floating anxiety, or in response to specific situations. Speaking in front of a group, interacting with an authority figure, fear of being watched, and intimacy with the opposite sex, are some of the situations that can activate the panic which can be characterized by an overall feeling of losing control, heart palpitations, dizziness, hyperventilation, and other physical symptoms. Often the person who suffers from this thinks “am I crazy?”, or “am I having a heart attack?” It is very common that after a person experiences this panic, he or she wants to avoid the situation that is associated with it…hence an “addiction to avoidance”.

In most cases the physical symptoms are the result of emotions being somatized. In other words, unresolved emotions left repressed, or not dealt with, turn into physical symptoms. In working with thousands of individuals who have suffered from panic attacks I have found that a common reaction is for the patient to think that there is something physically wrong that is causing the problem. Obviously it is important to check things out physically with your physician. Rule out physical problems. The problem often is that even after a person finds that there is nothing physically wrong, it is hard to accept this reality. In the vast majority of cases a panic attack is a psycho-physiological (mind-body) response.

Here are some steps to help with the control of the panic:

  1. Accept the reality. Acknowledge that a panic attack is upon you. Admitting that you are panicked does not mean agreeing to continue having panic attacks forever. It means that for the moment, you have to accept the reality and learn to flow with it.
  2. Roll with the punch. Just as professional boxers are trained to roll with the punch instead of turning into it, so must you learn to go with the flow of the panic attack. Don’t deny your feelings. Roll with them. Picture a surfer on a wave. The wave is the panic. Surf it and it will go away sooner than later.
  3. Tell someone you trust. If you are with someone who is close to you, you may feel better if you let that person know that you are experiencing the panic. This can relieve pressure.
  4. Learn relaxation technique. If there is any magic resolution to the problem, it is the reality that anxiety is incompatible with relaxation. For example the biofeedback technique of increasing the skin temperature of your hand a few degrees is enough to abort a panic attack.
  5. Remember Fear means False Evidence Appears Real.
  6. If panic attacks become severe or chronic it is imperative to resolve the underlying emotional conflict.

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Self Regulation


Often people tend to look for magic when it comes to solving problems. Here is some: Anxiety is incompatible with relaxation!! What does this really mean? Many symptoms of distress such as panic attacks or episodes of anxiety characterized by blushing, sweating, increased pulse, dizziness, increased muscle tension, hyperventilation, and an overall fear of losing control, can be controlled by internal self-regulation (relaxation).

Self-regulation is, in essence, natural medicine. Like any real skill it takes practice..just like an athlete needs to work out to improve performance, or an actor or actress needs to train to perform. There are many methodologies available to facilitate self-regulation including progressive relaxation, imagery, meditation, yoga, self-hypnosis, andbiofeedback. There is no one way which is best for everyone. People have different chemistry and therefore need different approaches. Breathing technology is indigenous to most relaxation strategies. The most productive method is that which teaches the individual to be independent and confident with the skill.

An example of biofeedback technique is hand warming. This is based on a conscious process where the individual learns to increase the skin temperature of the hands through a process of vasodilation. Skin temperature is not to be confused with body temperature. Dry warm hand equals relaxation. Being able to increase skin temperature 3-4 degrees is often enough to abort an anxiety or panic attack. This technique is also used to control migraine headaches.

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Self-Help & Treatment Options

  1. Free Introductory CD
  2. "Social Anxiety the Untold Story": Comprehensive Self-Help for Sufferers and Families
  3. The book, "Beyond Shyness: How to Conquer Social Anxieties" (Simon & Schuster)
  4. The book, "Work Makes Me Nervous: Self-Help for Performance Anxiety (Wiley and Sons)
  5. Comprehensive self-therapy audio CD program for social and performance anxiety
  6. Public Speaking Anxiety: Self Therapy Audio CD Program
  7. Therapy in Great Neck, New York
  8. Therapy worldwide via telephone or Skype
  9. Selective Mutism Seminar on Audio CD
  10. "Parenting The Selectively Mute Child": Self-therapy Audio CD Program
  11. Free social-ability questionnaire
  12. Subscribe to the Tip of the Month Club
  13. "Social Therapy and the Learning Disabled: A seminar on Audio tape and mp3
  14. Free "Parent Addiction" quiz
  15. AskJonathan: Get your questions about social anxiety answered