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How To Cure Panic Attacks By Exposure

 

Before you begin to practice exposure, make a list of situations you avoid. If there are many places you avoid, it is helpful to rank them in the order of the intensity you feel about them. Start practicing in situations where you will have the most chance of success, and later move to more difficult situations. Regular practice is essential.

Your first attempts can be regarded as experiments to explore your present limits, so try not to be too hard on yourself or discouraged if this exercise is very difficult in the beginning.

At first, try to identify what tends to raise your anxiety level. Then see which coping strategies are most helpful for you. Remember: the goal is to face and tolerate some anxiety without escaping from the situation. Even if you leave, it will help you if you experience the anxiety and decrease its level to some degree. Although you can escape a feared situation at any time, if you leave while your anxiety level is high, it’s best to return and reenter the situation as soon as you can to get more practice.

If you have trouble getting back into a situation in which you’ve panicked on a previous occasion, you may want to do some “imaginary exposure" first. Imagine yourself back in the situation and review those parts that make you most nervous, for instance, all the associated physical sensations and thoughts.

Practice your rational responses and slow, gentle breathing as you imagine the situation. Continue to imagine coping until these strategies lower your anxiety to manageable levels. You might want to tape record these exercises. If so, after you describe each panic situation, leave room on the tape to imagine using your coping skills.

Another useful strategy for reentering avoided situations is to break the task of going back into small steps. For example, if you’ve had a bad time in elevators, you might just want to look at the elevator on the first try, and the next time press the buttons to call the elevator, and later actually get on the elevator. For others, getting on the elevator right away seems to work best. Going with a partner YOU trust or a therapist may also help you.

Another strategy involves exposure only to internal fear cues - the rapid heartbeat, shortness of breath, etc. Even if you're in a safe place, imagining a feared internal
symptom can lead to a panic attack. lt's very possible that you don’t realize that what you actually have is a strong, illogical aversion to your own bodily sensations.

lf you can learn to bring the scary symptom to a therapist or a trusted companion in a safe situation. you can practice turning the symptom on and off using coping strategies. When the scary symptoms are under your voluntary control, a change in your heartbeat or your breathing, for example, will no longer lead to a panic attack.

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