In psychology, different theories explain anxiety in different ways. Treatment then follows from those explanations of anxiety. The CBT model of anxiety suggests:
You probably have heard a lot about the magical intervention of CBT so what is it?
CBT consists of a series of therapeutic interventions that target how our thoughts, feelings, and behaviors interact in the above model. This page will explain the core components of CBT for panic disorder.
Psychoeducation and information.
Part of CBT focuses on providing psychoeducation and information about how panic works according to CBT theory.
This part of therapy focuses on how your expectations, beliefs, and fearful thoughts about the panic contribute to the attacks. A therapist using CBT will also help you to modify, challenge, and change your thoughts.
First, you will learn information that helps you understand how your thoughts, behaviors, and physiological symptoms interact to produce panic. CBT heavily emphasizes how your thinking influences the panic cycle.
For panic disorder, CBT would emphasize fearful catastrophic thoughts such as " I am going to die," "I am having a heart attack" or "I am going to faint" and how they drive the panic cycle. In CBT for panic disorder, a therapist helps you see how these thoughts drive the need to escape and avoid.
If you have panic disorder you have behavior of escape and avoidance. A CBT therapist would help you learn how this is contributing to your cycle.
CBT therapy for panic disorder emphasizes self-agency. You begin to learn how you are in control and have the tools to heal yourself.
Another part of CBT treatment for panic disorder is Cognitive Restructuring. Cognitive restructuring is restructuring your cognitions.
During the cognitive restructuring phase of CBT, you learn:
CBT and Exposure Interventions in Panic
Exposure is a key feature of most good anxiety treatments.
Anxiety and panic occur when we misinterpret certain body sensations as danger when it doesn't exist. This triggers a fear response in our bodies and emotions. We begin to act as if we are in danger by looking for safety and avoiding the dangerous thing.
Exposure is when you deliberately do or expose yourself to the thing you are afraid of, in this case, have a panic attack.
Part of anxiety treatment learning the thing you are afraid of is not scary.
To do this, you need to face the fear and stop avoiding it.
Think about this. If you are afraid of all dogs and are never around any that don't bite, how will you know that all dogs don't bite?
You have to have experiences with dogs that don't bite to learn that they are safe. If you avoid all interactions, a phobia of dogs can exist because you have no evidence that any of them are safe.
Avoidance maintains fear. Exposure teaches you that fear is not substantiated.
Panic is the same. If I induce a panic attack and learn to stick with it, I can learn that I don't die or have a heart attack and see what is happening in my body from a calm place; my fear of panic drops, AND my panic attacks decrease. This is what the research shows.
CBT for Panic disorder might consist of situational or in vivo exposure. In vivo exposure is exposure to situations that might cause panic. Treatment may also consist of interoceptive exposure or exposure to the sensations associated with a panic disorder.
In vivo exposure also includes a survey of the safety behaviors you use to manage and avoid your discomfort. This is a common strategy in people who have anxiety.
Here is a list of common safety behaviors used to avoid and manage discomfort in people with panic disorders.
Safety behaviors, like avoidance, strengthen the panic cycle and make you worse.
A CBT therapist is concerned with helping you retrain your fear response!
Establishing a hierarchy of feared situations is often a part of treatment for panic disorder.
There are various ways to do exposure, the most common way is to start from least to most frightening.
A CBT therapist, when doing an exposure, will:
• Provide accurate expectations for what will happen during the exposure ( your fear will likely increase and then drop)
• Repeat exposure until fear diminishes
CBT for panic disorder will often consist of a certain kind of exposure called Interoceptive Exposures or exposures to internal sensations.
Internal sensations are what kicks off the fight or flight cycle.
This provides you with opportunities to examine negative ideas about what terrible things your internal sensations mean.
In CBT this will repeatedly happen until you feel comfortable and accept the internal sensations without fear, so they don't scare you and drive your panic!
Relaxing around these internal sensations will drop your resistance and decrease your panic attacks.
How do we do this?
A therapist will create exercises that induce panic by mimicking sensations that initiate the danger response (i.e., dizziness, increased heart rate).
Standard Interoceptive Exposure Procedures •
This article highlighted some main features of CBT for panic disorder. I hope this has been helpful for you if you have been trying to learn about CBT for panic disorder.
Here are some other pages on this website on panic:
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Medical information obtained from this website is not intended as a substitute for professional care. If you have or suspect you have a problem, you should consult a healthcare provider.