To celebrate the release of The Panic Deck, a new therapeutic resource and psychoeducational tool, author Elena Welsh presents some of her favorite strategies from the deck.
Join her for this discussion of ways to help clients find relief in the midst of a panic attack.
Panic is a very common experience. At least one in four adults experiences a panic attack in their lifetime, which is why it’s essential to have a full toolkit of strategies that can stop panic in its tracks.
Let me orient you to the deck. It’s split into two sections: crisis cards and wellness cards, which I'll cover in my next blog.
The crisis cards are intended to be used in the midst of a panic attack. When someone is in the middle of a panic attack, the logical part of their brain goes out the window, and they are consumed by this experience of panic.
A lot of panic symptoms are physical in nature, like increased heart rate, dizziness, sweating, numbness, tingling, and even gastrointestinal issues. It can feel scary, especially if it's a new experience. It’s very hard to maintain the logical side of the brain during a panic experience happening, so the crisis cards are designed to bear the brunt of the work for people who are feeling panic symptoms.
During a panic attack, clients can go through these strategies one at a time to hopefully reduce the length of the panic attack and help them calm down more quickly. As they work with the cards for a while, they’ll find there are certain tools and techniques that work the best for them.
1. Breathing Techniques
When you're having a panic attack, your fight-or-flight response becomes activated based on information that it receives from your anxiety.
Your body goes through changes in order to effectively fight or flee. These include shortness of breath, dry mouth, and a racing heartbeat. Your body thinks it's in immediate danger, and it's doing the best it can to keep you safe.
By engaging in breathing techniques, your mind may stay in that anxiety loop, but your body gets the memo that it can calm it down. In turn, that's going to reduce some of your panic symptoms and make the experience more manageable.
This is the best place to start in the midst of a panic attack, and usually it's an easy one to remember. You always want to start with a deep breath.
This is because during a panic attack, our breathing gets very shallow. We’re doing whatever we can to slow it back down and get that information to our body, even if our brain is still panicked.
This is a basic but effective option. It involves simply slowing your breathing down as much as you possibly can. Breathe in as slowly as possible, then breathe out as slowly as possible.
Alternate Nostril Breathing
This exercise also sends the message to the parasympathetic nervous system that everything is okay. It slows down your breaths, but it gives you something else to do if you're having a hard time staying focused on breathing alone.
Simply place your finger on one nostril and inhale, then move your finger to the other nostril to exhale, switching sides each time.
This is another way to guide yourself through breathing techniques. Use the visual anchor of your finger drawing a square. As you draw the first side of the square, inhale. As you trace the second side of the square, hold your breath. As you trace the next side of the square, exhale. On the fourth side, hold your breath again.
2. Grounding Techniques
These tools are different variations of pulling your mind out of its focus on panic. If you’re feeling shortness of breath, you may start to think, “I’m going to choke. This must mean something’s very wrong.” In turn, your brain gets increased threat information, and the panic symptoms increase.
What we're doing with grounding techniques is leaning into something that isn't focused on that anxiety.
Mental Grounding: Categories
This technique has a personalization element to it. Choose a category that you’re personally interested in, like sports teams, bands, books, or whatever else resonates with you. After you’ve chosen a category, think of as many things that belong in it.
Physical Grounding: Drink a Glass of Water
Just taking a sip of water is another simple tool that's giving your body something else to focus on physiologically. This is especially useful if you encounter a lot of dry mouth as part of your panic experiences. Think ahead and always make sure to have a water bottle, especially in situations that you know you’re prone to panic in.
Mental Grounding: Sing Along
This is one of my personal favorites, but it does feel silly to some people. Take what works for you and disregard the rest.
TThe idea here is by singing a song, you're engaging enough of your brain. You’re then unable to focus and fixate on the panic experience, thereby lessening its intensity. If you're by yourself, you can turn on music and just sing along. This is a great exercise if you struggle with panic while driving.
If you're not comfortable singing, you can even just think of your favorite song and write out the lyrics.
3. Distraction Techniques
There’s a little bit of overlap here with grounding techniques, but with distraction, we’re thinking about how to pull our focus away from the panic.
Distract: Using Sound
Shift your attention to any sounds that you hear. Try to list off five distinct sounds in your environment.
Try to think of a series of objects, using the colors of the rainbow as your guide. What’s something red? Something orange? Continue all the way through purple or violet. This exercise guides you through shifting your attention without much effort.
Changing your temperature or surroundings is another way that you can physically do something that doesn't take much brain power in the moment. If you're feeling hot, change your temperature in some way by reducing layers of clothing or moving to a different room. Changing your physiology gives your body something else to focus on so that it’s not fixated on the panic.
When combined, all of these small techniques can help the panic experience feel less intense and end more quickly.
Discover 58 Powerful Practices to Help Clients Find Peace from Panic
Created by anxiety expert Dr. Elena Welsh, The Panic Deck contains proven therapeutic tools to reduce panic. Now you can use the same tools Dr. Welsh developed and used in her therapy room to help her clients eliminate panic and fear.
Crisis cards offer practices to use during a panic attack to help you find relief in the moment.
Wellness cards consist of strategies to use in your daily life to reduce vulnerability to future panic.
Whenever you’re feeling overwhelmed – whether by panic attack or by everyday stressors – these powerful practices will help you find peace.
Elena Welsh, PhD, is a licensed clinical psychologist who specializes in working with clients with anxiety disorders from all walks of life in both inpatient and outpatient treatment settings. She also works with a wide range of mood and depressive disorders, including bipolar disorder, major depression, and post-traumatic stress disorder/trauma-related mental health issues.
Dr. Welsh has published articles in various medical and research journals and is the author of The Cognitive Therapy Workbook for Panic Attacks; Trauma Survivors' Strategies for Healing: A Workbook to Help You Grow, Rebuild, and Take Back Your Life; Getting to Good: A Guided Journal; and 5-Minute Stress Relief: 75 Exercises to Quiet Your Mind and Calm Your Body. She has served as an adjunct faculty member at various universities in Los Angeles.
Dr. Welsh received her doctorate degree from the University of Maryland, Baltimore County and completed advanced clinical training through a postdoctoral fellowship at Gateways Psychiatric Hospital in Los Angeles.
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