Use any or all of the following positive statements to help
you cultivate attitude of accepting, "floating," and
allowing time to pass during a panic attack. You may find
it helpful to repeat a single statement over and over
the first minute or two when you feel panic symptoms coming on.
You may also want to do deep abdominal breathing in
conjunction with repeating a coping statement. If one statement
gets tiresome or seems to stop working, try another.
* "This feeling isn't comfortable or pleasant,
but I can accept it."
* "I can be anxious and still deal with this situation."
* "I can handle these symptoms or sensations."
* "This isn't an emergency. It's O.K. to think slowly
about what I need to do."
* "This isn't the worst thing that could happen."
* "I'm going to go with this and wait for my anxiety to decrease."
* "This is an opportunity for me to learn to cope with my fears."
* "I'll just let my body do its thing. This will pass."
* "I'll ride this through--I don't need to let this get to me."
* "I deserve to feel O.K. right now."
* "I can take all the time I need in order to let go and relax."
* "There's no need to push myself.
I can take as small a step forward as I choose."
* "I've survived this before and I'll survive this time, too."
* "I can do my coping strategies and allow this to pass."
* "This anxiety won't hurt me--even it if doesn't feel good."
* "This is just anxiety--I'm not going to let it get to me."
* "Nothing serious is going to happen to me."
* "Fighting and resisting this isn't going to
help--so I'll just let it pass."
* "These are just thoughts--not reality."
* "I don't need these thoughts--I can choose to think differently."
* "This isn't dangerous."
* "So what."
* "Don't worry--be happy."
(Use this to inject an element of lightness or humor.)
If you have frequent panic attacks, I suggest writing your
favorite coping statements on a 3x5 card and carrying it
in your purse or wallet. Bring the card out and read
it when you feel panic symptoms coming on.
Explore the Antecedents of Your Panic Attacks
You can increase your mastery over panic attacks by investigating
the types of circumstances which tend to precede them. If you
are agoraphobic, you are very familiar with these circumstances.
You know that you are more likely to panic, for example,
if you are far from home, driving over a bridge, or sitting in
a restaurant, and so you systematically avoid these particular
situations. If you have spontaneous panic attacks that come "out
of the blue," you might find it helpful to monitor their
occurrence for two weeks and take careful note of what was going on
immediately--as well as for several hours--before each
one occurs. You might observe whether any of the
following conditions makes a difference in the likelihood
of our having a panic reaction:
* Were you under stress?
* Were you by yourself or with someone?
* If with someone, was it family, friends, or a stranger?
* What kind of mood were you in for several hours before
panic came on? Anxious? Depressed? Excited?
Sad? Angry? Other?
* Were you engaging in negative or fearfull thoughts just before you panicked?
* Did you feel tired or rested?
* Were you experiencing some kind of loss?
* Were you feeling hot or cold?
* Were you feeling restless or calm?
* Had you consumed caffeine or sugar just before panic came on?
* Are there any other circumstances that correlate
with your panic reactions?
Below is a Panic Attack Record. Use it to monitor
every panic attack you experience over a two-week period.
Make copies of the form and fill out one for each
separate panic attack. Answer all the questions for
the entire day from the time you awoke until the time
you panicked. If the attack happened at night,
answer for the day preceding that night.
By making the effort to record your panic attacks and
carefully observing any circumstances that consistently
precede them, you are taking an important step. You
are learning that you need not be a passive
victim of an event that seems totally outside your control.
Instead, you can begin to alter the circumstances of
your daily life in a direction that significantly
reduces the odds of having panic attacks. Be sure to
discuss your findings with your therapist.
Panic Attack Record
(Fill out one form for each separate panic
attack during a two-week period.)
Duration (minutes): _____________
Intensity of panic on anxiety scale (rate 5-10):_____________
1. Stress level during preceding day (rate on 1-10 scale): _________
2. Alone or with someone? _________________
3. If with someone, was it family, friend(s), stranger? _______________
4. Your mood for three hours preceding panic attack. Anxious ______
Depressed _______ Excited ________ Angry _______ Sad ______
5. Were you facing a challenge _______ or taking it easy ______?
6. Were you engaging in negative or fearful
thoughts before you panicked?
Yes _____ No _____
If so, what thoughts? ________________________________
7. Were you tired _______ or rested ______?
8. Were you experiencing some kind of emotional upset or loss?
9. Were you feeling hot _____ cold _____ neither ____?
10. Were you feeling restless and impatient?
Yes ____ No ____
11. Were you asleep before you panicked? Yes _____ No _____
12. Did you consume caffeine or sugar within
eight hours before you panicked?
Yes ____ No ______ If yes, how much? ________
13. Have you noticed any other circumstances which
correlate with your panic reactions? (specify)
 Anxiety Scale*
7-10 Major Panic Attack -- All of the symptoms in
Level 6 exaggerated; terror; fear of going crazy or
dying; compulsion to escape
6 Moderate Panic Attack -- Palpitations; difficulty breathing;
feeling disoriented or detached (feeling of unreality);
panic in response to perceived loss of control
5 Early Panic -- Heart pounding or beating irregularly;
constricted breathing; spaciness or dizziness; definite
fear of losing control; compulsion to escape
4 Marked Anxiety -- Feeling uncomfortable but still in control;
heart starting to beat faster; more rapid breathing;
2 Mild Anxiety -- Butterflies in stomach;
muscle tension; definitely nervous
1 Slight Anxiety -- Passing twinge of anxiety,
feeling slightly nervous
0 Relaxation -- Calm a feeling of being undistracted
and at peace.
The symptoms at various levels of this scale are typical,
although they may not correspond exactly to your specific
symptoms. The important thing is to identify what
constitutes a Level 4 for you. This is the
point at which--whatever symptoms you're experiencing-
-you feel your control over your reaction beginning
to diminish. Up to and through Level 3, you may be feeling
very anxious and uncomfortable, but you still feel
that you're coping. Starting at Level 4, you begin to
wonder whether you can manage what's happening,
which can lead you to further panic.
With practice you can learn to "catch yourself"
--abort a panic reaction before it reaches this point
of no return. The more adapt you become at recognizing
the early warning signs of panic up through Level 4
on the scale, the more control you will gain over
your panic reactions.
*Anxiety scale adapted from one developed by
Dr. Arthur Hardy in the TERRAP Program Manual, 1981