By Anna-Maree Osborne Clinical Counsellor and CEO Anewu Counselling Services (August 2018)

“When you change your mind, you change the entire world” Bryant McGill

Most people I have  counselled who experience panic attacks describe themselves as feeling instantly out of control . They describe losing control of their body. Quickly physical symptoms come rushing into their awareness, and they feel overwhelmed.

Although panic seems to occur instantaneously, anxiety involves several stages. Some or all these stages can take place outside  conscious awareness and happen very quickly.

Several of these stages also instruct the body on how to respond.  Anticipatory Anxiety  is usually stage one which begins as an approaching  feared situation arises. Quickly the mind may recall  past failures to handle similar situations. When we become mentally involved with a past event, our body tends to respond to that experience as though the event were happening RIGHT NOW.

People with generalized anxiety disorders pay attention  to anything which is vaguely threatening or negative, they tend to worry constantly,  making pessimistic assumptions on little evidence. (Alwahhabi,F.2003)

The stages of panic attacks usually involve;

  1. We contemplate facing our feared situation. That reminds us of our past failures. Since we are now recalling that we handle such situations poorly, we begin to question our coping abilities. “Can I really handle this? What if I panic again?” These kinds of questions send a message to the body.
  2. These unconscious statements give an instruction to the body to “guard against the worst possible outcome.” Danger is imminent protection against failure or danger is required. This is the  fight, flight, freeze reaction. Our bodies have been trained over millions of years to respond to emergencies. Our response therefore  answers with a moment’s notice to the instruction, “This is an emergency.” It responds the same way every time to any event that the mind calls an emergency whether it is an emergency or not.
  3. The body responds perfectly to an exaggerated message from the mind. It is not the body that is at fault, it is our thoughts, our images, and our negative interpretation of our experiences that need to be altered to gain control of panic.
  4. Physical changes assist the body in responding to an actual crisis. For instance, the eyes dilate to improve vision, the heart rate increases to circulate blood more quickly to vital organs, respiration increases to provide increased oxygen to the rapidly circulating blood, the muscles tense in the arms and legs to move quickly and precisely.
  5. During an emergency, breathing rate and pattern change. Instead of breathing slowly and gently from the lower lungs, we begin to breathe rapidly and shallowlyfrom the upper lungs. This shift not only increases the amount of oxygen into our bloodstream but it quickly “blows off” an increasing amount of carbon dioxide. However, when we are not physically exerting ourselves, it produces the phenomenon called hyperventilation.(shop centre for emotional health, 2018)

How can Counselling Help?

Clients must believe that they have the ability to take  control over panic. Many people feel helplessly out-of-control, experiencing panic as something that rushes over them from out of the blue. However, many of the early stages of the panic cycle take place outside conscious awareness.  Identifying these stages is crucial  to design a future plan that accounts for the entire cycle of panic not just those stages  consciously noticed during panic.  Early relationships and life history continue to affect people as adults and these memories reflect conscious and unconscious motivations. Hence the first step is to gain insight into these factors so that clients understand why certain situations trigger this panic response. By changing mental images,  thoughts and predictions about a client’s ability to cope, we can assist them to gain some control over physical symptoms .

Secondly, breathing and relaxation can assist the body to cease shallow breathing before the end of the cycle of panic . These changes can produce hyperventilation that may cause many of the uncomfortable physical symptoms experienced during a panic attack. By changing the way, the client breathes we can help them to reduce their uncomfortable symptoms during a panic attack.


Alwahhabi,F.Anxiety symptoms and generalised anxiety disorder in the elderly: A review Harvard review of psychiatry (July 2003),Vol,11,No.4.p 180-193 (accessed 24 August 2018)