Exposure Exercises To Treat Panic Disorder

Panic disorder is one of the most life-limiting conditions for those who suffer from it. Their day-to-day lives are punctuated with serious worries about the date of the next crisis. They therefore restrict their activities and their obligations. It is true that drugs can bring some improvement; however, it is the psychotherapy (and especially the exposure exercises) that make the most difference.

A panic attack is experienced as an intense and sudden terror which is accompanied by various physical and cognitive manifestations. The intense discomfort felt during the first attack causes the person to feel a “fear of fear”. Therefore, she remains alert and vigilant, fearing another crisis.

What is feared is the appearance of these unpleasant sensations. However, paradoxically, fear itself can cause us to magnify and oversize any normal bodily sensation. The excess of attention placed there, combined with a series of inappropriate thoughts, ends up causing another panic attack.

Interoceptive exposure

Finally, what happens is that the person ends up seeing certain harmless physical manifestations as dangerous and alarming. Palpitations are considered a sign of a heart attack, shortness of breath is interpreted as impending suffocation, and dizziness as the prelude to fainting. During a panic attack, the individual feels that he is going to go mad, lose control or even die.

In order to avoid such unpleasant situations, a series of avoidance strategies are initiated. Try not to do any activities or go to places that have been associated with the panic attack. In addition, safety behaviors are enforced, such as always carrying a water bottle or sitting near exits in any transport or public place.

All this avoidance allows the interpretation of danger to be perpetuated and deprives the person of verifying the harmlessness of his sensations. Therefore, the main element of treatment is exposure to these bodily sensations. It is about provoking these physical manifestations through different exercises so that the person can get used to them and stop fearing them.

Exposure exercises for panic disorder

Some of the most common preventative practices against a panic attack are as follows:

• Hyperventilate for a minute: Hyperventilation often causes dizziness, numbness, and a feeling of derealization. For this, it is necessary for the person to breathe in and out through the mouth at the rate of 30 times per minute.
• Breathe through a straw for two minutes: This exercise causes nausea and shortness of breath, as well as a rapid heartbeat and palpitations

• Move his head quickly from side to side for 30 seconds
• Make sudden changes in posture, such as getting up suddenly after a moment of rest. This will generate hypotension which will act as a barrier against overactivation
• Forced breathing is a good exercise to emulate the feeling of tightness and pain in the chest. To do this, the individual must breathe deeply, keep the chest muscles tense, and after releasing as little air as possible, breathe deeply again. This sequence must be repeated several times
• To create the feeling of suffocation and tightness in the throat, it may be enough to wear a garment with a stand-up collar or a tight tie. It may also be helpful to press on the back of the tongue with an object such as a toothbrush handle or a wooden tongue depressor.

• Staying in a very warm, warmly dressed environment may be enough to induce feelings of overwhelm similar to those of a panic attack.

Other exposure exercises that may be helpful

In addition to getting used to bodily sensations, exposure exercises through visualization can also be positive. That is, those in which the person imagines himself feeling the bodily sensations of panic and coping with them, without running away from them or avoiding them.

Likewise, it will be necessary to gradually make live exhibitions on places and situations previously avoided. Obviously, exposure can be aversive and unpleasant. However, it turned out to be the most effective intervention, with lasting results superior to those obtained with pharmacology.

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