Can Hypnotherapy Help with Panic Attacks & Panic Disorder?
 Bill Frost at Changing States offers panic attack online hypnotherapy via Zoom and in-person hypnotherapy in High Wycombe. Sessions seek to help you understand panic responses, reduce fear of future attacks, calm trigger responses and build practical coping strategies. Do speak to your GP first if symptoms could have a physical cause.
Panic attacks are relatively common and can be a part of a variety of other psychological issues eg phobias or trauma. In most cases the Panic Attacks stop when the underlying issue is resolved. Simple panic attacks may evolve over time into Panic Disorder.
Panic Disorder is fearing having a panic attack in the future. Panic Disorder is formally defined as a constant fear of future panic attacks that lasts for more than 1 month.
There is a probable link between the phase after using drugs (when neurones are highly activated) and the first panic attack. Prolonged and intense stress has a similar effect.
The treatment approach should examine lifestyle issues, stress management, phobias and anxiety symptoms. Underlying issues are treated at the same time as working with the panic attacks.
The trigger / panic response can be similar in nature to that found with phobias and can become ingrained over time. Care is taken to ensure that new coping mechanisms are put in place so you respond calmly to your triggers.
Hypnotherapy, in combination with in the moment behavioural and cognitive techniques, can help to rapidly break the stimulus response cycle and reduce the likelihood of future panic attacks.
Testimonial: "I consulted Bill out of sheer desperation as my panic attacks had increased rapidly over the last few months. I am amazed at the results of my two sessions with him. My stress levels have gone right down. Thank you, Bill, for your patience and help".
Book an online Zoom appointment or an in-person appointment in High Wycombe or send a WhatsApp message
What is a panic attack?
A panic attack is a sudden surge of intense fear or discomfort that triggers the body's fight-or-flight response, even when there is no immediate danger. It can come on quickly and may feel overwhelming, with symptoms such as: a racing heartbeat, shortness of breath, chest tightness, trembling, sweating, dizziness, nausea, tingling, or a fear of losing control. Panic attacks are frightening, but they usually pass within minutes.
People often use the phrase "anxiety attack" to describe a period of intense anxiety, worry or fear. But it is not usually a formal diagnosis in the same way as a panic attack. A panic attack typically comes on suddenly, peaks quickly and often includes strong physical symptoms. An anxiety attack usually builds more gradually in response to stress, uncertainty or a feared situation and may last longer. Both can feel distressing, so the label matters less than the impact. The treatment approach is very similar either way.
What happens during a panic attack?
Panic attacks are associated with physical symptoms that include the following:
- Shaking / trembling
- Feeling that your heart is pounding or racing
- Sweating
- Chest pain
- Shortness of breath
- Feeling that you are choking
- Nausea
- Cramping
- Dizziness
- Out-of-body feeling / sense of things not being real (Depersonalisation / derealisation)
- Tingling or numb feeling in your hands, or feet
- Chills or hot flushes
These symptoms are caused by an increase in stress combined with inappropriate breathing patterns ie hyperventilation. Hyperventilation in effect floods the body with oxygen which in turn generates physical sensations are often perceived as being threatening, which in turn increases the stress response, which in turn tends to increase the rate of breathing and so on.
As the panic escalates a person may also have an extreme fear of losing control, of being observed and losing control, going "crazy" or dying during a panic attack. It is very rare for a person to have all of these symptoms at once. However, the presence of at least 4 symptoms and they developing abruptly and reaching a peak within 10 minutes strongly suggests that a person is experiencing panic attacks.
Many of the symptoms that occur during a panic attack are the same as the symptoms of diseases of the heart, lungs, intestines or nervous system. The similarities between panic disorder and other diseases may add to the person's fear and anxiety during and after a panic attack. It is not uncommon for people to have reported to casualty departments several times as a result of misinterpreting panic attack symptoms with symptoms of serious physical illness.
The panic cycle
Second by second, the following tends to happen during the course of panic escalation:
- A stressful situation is encountered
- Adrenaline, noradrenaline and cortisol levels increase
- Rate of breathing increases
- Oxygen level increase and there is an increase in blood alkalinity
- This results in vaso-constriction (also an effect of cortisol)
- Vaso-constriction reduces higher cognitive functioning (the ability to logically reason reduces)
- Vaso-constriction also results in reduced ability to excrete CO2
- Multiple sensations are experienced
- Locus of focus is drawn to the sensations
- Stress levels increase as internal dialogue becomes negative
- The body is scanned to identify other symptoms of dis-ease
- Sensations are amplified psychologically
- Action is taken to get out of or escape the stressing situation
- The stressing situation becomes associated with the panic state
If the escape behaviour is not actioned the panic state tends to subside naturally in about 20 minutes. (This feature of the panic response is utilised at some level in most forms of therapy at one stage or another).
What is Panic Disorder?
When the panic attack response has become conditioned over time we begin to fear future occurrences and become anxious in anticipation. This generates a negative self-fulfilling prophecy that can itself generate a panic attack. Panic attacks combined with anticipatory fear / anxiety is known as panic disorder. Agoraphobia may or may not be present.
Panic disorder is a common condition in which a person has episodes of intense fear or anxiety that occur suddenly (often without warning). These episodes - called panic attacks - can last from a few minutes to several hours. They may occur only once in a while, or they may occur really quite frequently. The cause, or "trigger," for these attacks may not be obvious or there may be a series of very specific triggers.
Just the fear of having a panic attack is often enough to trigger the symptoms. This is the primary basis for a condition known as agoraphobia. Those with agoraphobia find it difficult to leave home (or another safe area) because they are afraid of having a panic attack in public or not having an easy way to escape if the symptoms start.
Click here for the The Diagnostic & Statistical Manual of Mental Disorders definition of panic attacks and panic disorder.
Why is a formal medical diagnosis important?
Given that the symptoms may in fact be due to some form of organic disease it is essential that all physical causes are eliminated before commencing any form of psychological treatment. If you think that you are experiencing panic attacks you should consult your GP in the first instance.
It is important that physiological causes for panic attacks have been eliminated by a GP or consultant. Physiological causes include some forms of epilepsy, mitral valve prolapse, hyperthyroidism and hypoglycemia.
What to do after a panic attack?
After a panic attack, it is common to feel tired, shaky, emotional or on edge. Your body has been through a strong fight-or-flight response, even if there was no immediate danger. Take a few minutes to recover: sit somewhere safe, loosen any tight clothing, and allow your breathing to settle naturally. You do not need to force yourself to feel calm immediately.
As and when you feel ready, gently return to what you were doing before. This helps teach the brain that the situation itself was not dangerous. It may also help to make a brief note of where you were, so this trigger can be brought into the therapy process. Try not to be self-critical, a panic attack is not weakness, but a false alarm from the nervous system.
What are the formal Diagnostic and Statistical Manual criteria (DSM) for Panic Disorder?
Click here for full research paper details
Hypnotherapy related research and reading
Research: Awake-Alert Hypnosis in the Treatment of Panic Disorder
American Journal of Clinical Hypnosis 47:4, April 2005
Research: Self-hypnosis for anxiety associated with severe asthma: a case report
Anbar, R.D. Self-hypnosis for anxiety associated with severe asthma: a case report. BMC Pediatr 3, 7 (2003).
Research: Rational self-directed hypnotherapy: a treatment for panic attacks.
Der DF, Lewington P. Rational self-directed hypnotherapy: a treatment for panic attacks. Am J Clin Hypn. 1990 Jan;32(3):160-7.
Eye Movement Desensitization and Reprocessing in the Treatment of Panic Disorder With Agoraphobia
Clinical Case Studies, Vol. 6, No. 1, 44-63 (2007), Isabel Fernandez Italian Association for Cognitive Behaviour Therapy and Elisa Faretta H. Bernheim Italian Institute of Clinical Hypnosis and Psychotherapy
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Additional panic attack / panic disorder related research sources:
| Battino R and South TL (2005) Ericksonian Approaches Crown House Publishing Ltd |
| The American Psychiatric Association (2000) DSM-IV-TR: Diagnostic and Statistical Manual of Mental Disorders The American Psychiatric Association |
| Der DF. Lewington P. () Rational self-directed hypnotherapy: a treatment for panic attacks.: American Journal of Clinical Hypnosis 1990;32(3):160-7 |
| Papp LA. Welkowitz LA. Martinez JM. Klein DF. Browne S. Gorman JM. Instructional set does not alter outcome of respiratory challenges in panic disorder. Biological Psychiatry 1995;38(12):826-30 In an attempt to reproduce the findings of Rapee et al ( |
| Van Dyck R. Spinhoven P. Does preference for type of treatment matter? A study of exposure in vivo with or without hypnosis in the treatment of panic disorder with agoraphobia. Behavior Modification 1997;21(2):172-86 There is evidence that preference |
| Andrews G, Creamer, M, Crino R, Hunt C, Lampe L and Page A (2002) The Treatment of Anxiety Disorders Cambridge University Press |
| Yapko M (1989) Brief Therapy Approaches to Treating Anxiety and Depression Brunner-Mazel |
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