ANITA – Panic Disorder – Continuous feeling of anxiety

Anita got in touch because she was struggling with panic attacks and a continuous low level anxiety. She led a very healthy lifestyle and worked in the ‘Healthy Living’ industry so having panic and anxiety was very hard for her to accept (in addition to the frightening symptoms)


hello.  I have been suffering with anxiety panic for over a year.  Yes, I went to doctor, cardiologist and neurologist and it has all been ruled that its chronic panic disorder. 

My first question is, while I have had several severe panic attacks which made me feel like dying……the thing is that now, there is a low level anxiety feeling almost every day through out the day….yes it comes in goes, but its ALWAYS looming in the back ground.  Im super sensitive to sounds, disorganization and if I have to multi task at work. 

Its not a full blown attack that the exercises that you teach are easy to apply in those extreme circumstances.  What do I do when I am feeling off in my body and notice that I am starting to get that tweaked feeling?  Its not the heavy breathing, sweating and the same as the extreme panic situations.  

How do Apply the CBT techniques in the lesser, but very very challenging to be in this low level anxiety through out my days.  Its like I’m hypersensitive and of course always wondering if the attack is going to progress into a full blown attack. 

Example….I was on a a work call today, and for now reason, I started to feel like i couldn’t concentrate on the conversation, and then then worried and scared that I wouldn’t be able to get though call, and feeling over whelmed…and after i got through call, i felt exhausted and like i needed to lie down.  these type of things happened a lot.  HELP!.  



Firstly – it might help to tell you that the most common complaint I hear is of a continuous feeling of anxiety – that don’t necessarily end up with full blown panic

I will be able to help you with this so don’t worry

But I see you only signed up with CBT4PANIC on Monday so I think the first thing to do is for you to carefully go through the program – books, video and audio so that we will both be on the same page and I wont have to repeat things that are already in the books

It might also help if you tell me a bit more about the problem in general – you say it started a year ago – was there any significant events or happenings that you feel may have triggered anxiety. Can you give me some information on your lifestyle or any previous problems with stress or anxiety – even as a child

Anything you can think of that you feel might be relevant

When you go through the books you will be asked to complete various worksheets – There is a worksheet called The Downward Arrow Technique – when you fill that in what base level thoughts do you end up at

Can you tell me how you feel anxiety affects your life – other than the horrible sensations it brings – what do you feel it says about ‘you’ as a person with regards family or work or other people

Anyway – go through the books and have a think about these questions and then we cab start to work on what to do next



I have had the entire week off from work to go through all the Videos. I will go back through and fill out work sheets as you requested. 

It seems My panic came out of nowhere. I live a very healthy and fulfilled life.  My husband and I have careers in the healthy living industry

We spend half the year on a small island. I can tell you that over the years i have become more claustrophobic, more worried and fearful about life and very focused on my physical health. Almost to a degree of neurosis.

My first extreme panic attack happened when i was alone without my husband on the island where we live and that did kick up my anxiety levels.  I experienced heart racing- shortness of breath and stroke feelings and since i was alone on an island and there is no real hospital there – that made it even worse. Plus its a Spanish speaking country and i don’t speak the language.  It was very dramatic.  But it occurred again and again periodically even after i was back to USA. That is when i went for medical tests and it all came back as panic. 

Now i am just left with the low level feeling like i’m going crazy and wont be able to deal with wonderful live I have created.  I work for myself. In job that changes people lives with my husband that i adore. We travel and have resources but yet my world has gotten very small from the panic.  My husband is my safety. And i used to be fearless. Now i am fearful about everything.  What more can i tell you?  That can help. In gratitude.



Hi A

Sometimes panic can be even more alarming when one feels that it absolutely ‘shouldn’t’ be happening – that makes us think the symptoms HAVE to be something very sinister – life and death

Possibly if you think back to your childhood you will find something related to anxiety or health worry either for yourself or someone else – (a family member may have had an illness etc) or significant adults may have been very health conscious and always talking about health in some way or another – we all have different starting points which may not seem obvious till we contemplate them

It’s not that that is vitally important – but it can help explain why fight or flight symptoms make us react with such extreme fear

Also people who experience heightened fight or flight reactions are generally sensitized over many years – it doesn’t have to be traumatic or horrible – it can just be underlying stress, or a situation that is continuously stressful or taxing

It sounds like you definitely had a standard initial terrifying panic attack and that definitely can account for all anxiety symptoms thereafter – because – as you will read in the workbooks – we spend our time after that desperately trying to avoid it ever happening again – and this leads to a continuous sense of anxiety and impending doom

The GOOD news is it is ALL a ‘mistake’  – you are not weak or emotionally unstable or doing something ‘wrong’ in your life

It doesn’t matter who it happens to – when someone experiences extreme fight or flight for the first time and they dont know what is happening it ALWAYS leads to panic – because we very understandably believe we are possibly going to die and panic is a natural reaction

The theme of CBT4Panic is ‘when you no longer fear the sensations of fight or flight they will stop happening’

This is your job now – to first TOTALLY understand what happened and what is happening – then you learn skills to cope with the feelings – then finally you use your knowledge and skills to go past the panic through planned exposure.

I absolutely guarantee you it WILL work and you WILL be free of these feelings.. I can say that because panic (and your continuous anxiety feelings) IS a mistake and once you correct that you simply can’t react in the same way again – which leads to the symptoms not arising so often until eventually they rarely arise at all and if they do you don’t feel at all as anxious about them

You are actually not fearful about ‘everything’ – you are fearful that certain people, places or things may trigger extreme feelings of anxiety in your body (or anxious thoughts) and this is a natural reaction when you don’t know what else to do

I might also guess that you may be adding a lot of guilt – possibly shame – at having this because your lifestyle and career is built on demonstrating the opposite of anxiety. That can be a tough puzzle to deal with but trust me I know from experience that the experience of panic and anxiety will make you even more helpful to peoples lives in the long term.

Anyway – for now go through the workbooks and videos – watch them over and over if necessary until you ‘get it’ – especially book 1 – find ALL the ways you resist and fight the feelings and all the ways you use safety behaviour

Take your time – this will not resolve overnight – it takes time to break the habit of anxiety

Think back as far as you can go to see if there is anything related to anxiety, tension, stress, health anxiety, illness, fear of death etc

I remember when I was doing this to overcome my fear of public speaking I remembered from childhood my America cousin visiting me (in Ireland) and my whole family were enthralled with his vibrant personality and ability to speak out and sing and dance and who knows what – and I felt quite devastated. Obviously it wasn’t my only relevant fear from childhood but I was quite surprised I remembered it when I tried to find clues to why I had such fear.

It just helps to give some meaning to why you experience anxiety

But also – some people can’t remember a single anxious time in their lives and they STILL get fight or flight – as I said it can happen for other reasons too.

As you go through the books – you can try to apply what is being said to your own level of anxiety – just because I talk about extreme panic reactions doesn’t matter – the low level anxiety is for the exact same reasons – and very often the reason we aren’t going into panic a lot is because we are avoiding so many things

Go over everything carefully and then get back to me



I have read some books on CBT and plan on seeking out a CBT therapist locally at some point when I return to the island   I am going to be there for 2 months, and the only thing I will have access to is a computer.  There are no therapist of ANY kind which is why I was desperate to have something that I could take with me and support me while I am there.  The one quick question is will CBT therapy help regardless of why the panic started? 

Meaning, My Naturopath has tried to convince me this is all hormonal and have me a huge supplement protocol, which didn’t help at all.  My GP MD, says it is a chemical imbalance and gave me xanax and zoloft which I literally took for a week out of desperation and it made it worse. 

I am to the point where I even anticipate vitamins as being something that can trigger this attacks, because I have had such horrible experiences in past.  I have tried everything and then i feel even more hopeless.  Then my mind goes to the place…”Well maybe it was all the LSD” you did as a teenager and now you are just insane. Like what if something i did or ingested in my past made my anxiety bad?  

I rack my brain with these thoughts and feel guilt that i should have led a more perfect life and its all my fault.  

So can CBT help regardless of WHY THE PANIC is occurring even if its hormonal, imbalance etc?  Knowing this would greatly ease my mind. 

You are a god send,.  there are days I feel my world is slipping from my control.  Yet the world sees me, as the picture perfect of healthy lifestyle mean while I am suffering at home.  Its so sad.  🙁  you have made my day better already. In gratitude.



HI robin.  I am going the work books as requested and the one question that keep coming back to be and causing fear is this.

Does it matter why the underlying panic is happening?  meaning, if I continue to master these techniques but the underlaying issue of why the panic is occurring is still there  i.e.; Hormones, chemical imbalance, etc)….will these techniques work.  

One fear that continues to happen is that i continue to worry that some how in the coarse of my life, I had damaged myself with the use of drugs/ alternative shamanic drugs in my past  and now that is the reason I am suffering now with panic disorder.  so even when I’m trying to make sense of the triggers and fight or flight, i still go back to that thought that no matter how much i do these exercises, that if there is something wrong chemically…..nothing will work or help me.  can you please answer me on this.  

Do these techniques help regardless of the reason the panic is occurring. I have ruled out medical reasons with a doctor.  What if its chemical or hormonal?  Please help me make sense of this and how to help this obsessional thought whenever i feel anxious?   It truly makes me feel like I’m going insane!




Since you have been candid about experimentation with drugs I can tell you that my panic disorder was actually triggered after taking pot (I went to Art college)

The drugs were obviously exaggerating underlying stress that had built up over many years since childhood. To begin with they exaggerated amazing highs but once I had my first ‘bad trip’ I started to build up a lot of fear of the sensations until one morning I woke up after taking a lot of hash and I couldn’t feel my arms or legs and ‘freaked’ out (went into panic)

It was this intense fear that then got me locked into the anxiety cycle for the next five years until I read Self Help for your Nerves by Dr Claire Weekes and I knew I had found the light at the end of the tunnel – it still took me a long time to recover but with practice I did fully recover and when I trained in Cognitive Therapy I realised that CBT was just building on Dr Weekes techniques and it works much faster – especially with the added information about safety behaviours

Anyway – I had your exact fear – that my drug taking had caused some irreversible damage to my brain – but I can absolutely assure you that no matter what causes heightened anxiety we very definitely ADD a LOT to it through additional ‘secondary’ fear

Think about it scientifically

Lets say a doctor could absolutely PROVE to you that the anxiety you are experiencing was actually completely harmless and could do you no harm whatsoever and that it may just give you an uncomfortable feeling now and then

and imagine you completely accepted that (in a ‘big sigh of relief’ kind of way)

Like someone with Tinnitus might accept the distressing ringing in the ears

Can you see that whilst you may still experience some very annoying sensations – you may not add the extra anxiety that you do now – which may account for 90% of the symptoms

and eventually you would just get used to it – get on with your life without living with SO much fear and you might even see that that might lead to you even forgetting about the symptoms and they may not even arise at all

This is exactly what DOES happen when you ‘really’ lose your fear of the symptoms (fight or flight)

and you WILL reach this point

But its good that you are uncovering your worse fears – because it is these fears that are fuelling the fight or flight and then more fearful thoughts

It is very important that you study the material thoroughly but then you must experiment with the knowledge – its not enough just to know it intellectually – it needs to be experiential

which is where planned exposure and behavioural experimentation comes in

You need to PROVE to yourself that this is all true

For example – work out all your safety behaviours – or things you do to stop or avoid anxiety arising – how you react when it does arise – how you react to your continuous feeling of anxiety – how you tense up – resist – what you think – how you wish it was different – the ‘why me why now’ thoughts – ALL the subtle resistances and ways you fight against rather than let go towards

then you experiment with NOT doing these things – instead of tensing up (or desperately trying to ‘relax’) try ALLOWING the feelings to do as they wish – even let them get WORSE – see what happens – maybe they actually do for 5 minutes but then they might decrease – and that will teach you something – and you keep experimenting until you really see what is happening

Anyway – for now keep studying – this will take some time – but you WILL get past this

and it may be hard to believe right now but you will eventually see this as a gift



You are an angel sent to me.  I was in South America 2 years, and like you I experimented with many hallucinogens, (also an artist like you) but my last TRIP was shortly before my anxiety appeared. 

Although I stopped all man made hallucinogens, I am very interested in the healing arts and shamanic medicines. I took a mixture of “medicines” and it was a VERY bad trip.  I was alone in nature and in a foreign land and i started to lose my mind working if I would ever make it back to society etc  and  about 3 months later i experience my first and most intense panic attacks in my life. 

That was the big one and then it started the vicious cycle that has continued since then.  As I said it not as dramatic as it was then but its like a low laying thing lurking in the background.  Its not 24 7 , it comes in goes through out the day and  when it hits, i become paranoid about having to be able to GET THROUGH my day, and how i will do all the tasks in the day, live like this, etc etc

I am looking for  CBT therapist locally but I feel more compelled towards working with you since you shared you story. In gratitude A



Hi A

From what you say  it all fits perfectly into classic panic cycle territory

Your bad trip probably caused some low level worry about feeling like that again some day

and this causes low level adrenaline which makes you sensitized over time – which can lead to a build up and overflow of fight or flight sensations – and because it isn’t readily connected to any immediate stressor – and then add to that your deeper fear that the drugs may have caused you some damage – and hey presto – huge surge of fight or flight and you get caught in the cycle

Probably your usual healthy lifestyle has kept you from experiencing too many huge panic attacks but it won’t stop the low level continuous anxiety because it has more to do with the fear in the back of your mind than any healthy lifestyle choices

To some degree this continuous feeling of anxiety is harder to shake than outright panic attacks – but you WILL do it in time

Go through ALL the books – the panic dialogues is often helpful to many people and I would suggest that you look into Mindfulness which is extremely helpful (but only after the CBT)

Decide now that you are going to become an expert in recovery rather than an expert in worry 🙂

I absolutely guarantee you you will see through this. I don’t tell people that when it comes to other disorders like depression because that has a lot of variables – but with this kind of anxiety it really IS based on misinterpretation and catastrophisation and when you fully understand that and take the necessary steps it simply HAS to change.

Keep at it and get in touch if you get stuck



I will happily work your program diligently.  As I explained  I am departing for the island (3 miles wide) soon and usually my PANIC peaks there, because that is where the first attack occurred and I am in the middle of the ocean on a remote island.  maybe a good type to Skype:)   there are no accidents and I am determined to make the panic into the ultimate blessing to help others.  and I am very blessed that I picked your program out of the blue out of the thousands of panic programs on line.  it’s meant to be!

I am the picture of health and vitality – so it makes me crazy that this plagues me (plus I have also struggled with Auto immune issues my whole life, which is why I got so into Organic and Vegan lifestyle.  I work so hard at living a clean life…..I don’t drink alcohol, smoke, I don’t even drink coffee or caffeine.  

So why?   I realize this is worth looking into on a deep level.

The other “safety pattern” i am falling into if believing if I try every detox, juice fast, supplement, I will find the cure to this anxiety and not only has that not worked, sometimes I have thought that when I try and take supplements like GABA, or natural serotonin building supplements for anxiety…….i actually have thought that it BRINGS ON the panic so instead of healing – it back fired and makes it worse.  

I have created quite the vicious cycle.   uGG.     I trust that connecting with you is part of my answer, as I have been praying to find the way out of this, without the use of supplements, diet, detox or anything external …I want to depend solely on myself and my own mind and nothing else at this point.  🙂  In gratitude again!

With Purpose,



Hi A

If you read your own reply again (and imagine someone else is reading it) you might see the anxiety in the sentences – 

‘drives me crazy that this plagues me’

‘work hard at living a clean life’

you in a sense don’t drink, smoke or take caffeine as part of the ‘hard work’ of living a clean life

and as you can see yourself you are frantically looking for a cure through various practices or supplements

I felt and did exactly all that for years!

Its great that are seeing it as possible safety behaviour

Trust me – I do believe that a healthy lifestyle is absolutely a good thing to do – but when it comes to anxiety it is SO important to observe in what exact WAY you are doing it

I wouldn’t say that any supplements are necessarily bringing ON the panic – but the frantic expectation that it should ‘get rid of’ the anxiety will send more anxiety signals to your body

Remember that the body follows your every fear – even the subtle ones – it cant distinguish between fear of real danger or the signals you send out when you take something in order to ‘get rid of’ something which you clearly FEEL needs to be gotten rid of because it is a threat to you, your life, and so on

It’s SO subtle we can miss it – which is why it helps to write all your thoughts and behaviours down

When you stop trying to get rid of the sensations and TRULY allow them to exist then you stop sending out the fear signals so the body has no ‘automatic’ need to ‘help you with increase adrenaline

it’s like a big puzzle

Your first goal is to figure out how on earth to stop trying to fix, change, stop or get rid of the feelings – and why doing that was not helping and why doing the opposite might be helpful

It first has to have SOME logic in it so that you will experiment with more belief that it will help

I would also suggest that while doing the CBT you try to just do your normal healthy living routine (that you had before anxiety) and completely drop ANYTHING that is designed to combat the anxiety in any way

Imagine the inner conversation that takes place..

“If I take this supplement it will ‘get rid of’ the feelings”

so the hidden belief is ‘these feelings are BAD / dangerous / life threatening / unacceptable

so I MUST get rid of them

This sends fear signals through the body ‘something very bad is happening and I MUST take something to stop it from happening’

The body picks up that there is grave danger and tries to help with the fight or flight response

and so you get more sensations

Then imagine the other way of looking at it

ok – I’ve been told this is anxiety and that resisting it is just maintaining it

let it be – go ahead – stop desperately wanting it gone – NOW!

whatever – do your worst – no need to get rid of anything – there’s nothing to ‘get rid of’ – its fight or flight sensations

let go towards it – smile – get on with other things

let the feelings be in the background – for now they may be here for a while to come


can you see that the second way is not sending out fear signals – in fact it’s sending out ‘it’s fine chill out’ signals

I often describe it like you were helping a child who mistakes a coat hanging on the door for a monster

If you tell the child don’t worry I will get rid of the monster either by chasing it or saying some magic words (or making some magic potion) – it may give some temporary relief but it wont take away the child’s belief that there really IS a monster – so it can come back again and again

But if you say – lets turn on the light and have a closer look – and you show that it’s just a coat – then the child can REALLY relax

Anyway – hope that helps



helps  more than you know. blessings robin.  xoxo

With Purpose,




Just wanted to add one thing after reading over what I wrote

Even though I say that if you fight or resist or try to get rid of – then that increases the anxiety

please don’t worry then about trying desperately to NOT resist or NOT try to get rid of

That’s just another subtle fear

Ultimately even if you DO trigger the fight or flight response by resisting or fighting the feelings YOU ARE STILL OK and NOT in any danger

The thing to remember is it’s just pointless – it wont work and the anxiety will be the same as before

but don’t worry that you are doing ‘more harm’ – you aren’t – it’s just more of the same



Hello.  I reread your email  several times and it then rather than on settling in the optimism, that the Hallucinogens are not the underlaying cause – and I need to chill out on that thought.. I get an email from my Naturopath that says it’s because of my age

she says that menopause and changes in hormones are the cause of my anxiety.  Now she wants me to do all this testing and try a bunch more supplements ( which we just agreed is not helping the situation in your previous email as it related to frantically trying to get rid of them).

Now what?   I really am not up to chasing this path.  But what is rather than a serious medical condition, it is related to something like HORMONES?  i think this a reasonable question.  Just thought Id quickly run it by you.  

Does the same rules apply, if it is from hormones?  I would approach the CBT the same I assume, but what about the whole process of trying to figured out if hormones is the cause?  ( i dread this actually, as I have been searching for 1.5 years)  HELP!   Blessings!



Hi A

There is absolutely no reason why you shouldn’t check that side of things

Like if someone had diabetes and Panic disorder and the diabetes was obviously not helping it would clearly be wise to do whatever was necessary with the diabetes

So I would suggest that you go along with that 

But clearly you did have some severe panic attacks and clearly you are very anxious about the symptoms so I would say you definitely have become caught in the anxiety cycle to whatever degree that may be

so even if hormones is contributing to the symptoms I would say your reaction TO then is very much to do with additional fear and increased fight or flight

so keep working on the anxiety anyway

even long after I recovered from the severe panic disorder I was still able to use the knowledge to help deal with many other difficulties in life

There are no rules in this – just working with each thing as it arises

Consider if you have felt any less anxious since you have been gaining some insight into the nature of anxiety and how it can be maintained. If you have even felt slight less fearful then that shows that to some degree you are adding secondary fear to the symptoms and it is worth understanding that and working with it

I suppose at least now you can observe how ‘desperately’ you want hormones to be the answer as you get tests or try supplements and if they don’t make any huge changes to the symptoms you can put that down to a useful behavioural experiment

I hope that helps



Greetings from the island. Been having a few minor episodes here and flash backs to previous ones.   Been using your techniques and it keeps me from going into full panic mode. You have helped me so much and i use the visualization techniques and observer mode to help me in those moments.   Been here a week and for the most part Ive been good but some minor bumps in the road. I plan on finishing the program as soon as my internet is sorted out.



Hi A

That’s great

Once you know whats actually going on it doesn’t take to long to fully ‘recover’

the key is to get to know the truth experientially not just intellectually and the only way to do that is to PROVE the truth of it with actual fight or flight

and that is why exposure and behavioural experiments are so important in CBT

So – in other words – don’t hope that you wont feel any more fight or flight – or panic – be as willing as possible to experience fight or flight (which can arise due to your experiences with it) and practice the techniques

the more you do that the more confident you become and the less the fight or flight arises

Anyway – glad to hear that its going well



HI.  Robin.  it seems the way my panic works is that I am super optimistic that things were getting better and it seemed LESS attacks for the first 3 weeks I was here.  But then, when my parents were visiting this week,I had a moment when I was standing in line at a crowded restaurant and I felt like I was going to pass out and i started feeling panicky and weird….

that episode started a whole 2 days of a chronic low lying FEAR and uneasiness in my body. 

And now Im afraid to take a trip this weekend off island with friends because I am simply in a bad space. When I went to bed last night I started catastrophising all the the bad things I could think of, (I’m still not well, I can’t travel normally like other people, I don’t want to be in a situation traveling if I feel like this, I can’t live like this etc…)

and now I feel depressed that the vicious cycle still got it hold on me.  HELP.  I definitely feel hopeless as this attack took hold just like before the CBT and while cancelling my plans to travel with friends this week may be considered an avoidance behavior, I seriously don’t feel like I will enjoy myself knowing I’m in this state. 

I am choosing to stay on the island and have a more low key weekend rather than an action packed weekend of long car travel etc……..but then I’m afraid that the behavior of cancelling is fuelling the fire.  its possible that I may really deep down don’t want to go on the trip but I know for sure feeling like this, I am afraid I will feel uncomfortable and it will hold my friends back from having a CARE FREE WEEKEND of travel. 

Is there anything you can share from your perspective?  I feel like a loser and retarded that I never used to be like this and used to be able to be foot loose and free to do spontaneous travel and no I can’t HELP


Hi A

Don’t worry – Each person goes through the exact same process – I have had this exact reply from so many people you would be amazed

This is just what happens – and sometimes the quicker you felt relieved about panic the harder it feels to get a setback

The truth is we cant really recover with information alone – (unless we only had one or two panic attacks) we need to apply the knowledge again and again with actual fight or flight symptoms until the penny REALLY drops that we are in no danger

Your reaction to fight or flight is a very clear reflection of how you feel about the sensations deep down. So our reaction is like a barometer which shows us we need to do more work.

To begin with when we learn more about what is happening we feel an immediate sense of relief – but in the back of our mind we still haven’t ‘really’ lost our fear of the symptoms. We kind of hope.. maybe.. this it it ‘gone’.. phew..

but deep down we don’t realise that we haven’t had enough real proof that these symptoms REALLY are harmless – as harmless as a sneeze

so the fear is eased but not really gone and if we get the slightest symptom we can again get triggered into full panic. Thats just the way it goes. It is perfectly normal and is actually a necessary part of recovery

For instance. After I fully recovered I STILL had the odd full blown fight or flight ‘explosion’ with all the horrible sensations and thoughts – HOWEVER because I had practised SO many times with it I could just let it happen in the background (whilst I did feel uncomfortable but certainly not terrified) and within minutes it would pass and I really would just get on with my day and not worry that it was all back to haunt me.

That is the DEGREE to which I really really really KNEW that I was NOT in any ACTUAL danger

Up to that point I had MANY MANY setbacks like you describe. And each time I just had to get back to the drawing board and basically start again – go over the understanding, the skills and practice more planned exposure

You have been learning about recovery for a VERY short time – trust me – and it really would have been very unlikely for you to totally understand and lose your fear in this short time

The reason you feel so bad at the minute is because you still have a LOT of fear about the symptoms – which is easily proved because your reaction IS one of extreme fear. You don’t have to guess at what has happened – your fear reaction IS the reason you feel so bad – simple as that

So you need to go over it all again – and this time go through it all VERY carefully and slowly and do ALL the worksheets and then you really need to consider planned exposure

Don’t worry for now about backing out of trips and so on – forced exposure is ok but it doesn’t really teach you much and if you get a worse panic attack it can set you back again

so avoidance at this point is fine. Just get back to the study and work out how to practice GRADUALLY with the symptoms. Read ALL the books – the Panic Dialogues will be helpful too.

Be honest with yourself about how deeply you studied the information. You felt quite good quite quickly so the temptation then is to ‘leave it alone’ -‘ if it aint broke dont fix it’ – and thats fine but now you are in a normal setback its time to get back to the study and practice

and accept that recover and setback can happen many times – but each time you learn more until eventually the setbacks cause less and less concern and the you don’t even get setbacks because there is no deep fear anymore

Its ALL about losing the fear of the symptoms

CLEARLY you still have LOTS of fear – or else you would be feeling so scared about the symptoms returning

Thats not a criticism or a judgement – its just a scientific fact

“Oh.. yes.. obviously i MUST still think that fight or flight is dangerous or else I wouldn’t be so scared  lol’

So then you realise – ‘ah – so I need to study more to lose the fear and to do that fully I HAVE to practice the techniques WITH the fear itself so that I REALLY know deep down that I am in no danger – rather than just hoping ‘it’s gone.. phew’

What you are experiencing now is PERFECTLY normal – par for the course

It is very understandable also – fight or flight is SUPPOSED to make us feel scared so that we can fight or run

But since this is a mistaken response we freak out because we think we are in some mortal danger

Don’t beat yourself up – or berate yourself

You absolutely COULDN’T react any other way – it’s mother nature

But it IS a false alarm

so you DO need to understand that more fully

Back to the drawing board

You haven’t lost ALL that you learned

It just feels that way

You will again get back on track

and later you may again feel a setback – but even then – next time it wont feel like such a shock

and so it will go until you really ‘get it’

It’s not ‘luck’

It’s about understanding the mistake – the false alarm

and about proving that to your brain

you WILL get there

You are in no danger even if you again had the worlds worst panic attacks

its just the same mistakes as before

and it’s so subtle we don’t even realise we do it

And please keep in mind that you are in the healing/helping profession – and I have noticed that people who help others often have to learn the long way so that they then have more in depth knowledge to pass on to others. People who recover too quickly cant really explain to others how to do the same

Trust me – when you recover you will know EXACTLY how and why and you will help many others do the same

Let go all over

r e l a x your body

allow the fact the you had panic in the first place and that you felt it was gone but now you think its back

Thats ok – thats just what is at this moment

relax towards that

its pointless to think it shouldn’t be happening

it is as it is

but it will change

let it all exist

If you feel you need to avoid for now – fine – avoidance isn’t a crime

Avoidance in the long term just keeps you stuck

but now you are learning you WILL work with avoidance and safety behaviour at some point

so take your time – study more and practice with avoidance when you understand it more

OR – if you choose to not avoid and you go somewhere – you MIGHT be fine

but if not – even if you have panic – thats ok – your not in any actual danger

and later you can resume your study and practice

It’s ALL ok

keep going over the books and video

take the worksheets more seriously

study book 3 – exposure – try to see how planned exposure is the quickest way to learn the truth

You will get there

But it WILL take more time – and possible a few more setbacks

That is totally normal

You are right on schedule 🙂



AGAIN.  Your presence is so valuable. 

Personal question. Did your panic disorder at all have elements of OCD obsessive disorder. Since all this anxiety I have become kinda OCD about orderliness. Questions trying the project the future. Racing thinking and control with my surroundings. Not sure how to deal with this.  Can CBT help with this?    

I ask a million what if questions to my husband and I am driving him crazy.  We are trying to do a remodelling project here in the Caribbean which brings a certain amount of stress even for a sane person. ie.,  getting good help, trusting people with your property, getting materials etc is daunting. But I have become seriously OCD since all this panic and wondering how CBT can help. ?   A thousand thanks from across the ocean. In gratitude




Panic disorder can have associated obsessive components – I had a lot of obsessive thoughts

Keep in mind that the fight or flight response is MEANT to make your mind go on VERY high alert

its designed to help when we are in mortal danger – so our senses become very heightened so that we can be on the look out for danger – we will focus intently on singular things – and try to make sure everything is ‘safe’ and correct and under control

Its a great thing is we actually are in danger

But when its a false alarm then it doesn’t make a whole lotta sense and it just freaks us out – and since there is no danger to focus on our ‘alert mind’ focusses on whatever is at hand

Its all just the same thing in different guises

You need to start again with the books and really get to know it all at a very deep level – and then you need to start ‘catching’ all the ways the mind and body pull you in – and use the techniques to counteract that

The fact that you are realising you are obsessing and asking for reassurance or what ifs is a good sign

and to begin with its not easy to NOT do that

but the more you study and apply the strategies the more you will chip away at the extreme behaviours – you will start to see all the subtle behaviours

for instance – after a while instead of asking ‘what ifs’ 50 times in a row – you might ask 20 times and then REALISE you are doing that and apply a coping strategy – or do the flash card – or some mindfulness – (all in book 2)

and then you may go back to 50 times again

and then later you will catch it again after 15 times

and so on

its a process

just accept that you need to study – learn – and apply the CBT – over and over

and as I said – even if there are elements of hormonal problems or anything physical – you still will have been caught in the anxiety cycle to some degree – so this practice is essential

Try not to label things too much – its good to some degree but once you realise that you are caught up in anxiety stick with that level

So rather than saying ‘I’m having panic’ – or ‘I’m getting OCD’  try to just stick with saying to yourself in a clear scientific way ‘I am experiencing fight or flight symptoms which are causing me to act and behave in certain ways – but its ok I’m not in and danger and I am not ‘ill’ or disturbed – it’s just a FALSE ALARM’

Language is important

You almost have to be a scientist looking in on ‘A’ and not judging her – just seeing the misinterpretation and catastrophisation and safety behaviours and anxiety cycles

the more you can step back and observe the more you will be able to stop adding secondary fear – and when you let the fight or flight run its course without too much reaction or labelling it will die down on its own

it is VERY early days yet for you to work through this – you will get there but it WILL take more time



Robin. You must know me well energetically because you always call me to the mat.  I appreciate your style and the way you I communicate so much.

So the other funny fact about living on this small island – aside from being remote, the first place I experienced my first attack and a place that  greatly heightens my anxiety.  Its also a place with things like malaria and Zika virus which is transmitted my mosquitos. I already told you I have obsessive thought about getting sick and my health- so there is always an underlying scare that I will come down with Zika when I’m here,  yet I choose to live here and it’s the most spectacular place on earth.  

Ironic its where I’ve chose to grow roots. Lol. Guess its meant to be a teaching experience to deepen my practice and have faith.   Back to practice I suppose for me.   Life is funny.  Even the way I came to communicating with you. I need to focus on the joys and the great blessings and honestly wish I wasn’t as sensitive in my body – but I know it’s a blessing. I must trust and do the work. I know this.  Back to the program today

In joy. A



Hi A

Just wondering how you were getting on?




Robin.  Ive been meaning to reach out. My husbands dad died and i’ve been dealing with cancer with my dad.  

I would say that the panic is there but i’m learning to accept and live with it. Your help and techniques have been life changing for me.


Hi A

Gosh I’m very sorry to hear about all that

But I’m glad you are coping with everything ok

Can I suggest that you still go over the books regularly and really study up on ‘exposure’

You say the panic is still there but honestly you CAN and WILL reach a point where it’s NOT there – at all

I appreciate it must be difficult to practice with panic with having so much else to deal with but just keep it in mind when you are ready 

I’m happy to help

Keep in touch



I still wake up in the middle of the night and feel like i’m having a heart attack and heart racing and shallow breath.  And yes its been hard with all the emotional things happening. I don’t know how to cope with the panic that wakes me up in sheer terror. It still scares me




I’d love to say that I have some simply tricks to deal with that

But the reality is that you still haven’t worked with the books/knowledge/practice enough to get the complete understanding that will free you completely of panic

If you are still afraid of the fight or flight then you simply haven’t proved it to yourself that there is nothing to fear

It’s a straight forward equation – and that is GOOD news – you don’t have to wonder ‘why’ you still have panic – you don’t have to think that there IS some ‘other’ problem

Nope – the answer is simple – you are caught in the anxiety cycles and you just haven’t figured it out – enough yet understandably – how to break the cycles

so – really you just need to get back to study and practice

and I am happy to help along the way

You need to fill in all worksheets and make flashcards and planned exposure etc etc – there is just no other way

and isn’t it great that there IS a way – and I GUARANTEE that it will work and DOES work

anyway – back to the drawing board

with regards waking in the middle of the night – you need to have a PLAN

there’s absolutely no point just hoping you wont wake in panic or just practice ‘vaguely’ when you do wake in panic

You need to read the first two books VERY carefully

Then create a FLASHCARD for beside your bed

The you need to realise you are caught in a repetitive cycle of fear – you EXPECT to wake in panic – so you DO and all your thoughts and behaviour probably maintain all this

as SOON (and I emphasis **AS SOON**) as you wake up and you feel panic you need to choose IMMEDIATELY – not in 2 minutes but IMMEDIATELY to PRACTICE – don’t ‘freak’ out – don’t resist – don’t fight – don’t try to desperately relax – don’t add thoughts of why and what and what if and oh my god’

OBSERVE all those behaviours and thoughts happening but choose NOT to ADD to them 

Follow the plan – or Flashcard – whatever it may be

Ok – this is just anxiety – I’ve had it before and nothing ever happens

The fact that I get it every night is a sign its just anticipatory anxiety 

I know now how anxiety works

The most common symptoms are fast heartbeat – breathlessness – sweating – weird sensations etc etc

Take a slow breath and let it out slowly




let go all over


Give it time

Look around the room – feel it’s steadiness

everything is ok

the symptoms rise and fall then rise again and fall – this can happen for ages

keep waiting

no need to get up or be ‘extra’ safe or worried

just be still

tell your body – everythings ok – we are in no danger – thanks for the adrenaline but you can put it away now – thanks anyway body


and breathe again

and let go all over again

and wait some more

even use my emergency panic audio

But MOSTLY get back to the books and practice



(To be continued..)