CBT4Panic
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  • THE WORKBOOKS
    • BOOK 1. UNDERSTANDING PANIC
    • BOOK 2. RAPID RECOVERY SKILLS
    • BOOK 3. RAPID RECOVERY PRACTICE
    • BOOK 4. MAINTAINING RECOVERY
    • OBSESSIONAL THINKING
    • BLANK WORKSHEETS
  • VIDEOBOOKS
    • VIDEOS Bk 1 – UNDERSTANDING
    • VIDEOS Bk 2 – RECOVERY SKILLS
    • VIDEOS Bk 3 – RECOVERY PRACTICE
    • VIDEOS Bk 4 – MAINTAIN RECOVERY
    • EMERGENCY FLASHCARD
  • EMERGENCY AUDIOS
  • THERAPY DIALOGUES
    • Nicole – Panic Disorder / Health Anxiety
    • Denise – Obsessional Thoughts with Panic
    • Brendan – Panic – Depression – Obsessional Thoughts
    • Hilary – Panic and Health Anxiety (specific fear of MS)
    • Julie Panic Disorder
    • ANITA – Panic Disorder – Continuous feeling of anxiety
    • Emergency Self Talk Scripts
  • MINDFULNESS
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    • About the 4 Steps in CBT4Panic
    • TESTIMONIALS
    • Download all PDF workbooks and mp3 emergency audio files
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Workbook 1

  • Understanding Panic & Anxiety
  • Foreword – I had Panic Disorder myself
  • A 4 Step Recovery Plan
  • DSM Criteria for Panic Attack & Panic Disorder
  • Panic Attacks can be part of another disorder
  • Before we Begin
  • Two Weeks Towards Freedom
  • Anxiety is a perfectly normal and necessary part of life.
  • But what about STRESS ? Isn’t it a bad thing?..
  • Anxiety symptoms stem from the very helpful ‘Fight or Flight Response’
  • The Fight or Flight Response Symptoms
  • Now look at the typical symptoms of a panic attack..
  • Fight or Flight Sensations are not actually harmful
  • When Fight or Flight happens for no clear reason we panic
  • We panic because we make a MISTAKE!
  • Meet Miss-Interpretation and Mr CATASTROPHE
  • This ‘mistake’ leads to a cycle of fear, adrenaline, fear, adrenaline
  • The Panic Cycle
  • A panic attack CANNOT cause you any ‘actual’ harm
  • Adrenaline HAS to die down eventually
  • Misinterpretation and Catastrophisation get us caught in the panic cycle
  • How we ‘misinterpret’ and ‘CATASTROPHISE’ the symptoms
  • Common Catastrophic Thoughts
  • Why do we have REPEATED attacks?!!
  • It is fear of the panic itself that leads to further attacks..
  • The ANTICIPATORY ANXIETY Cycle
  • Everyone becomes caught in the same anxiety trap
  • You don’t need to get rid of stress to overcome panic
  • Panic is maintained by Safety Behaviour and Avoidance
  • The Safety Behaviours Trap
  • Safety Behaviours play a HUGE part in maintaining panic attacks
  • An example Safety Behaviour Cycle
  • The AVOIDANCE trap
  • You may start to AVOID situations where you think you might panic
  • What exactly is Agoraphobia?
  • Commonly Avoided Situations and Places
  • Why AVOIDANCE makes things worse..
  • Example ‘AVOIDANCE’ Cycle
  • Real Life Case Study
  • The four main CYCLES in PANIC
  • Summary of Step 1 – Understanding Panic
  • You are now ready for Workbook 2

Workbook 2

  • Workbook 2 – Rapid Recovery Skills
  • The key to TOTAL and ABSOLUTE Recovery
  • The Problem and The Solution
  • These skills are not avoidance techniques
  • Part 1. Change the way you THINK!
  • Correcting mistaken beliefs ABOUT panic reduces our fear
  • 4 STEPS to changing the way you think about panic
  • CATCH IT – Identify the unhelpful thoughts
  • How to find the hidden fearful thoughts
  • Downward Arrow Technique Questions
  • Downward Arrow Technique Worksheet
  • Identifying thoughts using a Panic Sequence Profile
  • Panic Sequence Profile Example 1
  • Panic Sequence Profile Example 2
  • Challenge and Restructure the unhelpful thoughts
  • Correcting Common Misinterpretations
  • FALSE ALARM 1. “I’m having a heart attack!”
  • FALSE ALARM 2. “I’m going to pass out / faint!”
  • FALSE ALARM 3. “I’m going to stop breathing!”
  • FALSE ALARM 4. “I’m going crazy – having a nervous breakdown!”
  • FALSE ALARM 5. “I’m having a stroke!”
  • FALSE ALARM 6. “I’m going to lose control!”
  • FALSE ALARM 7. “my vision is blurred.. I’m going blind!”
  • FALSE ALARM 8. “I’m going to be humiliated!”
  • FALSE ALARM 9. “I’m going to collapse – I feel so weak!”
  • FALSE ALARM 10. Waking up in panic (Nocturnal panic attacks)
  • FALSE ALARM 11. ‘Derealisation’ and ‘Depersonalisation’
  • FALSE ALARM 12. ‘Obsessional Thoughts’
  • Obsessional Thoughts Cycle
  • Obsessional Thoughts – shift to OBSERVER mode.
  • Keeping a ‘Panic Attack Diary’
  • Example Panic Attack Diary
  • Examples of common Catastrophic Thoughts (for Panic Diary)
  • Examples of common Behavioural Reactions (for Panic Diary)
  • Recovery Skills Part 2. Acceptance Behaviour Strategies
  • RESISTANCE and AVOIDANCE maintains the problem
  • CATCH IT – CHECK IT – CHANGE IT
  • Don’t ‘TRY’ to RELAX! – just LET GO of any added tension
  • Why deep breathing exercises can make things worse!
  • Ride the waves of panic – float through them
  • Stop ‘Stirring the pond’ – just LET IT BE – DO NOTHING
  • Stop watching the CLOCK! – It will pass – WAIT – give it TIME.
  • Ultimate Acceptance # 1. IGNORE the panic – get on with your day
  • Ultimate Acceptance # 2. EXAGGERATE the symptoms
  • There is NO NEED to be ‘careful’ with yourself!
  • Acceptance Behaviour Strategies summary..
  • Recovery Skills Part 3. Mindfulness Techniques
  • Lessening your focus on the panic
  • See the thoughts as JUST thoughts..
  • See sensations as JUST sensations
  • Test Pilot mode
  • Thought Labelling
  • Question and Answer Technique
  • How to remember the skills during panic
  • NORMALISING Statements
  • NORMALISING statements before or after panic
  • NORMALISING Statements DURING PANIC
  • The importance of ‘FLASHCARDS’
  • An example FLASHCARD
  • Example FLASHCARD – ‘NORMALISING STATEMENTS’
  • Cartoon illustrated Visual Flashcard
  • How practicing your skills on panic attacks develops
  • No matter what – panic is not harmful
  • The reason to avoid too many ‘symptom details’
  • Summary of Step 2 – Rapid Recovery Skills
  • You are now ready for Workbook 3

Workbook 3

  • Workbook 3 – Rapid Recovery Practice
  • Exposure is the KEY to recovery
  • Graduated Exposure Practice works on 3 levels
  • 3 Types of Graduated Exposure
  • Learning from Graduated Exposure
  • EXPOSURE PRACTICE 1 – Overcome Fear of PHYSICAL sensations
  • Why Interoceptive Exposure practice SO important!
  • ‘Interoceptive’ Exposure Practice POINTERS
  • ‘Interoceptive’ Exposure Practice 1 – Pounding Heart
  • ‘Interoceptive’ Exposure Practice 2 – Dizziness
  • ‘Interoceptive’ Exposure Practice 3 – Choking
  • ‘Interoceptive’ Exposure Practice 4 – Light Headedness
  • ‘Interoceptive’ Exposure Practice 5 – Shaking – Trembling
  • ‘Interoceptive’ Exposure Practice 6 – Shortness of Breath
  • EXAMPLE Interoceptive Exposure session
  • If Interoceptive Exposure seems too difficult
  • Example Interoceptive Exposure Worksheet
  • Interoceptive Exposure Case Study
  • EXPOSURE PRACTICE 2 – Lose your fear of EXTERNAL situations
  • ‘REAL LIFE’ Graduated Exposure Practice
  • Creating your Exposure ‘Fear hierarchy’
  • An Example ‘Fear hierarchy’ Worksheet
  • Create a ‘Smaller Steps’ Fear Hierarchy
  • Example ‘Smaller Steps’ Fear Hierarchy
  • Planning Real-Life Exposure – S.M.A.R.T. Goals
  • How long should ‘Real Life’ Exposure last
  • ‘REAL LIFE’ Exposure Practice Essentials
  • A key moment in Exposure Practice.. learning to ‘WAIT’
  • Troubleshooting ‘REAL LIFE’ Graduated Exposure Practice
  • Example – Graduated Exposure Worksheet
  • Example Exposure SESSION with Cartoons
  • Exposure Practice FLASHCARD
  • Exposure – Dropping Safety Behaviours
  • Example ‘Safety Behaviours’ Cycle – with Cartoons
  • Examples of common Safety Behaviours
  • Safety Behaviours fall into 2 categories
  • DAILY-LIFE ‘Safety Behaviours’ Hierarchy example 1
  • Safety Behaviours Hierarchy example 2 – ‘Situation Specific’
  • EXPOSURE PRACTICE 3 – Imaginal Exposure
  • Imaginal Exposure – How it works
  • Imaginal Exposure – Illustrated EXAMPLE
  • Imaginal Exposure – EXAMPLE SCRIPT
  • ‘Behavioural Experiments’
  • Behavioural Experiments – EXAMPLES
  • Summary of Step 3 – Practicing Recovery
  • You are now ready for Workbook 4

Workbook 4

  • Workbook 4 – Maintaining Recovery
  • Troubleshooting if progress is slow
  • A VITAL part of recovery – Dealing with ‘Setbacks’
  • Dealing with ‘Setbacks’ – Distorted Thoughts and Rational Responses
  • Dealing with ‘Setbacks’ – Essential Reminders
  • The benefit of ‘Setbacks’ – moving beyond all doubt
  • Common ways we maintain anxiety BETWEEN attacks
  • Dealing with a ‘continuous’ feeling of anxiety
  • The power of ‘power naps’
  • Unusual symptoms – Symptom Shifting
  • A complete LIST of ‘possible’ anxiety symptoms
  • Anxiety Symptoms: The List
  • Try to avoid becoming an ‘expert’ on symptoms!
  • It doesn’t feel like ‘just’ anxiety
  • Fears about getting better
  • The strange feeling that you WANT to panic
  • Are you REALLY ‘accepting’ the feelings
  • Do less self focussing – ‘Normalise’ your routine
  • Panic Attacks are not your fault
  • Dealing with feelings of Depression
  • More about Clinical Depression
  • More about Depression
  • What are the treatment options for Depression?
  • Problems on awakening from sleep
  • Problems getting to sleep
  • What about diet and exercise?
  • Panic attacks triggered by ‘recreational drugs’
  • Shouldn’t I be practicing Relaxation Exercises?
  • Should you take Medication?
  • Fear of getting Blood Pressure measured..
  • Dealing with work, friends and family
  • Professional Help – Going to a Cognitive Therapist
  • Recommended Reading
  • Celebrities who have had Panic Attacks

Julie – Panic Disorder

  • Julie – Panic Disorder – Google Chat Dialogues
  • DIALOGUE number 1 – ‘Mental Panic’
  • DIALOGUE number 2 – Anxiety about Recovery
  • DIALOGUE number 3 – Explaining the ‘Self Talk’ process
  • DIALOGUE number 4 – Panic after Exposure Practice
  • DIALOGUE Number 5 – Try not to be overly ‘careful’ with yourself after panic
  • DIALOGUE number 6 – The impact of panic disorder on the rest of your life
  • DIALOGUE number 7 – Surprised by sudden ‘setback’
  • DIALOGUE number 8 – Late night anxiety and sense of isolation and vulnerability
  • DIALOGUE number 9 – Panic triggered by bad news – then fear of ‘going mad’
  • DIALOGUE number 10 – Trying desperately to be ‘calm’ means the fear of panic is still there

Denise – Obsessional Thoughts

  • Denise – Obsessional Thoughts with Panic
  • 4 March to 15 March – Reaching out and assessing the problem
  • 17 March to 30 March – Panic attack in Hairdressers – Overwhelming obsessional thoughts on road trip
  • 8 April to 9 April – Major ‘Setback’ “Am I the ONLY one who is incurable!?”
  • 18 April to 20 April – I can’t accept that the thoughts are JUST anxiety!
  • 24 April to 25 April – “Why is my new attitude not working quicker for me!?”
  • 3 May – Still fearful but we uncovered the reason behind all the anxiety
  • 4 May to 8 May – Uncovering the specific anxiety ‘process’ for Denise
  • 11 May – Trying to break the compulsion for ‘reassurance seeking’
  • 2 June to 3 June – Addressing why she wasn’t sending any worksheets or homework
  • 4 Jun – Finally decides to get serious about the homework and worksheets
  • 7 June to 9 June – ‘mental panic’ and more reassurance seeking
  • 19 June – Thought become so overwhelming I recommend she consider medication
  • 18 July to 29 July – On medication but still no sign of any worksheets or homework
  • 8 Aug to 22 Aug – Finally all the anxiety starts to unravel

Nicole – Panic & Health Anxiety

  • Nicole – Panic Disorder / Health Anxiety
  • #1 – Working with the CBT practice after a setback
  • Panic attack over how many baked potatoes for tea!
  • Anxiety causing me to doubt my ability to cope at work
  • Will I ever get back to living a happy carefree life?!
  • I still find it hard to ‘accept’ that anxiety can make u feel so tense and just rubbish!
  • Sorry to keep bothering you.. but I’m SURE I’m DYING!
  • I got that sudden “ohmygod stop everything NOW” sensation, a true feeling of panic
  • I think I’ve developed an obsession with my iron levels
  • Nicole’s list of experiences where she was convinced she was in grave danger
  • Overall, I felt extreme panic but managed to plough through it so I’m pretty pleased.
  • From panic to pregnant!

Audios

  • AUDIO number 1 – workbook 1 – Understanding Panic
  • AUDIO number 2 – Help During a Panic Attack
  • AUDIO number 3 – If you feel overwhelmed
  • AUDIO number 4 – help with ‘Mental Panic’
  • AUDIO number 5 – Dealing with palpitations
  • AUDIO number 6 – If you wake up in panic
  • AUDIO number 7 – If you feel anxious and can’t sleep
  • AUDIO number 8 – How to stay motivated to recover

Emergency Self Talk Scripts

  • Emergency Self Talk Scripts
  • When you have panic
  • When you can’t sleep
  • Don’t blame your poor body – it’s trying to help!
  • Dealing with a feeling of ‘Jitteriness’
  • Fear of leaving the house

Overcome Obsessional Thinking

  • Overcome Obsessional & Frightening Thoughts
  • **BEFORE YOU READ ON**
  • A 3 Step Recovery Plan
  • Step 1. Understanding OBSESSIONAL Thinking
  • Different types of obsessional / frightening thinking
  • The thoughts themselves are not the problem The thoughts are a DECOY..
  • Obsessional Thoughts Cycle
  • What makes our thinking become ‘obsessional’
  • Common catastrophic thoughts that lock us in the cycle of fear
  • The thoughts are not ‘who you are’
  • Why might we think thoughts of a disturbing nature?
  • There goes that song again..
  • “But these thoughts feel worse than a song stuck in my head!”
  • “But why am I thinking these thoughts?..”
  • Your mind does not have a ‘mind of it’s own’
  • You are NOT the thoughts you are EXPERIENCING the thoughts
  • This problem is VERY common
  • When will these thoughts go away!?
  • What MAINTAINS Obsessional Thinking
  • Avoidance and Thought Control Strategies
  • Why Avoidance and Thought Control Strategies maintain the problem
  • Step 2. Rapid Recovery Skills
  • Identifying the underlying thought process. What are you REALLY afraid of?
  • Keeping an ‘Obsessional Thoughts Diary’
  • Sample Obsessional Thoughts Diary
  • What you resist.. PERSISTS
  • The Thought Control PARADOX
  • Learn to OBSERVE rather than ‘react’ to the thoughts
  • See the thoughts as Just Thoughts
  • Describe how you feel as if you were a ‘test pilot’
  • Question your reactions
  • Distract yourself if you need to
  • A useful technique – shift to OBSERVER mode.
  • How to REMEMBER all this
  • ‘Normalising Statements’
  • Flashcard for Obsessional Thinking
  • Step 3. Rapid recovery PRACTICE – Graduated Exposure
  • Graduated Exposure Practice works on 3 levels
  • Graduated Exposure – The Basic Procedure
  • Learning from Graduated Exposure
  • Exposure Practice – Creating your ‘Fear hierarchy’
  • Planning your exposure practice
  • ‘Smaller Steps’ Hierarchies
  • Exposure Experiments – EXAMPLES
  • Graduated Exposure Worksheet
  • Graduated Exposure Guidelines
  • Troubleshooting Graduated Exposure

Mindfulness

  • An Introduction to Mindfulness
  • Mindfulness for panic & anxiety isn’t a tool for avoidance or distraction
  • What is MINDFULNESS ?
  • Mindfulness seeks to develop and nourish present moment awareness.
  • Try it now – a ONE MINUTE exercise in Mindfulness
  • Notice what happens after just one minute of Mindfulness
  • Why Mindfulness is so important
  • Thoughts can be with us from morning to night without a break
  • Sometimes we hardly have time for life at all..
  • Painful thoughts, feelings and emotions about the past and future can overwhelm us too..
  • Thoughts and feelings can be so distressing we try to block them out or avoid them
  • Mindfulness can help to change all this.
  • Mindfulness alerts you to any negative cycles of thinking or behaviour
  • Your health and ability to concentrate and tolerate stress will improve
  • You will find it easier to deal with difficult situations and experiences
  • Mindfulness in PRACTICE – first lets look at what Mindfulness is NOT
  • There are two forms of Mindfulness practice
  • Mindfulness in Everyday Life
  • Mindfulness in Everyday Life Preliminary Exercise – THE BODY SCAN
  • The Body Scan Exercise
  • Mindfulness in Everyday Life Exercise 2. Begin the day MINDFULLY
  • Mindfulness in Everyday Life Exercise 3. Mindful Walking
  • Mindfulness in Everyday Life Exercise 4. Mindfulness in Daily Activities
  • Sitting Mindfulness Practice
  • What is the ‘goal’ of Sitting Mindfulness
  • Sitting Mindfulness Practice – It’s like being at the gym
  • Sitting Mindfulness Practice – Some things that may happen..
  • Sitting Mindfulness Practice – Some more things that may happen..
  • What if thoughts get out of control?..
  • So what CAN we do about thoughts?..
  • Dealing with Thoughts #1- Using an ANCHOR..
  • Dealing with Thoughts #2 – See thoughts AS just thoughts
  • Dealing with Thoughts #3 – Let thoughts BE – just as they are..
  • Dealing with Thoughts #4 – Labelling the thoughts
  • What about overwhelming FEELINGS & EMOTIONS?
  • Emotions become more overwhelming when we extend them into the past or future
  • Sitting Mindfully With Emotions #1 – Use an anchor
  • Sitting Mindfully With Emotions #2 – feel the emotion as a bodily sensation
  • Sitting Mindfully With Emotions #3 – Stay aware in the present moment
  • Frequently Asked Questions
  • A 4 Stage Mindfulness Schedule
  • Mindfulness Practice Schedule
  • Taking it further – The practise of Self Enquiry
  • Insight through Self Enquiry
  • Some interesting facts about Meditation
  • Famous Meditators
  • Mindfulness Resources
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