The Panic Paradox: If you don’t want it, you got it!

Panic disorder is, at its core, a phobia of panic attacks. You’ve had a panic attack, for whatever reason, and have grown to hate, fear, and dread subsequent attacks.

Perhaps you’re now spending your life trying to ward off further attacks through various avoidances and safety behaviors.

Here’s the paradox: In most cases if I could wave a magic wand and you no longer cared one bit whether you ever had another attack, the attacks would stop completely. It is the very drive to NOT have another panic attack that further fuels the condition. You resist it then it persists; you accept it and the panic abates.

The treatment for panic disorder makes sense if you understand this. The ultimate goal is not to care so much whether you have another panic attack, and when they go away to be okay with the possibility that you might have another attack some day.

Yes, yes…easier said than done. I agree, but who says that life is supposed to be easy?

So how do you care less about whether you have another panic attack?

See your doctor to rule out a medical explanation for the panic and to get information as to the fact that you are not in imminent danger when you have a panic attack.

  1.  Learn more about panic disorder. There are a lot of helpful web resources (hopefully this blog is one). See the Resource links at www. I also recommend the book Don’t Panic, third edition, to my clients with panic disorder. The author, Reid Wilson, Ph.D., has written one of the best panic disorder books I have seen and I think it should be required reading for those seeking to manage their panic.
  2.  Face your feared physical sensations head-on without safety behaviors. If you are afraid of dizziness, for example, make yourself slightly dizzy by mild spinning and then sit with the subsequent anxiety passively until it passes. Repeat until it is no longer anxiety provoking and then up the length or speed of spinning until dizziness is no longer a feared sensation. Repeat with other feared sensations.
  3.  Face your avoided situations without safety behaviors, whether it is crowds, stores, or open spaces. Adopt an inviting and accepting stance towards your anxiety. Let your anxiety jabber on in the background while you let it run its course. Repeat until anxiety subsides.
  4.  Next, face your previously feared situations while bringing on the feared sensations intentionally. For example, go to a crowded store, stop by the restroom or other private place and spin, jog in place, practice holding your breath…whatever it takes to trigger the sensations you associate with panic. Then re-enter the situation and adopt the passive and accepting attitude and allow anxiety to run its course without a struggle. Then repeat until these situations no longer trigger your fears.
  5.  Once your confidence goes up that you can cope with whatever panic throws at you quickly and effectively, continue to foster the attitude that going towards your anxiety is the best route through it and that you are willing to face the occasional recurrence of panic should it return. The best defense against the return of panic is to genuinely not care if it does.

This sounds difficult and it really can be. Seek help from a panic disorder specialist should you want assistance with this process. The best way to find one closest to you is through the Anxiety Disorders Association of America website (

When it comes to anxiety disorders, I encourage you to invest in MORE discomfort in the short term in order to have a more comfortable future.

Eric Goodman, Ph.D.