How to Overcome Panic Attacks and Anxiety: A Step-by-Step Therapeutic Success Story

When speaking about anxiety and panic, we tend to look for ways to calm down when the cycle has already begun to overwhelm us, which is often already too late. In order to truly gain control in such situations, the time to begin breathing exercises (ideally to the point of fully emptying your lungs), is the moment you feel a panic attack approaching, or when a familiar physical symptom of anxiety begins. It is essential to practice these breathing techniques daily, especially when you're feeling calm and not only during times of anxiety. The more you practice, the easier it will be to manage anxiety when it hits.

Another helpful method to cope with panic attacks is understanding that during an attack, our reactions tend to be extreme and dramatic, and our thoughts become distorted and exaggerated. Truly internalizing this idea is a significant step toward healing.

During an attack, it’s critical to focus on your thoughts and recognize that the likelihood of the feared event actually happening is very low, especially compared to the intense stress you're feeling. For example, Reut experienced physical symptoms and was convinced she was having a heart attack, but once the symptoms subsided, she realized that wasn’t the case. Logically, the next time she feels those symptoms, she should be able to reassure herself- although emotionally, her body may still signal danger. Normally, emotions serve our intellect, but during anxiety, our emotional responses don’t function rationally.

In Reut’s situation, the intensity of her anxiety didn’t match the actual likelihood of what she feared happening. That gap reveals an internal imbalance of an emotional response that doesn’t reflect reality.

Any extreme emotion can harm us. For example, feeling guilty after doing something wrong is natural. However, when guilt becomes overwhelming, it is destructive. Our emotional reactions need to match our life experiences in healthy, balanced proportions.

As part of her treatment, Reut worked with Michal to reflect on her reactions after each anxiety episode. Michal asked her to consider: Was the outcome really as bad as it felt in the moment? Did the emotion match the actual event? The answer, consistently, was no. She didn’t have a heart attack and she didn’t faint from dizziness or weakness- the fear simply didn’t match the facts.

Michal asked Reut to create a table where she recorded the emotions she felt during a panic attack, the actual facts, and evidence showing the emotion didn’t align with reality. Michal asked her to review the table regularly, so that her rational mind could begin to distinguish between real danger and imagined fear.

After several months of weekly sessions, Reut began to understand that although she had experienced some serious panic attacks, she had always continued with her life as best she could, and her worst fears had never actually materialized. Slowly, her anxiety threshold improved, and the frequency of panic attacks decreased.

Eventually, Reut began responding to anxiety with reason. When her heart raced, instead of assuming it was a heart attack, she reminded herself that heart rate also increases during cardio workouts, and this is not harmful. This shift in perspective often calmed her almost immediately, because it was concrete proof that her emotions were not aligned with reality.

Michal later guided Reut through exposure therapy. Together, they practiced simulating the sensations of a panic attack- racing heart, dizziness (using a spinning chair), and breathlessness (by holding her breath). These exercises were done while Reut was calm, under supervision, to teach her brain that the symptoms aren’t dangerous. Instead of panicking, Reut learned to think: "It’s okay. I’m in control. This is just a feeling. My thoughts aren’t rational right now."

The exercises were introduced gradually, helping her lose the fear of physical symptoms and gain tools to manage them. Over time, Reut learned to calm herself and gained confidence in her ability to cope with future attacks.

Reut continued seeing Michal for about a year and a half. She was deeply committed to the process, followed every task, and had a strong therapeutic bond with Michal, which made all the difference.

By the end of their journey together, Reut knew how to respond practically when anxiety appeared. She realized that she couldn’t fight the anxiety, but rather had to allow herself to experience it without fear, and then it would pass.

Her panic attacks became significantly less frequent. She returned to a healthy routine, both at work and at home, and most importantlly, her joy in life returned.

Anat Doron is a psychotherapist.