Specialties
Panic Attacks
Your Own Body Became the Dangerous Thing
Your heart races and your breathing changes.
You go dizzy, hot, shaky, nauseated, or strangely detached, and some part of you is certain something terrible is happening.
The first one is frightening enough on its own.
What comes after it is the part nobody warns you about.
Now You Watch for the Next One
After the first attack, the fear finds a new target: the one that hasn’t happened yet.
You read your own body for evidence all day, without ever deciding to.
A skipped beat at your desk. A warm room. Light-headedness when you stand up too quickly.
Exercise goes first, because a heart working hard feels too much like the beginning of one.
The More You Work Around It, the More Convincing It Gets
Crowded rooms come off the list.
Then public transportation, long drives, heat, presentations, restaurants, anywhere leaving quickly would be hard.
Your life gets organized around preventing panic, one defensible choice after another.
And the smaller your world becomes, the more convincing the fear feels.
Your Escape Plan Is Part of the Cycle
Whatever you do to make a panic attack stop gets the credit for the fact that nothing bad happened.
You leave the restaurant, the feeling passes, and leaving looks like the reason.
So the exit gets a little more necessary every time you use it.
And your body never finds out what happens when you stay.
Your Treatment Goes at the Sensations You Fear
Panic is highly treatable, and cognitive and behavioral approaches do part of the job here, along with skills for the minutes when anxiety starts to climb.
Exposure-based treatment does the rest, and this part asks something real of you.
In interoceptive exposure, with your clinician right there, you bring on the physical feelings deliberately and in small doses: heart rate up, breathing changed, the light-headedness you’ve been steering around for months.
Then you stay with it while it peaks and comes down on its own.
You Approach the Situations in an Order You Can Manage
This feeling is uncomfortable, but it is not dangerous.
Enough repetitions and your body reaches that conclusion on its own.
Then the situations get their turn, in an order you and your clinician build together.
We won’t put you in the hardest situation first and hope it goes well. You start somewhere manageable, stay past the peak, and find the next item on the list smaller than it was.
Your List Starts Growing Back
You drive where you want to drive.
Exercise comes back, and so do travel, restaurants, and crowded rooms.
You speak up in a meeting without first working out how you’d get to the door.
Panic becomes something you know how to handle instead of something that makes decisions for you.
Be Somewhere Without Planning How You’d Leave
Use that as your measure.
The middle of a row. A seat with your back to the door. A flight you spend thinking about where you’re going.
Send us the list of places you’ve cut out, because that’s where your clinician starts.
Tell Us Where You’d Like This to Move
You don’t need the whole thing figured out before you write to us.
Some people know exactly which kind of therapy they want. Others know only that something isn’t working anymore, and that’s enough to start with.
Tell us what’s been going on, what you’ve already tried, and what you’d like to feel different. We’ll think it through with you and point you toward the therapist and the approach that fit.
You’ve done plenty of understanding already, and now it’s worth finding out what gets it moving.