How Therapists Can Help Clients With Panic Attacks

If you’re a therapist who wants to help clients with panic attacks, there are a number of practical techniques that can reduce symptoms and help them regain confidence.

Understanding Panic Attacks

Panic attacks are sudden, intense episodes of fear and anxiety that can feel overwhelming to the person experiencing them. They can be frightening, and people often worry that they are seriously ill or losing control. Around one person in ten experiences at least one panic attack during their lifetime, often following a stressful event. In the UK, approximately one person in fifty goes on to develop panic disorder. (Patient.co.uk, 2025)

Panic disorder is around twice as common in women as in men. And between 40% and 70% of people who experience panic attacks have them at night whilst asleep, as well as durig the day.

The causes are thought to be as varied as childhood influences, hormone levels, genetics, life experiences, learning and personality as well as high stress and anxiety levels generally. That means that although the client will probably be focussed on stopping the attacks, it’s worth introducing some holistic stress management as well.  

The Symptoms of Panic Attacks

As with any anxiety related issue, there are physical, emotional, behavioural, and cognitive aspects to a panic attack. The physical symptoms are similar to stress or anxiety, in particular people report nausea, sweating, trembling, pins and needles, feelings of dissociation, and fast or irregular heartbeat. Accompanying thoughts often include thinking they are going mad, having a heart attack, or about to faint or die. Often they feel that others are staring at them, or that they need to urgently get away from their current environment.

These are severe physical symptoms and cognitions that have a knock-on effect on people’s behaviour, emotions, confidence, and self-esteem. Sufferers often experience growing levels of anticipatory anxiety and avoid places where they think they might have a panic attack, especially social situations.

The symptoms of panic attacks often be linked to or mimic those of other conditions needing medical attention, including thyroid imbalance, heart or lung problems, ear disturbance and epilepsy. If clients experiencing panic attacks have not already seen a medical practitioner, they should be advised to do so, to rule out these other causes of their symptoms.

Help Clients with Panic Attacks

Teach the client about stress and anxiety, so they understand that (even though it’s unpleasant and scary) that they are safe during a panic attack. And/or explain the anxiety cycle and how negative thoughts and high levels of anxiety drive one another.

Reframe the panic as a protective mechanism operated by the unconscious which has become over-sensitive but is not vindictive. (Metaphors about over-zealous security guards or burglar alarms that go off when there is no burglar are useful here.)

Reassure clients that they will not suffocate during a panic attack because they are breathing more quickly and taking in more oxygen than usual to fuel the energy surge. Hyper-ventilation (‘over-breathing’) makes them feel as if they don’t have enough oxygen, but the opposite is true.

Coping Strategies for Helping Clients with Panic Attacks

To help clients with panic attacks, it’s good to encourage the use of coping strategies. Clients may find them difficult if their anxiety levels get high, but used early in the process, they can help prevent that from happening. Useful options are:

• OMG technique (see below).
• Beathing techniques.
• The changing modalities technique.
• Set up positive anchors and collapse negative ones that tend to trigger a panic attack.
• Distraction techniques, especially those that use logic, language, or memory to counter-act the stress response. Counting, singing, reciting poems or lists (names beginning with each letter of the alphabet in turn, Eurovision song contest winners, dog breeds, etc.).
• Use a SUDS scale to rate the panic at regular intervals, with 10 being as bad as it can get and 0 being calm and relaxed. This works as a distraction technique, disassociates them from the panic, and makes them more aware of when the symptoms start to subside.

If clients find it difficult to use coping strategies during an attack, ask them to exercise instead. They may be concerned that this will put their heart rate up even more, but dancing, jogging on the spot, running around the block etc. dispels stress response hormones in the way they were meant to be dispelled, by physical action. Running from a tiger is, after all, exercise of a sort.

If an attack happens in the session, talk them through a coping strategy using a slow, quiet voice. 

The OMG Technique: an Effective Way to Help Clients With Panic Attacks

The OMG technique (Haines, 2015) can be used by anyone who is experiencing strong or overwhelming anxiety or panic, and many of the above techniques sit well within one or other of the stages. Many also rather like the name which encourages them to use it.

• Orientation within a space encourages use of the thinking mind. Acknowledge what is happening and pay experience what is happening in the moment, to you and in the environment.
• Movement hacks the biological preparedness for activity that the stress response brings about. Change your posture, wiggle arms, fingers or toes, or walk around. Asymmetrical movement is thought to be particularly useful so try swinging your arms one at a time or tapping your knees if you have to remain seated.
• Grounding via breathing exercises promotes relaxation and slows the heart rate. Self-soothing or connecting with your own body (e.g. stroking your arms) may be helpful.

Beating Panic Attacks Through Hypnotherapy

Coping strategies can be discussed in the waking state and then reinforced through suggestion, rehearsal and future pacing in trance.

Avoid overwhelming clients with dozens of techniques at once. Two or three well-practised strategies are usually more effective than a long list. Review their effectiveness regularly and add new options only when needed.

Treating Panic Attacks with Hypnotherapy

Panic attacks rarely occur in isolation. As therapy progresses, it is often helpful to address wider issues such as:

• general stress and anxiety
• confidence and self-esteem
• self-care
• lifestyle factors
• underlying triggers

Review the client’s lifestyle and encourage them to

• eat a healthy diet
• get a good night’s sleep
• take appropriate exercise for their age and health levels
• use self-hypnosis or meditation regularly
• quit or reduce smoking, alcohol and caffeine

Metaphors, suggestion and future pacing can aid relaxation, help the client feel in control, and boost their confidence that they can beat their panic. If it fits with your way of working, you can also explore why the client’s unconscious mind believes the panic attacks happen, or are necessary, using parts, regression or other analytical techniques.

Helping Clients with Panic Attacks

Panic attacks can be frightening, but they are also very responsive to hypnotherapy. The combination of reassurance, psychoeducation and a small number of well-practised coping strategies can make a significant difference. As clients begin to understand what is happening in their minds and bodies, they often discover that the fear of panic is far more disabling than the panic itself and that confidence can return surprisingly quickly once that fear starts to fade.

References:

Haines S (2015) Touch Is Really Strange. Singing Dragon JKP.

Patient.co.uk. (2025). Panic attacks. [online] Available at: http://www.patient.co.uk/health/Panic-Disorder-(Recurring-Panic-Attacks).htm [Accessed 1 Jun. 2026].

Disclaimer
The information and ideas shared on this blog are based on the author’s professional experience, research, and training. They are intended for educational purposes and to support reflection and professional development. Therapists should always apply their own professional judgment and consider the needs of individual clients when using any techniques or suggestions discussed here.
While every effort is made to ensure the information is accurate and helpful, no responsibility can be accepted for any loss, damage, or difficulties arising from the use or misuse of material contained in these articles.