If you're reading this in the middle of one — start with this: it will pass. It always does. Every panic attack you've ever had has ended. This one will too.
Barbara Spaulding, LCSW, has spent nearly 40 years helping people through exactly this moment — both as a therapist and, earlier in her life, as someone who had panic attacks herself for fifteen years before learning her way out. In her book Anxiety and Panic: Your Path to Recovery, she shares a technique she developed with a client named Susie, who found herself frozen in a stairwell thirty minutes before a work presentation, unable to move.
What's actually happening in your body
Panic attacks come on fast — tight chest, shallow breathing, tingling hands, a desperate urge to flee. It feels like something is dangerously wrong. It isn't. Barbara's core teaching point is this: panic is uncomfortable, disconcerting, and terrifying — but it is not dangerous. Your body is reacting to a perceived threat, and the fear itself is what keeps fueling the symptoms. The reaction you're having to the panic is what keeps it going, not the original trigger.
The step-by-step method
These steps, adapted from her book, are meant to be practiced when you're calm, so they're already familiar when you need them:
Breathe out first, then breathe in. Exhaling interrupts the anxious breathing pattern immediately — it's more effective than trying to take a big breath in first.
Focus on your breath. Picture yourself breathing out panic and breathing in calm.
Get grounded. Put a hand on your chest, your knee, or your heart. Physical contact with your own body signals safety.
Pick one object and hold your eyes on it. A single point of visual focus interrupts the mental spiral.
Don't make decisions or promises. Avoid thoughts like "I'm never coming back here" — these create new anxious associations that make the next panic attack more likely.
Don't negotiate with panic. You won't win, and trying only teaches your body that panic requires bargaining to end.
Ride it out. Stay in your body, stay in the present moment, and keep breathing.
The one instinct you have to override
Your entire nervous system will be screaming at you to run, fight, or freeze. Every part of you will want to escape. Barbara's advice here is counterintuitive but central to her whole approach: you cannot outrun a panic attack. It travels with you. The way out isn't through more fighting or fleeing — it's through learning to sit with the discomfort while you breathe, which is a skill, not a personality trait, and it can be built with practice.
Why avoidance afterward makes it worse next time
It's tempting, once the panic has passed, to avoid whatever triggered it — the elevator, the highway, the crowded room. Barbara's client Susie took the stairs instead of the elevator after her panic attack passed, and she recognized in the moment that she was avoiding. Avoidance offers short-term relief but reinforces the belief that the situation really was dangerous, which sets up the next episode. Real recovery includes going back — gently, on your own timeline — using calm skills rather than white-knuckling through it.
Building the skill before you need it
The breathing technique above works best when it's not the first time you're trying it. Barbara recommends practicing calm breathing during ordinary, non-anxious moments — brushing your teeth, waiting in line, driving — so that when panic does show up, your body already knows what to do.
This is one piece of a much larger framework in Anxiety and Panic: Your Path to Recovery, which includes 17 total calm skills — from grounding and "three words" techniques to rewriting the inner dialogue that makes panic worse.
If panic attacks are a regular part of your life, you don't have to figure this out alone. Barbara Spaulding's book walks through the full recovery process, and her free biweekly Anxiety Relief Zoom group is open to anyone who wants live support. Details at anxietyandpanic.net.
If you're in a mental health crisis or having thoughts of harming yourself, please reach out to a crisis line or emergency services in your area — this article is educational and isn't a substitute for professional care.