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Approaching the bodily sensations associated with panic attacks






Another way to address the avoidance that goes along with panic attacks is to approach the very sensations associated with panic attacks. The exercises so far have focused on helping you manage avoidance of situations, objects, and activities. One reason for this is that the avoidance of these activities and situations can be problematic in and of itself, interfering with your quality of life and limiting your ability to live your life fully. Most of these forms of avoidance, however, are really all about avoiding the bodily sensations that go along with panic attacks. Isn’t that one of the main reasons you avoid so many of the activities and situations you identified previously? For many people, the avoidance of these bodily sensations is what drives the rest of their avoidance behaviors. So, the best way to address this form of avoidance is to approach these sensations themselves. And, as much as that may be a very scary proposition, there are DBT skills to help you through it.

Two skills in particular can be very helpful. The first is to use the acting opposite to emotion skill (Linehan 1993b) we described previously to approach each of the feared bodily sensations you identified in exercise 8.3. Use the following exercise to help you with this. First, write down again in the first column all of the bodily sensations you associate with panic attacks and try to avoid. They will be the same sensations you identified in exercise 8.3.

Exercise 8.5 How to Approach Feared Bodily Sensations Associated with Panic Attacks

Write down all of the bodily sensations associated with a panic attack that you try to avoid. Next, write down different things you could do or actions you could take that could lead to these sensations and put you into contact with them.
  1. 2. 3. 4. 5.
  1. 2. 3. 4. 5.
  1. 2. 3. 4. 5.
  1. 2. 3. 4. 5.
  1. 2. 3. 4. 5.

Next, identify several different things you could do to get in touch with these bodily sensations. Try to generate as many actions as possible that could lead to these sensations and put you into contact with these internal experiences. They don’t have to be normal activities you would typically do in your everyday life, just anything that could give you the chance to approach these feared sensations. So, if you are afraid of your heart racing, think of things you can do to get your blood pumping. How about jumping up and down, running up stairs, or doing push-­ups? See table 8.1 for different ideas about how to get into contact with the physical sensations that often go along with panic attacks (Schmidt and Trakowski 2004). Once you have identified actions you think may work for you, write them in the second column of exercise 8.5. Use this list to help you get in contact with these sensations, approaching them over and over again until they become less scary.


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