How I Used CBT Techniques to Smash Past a Panic Attack

CBT stands for Cognitive-Behavioral Therapy. It’s not “what I do” exclusively, but I’ve already written all about why I chose talk therapy with some CBT. The goal is to change what’s going on in my head by changing my behavior. Tonight, I get to show you exactly how it works.

Last night, I woke up too late from a too-long nap at 8:00 pm. And something felt off. I knew it was one of two things: bladder infection or dehydration. So I started drinking water like it was going out of style. If I’m really dehydrated, that makes the pain go away. It’s happened before. If not, well, then… not. It gets worse. Once I know it’s an infection, I have to decide if I can wait until my regular doctor’s office opens, or if I can’t make it that long. Around 3:00 am, I woke Nathan up. I couldn’t stop crying in pain. I knew we had to go to the Emergency Room. You can’t kill an infection with wishing or even hydrating. Pills have to kill the darn thing. But I was so scared.

Before we left, I made him promise that he wouldn’t let the doctors keep me in the hospital. I made him promise that we would come home together. Because I have been trapped in the ER, alone, without the choice to leave. Even though my reasons for going to the hospital were so incredibly different last night, I really felt terrified to walk through those doors. Just seeing an Emergency Room sign, for any Emergency Room, makes me feel panicky. And because ER doctors don’t know you, having a panic attack in an Emergency Room triggers a whole series of cautionary steps. I support that policy, but being the patient who has to have three psych consults and stay for twelve hours under observation? It sucks.

Here’s what I did to keep myself calm:

  1. I said it out loud. When I made Nathan promise that he wouldn’t let them keep me, which he couldn’t actually do if they really thought I was not psychologically okay, I was just expressing my fears. When I do that, they get outside my head. When I say it out loud, I can hear that it is not a realistic fear.
  2. Deep breaths. It helps with the pain. It helps keep me calm. It’s the most basic CBT technique out there.
  3. Focus on keeping my voice steady. This one can back-fire, but it works for me when I have to say specific things. I can go over in my head what I have to say to the triage nurse, the ER nurse, the doctor, the supervising doctor. After a good, deep breath, I can say those words in a calm, clear voice. Hearing my own voice stay even helps convince my brain that I am not panicking. The best part is that the professionals respond really well to a calm, articulate patient, so it’s a good kind of cycle to get into.
  4. Say “Thank you.” In my life, nurses have been awesome and amazing and so helpful. If it weren’t for the nurses in the psych ward, I wouldn’t have worked my out of there in under two weeks. That’s a long story. Here’s what happens when I look a nurse in the eyes and thank her for her help: she looks at me like I’m a real person and tells me what’s going on. “This is going to hurt, take a breath.” And “We have some of your labs back, but I don’t know how long it’s going to take to get all of them, and then the doctors are going to have to look over them. I’m sorry it’s taking so long.” (My nurse last night was Priscilla. She’s a star.) Talking to the nurse and hearing what’s going on keeps me engaged in what is actually happening instead of what I’m afraid might happen.
  5. Let Nathan make me laugh. The beauty of marriage is that he’s already seen me at my worst. So if I burst into tears and refuse to let him move more than three feet away from me, he doesn’t think any less of me. Then, he tells me a joke. And I laugh, even though laughing hurts (literally). And it’s a good distraction.
That’s how it works. And it does work. I tell myself to do something. Something I can do, like saying “Thank you.” And then I actually do it. This acts as a distraction, and it puts a stop to any negative cycle. And look, I did ok!
Okay, so the morphine really helped my mood. But they gave me morphine, which means they didn't think I was crazy! (They don't often give crazy people narcotics.)

This was going to be the end of this post. But then, I got a package in the mail this evening. It was a gift from Cylene, aka The Lovely Smith, who really is lovely. She’s a lovely person. Her blog about jewelry making and other things recently introduced a new design: a thin stacking ring with a loop of contrasting metal (gold or copper) that can spin around. She mentioned that she calls them “fidget rings,” and I joked that she should try selling them in psychiatrists’ offices–jewelry for anxious people!

Well, she sent me one. And it’s the perfect CBT tool. It’s easy to always have with me. It gives me a behavior to repeat (fidgeting with the loop–I’ll show you a picture). It makes me think about this random act of kindness from this artist who did not send me jewelry so that I could promote it here or anywhere. She sent it to me because she knew that I would love it. She says she wanted my feedback, but the chances of me not loving this ring were slim-to-none. She actually crafts jewelry for heaven’s sake, by heating up metal and stuff–what do I have to tell her? It would have had to be painfully uncomfortable for me not to love it. But I also love that it is a physical symbol for why CBT works. What we do can change how we think. I now have something to wear that gives me something to do that inspires positive thoughts!

Doesn't it also look great with the three silver stacking rings I already owned from Cylene's shop?


  1. cylene said:

    oh anne-marie – what a lovely post!!!! you didn’t have to blog about the ring – but you were right, it fits perfectly into what happened to you!!! i am glad that the timing was right, and that you loved it. yay for jewelry for anxious people!!!! xoxoxoxox

    February 7, 2012
    • Anne-Marie said:

      I told you it was crazy good timing! Jewelry for anxious people–untapped market? <3

      February 7, 2012
  2. Rose Holmes said:

    Keep on going, you’re gonna be a strong wonderful mother, just as you are a strong wonderful daughter now!

    February 8, 2012
  3. Just for Fun said:

    […] I’d do it for fun. My brain is fried from the antibiotics I’m taking to kill the darn bladder infection. I think they’re killing brain cells, too. I feel like I’m just waking up from a nap […]

    February 9, 2012
  4. Lindyloo said:

    Thank you so much for this post. I had a panic attack in the middle of the night, after having a dream about having a panic attack. I couldn’t find my piece of paper that reminds me what to do when I’m having a panic attack, which almost created another one. Panic attacks were piling up readily. I rang my husband (shift worker) for assistance, but he was busy taking a fare (cab driver). I read your blog, took notes and made a new and better panic list. I told myself thank you for losing the first list. I will get stronger. This whole panic disorder thing is only one year old, so hopefully if I can learn some more CBT techniques and read inspirational things such as yours, I’ll stop the negative cycle. I have also determined to buy myself some sort of fidget ring. Thank you, from Linda (Australia)

    November 16, 2012

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.