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Is It Panic? Or a Heart Attack? with Christine Padesky - Duration: 3:01.

A panic attack can feel remarkably similar to a heart attack.

And when clients are afraid they're having a heart attack, it can easily send panic and

fear throughout their system.

So how can we convince clients that anxiety and panic aren't going to kill them?

According to Dr. Christine Padesky, it's not something we do with words.

First of all, it's not a discussion we have, and it's an experience we create.

So what we find out with panic disorder is what physical or mental sensations convince

them that they're having a heart attack, a stroke, going crazy, whatever their fear is.

And then we recreate those sensations in the office.

So we have developed a whole variety of ways to induce almost every sensation under the sun.

And so with heart attack, if it's a racing heart, then we would have them run in place.

We would have them think about having a heart attack while they're running in place.

We do lots of things to induce the same situation that's going on during a panic attack.

And at the point where they think they've got to stop because they are, in fact, going

to have a heart attack, we say, "Let's go a little bit further.

Let's really test this out."

Now we do this in the office, and then we also have them be practicing it at home.

Maybe at first, they'll only practice it at home when someone else is in the house because

if I have a heart attack, then they can call the paramedics.

But eventually, we have them practice it alone so that they fully believe it.

And we track their confidence in how much do you believe theory one, "I'm having a heart attack"?

How much do you believe theory two, that "My heart is racing but this is not dangerous"?

What happens over time is they get to the point where they...

We keep working with them until they fully believe.

They've done enough experiments that they believe no matter how fast my heart races,

it doesn't cause me to have a heart attack.

At that point, the interesting thing is, not only do their daytime panic attacks stop but

if they have been experiencing nighttime panic attacks, those stop as well.

And we think that's because when we sleep, our brain monitors for danger, and if we really

believe that a racing heart means heart attack, as our heart rate goes up and down while we

sleep at night, someone with panic disorder with that belief actually will wake up with

a panic attack when they're heart rate goes up at certain points during the night.

When they no longer believe those things when they're awake, their nighttime attacks go

away as well, which is one of the kind of tests of the cognitive model of panic disorder.

How do you approach working with clients who experience panic attacks?

And what have you found to be effective?

I'd like to hear from you.

Please leave a comment below.

And thanks for watching.