Answers to 10 Most Frequently Asked Questions

What Do I Do in the Moment of Panic?

There is no easy answer to this question. That's because there is no magic ritual to stop a panic attack in the moment. For most people, the ability to stop a panic attack is developed over time.

When a panic attack hits, you literally don't have time to think. A tiny part of your brain called the amygdala activates your body's natural fear
response faster than your cerebral cortex can process a conscious thought.

That's why you need a way to stop the panic that doesn't require thinking, and that you can prepare ahead of time. To stop panic in the moment, you need a conditioned, automatic reflex to counter it
with. I call this reflex the "relaxation reflex."

"How do I develop a relaxation reflex?"

To develop a relaxation reflex, repeat the same word over and over while you practice your breathing and muscle relaxation exercises. If you
do this over time, you will teach yourself to associate a state of deep relaxation with your cue word. Then, whenever panic strikes, you can say your cue word and your body will respond with relaxation.

The relaxation reflex gives you the ability to relax on command in most any situation, without having to go through elaborate breathing and
relaxation exercises.

"How do I know the relaxation reflex will work?"

The science behind the relaxation reflex comes from classical conditioning experiments conducted in the late 1890s by Russian psychologist, Ivan Pavlov. Pavlov trained a dog to salivate at the sound of a bell. He began by ringing a bell right before the dog received food. After numerous
repetitions, the dog would salivate at the sound of the bell, even in the absence of food.

Just as Pavlov could train a dog to salivate at the sound of a bell, you can train yourself to relax at the sound of a cue word. I can attest to
this from personal experience.

In my recovery from agoraphobia, I worked hard to develop a conditioned relaxation reflex. I repeated the word "relax" every time I exhaled during breathing practice or released the tension from a muscle group during progressive muscle relaxation. I used a written script to guide me through the relaxation process, which my mom read
to me at least twice a day. My goal was to train myself to associate the word "relax" with a state of complete calm.

My experiment with classic conditioning worked! It took daily practice over several months, but I conditioned my body to relax on command.
Conditioned reflexes like the relaxation reflex are very powerful and can stay programmed in the wiring of your brain for a very long time.

In December of 2006, amidst holiday crowds in a Southern California mall, I felt a panic attack coming on for the first time in years. I began to
hyperventilate. My hands and face began to tingle, and the shopper's faces became blurry. I sat on a bench, closed my eyes, and repeated the word "relax" over and over to myself. Nearly twenty years after I created it, my relaxation reflex kicked in. The panic attack subsided and I was
able to resume shopping. That's the power and permanence of the relaxation reflex.

People regularly ask me if I think I could ever slip back into agoraphobia. I always say no without hesitation, because I will always have the
power to stop anxiety in my body before it spreads into full-blown panic - thanks to the relaxation reflex.

You, too, can develop a relaxation reflex to stop panic attacks just as I did. It may take daily practice over a period of several months (or more), but once you develop it, you'll have a conditioned reflex in your body to call on in the moment of panic that is strong enough to overcome the fear response every time.