What to Do If a Client Experiences a Panic Attack during a Session

By Kimberley Quinlan, LMFT

When a client begins to panic in session, it can be easy to get triggered yourself. You may notice the urgent desire to rescue them from their discomfort in fear that they will blame you for triggering them, or in fear that they will associate therapy with extremely uncomfortable emotions. Here are some tips to help you when your client experiences a panic attack during a session:

· Tip #1: Remind yourself that their panic will rise and fall like a wave of the ocean. Resist the urge to try and intervene, as this will take away an opportunity for them to practice riding the panic wave on their own. If you intervene, reassure, or coach them too much, they will leave the session believing they need you every time they panic. Think of yourself as the flight steward. If you model being calm and confident in the client, they will be more likely to be confident in their ability to ride the wave of a panic attack.

· Tip #2: Educate the client on what they might experience. You might say, “It seems you are having a panic attack. I am right here with you, but I want you to know that the sensations you are feeling are temporary. They will rise and fall on their own. There is nothing you need to do except be patient and kind. Let’s practice not resisting these sensations, as that will likely only make it worse.” You might gently smile at the client and sit with them as the sensations wax and wane.

· Tip #3: Try your best to continue with the session’s agenda. Was there homework you needed to check in on? Did the client have any questions? Resist the urge to let the panic attack hijack the session. This will model to the client that we don’t let fear get in the way, and we always do our best to continue with behaviors that line up with their values.

· Tip #4: Celebrate! Never miss an opportunity to celebrate our clients’ wins! Congratulate them on getting through the session while experiencing a panic attack. Validate how hard it was for them and reflect how they successfully rode a wave of a panic attack in real time. You might also say, “That was quite something! Now you know that you can have a conversation while having a panic attack.”

Kimberley Quinlan, LMFT, is a psychotherapist in private practice specializing in the treatment of obsessive-compulsive disorder (OCD) and related disorders. She has been practicing meditation and mindfulness for many years, and has a special interest in the integration of mindfulness and self-compassion principles with cognitive behavioral therapy (CBT) for OCD, anxiety disorders, and eating disorders. Kimberley is host of the Your Anxiety Toolkit podcast, and founder of www.cbtschool.com—an online psychoeducation platform for OCD, anxiety disorders, and body-focused repetitive behaviors (BFRBs). Quinlan is known for her vibrant and mindful approach to mental health issues, and is an expert presenter and support group facilitator for various conferences worldwide. She has been featured in many world-renowned and prestigious media outlets, including the Los Angeles Times, The Wall Street Journal, and The Washington Post; and has consulted on various mental health issues for programs such as ABC’s 20/20.