Solving fear of fear as therapy for panic attacks is the most important pillar in treatment of anxiety and panic.

Anxiety: solving it

There are simple self-help techniques to gain control over anxiety and thereby solve the problem. Surprisingly, many people who have learned to solve the anxiety, stay worried. Even though they do no longer have anxiety or can easily reduce their anxiety, many continue to be restless.

Fear of fear

We call this unrest "fear of fear". They no longer have anything to be anxious about, but they anticipate in their mind that there is a possibility for anxiety or a panic attack to return. For these people, explaining to them that their problem is not anxiety itself, but rather the fear of fear - the anticipation anxiety - is important. This way they learn to see that they should not only have their anxiety as the goal of therapy. They should also deal with their fear of fear, so that they can get fully rid of any panic attack or anxiety they might suffer from.

Therapy for panic attack and anxiety

As shown above, therapy for anxiety disorders should include techniques to reduce anxiety as well as techniques to take care of the fear of fear. Techniques to conquer anxiety or reduce it exist in many shapes and forms: breathing techniques, yoga, meditation, autogenous training, self-hypnosis, anti-worrying exercises, and so on. All these techniques are useful. In my practice as a physician, I notice that it is very important that the doctor or therapist is flexible, and together with the patient looks for the techniques which are most suitable for their personal situation. In the online self-help program "", the software program assists people in making this choice. They can then try different types and evaluate what works best in different situations.

Cognitive solution focused therapy for anxiety and panic attacks

Solution focused therapy, as well as cognitive solution focused therapy, helps the patient to find confidence in that there are solutions which can be learned. Furthermore, this type of therapy help anxious people to find small yet useful solutions within their own lives and environments. Often they already know of some solutions which help, but have simply forgotten about them. The solution focused questions asked by the doctor or therapist can help the sufferer of anxiety to rediscover these small solutions themselves.

Cognitive behavioral therapy(CBT) for anxiety and panic attacks

Cognitive behavioral therapy (CBT), developed by Aaron Beck, helps anxious patients to recognize and work through the negative and worrying thoughts which (subconsciously) cause the panic attacks, stress, and anxiety. The therapist will help the patient to "defuse" these negative thoughts and will also help the client in finding more valuable thoughts which do not lead to anxiety or panic. Afterwards, the patient will be requested to practise these positive thoughts and to train themselves in finding negative thoughts which need to be invalidated.

Rational Emotive therapy (RET or REBT) in anxiety disorders

Rational emotive therapy (RET or REBT), developed by Albert Ellis, generally does the same which CBT does. There are small differences in the method compared to the former, but they work via the same principles on a fundamental level.

Hypnotherapy for anxiety and panic attacks

Hypnotherapy is very efficient to get rid of acute anxiety quickly. The effect of a one-time direct hypnosis has an effect of about 48 to 72 hours. Afterwards, the effect slowly disappears, unless it is supplemented with self-hypnosis or other therapeutic interventions. It is thus an ideal technique for concrete situations like performance anxiety prior to an exam, presentation or job interview within 48 hours. Self-hypnosis is a powerful tool to teach a client to stop their anxiety themselves with the help of  self-hypnosis exercise.

Stress guidance with the therapy of anxiety disorders

It is clear to see that most anxious people also seem more tense. They speak more quickly, their muscles are tensed up. Even if many of them tell you they are not stressed. They do not always experience their tension as tension. That is why the free stress meter on this website is so useful: you can quickly evaluate if you have any form of stress, with the help of just 21 short questions. Feel free to test yourself sometime! By learning techniques to lower the general level of tension, the amount of anxiety attacks and the intensity of the panic decreases. It is recommended to integrate stress guidance and therapy.

A flexible therapeutic approach to treat anxiety and panic attacks

Personally, I usually want to approach people with anxiety with solution focused therapy, as it is friendlier, softer, and leads to good results with many people. In case I feel like negative thoughts continue to follow the patient, I move on to cognitive behavioral therapy. The one type of therapy puts more focus on the client finding their own solutions, while the other has a more rigid program of what to focus on first among the negative jammers, to then reformulate these in a positive way. In both cases, I usually also make use of anti-worrying exercises or self-hypnosis exercises as well as an amount of basic principles of healthy stress management. This flexibility is important. In general, people with anxiety are naturally less flexible, so it helps to have a doctor or therapist who is. This same flexibility has been built into the development of the online self-help program which offers online therapy for anxiety disorders.

Online self-help program and guidance with anxiety and panic attacks

More and more people look for solutions for their anxiety problems via the internet, in the shape of online self-help and guidance. The positive part of self-help is very clear: the patient heals themselves. They prove to themselves that they - often even anonymously - can overcome their own problem. The self-help program then has the role of a compass and map, which guide you through the land of healing. "" is probably the first online self-help program which flexibly integrates the advantages of different types of therapy in this way.

Self-test for anxiety or panic attack

Would you like to know to what extent stress, tension, anxiety, or even depressed feelings play a role in your panic attack? Then easily test this by answering a test with 21 short questions.

Paul Koeck, MD