An effective cognitive behavioral technique for those suffering from panic attacks makes intentional use of the breath. Persons who suffer from panic attacks tend to hyperventilate (shallow, rapid breathing) when stressed, which may trigger heart palpitations that they then misinterpret in a catastrophic manner (e.g., believing they are dying, are going to pass out, are losing their mind). Engaging in a “focused breathing” exercise – slowing inhaling and exhaling through the nose (with the mouth closed!) – can help to calm the person experiencing sensations of panic. As the hyperventilation is brought under control and the breathing returns to normal, the panic episode may dissipate within several minutes. In this way, individuals prone to panic attacks learn the effectiveness of breath control, and the association between the sensations of panic and breathing.
Logotherapy was developed by Viktor Frankl, a holocaust survivor of Auschwitz and Dachau concentration camps. In contrast to psychoanalysis, which is heavily retrospective and introspective, logotherapy is a meaning-centered psychotherapy that is focused on the future and the meanings to be fulfilled by the individual in his or her future, regardless of what the past has encompassed. The term itself has its origins from the Greek word Logos, or meaning. Frankl’s Logotherapy was part of The Third Viennese School of Psychotherapy with its focus on the meaning of human existence and the individual’s search for meaning to his/her existence, and its de-emphasis on the the „vicious-circle formations and feedback mechanism which play such a great role in the development of neuroses.“ Striving to find meaning to one’s existence is thought to be the primary motivational force in humans, which according to Frankl, can contribute significantly to breaking up the self-centeredness of the neurotic.
Mervin Smucker [Summarized from Frankl, Viktor (1984). Man’s Search for Meaning: An Introduction to Logotherapy.]
A combination of prolonged exposure has sometimes been used in combination with stress inoculation training to treat adult trauma victims suffering from posttraumatic stress (Foa et. al., 1991). This combined approach involves an initial 2-hour evaluation followed by eight weekly sessions (1.5 – 2.0 hours each) that include: (1) education about the normal reactions to assault, (2) breathing training, (3) three types of relaxation training, (4) reliving the assault (imaginal exposure), (5) confronting current feared, but safe, situations (in vivo exposure), (6) cognitive restructuring regarding attributions and beliefs about the assault, (7) assertiveness training via role-play, (8) covert modeling and (9) guided self-dialogue. Following the end of each session, homework is assigned which involves instructing the patient to listen daily to the audio recording of the session and to record their subjective units of distress (SUDS) on a homework sheet, which is then brought to the next therapy for review.
Mervin Smucker, Ph.D., is an international trauma consultant and author of numerous articles and books on trauma and cognitive-behavioural therapy interventions.