Can an online session help with symptoms of anxiety that mirror sensory-motor OCD / trauma?

Cognitive-behavioral therapy (CBT) and other types of counseling can often help people who have panic attacks and who have panic disorders. CBT aims to help you change the way you see challenging or frightening situations and to help you find new ways to approach these challenges as they arise. You can find CBT for individuals or groups, online or face-to-face, and the length of treatment can also vary. In exposure-based CBT, your therapist will expose you to something that can trigger a panic attack and help you work your way through it. As well as changing behavior, there is some evidence that CBT might affect structures in your brain that are responsible for panic symptoms.

By recognizing that you’re having a panic attack instead of a heart attack, you can remind yourself that this is temporary, it will pass, and that you’re OK. Take away the fear that you may be dying or that impending doom is looming, both symptoms of panic attacks. This can allow you to focus on other techniques to reduce your symptoms. It is not always possible to avoid triggers for a panic attack, but if you know what triggers it, this can help you understand that it is a panic attack and not something else.

Some panic attacks come from triggers that overwhelm you. If you’re in a fast-paced environment with a lot of stimuli, this can feed your panic attack.To reduce the stimuli, close your eyes during your panic attack. This can block out any extra stimuli and make it easier to focus on your breathing.

Mindfulness can help ground you in the reality of what’s around you. Since panic attacks can cause a feeling of detachment or separation from reality, this can combat your panic attack as it’s approaching or actually happening. Mindfulness involves: focusing your attention on the present, recognizing the emotional state you’re in, and meditating to reduce stress and help you relax. Focus on the physical sensations you are familiar with, like digging your feet into the ground or feeling the texture of your jeans on your hands. These specific sensations ground you firmly in reality and give you something objective to focus on. Experts say that mindfulness strategies, such as meditation, can help manage anxiety symptoms, although it’s not clear they can treat an underlying anxiety disorder.  

Some people find it helpful to find something to focus all their attention on during a panic attack. Pick one object in clear sight and consciously note everything about it possible. For example, you may notice how the hand on the clock jerks when it ticks, and that it’s slightly lopsided. Describe the patterns, color, shapes, and size of the object to yourself. Focus all your energy on this object, and your panic symptoms may subside.

Muscle tension is a symptom of anxiety, and muscle relaxation techniques can help reduce tension and promote relaxation during an attack. Progressive muscle relaxation aims to release tension in one group of muscles at a time to relax the whole body. Much like deep breathing, muscle relaxation techniques can help stop your panic attack in its tracks by controlling your body’s response as much as possible. If you attend muscle relaxation therapy, your therapist might take you through the following steps:

• First, you may learn how to tense the muscles before releasing the tension.
• Then, you will learn how to relax the muscles without tensing them first. 
• You may also learn how to relax specific sets of muscles, for example, in the shoulders, for practical use in everyday situations.
• Finally, you may learn how to practice rapid relaxation, when you can identify any areas of tension and release it as needed.
• To start relaxing your muscles at home, consciously relax one muscle at a time, starting with something simple like the fingers in your hand, and move your way up through your body.  Muscle relaxation techniques will be most effective when you’ve practiced them beforehand.

Picture your happy place: Guided imagery techniques can help reduce stress and anxiety. Research suggests that both spending time in nature and visualizing nature can help treat and manage anxiety. What’s the most relaxing place in the world that you can think of? A sunny beach with gently rolling waves? A cabin in the mountains? Picture yourself there and try to focus on the details as much as possible. Imagine digging your toes into the warm sand, or smelling the sharp scent of pine trees.

Research shows that regular exercise can not only keep the body healthy, but boost mental well-being, too.  Experts have found that exercising at 60 to 90 percent of your maximum heart rate for 20 minutes three times per week can help reduce anxiety.  If you are not used to exercising, talk with your doctor before starting. There is some evidence that starting aerobic exercise anew can trigger additional anxiety in people with an anxiety disorder. Building up gradually can help your body adjust and avoid breathing problems. Aerobic exercise includes activities such as running on a treadmill.  If you feel stressed or you’re hyperventilating or struggling to breathe, stop and take a rest or choose a more moderate option, such as walking, swimming, or yoga.

Repeating a mantra internally can be relaxing and reassuring, and it can give you something to grasp onto during a panic attack. Whether it’s simply “This too shall pass,” or a mantra that speaks to you personally, repeat it on loop in your head until you feel the panic attack start to subside.

I most often utilize CBT modalities and have found that this can consistently be an effective modality for treating anxiety (particularly anxiety triggered by anniversaries or specific dates).