Managing Panic Attacks with CBT in OKC
Panic attacks do not ask permission. They hit at the checkout line in Crest, on I‑235 at rush hour, or at 2 a.m. when the house is quiet and your chest feels anything but. In Oklahoma City, I meet people from every zip code who tell a version of the same story: a sudden surge of terror, a pounding heart, dizziness, a certainty they might pass out, die, or lose control. The episode subsides, but it leaves a bruise on your confidence. Then the fear of the next attack starts rearranging your life.
Cognitive behavioral therapy, or CBT, gives structure to this chaos. It is not a magic trick, and it does not erase life’s stressors. What it does, when practiced with intention, is restore a sense of predictability inside an unpredictable nervous system. In the hands of a skilled counselor, CBT becomes a playbook you can carry into work, church, parenting, and everything else that makes up a life in OKC.
What a panic attack is, and what it is not
Panic is a false alarm, a hardwired survival system misfiring at full volume. The body surges with adrenaline. Breathing quickens. Vision can narrow. The mind searches frantically for an explanation, often latching onto catastrophic thoughts: I am suffocating. I am going crazy. People will see me fall apart.
That last part matters. Panic attacks are uncomfortable, sometimes terrifying, but they are not dangerous. They crest and fall. The spike usually lasts 5 to 10 minutes, with aftershocks that can linger. People rarely faint because blood pressure tends to rise, not drop. The chest pain feels like a heart problem, but in healthy individuals under 50, emergency room evaluations often return normal. If you have new or unexplained symptoms, especially if you have cardiac risk factors, see your physician. Once medical concerns are addressed, CBT targets the cycle that keeps panic alive.
The cycle that feeds panic
When I map this out with clients, we draw three arrows in a loop: sensations, interpretations, behaviors. A sudden flutter in the chest triggers a thought like what if this is a heart attack. That thought accelerates fear. The body ramps up. You feel dizzier or more breathless. The threat seems confirmed. Then come the behaviors, sometimes subtle: you leave the aisle at Target, you scan for exits at church, you sit near a door in staff meetings, you keep a water bottle, mints, and a phone ready for “just in case.” Those behaviors reduce distress in the moment, but they silently teach your brain that ordinary sensations are dangerous. The next time, the loop spins faster.
CBT interrupts this loop at each point. We learn to reinterpret sensations, to ride the wave of adrenaline without catastrophic conclusions, and to change behaviors in a way that weakens fear rather than feeding it.
Why CBT fits the OKC lifestyle
Oklahoma City spans miles. We spend time in cars, on ball fields, in large venues like Paycom Center, and in sprawling churches. The spaces themselves can become triggers: long bridges on the Kilpatrick Turnpike, packed pews where slipping out feels conspicuous, elevators in medical buildings on Memorial. CBT is practical. It lets you practice skills in the settings that matter to you, not just in a quiet therapy room.
I often collaborate with clients to map their week: school drop‑offs near Lake Hefner, a job downtown, dinner at a busy restaurant, Bible study on Wednesday, a Thunder game on Friday. That map becomes a treatment plan. We do gradual exposures with what you already do, where you already live.
The building blocks of CBT for panic
We begin with education, not as a lecture but as a way to demystify symptoms. If you understand why your hands tingle during hyperventilation, the sensation loses some of its power. Next comes monitoring. Clients track episodes for a couple of weeks, noting triggers, thoughts, and behaviors. This is not homework for homework’s sake. The patterns we find shape the plan.
Two core tools then anchor the work. First, cognitive restructuring, which is a structured way to examine and replace catastrophic thoughts. Second, interoceptive exposure, which means we practice the bodily sensations of panic on purpose, in a controlled way, so they stop feeling like ambushes. Later, we add situational exposure, stepping back into places you have been avoiding. All of this sits on a foundation of skills like paced breathing, posture adjustments, and values‑based action so you are not only chasing symptom relief but also reclaiming what matters.
Getting specific with cognitive restructuring
The goal is not positive thinking. The goal is accurate thinking under pressure. When panic hits, thoughts tend to be fast, sticky, and absolute. We slow them down.
A client who drives the Broadway Extension tells me, If I get dizzy on the overpass, I will crash. We examine the evidence. Have you ever crashed during an episode? No. Have you driven while anxious and still kept the car in the lane? Yes, many times. What does dizziness from anxiety usually do? It comes and goes in 30 to 60 seconds. Is there an action you can take that is safe and lawful if needed? Yes, signal and take the next exit. We are not trying to eliminate fear, only to anchor to what is true and controllable.
People sometimes worry that challenging thoughts will jinx them, as if accuracy invites danger. I remind them that the brain is already predicting catastrophe. We are giving it a fair trial, not a pep talk.
Interoceptive exposure, the heart of the work
Interoceptive exposures are exercises that create physical sensations similar to panic. We do them to retrain your brain’s alarm system. Spinning in a chair for dizziness. Running in place to elevate heart rate. Holding your breath for a few seconds to mimic breathlessness. Breathing through a thin straw to feel resistance. The first times, we do these together in session so you learn to notice, name, and ride the sensations.
Here is the part that surprises people: we do not focus on deep breathing during the exposure. We aim to experience the sensations without rescue behaviors. You let the heart pound. You notice the alarming thought rise, then you let it pass. You do not check your pulse. You do not sit down immediately. Your body learns on a deep level that these feelings are tolerable and temporary.
We then assign brief daily practices at home, no more than 10 to 15 minutes. Over two to six weeks, most people see a significant drop in fear of the sensations, which weakens the panic cycle.
Situational exposure in OKC settings
Once bodily sensations feel less threatening, we step back into the places panic has colonized. A teacher who avoids staff meetings might start by sitting one row closer to the center, then two, eventually staying for the whole meeting without planning an escape. A parent who skips school assemblies might attend the next one, choosing a seat with moderate comfort, maybe middle aisle instead of back row.
Public spaces relevant here include busy restaurants in Midtown, the Costco warehouse, long lines at the DMV, and Sunday services that run 70 to 90 minutes. We build a ladder from easiest to hardest, then climb it steadily. The measure of success is not zero anxiety. It is your willingness to stay present and behave according to your values even when discomfort shows up.
The role of breathing and posture
Breathing advice is everywhere, and some of it backfires. Slow, steady exhalation is helpful because it signals safety to the nervous system. But forced “big breaths” can worsen dizziness by blowing off too much carbon dioxide. I teach a simple cadence: in through the nose for about 4 counts, out through pursed lips for about 6. The ratio matters more than the exact numbers. The exhale should be longer.
Posture helps. When panic hits, people hunch, tighten the jaw, and hold their breath. Uncross your legs, place both feet on the floor, let your shoulders drop, unclench your hands, and soften your gaze. This is not a cure, it is an anchor. It keeps you in a stance that supports stability and easier breathing.
What tends to get in the way
Three obstacles show up often. First, subtle safety behaviors. Carrying a bottle of water everywhere is not a problem, but taking a sip every 20 seconds to prove you are okay keeps the fear alive. Second, overmeasuring. Constantly checking heart rate or tracking every blip on a health app convinces your brain that danger is near. Third, all‑or‑nothing expectations. People say, If I still feel anxious, I failed. Not true. Anxiety is the visitor. Your job is to host it without changing your plans to suit it.
I ask clients to pick one or two safety behaviors to drop each week. Keep it gentle and deliberate. The goal is confidence, not punishment.
Faith, values, and Christian counseling options
Faith is a strength for many in OKC. When someone requests Christian counseling, we integrate Scripture and prayer in a way that supports the work. There is a difference between using faith as a safety behavior and drawing on it as a genuine resource. Repeating a verse to make the dizziness stop is a rescue strategy. Praying before a planned exposure and reminding yourself during the exposure that you are not alone aligns with values and courage.
I sometimes invite clients to pair a short breath with a brief centering phrase that reflects their beliefs, for example, Inhale, Here I am; exhale, Lord. The emphasis remains on facing the feared sensations and behaviors. The phrase organizes attention and connects the practice to meaning.
If faith is not your framework, we anchor to other values: being present with your kids, showing up fully at work, traveling again, or singing in the choir because music matters to you.
When panic intersects with marriage and family
Panic does not happen in a vacuum. Partners often change routines, take on extra driving, or avoid events together. That helps in the short term, but it can tighten panic’s grip. In marriage counseling, we coach both partners to respond in ways that support growth. The partner learns to resist rescuing while still conveying care. The person with panic learns to ask for the right kind of support.
A practical example: you and your spouse plan a date at a busy restaurant. You feel the familiar surge while waiting for a table. The old pattern has you leave immediately. A better pattern is to share a plan quietly: I am going to step outside for two minutes to let this pass, then I want to come back in. The spouse says, Got it, I am here if you need me. No pleading, no panic management huddle, no interrogation about symptoms. Two minutes later, you both return. That small victory matters more than you think.
Parents often worry about how panic affects children. The best message for kids is simple and truthful: Sometimes my body gets revved up, but I am okay, and I know how to handle it. Then show them you can stick with the soccer game or the school play even if you feel wobbly for a bit.
Medication and CBT, not either/or
Many clients arrive already taking an SSRI or as‑needed benzodiazepine prescribed by their physician. Others have avoided medication entirely. My stance is practical. SSRIs can lower the baseline anxiety and reduce attack frequency over 4 to 12 weeks. That often makes CBT easier to engage. Benzodiazepines can help in acute moments, but they can also undermine exposure work by blunting the learning. If medication is on the table, coordination between your counselor and prescriber improves outcomes.
I have seen strong results both with and without medication. The common factor is consistent practice of CBT strategies in real settings.
What progress looks like
Progress is rarely a straight line. Early on, you may notice attacks feel the same in intensity but shorter. Then the gap between episodes widens. Fear of fear softens. A month in, clients often say, I still get spikes, but I do not reorganize my day around them. That is a major milestone. Later, we aim for skill maintenance. You keep a light practice of exposures, like a runner who keeps a base level of fitness.
Relapses happen, usually after big stressors or health events. We plan for them. The plan is not heroic. It is a short checklist you know by heart.
- Notice early signs without rushing to fix them, label it as a false alarm. Drop one safety behavior on purpose, even a small one like changing seats less. Do one interoceptive exercise that day, brief and deliberate, to remind your brain you can handle it. Return to a recent exposure spot within 24 to 48 hours, even for a short visit. Reconnect with support, whether your counselor, spouse, or pastor, to name the setback and reset.
Clients who keep this plan handy recover faster from flare‑ups and avoid sliding back into avoidance.
A brief case vignette from the city
A project manager from Edmond started counseling after two roadside pull‑offs on the Kilpatrick. She stopped using the turnpike and added 25 minutes to her commute. In session, we practiced running in place, straw breathing, and spinning. She rated her fear, rode it, and watched it fall without doing anything to make it stop. We then planned a graded return to the turnpike, first driving frontage roads parallel to the route, then entering for a single exit, then two, eventually the full span over two weeks.
She texted after a morning drive, no details, just a photo of her coffee in the cupholder and the dashboard clock. Her message was clear. The avoidance had ended. Later, when a new spike hit in a conference room, she used the same skills, changed nothing about her participation, and the spike passed.
The important part is not the turnpike. It is the principle. You practice on purpose so you can live on purpose.
Finding a counselor in OKC who fits
Training matters. Ask potential counselors about specific experience with CBT for panic and whether they use interoceptive and situational exposure. Listen for a plan that includes assessment, skills training, and real‑world practice. It is okay to ask about session structure and how progress gets measured. If you prefer Christian counseling, ask how faith is integrated without replacing evidence‑based techniques.
Fit matters just as much. You need someone who is steady, direct, and collaborative. Panic therapy is active. The counselor should be willing to leave the chair when needed, to walk hallways, take the elevator, sit in a crowded lobby, or role‑play a tough conversation. Sessions typically run weekly for 8 to 16 weeks, with adjustments based on your pace.
How to start your own practice week
Begin with two small commitments. First, set a daily 10‑minute practice window. Use it for one interoceptive exercise and a short thought record. Second, choose one avoided situation to re‑enter at the easiest level, stay for a defined time, and resist the urge to escape early. Keep a simple log of what you tried, what you felt, and what you learned. Share it with your counselor at the next meeting.
Expect discomfort. That is not a sign of failure. It is the curriculum.
What not to do when panic flares
When panic surges at work, the most tempting move is to leave abruptly. There are times to step out, especially if you need a private minute. But disappearing repeatedly cements the belief that leaving saved you. Another common misstep is crowdsourcing reassurance, texting five people for safety checks. That gives short‑term relief and long‑term dependency.
People also overcorrect their health behaviors. They cut all caffeine and sugar, start rigid sleep routines, buy supplements and gadgets. Some moderation helps, especially with coffee if you are sensitive, but most of the progress will come from changing your relationship to sensations and thoughts, not from perfecting lifestyle variables.
When panic rides along with other issues
Panic often travels with generalized anxiety, depression, or trauma. Each adds layers. If you have trauma history, exposure work is still possible, but the pacing and targets shift. We avoid flooding the system. If depression has sapped motivation, sessions may include behavioral activation to rebuild momentum. If you struggle with health anxiety, we balance medical prudence with reduced checking. None of these are dealbreakers. They just mean a more thoughtful map.
A word about cultural fit and community
OKC has a mix of small‑town warmth and metro sprawl. You can walk into a counseling office and see someone you know from church or your kid’s school. If privacy feels tricky, ask about appointment timing, entrances, or telehealth options. Virtual CBT works, especially for panic, because exposures happen where you live. I often coach clients through a grocery run or a parking garage walk via phone or video, then debrief after.
Community helps. When appropriate, I encourage people to tell one or two trusted friends what they are working on, not to get rescue texts but to normalize the project. A friend who says, If it hits during the concert, I will sit with you and we will ride it, is better than three friends on speed dial promising to pick you up.
What success gives back
Panic steals time and possibility. Success returns them. You can take the longer route because the view on the bridge is worth it. You can stand through a worship set because the music matters more than the flutter in your chest. You can sit in a quarterly meeting and pay attention to the numbers instead of the what‑ifs. The attacks may not vanish entirely. Many clients still feel a quick surge a few times a year. The difference is how little those surges mean. They come, you notice, you breathe with the longer exhale, you stay aligned with your plan, and you move on.
It is not only about symptom reduction. It is about reclaiming agency. When I hear a client say, I had a wave in the cereal aisle and kept shopping, that is professional music to my ears. Recovery is built out of specific, ordinary wins.
If you are ready to begin
If you are in OKC and panic has been running the show, reach out to a counselor trained in CBT. If faith is central to your life, ask for Christian counseling that honors both your beliefs and evidence‑based care. If panic has strained your relationship, invite your spouse into a session or two so you can align on the plan. Give the process six to twelve weeks of consistent effort. Keep the practices small and daily. Expect discomfort and notice how it loses its bite when you do not bargain with it.
You do not have to wait for a future without panic to start living. The irony of this work is that freedom grows fastest when you stop chasing certainty and start practicing courage in the middle of uncertainty. Oklahoma winds are strong, but they pass. So do panic surges. With the right approach, you can let them blow through while your feet stay planted where you want to be.
Kevon Owen - Christian Counseling - Clinical Psychotherapy - OKC 10101 S Pennsylvania Ave C, Oklahoma City, OK 73159 https://www.kevonowen.com/ +14056555180 +4057401249 9F82+8M South Oklahoma City, Oklahoma City, OK
