Relaxation to Divert a Panic Attack (by Diana)

This relaxation script is by Diana. It is an exercise for diverting a panic attack, and involves a scenario that describes anxiety over learning to memorize a prayer.

Disclaimer: If you have chest pain, see a doctor. This relaxation script provides assurances that the chest pain experienced with panic is not a heart attack. DO NOT assume that your chest pain is not a heart attack without first seeking medical attention. Only use this relaxation script if you have received medical confirmation that your chest pain is related to panic and not to any other medical condition. 

The relaxation to divert a panic attack script begins here.

Let’s take a few moments to relax, and then we will look at 1. The event that starts the panic. 2. Awareness of signs of a panic attack. 3. the focus object – narrator’s voice. 4. The assurance of calm and what mastery over the panic is like. 5. the ending that makes you not fear relaxation being over.

Before we discuss each of these things, take a few moments to just relax.

[Include a progressive relaxation exercise here.]

Situation: Let’s pretend you are seeing a spiritual teacher and you are praying out loud saying the very well-known prayer, “Our father who art in heaven. Hallowed be thy name.” Then you remember that some people say a short version of this prayer and a long version and you don’t know which one to say. Some people finish the prayer “deliver us from evil.” Others say, “Thine is the kingdom, power, and glory forever.” at the end. You are memorizing the prayer but don’t know which version to go by so you panic.

Awareness of symptoms: Imagine that the skilled person says, “As you are reciting this prayer I notice that you are looking flushed and breathing quickly.” You complain, “My heart’s pounding in my chest. My chest and ribs are hurting when I take a deep breath. I can’t get enough air. I’ve heard this prayer in church or school and I wonder if I’m there instead of in meditation with you, Spiritual teacher. What if I’m going crazy?”

You may think the panic is over the verses of the Our Father and you may be afraid to hear it spoken or of saying it out loud. This is how your mind is trying to make sense of what’s happening in your body. The problem to solve is the panic sensations themselves. You may feel thirsty. If you need any water, pause the script and get some and return to listening.

The focus object: The teacher or narrator’s voice saying, “If you are having trouble because you feel overwhelmed by what you feel in your body listen to the sound of my voice. Is my voice low or high, soft or loud, male or female. Continue listening to what I’m saying. You are aware of my voice. I’m getting you through what’s troubling you right now. It’s okay.

Reassurance: This is a panic attack. People who are having a heart attack get chest pain but it’s only on their left side where their heart is. They do not have the increasing anxiety but are aware of their pain. People who have a panic attack feel their chest pain throughout their whole chest, and it may hurt to breathe, but the best thing to do is to keep breathing. The “what if” thoughts or fears of going crazy will go away soon. I’ll wait for you to feel better before we continue reciting the prayer. While you are breathing slower and more evenly now and your heart beats slower while I talk I’ll tell you some affirmations that are true. Please listen to the sound of my voice. My voice is stronger than your physical sensations you are feeling because you are in meditation with me. No one has ever died of a panic attack, and you cannot die from yours either. This is not an asthma attack. It may feel like one because of tightness or pain that you are feeling. It is a panic attack, and it will go away by using relaxation. Keep listening. If you can think of nothing else, think about the narrator’s voice.

Affirmations about your hands: Now I’d like you to rub your hands together. Feel the friction of your hands rubbing together. Hear the whooshing sound of your hands. Now a second time try rubbing your hands together but with lotion. It will feel different and it will sound different to you. Feel how soft the lotion makes your hands feel. Smell the lotion as you rub it into your hands. Feel how warm and heavy each of your fingers is when you rub the lotion on each finger. This is relaxation. This is what the beginning of progressive relaxation feels like. It feels so good. Now clench your right hand into a fist, then let it go. Feel the heaviness and warmth in your fingers. It may feel like the numbness you can get from a panic attack, but this sensation is different. It is because you did an action that starts a relaxation routine. Now clench your left hand into a fist, then let it go. Feel the same warmth and heaviness. Now clench both hands into fists, and let them go.

Affirmations about relaxation: People who are very skilled at relaxing at will learn 3 things. They learn how to relax…learn what relaxation feels like…and learn what exercises are effective to bring the relaxation response to their bodies. The relaxation response is slow and even breathing, regular and steady heartbeat, pleasant warmth and heaviness in arms and legs, and what it feels like for their mind to be free of repetitive worry thoughts. People don’t learn to control physical responses that are automatic. They learn how they feel when they are relaxed. They teach their minds and bodies to give them that feeling through practicing what relaxation feels like for them. They learn what changing from a fast to a slow heartbeat feels like and what the difference is between shallow quick breathing and deep slow breathing.

Now I see that you are calmer. Would you like to continue the prayer you are learning?
Then let us recite the following memory aid: Let it be holy, let it come, let it be done, give, Forgive, lead us not, deliver us. These are the main actions we ask for in the “Our father.” This is how you can learn the second part of the prayer.
Imagine that your spiritual teacher is reading the prayer out loud:

Our Father who art in heaven,
Hallowed be Thy Name.
Thy Kingdom come.
Thy Will be done
on Earth as it is in Heaven.
Give us this day our daily bread,
and forgive us our trespasses,
as we forgive those who trespass against us,
and lead us not into temptation,
but deliver us from evil.
For Thine is the Kingdom,
and the Power, and the Glory,
for ever and ever.
Amen.

Now your spiritual teacher tells you: “this is how you know when you’ve overcome a panic attack. You do an activity and it produces no physical symptoms of a panic attack because you’ve replaced the panic with relaxation. It is physically impossible to panic and do a relaxation exercise at the same time. In this example the panic and replacement is over your memorizing of the Our Father prayer. If you can say it in your head or out loud without the palpitations or the difficulty breathing or the chest tightness, that is mastery. That is a 5 or below on an anxiety scale of 1-10. A relaxation exercise like this one is a negative 1 or above in the negative numbers, the thing that cancels out anxiety. Anxiety starts if you feel some uneasiness, and it can start with worrying thoughts, quickened breathing or heartbeat or blushing. It may start the next time you meditate but the relaxation you are doing now will be the same routine that you do the second time you meditate, and it may feel very similar to this. It will work even if you don’t feel any different at all. The key is practicing every day because relaxation is a skill to learn. When you notice the anxiety sensations or worried thoughts coming you can learn to replace this response with calm breathing and the beginning of progressive relaxation that starts with rubbing your hands together. Please rub your hands together one more time before I pause and let you reflect on your spiritual meditation. The next time you hear my voice I’ll tell you how you can use your mind to bring the relaxation response.”

(Pause)

“Your whole body can relax deeply because there is nothing you need to do…besides a feeling of relaxation…and nowhere to be…except relaxing…the only thing you need to do and be is to relax deeply and comfortably and to drift just to drift and relax happily…enjoying a relaxed feeling that is so easy to create and so natural that you may even begin thinking about relaxing even more. And this may even begin to occur right now as you notice that you are relaxing. And soon you may notice that you are becoming deeply relaxed. And this might start now and it might start a moment from now or it might have already begun. And you may just feel as if you want to relax now…or you may decide to just drift pleasantly and not even think about relaxing…you may not even decide to relax now or later but you just find that it is so comfortable and pleasant to just be right here in this moment now and so relaxed.”

“You will hear the sound of my voice a little longer. Let’s do a passive progressive relaxation as a reminder of the calmness that you feel right now as I have turned your panic attack into relaxation. You can learn to do this yourself by listening to this exercise every day. As I say a name of a part of your body and then the word “relax” you will feel that part relax. “Relax” is a cue word. First, we’re going to do one part of active progressive muscle relaxation to feel the difference between tension and relaxation in your hands.”

“To feel the tension. 1. Squeeze your right hand into a fist. Hold. Then let it go. Feel the relaxation going down each finger and thumb. 2. Squeeze your left hand into a fist. Hold. Then let it go. Feel the relaxation going down each finger and thumb. 3. Press your palms together. Hold. Feel the tension in your arms, wrists and your hands. Then let your hands drop to your sides. Feel the relaxation spreading through your arms, wrists and hands. 4. Clasp your fingers together so that when you pull you are pulling your right hand to your right side and your left hand to your left side but your fingers are keeping you from dropping your arms to your sides. Hold but do not strain. Then let your fingers go all at once and feel the relaxation in each finger. 5. Now rub your hands together. Hold. then stop and feel how relaxed your fingers and hands are.”

“Take a slow and even breath…feel your collar bones widen slightly and your whole ribcage expand as you inhale. Then feel the tension leave your body as you exhale…”

“Breathe…relax.”

“You may feel your shirt with a collar move as you breathe… or you may feel the cool air on your collar bones when you breathe when you are wearing a shirt with no collar. Both of these sensations are normal even if they may be new. Focus on your head…relax. Your face…relax.”[Continue to name each part of the body and relax all the way down to your toes.]

“You may feel a little sleepy…especially if you haven’t relaxed before. That’s okay.”

“Now you are finished with this exercise. You can memorize this feeling. Wiggle your fingers and toes. Move around to wake up sleepy muscles. Make a resolve to write down a reminder or put it in some spoken form like an iPhone so it will tell you to do “progressive relaxation” each day. You can know that when you have a panic attack it can be stopped by body awareness, reassurance, breathing, and relaxation. You needn’t worry that since the exercise is ended for this time that relaxing has gone away. You can finish this exercise feeling calm knowing that you will come back to it when you need to. This is a necessary part of your day just like drinking enough water is. Your reminder that you have made will beep at you or speak to you as a prompt for you to return to this exercise.”

“You cannot panic and relax at the same time because your body only lets you do one or the other. Worry is like panic, and praying is like relaxing. It is mentally impossible to worry and pray at the same time. Your prayer cancels out your worry because in processing your prayer your mind can’t worry. This is how treatment for panic and worry can be effective when you are blind and you have both problems to solve. Happy relaxing. Happy praying.”

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