Supplemental Material

Panic Attacks Workbook:

A Guided Program for Beating the Panic Trick

Contents

Self-Assessment Questionaire . . . . . . . . 2
AWARE Steps . . . . . . . . . . . . . . . . . . . . . 6
Panic Diary . . . . . . . . . . . . . . . . . . . . . . . .7
Panic Cycle Diagram . . . . . . . . . . . . . . . 9
Symptom Inventory . . . . . . . . . . . . . . . . 10
Self-Hypnosis Instructions . . . . . . . . .11
Additional Information . . . . . . . . . 12
 Self-Assessment Questionnaire

Write down your answers to the following questions:

1. Place a check mark beside each of the following symptoms you have experienced that developed abruptly
and reached a peak within ten minutes:
r palpitations, pounding heart, or accelerated heart rate K sweating
r trembling or shaking
r sensations of shortness of breath or smothering
r feeling of choking
r chest pain or discomfort
r nausea or abdominal distress
r feeling dizzy, unsteady, lightheaded, or faint
r derealization (feelings of unreality) or depersonalization (being detached from oneself)
r fear of losing control or going crazy
r fear of dying
r paresthesia (numbness or tingling sensations) K chills or hot flushes
r other ______________________

A panic attack is defined as a discrete period of intense fear or discomfort, in which four (or more) of the above
symptoms developed abruptly and reached a peak within ten minutes. With this definition in mind, look at
which symptoms you have checked above. Have you experienced one or more panic attacks?

r Yes r No

2. In all your experience with panic, have you had at least two panic attacks that came “out of the blue.” In oth-
er words, were these attacks you did not expect or anticipate because you were not in any kind of situation you
usually feared?

r Yes r No

(If “no,” go directly to 7. You don’t appear to meet the criteria for panic disorder.)

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
2
3. Did one or more of these panic attacks change your usual attitude and behavior for at least one month, in one
or more of the following ways?

a. worry about having additional attacks

b. worry about what an attack implies about you (for example, “going crazy”)
or might do to you (for example, heart attack or loss of control)
c. a significant change in your behavior because of the attacks, and fears of more attacks

r Yes r No

(If “no,” you don’t appear to meet the criteria for panic disorder; go directly to 7. If
“yes,” you appear to meet the criteria for panic disorder; check “panic disorder“ in the space below 15, then pro-
ceed to 4.)

4. Do you avoid going into certain situations, or engaging in certain activities, in an effort to avoid having anoth-
er panic attack?

r Yes r No

5. Are there situations or activities in which you will participate only if you can try to prevent a panic attack by
bringing either a trusted companion, or certain objects that reassure you, such as a cellular phone or a water
bottle?

r Yes r No

6. If you do not avoid any situations or activities, are there activities or situations in which you experience a great
deal of anxiety and fear about having a panic attack?

r Yes r No

(If you answered “yes” to any one of questions 4, 5, and 6, you appear to meet the cri- teria for panic disorder
with agoraphobia. If you answered “no” to all three questions, you appear to meet the criteria for panic disorder
without agoraphobia. Go to 15 and check the appropriate box, then proceed to 7.)

7. Do you experience a strong, persistent fear of situations in which:

a. you are exposed to unfamiliar people

b. you receive attention from others
c. you make some kind of presentation or performance for an audience K Yes K No
8. Do you fear that you will act in an embarrassing or humiliating way in these situations?

r Yes r No

(If you answered “yes” to both 7 and 8, proceed to 9. If you answered “no” to one or both, go directly to 13 be-
cause you don’t appear to meet the criteria for social phobia.)

9. Do you avoid such situations in order to avoid the anxiety? r Yes r No

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
3
10. Do you become highly anxious when you are actually in such a situation? r Yes r No

(If you answered “yes” to either 9 or 10, proceed to 11. If you answered “no” to both,
go directly to 13, because you don’t appear to meet the criteria for social phobia.)

11. Do you have responses to social situations, and the anxiety you experience about them, which interfere sig-
nificantly with:

a. your normal routine r Yes r No

b. your work or school performance c. your social activities r Yes r No

d. your mood in general r Yes r No

(If you answered “yes” to at least one of them, proceed to 12. If you answered “no” to all four, go directly to 13,
because you don’t appear to meet the criteria for social phobia.)

12. Do your fears include a wide variety of social situations, or are they focused on just one or two areas, such as
public speaking and introducing yourself at meetings? (Check only one.)

r a. a wide variety
r b. just one or two areas

(If you selected “a,” you appear to meet criteria for social phobia, generalized type.
If you selected “b,” you appear to meet criteria for a social phobia, specific type. Go to 15 and check the appropri-
ate box, then proceed to 13.)

13. Do you fear and avoid any fairly specific situation or object, such as:
K certain animals or insects (for example, spiders, bees, dogs, birds, snakes, etc.)

r storms, or aspects of storms such as thunder, lightning, wind, etc.

r heights
r water
r darkness
r blood or injuries
r injections and the equipment used for injections K medical procedures
r doctors or dentists K illnesses
r bridges
r tunnels
r flying

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
4
 r elevators
r driving
r enclosed spaces
r vomiting
r choking
r other ______________________

(If you checked at least one, proceed to 14. If you didn’t check any, go directly to 15. You don’t appear to meet
criteria for specific phobia.)

14. Do you experience this fear only when you have to face the situation you fear, or think about it? Or do you
experience it in situations that are entirely unconnected? (Check only one.)

r a. only when I face it or think about it

r b. could be anytime, anyplace

(If you checked “a,” you appear to meet the criteria for specific phobia; go to 15,
check the box for specific phobia, and list your feared situations or objects in that section. If you checked “b,” go
on to 15 without marking any more boxes, because you don’t appear to meet the criteria for specific phobia.)

15. Results of my self-assessment:

Panic disorder

r with agoraphobia
r without agoraphobia

Social phobia
r generalized type
r specific type

Specific phobia (identify feared objects or locations)

_____________________________________________
_____________________________________________
_____________________________________________

Your self-assessment indicates that you meet criteria for the anxiety disorders you checked above. There are still
some steps you need to take in order to establish a conclusive diagnosis. These steps are explained in Chapter 1.

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
5
 AWARE Steps

A: ACKNOWLEDGE & ACCEPT

I observe my symptoms of fear and work with them. I don’t try to ignore, deny, fight, or flee them.

W: WAIT & WATCH

I’m just a passenger. I observe and journal my thoughts and reactions while I wait to arrive at my destination.

A: ACT
I don’t need to make the fear stop. That will happen no matter what I do. I just need to wait. If I can make myself
more comfortable while waiting for the fear to pass, maybe with deep breathing or journaling, I can also do that.

R: REPEAT
When I experience repeated flurries of fear, I’ll just take these steps from the top.

E: END
The fear will end even when I think it won’t. All I need to do is wait, because I’m a passenger, not a pilot.

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
6
 Panic Diary

Panic Level (0-100): ____________ Time at start: ____________ Time at end: ____________

Physical Symptoms:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

What were you thinking just before your anxiety increased?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

What were you reacting to?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________
________________________________________________________________________________________

What scary thoughts are you having now?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
7
How are you responding to them?

r distraction r humor r charting r discussion with others

What are you saying to your scary thoughts?

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

What are you doing to make yourself more comfortable physically?

r deep breathing r stretching r getting up and standing r walking

relaxing muscles of: r chest r diaphragm r throat r shoulders r jaw

What works best for you? List, in order:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
8
 The Panic Cycle

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
9
 Symptom Inventory

Physical Sensations

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

Thoughts
_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

Emotions
_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r
_______________________________________________________________ r r r r r r r r r r

Behaviors

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

_______________________________________________________________ r r r r r r r r r r

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
10
 Self-Hypnosis Instructions

1. Begin by sitting comfortably (or lying down, if you prefer; in that case, elevate your
head slightly with a pillow). Sigh gently and use that exhalation to relax your shoulders and upper
body. Do your belly breathing for a few moments.

2. As you feel your breathing relax, begin to focus on a cue word, repeating it silently
and slowly on each exhale.

3. After a few moments of focusing on the cue word (maybe 6 to 12 repetitions, but
the number isn’t important), stop repeating the word and make the following suggestion to your-
self: “I’m going to let myself relax now.” Simply say or think those words to yourself in a permis-
sive way, without commanding or demand- ing anything.

4. Continue your belly breathing, count down silently and slowly on each exhale,
from 20 to 15.

5. At 15 or thereabouts, pause to give yourself another gentle sug- gestion. You might
choose to simply repeat the first one. If you have any special reason for this particular relaxation,
you could state it now, for example, “I’m going to let myself float through these panicky feelings.”
Use only positive, permissive sugges- tions. Avoid any suggestions that urge you to make any kind
of effort, to achieve a particular goal, or to stop doing something. (Examples of unhelpful sug-
gestions would be: “I’m going to try to relax more than ever before” and “I have to stop worrying
about the stock market right now!”)

6. Resume counting down on the exhales, from 14 to 10 or so.

7. At the count of 10 or thereabouts, stop counting. If you’re doing this exercise with
your eyes closed, open them now, look briefly to your right and your left, then close your eyes
again if you wish, and go back to Step 1, repeating the entire sequence again. (Or, if you’re doing
it with your eyes open, blink slowly several times, look briefly to your right and your left, and go
back to Step 1, repeating the entire sequence again.)

8. Go through the entire sequence three times.

9. After the third time, give yourself a final suggestion, something that fits your cir-
cumstances. If you’re ready to go to sleep, say something about sleeping comfortably. Or you can
give yourself a suggestion about the rest of your day—something like: “Now I’m going to return
my attention to the present, returning with an alert, focused mind in a more comfortable state,
looking forward to the activities of the rest of my day.”

WetwareMedia.com
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
11
 Audiobooks You May Enjoy
The Worry Trick
This audiobook is designed to
help you break the cycle of wor-
ry. Rather than encouraging you
to avoid or try to resist anxiety,
you’ll learn to see the trick that
underlies your anxious thoughts,
and what you can do about it.
Click to learn more at Audible.com
The Little Book of Big
Change
The no-willpower approach to
breaing any habit! If you want to
understand the science behind
your habit, make the decision to
end it, and commit to real, last-
ing change, this audiobook will
help you to finally take charge of
your life.
Click to learn more at Audible.com.
Supplemental Material for Audiobook: PANIC ATTACKS WORKBOOK by David Carbonell, PhD
from
WetwareMedia.com
Rewire Your Anxious Brain
The brain is a powerful tool, and
the more you work to change
the way you respond to fear and
anxiety, the more resilient you
will become. Learn to literally
“rewire” the brain processes that
lie at the root of your fears.
Click to learn more at Audible.com
The Sacred Hub
The power that holds the num-
berless stars in the vast heavens
is within us. This inspiring guide
will help you venture beneath
the conditioned mind into the
freedom and happiness of your
own innermost being.
Click to learn more at Audible.com
WetwareMedia.com
12
Calming the Emotional
Storm
Learn to cope with difficult
emotions calmly and responsibly
by using powerful skills from
mindfulness, CBT and DBT
therapy. This audiobook will help
you work through a crisis without
letting emotions take over.
Click to learn more at Audible.com
Art & Skill of Buddhist
Meditation
This audiobook offers a prac-
tical guide to building a strong
meditation practice by unifying
mindfulness, concentration,
and insight into a single, inte-
grated approach.
Click to learn more at Audible.com