Panic Attack: Reduced Breathing and Mini-Pace Progression

Overview

  • Purpose: Use gentle breath-hold and reduced breathing to increase CO$_2$ tolerance and reduce the feedback from air hunger that can fuel panic symptoms.
  • Goal: provide a simple, progressive tool that helps people prone to panic attacks make measurable progress without triggering strong fear.

Core Technique: Reduced Breathing (Breath-Hold)

  • Step: normal breath in through the nose, normal breath out through the nose, pinch the nose and hold, walk forward for 10 paces, then walk back.
  • After the hold: release and breathe through the nose, staying in regular nasal breathing for about 30\ s (approximately 0.5\ \text{min}).
  • Rationale: incrementally expose to air hunger to train tolerance; air hunger can amplify symptoms if pushed too hard.

Dose Variations

  • Shorter dose option: reduced breathing for about 30\ s, then normal breathing for about 60\ s, and repeat as needed.
  • Dosing can be adjusted to individual needs (shorter bursts or longer recover periods).

Progression and Monitoring

  • After each round, ask the client how they feel: is it fearful or tolerable?
  • If they cope with air hunger, increase the pace or hold duration gradually.
  • Example progression: try holding for 15 paces; if tolerated, increase again.
  • Main safety rule: do not push into strong air hunger that produces symptoms.

Mini Paces and Short Steps

  • Use mini paces/short steps to generate progress and improve the control pause progressively.

Practical Steps (Quick Reference)

  • Step 1: Normal breath in through the nose, normal breath out through the nose.
  • Step 2: Pinch the nose, hold the breath for 10 paces.
  • Step 3: Let go and resume nasal breathing for about 0.5\ \text{min} to 1\ \text{min}.
  • Step 4: Optional alternative dosing: reduced breathing for 30\ s, then normal breathing for 60\ s, repeat.
  • Step 5: For progression, attempt up to 15 paces; assess coping and adjust accordingly.

Notes

  • The overall aim is gradual, incremental exposure to air hunger to build tolerance and maintain control during panic risk.