What to Tell Your Anxious and Panicky Clients About Their Anxiety

Generalized anxiety is common, and many people experience panic disorder.

“Do not anticipate trouble or worry about what may never happen. Keep in the sunlight.”

– Benjamin Franklin

“People just don’t understand how bad it feels!”

My client, Rachel, almost wept as she spoke of the horrible anxiety she’d suffered for years. Sometimes her anxiety boiled over into the “worst panic attacks imaginable”.

I nodded as she continued.

“People say, ‘Yeah, I used to have panic attacks too’, but they still don’t seem to understand how bad it is for me, how I just can’t do anything when one comes on!” She miserably described all the usual characteristics of panic:

• Shortness of breath
• Dry mouth
• Sweaty palms
• Racing pulse
• Feeling like she might be sick, or empty her gut contents in “other ways”
• Shaking
• Feeling stuck to the spot but wanting to escape
• Feeling like her thoughts are going too fast or that she can’t think at all
• Feeling like she’s going to die or go mad or humiliate herself.

Rachel was right. It can be hard to believe that anyone else could possibly know what it’s like to experience the searing horror of utter panic when everyone else around seems calm and ‘normal’.

Of course, generalized anxiety, a sense of foreboding and uncomfortable tension, is common,¹ and ‘normal’ people do experience panic disorder.²

But when you’re the one experiencing it, it can feel really isolating.

I taught Rachel ways to stop panic attacks, but there were some important things I really wanted her to know about anxiety and panic, because knowledge is power. And this might be really valuable for your clients too.

So how can we psychoeducate our clients when it comes to anxiety and panic disorder?

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Tip one: Reassure them that ‘normal people’ experience fear and panic.

In fact, it’s normal to feel panic. Human reactions are so often labelled as ‘disorders’ that our clients can forget that anxiety and panic are in fact evolutionary tools, designed to save us from danger. Yet, like any tool, they can be misapplied or even give the illusion of controlling us!

I reassured Rachel that anxiety isn’t an illness or disease in itself. Like, say, appetite, it’s only a problem when it becomes uncontrolled and excessive.

Although countless people that I’ve treated for trauma, panic attacks, and worry now consider themselves cured, the capacity for anxiety needs to always be available to us.

Rachel had been feeling “like a weirdo” for being so anxious, so she was reassured as well as intrigued when I told her about research showing that anxious people tend to be safer during real emergencies, as they tend to flee the soonest, even before the real emergency gets going.³ Some anxiety, when it’s needed, is vital. And sometimes we need to go all the way.

“So,” I suggested, “we don’t cure anxiety and panic, we align it. Just as we don’t want to totally disable an oversensitive car alarm – we want to reset it so it goes off only when it really needs to.” This made the therapeutic progress feel much easier, less daunting.

We can, more specifically, help normalize other ‘characteristics’ (I much prefer this word to ‘symptoms’) of panic and anxiety.

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Rachel, like most clients, understood the fight-or-flight response. Terror, panic, or even mild anxiety are all different parts of the same continuum. When we reach the far end of anxiety and fear, we panic.

But she was confused by something: “Sometimes I feel like it’s not fight or flight… but like I’m sort of stuck, or frozen to the spot!”

I explored with Rachel the fact that before we either fight or flee, we freeze. Often this is just for milliseconds, but – here’s the thing – if we feel inescapably trapped, we may find that our energy shuts down and we just stay in freeze mode.

“Take a squirrel on a garden fence. If it becomes aware that you, a possible predator, are observing it, it may freeze. But then, if you approach, it will come out of this frozen state and scamper off at a sprint. It’s gone from freeze to flight.”

This made perfect sense to Rachel, especially when I suggested that many bigger predators detect their prey largely through motion. When a tiger comes your way, freezing may make you harder to spot – which hopefully means it will move on, giving you a chance to vamos fast.

So this freezing before fight or flight is natural, and was once vital for survival purposes. But we humans sometimes freeze when we wrongly feel trapped or helpless. Many depressed people feel stuck, as though they can’t act or help themselves even when perhaps they could – this is what we call learned helplessness.

I also described other characteristics of high anxiety and panic.

Tip three: Describe why they’re experiencing their symptoms

Fast breathing, racing heart, sweaty palms, shaking, racing thoughts, “dodgy bowels”. These were the “horrendous” symptoms of Rachel’s six-month-long ordeal of panic and high anxiety. And of course, these experiences can be scary in themselves and make us fear the panic… which of course feeds into it even more.

I conversationally described the adaptive purpose of the very symptoms Rachel had described. So:

• Fast breathing and racing heart happen in anticipation of exercise: running or fighting. Our bodies prepare us to exercise before we actually begin to. How cool is that!? (If heavy exercise is actually needed, of course!)
• Sweaty palms, once dried, improve our grip so we can better climb into trees for safety.
• Shaking happens when we try to make ourselves stay in one place when we are afraid. Your body is trying to both go and stay at the same time, so it shakes. The larger muscles also get primed for action, so that finer muscle movements may feel harder.
• Thoughts race, because in true emergencies we really do need to think fast, and also simplistically. Run or fight? Our thinking needs to race along with our physical reaction.
• Even the desire to defaecate or vomit, I suggested unappetizingly, may have an adaptive function in potentially making us less appetizing to large predators. After all, I told Rachel – all the while maintaining eye contact! – what predator wants to consume a morsel covered in sick or poop?!

Rachel reported feeling less afraid of her symptoms after what had been, for her, an illuminating conversation. These were no longer ‘symptoms’ of a ‘disorder’ but adaptive characteristics, potentially vital in their place, simply going off at the wrong times and far too frequently.

Fear hates to be laughed at

Of course, this normalizing of the characteristics of anxiety and panic was just a small part of my work with Rachel. But she did find that this new way of looking at her symptoms instead as adaptive characteristics helped her fear the fear much less.

Rachel even told me that she’d laughed at a situation at work in which her hands started to feel a little sweaty and her tummy started feeling loose.

“I remembered what you’d said about hands drying to help us climb from predators, a loose tummy preparing to make us less appetizing for predators, and I thought, ‘Well, I don’t really need to be doing that in this meeting!’… and the fear just went away!”

Now for Rachel, reaching that point was also thanks to the other work we’d done, but helping our clients understand what they’ve been experiencing and why can often be extremely reassuring.

Rachel quickly learned to switch off panic when it wasn’t needed (which was nearly all the time!). She started to relax more, and because of that felt not just mentally but also physically healthier. Her sleep improved too.

But best of all, she said, “I now feel in control of my life!”

Learn How to Use Your Communication to Relax Your Clients Fast

The first thing to do with an anxious client is calm them down so they can think clearly. Clinical hypnosis is the art and science of capturing the attention and turning it to therapeutic aims, and with that comes deep, beautiful relaxation. Your anxious client will leave your session feeling better than they have in months. Learn more about Mark’s online course Uncommon Hypnotherapy here.

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About Mark Tyrrell

Psychology is my passion. I've been a psychotherapist trainer since 1998, specializing in brief, solution focused approaches. I now teach practitioners all over the world via our online courses.

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