Panic attacks and agoraphobia can be frightening, overwhelming, and deeply limiting to live with. You may feel as though panic comes “out of the blue”, or find yourself constantly on edge, worrying about when the next wave of fear will hit. Over time, you might start to avoid certain places, situations, or activities — not because you want to, but because you’re trying to keep yourself safe from panic.
Panic and agoraphobia can interfere with work, relationships, travel, and everyday independence. You may spend a lot of time paying attention to how your body feels, planning escape routes, or avoiding situations that feel risky. What often starts as an understandable attempt to cope with fear can, unintentionally, lead to even more anxiety and restriction over time. The strategies that once helped you feel safer can end up making panic feel more powerful and in control.
Experiencing panic does not mean you are weak or broken; it is a very human response to perceived threat, even when that threat feels confusing or hard to explain.
However, there is hope for change. Research and clinical experience show that people can and do recover from panic attacks and agoraphobia. Even when hope feels difficult, it’s important to remember that it is is possible to reduce fear, rebuild confidence, and begin to live more freely again.
Read on for information about the kinds of therapy I offer that can help support you in understanding panic, and gently expand your world again.
Cognitive Behavioural Therapy (CBT) is a structured, evidence-based psychological treatment that is highly effective for panic attacks and agoraphobia. CBT focuses on understanding how fear, physical sensations, thoughts and behaviours interact — and how certain coping strategies, while understandable, can unintentionally keep panic going over time.
Panic attacks involve sudden surges of intense fear accompanied by physical symptoms such as a racing heart, dizziness, breathlessness, or a fear of losing control. Agoraphobia often develops when people begin to avoid places or situations where panic has occurred, or where escape or help feels difficult. Not everyone who experiences panic attacks will also deal with agoraphobia. CBT helps break these cycles in a gradual, supportive way.
• Personalised formulation: Working together to understand your unique pattern of panic, fear, and avoidance, and what keeps it going.
• Psychoeducation: Learning how anxiety and panic work in the body, and why symptoms, while distressing, are not dangerous.
• Working with thoughts: Identifying and gently challenging unhelpful thoughts and interpretations about bodily sensations, danger, or loss of control.
• Gradual exposure: Gradually facing feared sensations and situations in a planned, manageable way, to rebuild confidence and reduce fear.
• Reducing other behaviours: Understanding and letting go of strategies that accidentally keep panic going, such as monitoring your body or reassurance-seeking.
• Relapse prevention: Developing tools to manage setbacks and maintain progress over time.
CBT is usually delivered in weekly sessions, with practical exercises between sessions to help consolidate learning and build confidence in real-life situations.
CBT is one of the most well-researched treatments for panic disorder and agoraphobia. A large body of research shows that CBT leads to significant reductions in panic attacks, anxiety, and avoidance, with benefits that are often maintained long-term. CBT is recommended by NICE (NHS England and Wales) and the Matrix (NHS Scotland), and as a first-line psychological treatment for panic disorder and agoraphobia. It is widely used in NHS and private settings and is considered a gold-standard, evidence-based approach for these difficulties.
Compassion focused therapy (CFT) focuses on developing compassion towards yourself and others, to reduce self-critical thoughts and beliefs, and improve mood. You might also benefit from using compassion focused techniques in therapy if you judge yourself for experiencing panic and agoraphobia, feel ashamed of having problems, or tend to ‘beat yourself up’ for having panic attacks or not being able to do the things you would like to do.
