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VIDEO: A Paradoxical Approach to Panic

The First Session

Rich Simon & Reid Wilson
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With years of experience treating anxiety-riddled clients, Reid Wilson, author of Don’t Panic, knows a thing or two about helping people rein in the trademark rapid breathing, cold sweats, and stammering that occur during a panic attack.

To cut off panic attacks at the source, Reid takes a provocative approach. Put clients in uncomfortable situations—have them hyperventilate, for example—and then guide them out of the panic experience as their ally. In fact, he says, you can hyperventilate alongside your panicked client. It builds rapport, and makes them feel less alienated. An early goal, he says, should be to have your client leave the first session thinking, “Thank god I finally found someone who understands me.”

In this brief video clip, Reid discusses his approach with clients between the ages of 17 and 23, neck-deep in a sea of chaotic college life, heavy drinking, and rapidly evolving relationships that is a breeding ground for panic attacks. “All people with anxiety don’t tolerate uncertainty very well,” says Reid. “But in high school, I know what the rules are, and if I’m breaking them or not. Once I get to college, the decision-making is no longer clear for me, and it puts a crack in the defensive system.” Conquer anxiety in this age group, Reid says, and you can handle almost anyone. 

Rich Simon

Rich Simon

Richard Simon, PhD, founded Psychotherapy Networker and served as the editor for more than 40 years. He received every major magazine industry honor, including the National Magazine Award. Rich passed away November 2020, and we honor his memory and contributions to the field every day.

Reid Wilson

Reid Wilson, PhD, is a licensed psychologist who directs the Anxiety Disorders Treatment Center in Chapel Hill and Durham, NC. He is author of Stopping the Noise in Your Head: The New Way to Overcome Anxiety and Worry and the classic self-help book Don’t Panic: Taking Control of Anxiety Attacks. He is co-author of Stop Obsessing! How to Overcome Your Obsessions and Compulsions, as well as Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous & Independent Children. Dr. Wilson is a Founding Clinical Fellow of the Anxiety and Depression Association of America (ADAA) and Fellow of the Association for Behavioral and Cognitive Therapies (ABCT). In 2014, he was honored with the ADAA’s Jerilyn Ross Clinician Advocate Award – the highest national award in his field. He designed and served as lead psychologist for American Airlines’ first national program for the fearful flier and serves as the expert for WebMD’s Panic and Anxiety Community.

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