Panic disorder has a lot to do with being afraid of panicking. A comprehensive treatment will address fear of fear, which generally involves approaching verses avoiding fear. This is known as exposure. The basic concept of exposure is that a person stays in the presence of a threatening stimulus long enough for his or her fear to go down, at least a little bit.
When a person has a panic attack it is not uncommon for the person to fear the panic itself. This has the paradoxical effect of making the panic worse. For instance, it is normal for a person’s heart to race when exercising. A person who has panic attacks may start to become hypersensitive to feeling his or her heart racing. This may result in the person’s avoidance of going up or down stairs. While the intention is to avoid panic, this can be problematic as more situations become associated with the panic. Eventually the panic is more in control of the person than the person is in control of the panic.
Most of the time, the situations, events, or circumstances the person is afraid of are not harmful. Treatment generally consists of educating people on panic and non-useful ways of thinking, It involves helping people regulate anxiety through breathing exercises, controlling their body with progressive muscle relaxation, and facing feared situations over and over again until the fear goes down. Part of emotion regulation training encourages persons to identify the function of the fear (Does it truly help them avoid harmful situations? Or is the fear getting them to avoid living the life they want?). Too much fear may be fear worth trying to change. The DBT opposite-action-to-emotion skill is to approach, which is exactly on target with evidence-based treatments for treating fears and phobias.