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Record panic episodes with triggers, sensations, catastrophic thoughts, safety behaviours, and actual outcomes to identify patterns and build evidence against catastrophic predictions.
Complete an entry as soon as possible after each panic episode (or strong wave of anxiety). The goal is to capture what triggered it, what you felt in your body, what you thought was happening, what you did to cope, and what actually happened. Over time, patterns emerge that help you and your therapist target the key maintenance factors.
Use throughout the intervention phase to monitor panic attacks and near-panic episodes. The diary captures the cognitive, physiological, and behavioural components of each episode to identify patterns and track progress.
Explain that recording panic episodes helps identify patterns that are difficult to see in the moment. Emphasise that the goal is curious observation, not perfect recall. A brief record soon after the event is more useful than a detailed one days later.
For clients experiencing very frequent panic attacks (multiple daily), simplify the diary to capture only the key variables to reduce monitoring burden. For clients with infrequent attacks, extend the diary to include near-panic episodes and moments of heightened body vigilance.
If completing the diary triggers anticipatory anxiety about having panic attacks, discuss this openly and consider whether monitoring is inadvertently increasing body scanning. Adjust the approach if needed to prevent the diary itself becoming part of the maintaining cycle.
Look for patterns in timing, context, and the specific bodily sensation that triggers the catastrophic misinterpretation. Many clients discover that their panic attacks are less random than they believed. Track safety behaviour use alongside panic severity to demonstrate how dropping safety behaviours does not lead to the feared outcome.
Suitable for clients working with panic, diary, cbt, catastrophic misinterpretation, body sensations, safety behaviours, clark. This tool can be used as a standalone worksheet or as part of a structured homework plan.
Create a free account to access 10 worksheets per month.
Gather normalising evidence by surveying others about whether they experience the same body sensations and fears — challenging the belief that your experience is abnormal.
Log interoceptive exposure exercises that deliberately produce feared body sensations to break the link between sensations and catastrophic interpretations.
A formulation based on Clark's cognitive model of panic — mapping the vicious cycle of catastrophic misinterpretation of body sensations.
Challenge catastrophic misinterpretations of body sensations by examining evidence and generating realistic alternatives.