Challenging automatic thoughts you have during a panic attack


While undergoing Cognitive Therapy, you will challenge the automatic thoughts you have during a panic attack. You can do this by using steps 1 to 3 of the Thought Record in NiceDay.

Step 1 of the Thought Record

To challenge the thoughts that arise during your panic attack, you start with gaining insight in your thoughts by writing down what happened. Use the questions from the though record.

What happened?

Describe the event that triggered the panic attack or unpleasant feeling.

How anxious did you feel?

Write down how anxious you felt on a scale of 0-100.

What were your thoughts?

Describe the automatic thoughts that preceded the feeling. How credible are these thoughts on a scale of 0-100?

How did you react?

What did you do when you felt anxious? How did you react to your feelings?

What consequence did this have?

What was the result of your behaviour? Describe the consequence of your reaction. Was it positive or negative.

Step 2 of the Thought Record – Challenging the thought

Ask yourself three of the seven questions in the app about your automatic thoughts. For example:

  • What’s the worst that could happen? Would I be able to get over that?
  • Is there another perspective that I haven’t thought of yet? Is this thought actually true?
  • What would I say to a friend or colleague who has a similar thought?

Step 3 of the Thought Record – Formulate a rational thought

Is it possible to formulate a more rational thought to replace the automatic negative thought, one that is neutral or positive and evokes less fear? How credible is this rational thought on a scale of 0-100?

What did you learn from this exercise?

Doing this exercise can give you some insight in your anxiety. Consider what you have learnt about your anxiety. Do you recognise certain patterns? Could this help you feel less anxious?



Keijsers, G. P. J., Van Minnen, A., Verbraak, M., Hoogduin, C. A. L. & Emmelkamp, P., (2017). Protocollaire behandelingen voor volwassenen met psychische klachten.

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