Identify and reduce safety behaviors

Notice the things you do to prevent catastrophe during panic — and experiment with dropping them.

Why it works

Safety behaviors (sitting down to avoid fainting, checking pulse, leaving the situation) prevent disconfirmation of the catastrophic belief. If you always sit when dizzy, you never discover that standing through the dizziness would not cause you to faint. Safety behaviors also maintain anxiety by keeping the catastrophic interpretation live — they signal to the brain that the threat was real and the behavior was necessary.

How to do it

1. List what you do during or before feared situations to "prevent" the catastrophe.
2. Ask: if the catastrophe wouldn't happen anyway, does this behavior matter?
3. Choose one safety behavior and experiment with dropping it in a safe context. What actually happens?

Evidence

Safety behavior reduction is a theoretically motivated and empirically supported component of cognitive therapy for panic and other anxiety disorders. Studies show that dropping safety behaviors during exposure enhances disconfirmation and accelerates improvement. (rct)

The evidence is for anxiety disorders broadly; for panic specifically, safety-behavior reduction is part of Salkovskis's model and is typically studied within full treatment packages.

Sources

• Salkovskis et al. (1999), safety behaviors in cognitive therapy for panic, Behaviour Research and Therapy

Common mistake

Confusing safety behaviors with genuine safety preparations — a safety behavior is one that prevents the learning opportunity ("nothing bad happened because I sat down") rather than a necessary precaution.