When Panic Attacks by David D. Burns Summary

When Panic Attacks outlines over 40 drug-free cognitive behavioral therapy (CBT) techniques to conquer anxiety, panic attacks, and chronic worrying. Dr. Burns, a Stanford psychiatrist and CBT pioneer, challenges reliance on medications, offering practical tools like thought journaling and exposure therapy to reframe irrational fears. The book blends clinical research with actionable exercises, emphasizing self-empowerment for lasting mental resilience.

This book is ideal for individuals struggling with anxiety disorders, panic attacks, phobias, or social shyness. It’s also valuable for therapists seeking CBT-based strategies and readers interested in evidence-based, medication-free mental health solutions. Burns’ clear, compassionate tone makes complex psychology accessible to both self-help enthusiasts and professionals.

Yes—it’s a seminal work by a leading CBT expert, with techniques proven more effective than medications in clinical studies. Readers praise its step-by-step exercises, relatable case studies, and humor-driven methods. Henny Westra of York University calls it a “masterpiece” for its actionable tools to dismantle anxiety.

Key ideas include:

• Cognitive distortions: Identifying and reframing irrational thoughts like catastrophizing.
• Exposure therapy: Gradual confrontation of fears to reduce avoidance behaviors.
• Double Standard Method: Treating oneself with the same compassion offered to others.
• Externalization of Voices: Role-playing dialogues to challenge anxious thoughts.

Burns prioritizes rapid, self-administered techniques over lengthy counseling. Unlike passive talk therapy, his methods—like the “Acceptance Paradox” (embracing anxiety to neutralize it)—require active participation. He critiques overmedication, advocating CBT’s long-term efficacy for anxiety.

• “You can defeat your fears by exposing the lies they feed you.”
• “Anxiety isn’t dangerous—it’s just uncomfortable.”
• “The moment you stop fighting panic, it loses its power.”

These emphasize self-compassion and cognitive reframing.

Yes. Burns discusses SSRIs and benzodiazepines but cautions against reliance due to side effects and dependency risks. He argues CBT offers longer-lasting results by tackling root causes rather than masking symptoms.

Absolutely. Techniques like the “Feeling vs. Reality” exercise help users differentiate irrational fears (e.g., “I’ll embarrass myself”) from factual outcomes. Burns also recommends pre-speech relaxation drills and positive visualization.

Some note the workbook-style approach demands consistent effort, which may challenge those with severe executive dysfunction. Others desire more guidance on combining CBT with medication for complex cases.

While Feeling Good focuses on depression, this book targets anxiety disorders. Both use CBT frameworks, but When Panic Attacks adds newer methods like “Externalization of Voices” and anxiety-specific relapse prevention strategies.

• Test anxiety: Use the “Double Standard” method to replace self-criticism with encouragement.
• Social anxiety: Practice “Survey Technique” to reality-check others’ perceptions.
• Panic attacks: Apply “Acceptance Paradox” to reduce fear-of-fear cycles.

Burns is an emeritus Stanford psychiatry professor and CBT pioneer whose work has influenced millions. His 1988 Phil Donahue Show appearance popularized CBT, and Feeling Good sold over 4 million copies. Clinical trials at institutions like Penn validate his methods.