Panic attacks have a way of stealing the horizon. One minute you are answering an email or parking the car, the next your heart surges, breath stutters, and the room tilts strange. Even when a person knows it is panic, the body can feel convinced that something catastrophic is unfolding. It is hard to think your way out when the threat seems to live in your chest, throat, and hands.
Somatic experiencing offers a body-first way to untangle that loop. It does not dismiss thoughts or memories, it simply starts where panic happens most vividly, in sensation and reflex. Over the years, working with clients who fear their next attack more than the attacks themselves, I have watched small, precise shifts in body awareness turn the tide. Not all at once, not like a switch, more like learning a familiar coastline at different tides until you can steer through.
What panic feels like in the body
Language stumbles when describing panic. People say they feel like they are suffocating, poisoned by adrenaline, or about to pass out. The medical rule-outs matter here. Thyroid flare, arrhythmia, stimulant overuse, asthma, and low blood sugar can mimic or amplify panic. Many clients show up after emergency room visits where the ECG was clean and the oxygen was fine, yet the distress was not.
Physiologically, panic aligns with a sympathetic surge. Heart rate rises, pupils dilate, blood is routed away from digestion to big muscles, and breathing quickens. If that arousal hits fast and the person fights it, breath https://medium.com/@whyttacawi/integrative-mental-health-therapy-and-movement-the-body-as-a-healer-c47fda28e016 can become shallow and high in the chest. Carbon dioxide drops, which feeds dizziness and tingling. The mind races to interpret the sensations, often landing on the scariest story. Then the body hears that story and adds more fuel. You get a self-reinforcing loop of sensation and meaning.
The loop is not a personal failure. It is a healthy nervous system doing its best with imperfect information. The work is to widen the range of states that feel safe, teach the body how to ride the wave, and give the mind evidence that the storm passes.
Why start with the body
Somatic experiencing grew out of observing how animals in the wild mobilize and discharge survival energy without getting stuck. In humans, social norms, past trauma, and our storytelling minds can interrupt that arc. We tense and brace rather than complete the movement the body wanted to make. Over time, those incomplete reflexes can create a narrow window where arousal feels intolerable.
Working through the body is not a detour around thoughts. It is an efficient way to update the alarm system at the level where the misfire began. Somatic experiencing asks a simple question: what is your nervous system doing right now, and how can we help it do what it is trying to do more fully and safely? Instead of forcing relaxation, we support completion, containment, and integration.
The principles that matter most for panic include titration, pendulation, orientation, and resourcing. Titration means taking in small doses of activation rather than flooding yourself. Pendulation describes the natural rhythm of moving between activation and settling, like rocking gently across a midpoint. Orientation returns the senses to the present environment so the nervous system registers safety. Resourcing finds sensations, images, and movements that feel steady or pleasant enough to counterbalance distress.
How somatic experiencing helps during and between attacks
A common mistake is to reserve all techniques for crisis. That is like trying to learn to swim only when you are already in a rip current. The body needs practice at lower intensities. In session, we first map how panic moves for you. Maybe it climbs from stomach to throat in under 10 seconds. Maybe it starts with heat behind the eyes. These are not trivia. They are reliable entry points for timely support.
I often start with orientation. People in panic stare inward and miss the cues of safety in the room. I will ask someone to let their eyes move without fixing, to notice a patch of color or the weight of their back against the chair. Then we check the breath, not by taking a big inhale, which can spike things, but by softening the exhale and letting the next inhale arrive on its own. If the chest is tight, I might ask for a tiny, almost unnoticeable sigh, the kind that loosens the throat.
Next we investigate sensations in small slices. If the heart is pounding, we feel it for two or three beats, then look away from it to the soles of the feet or the stability of the floor, then return for a few more beats. That is pendulation, and it reduces the sense of being trapped. If the hands want to clench, we might let them clench a little more, then slowly release, so the nervous system completes a protective gesture it already started.
When appropriate, gentle movement helps discharge stuck survival energy. I have invited clients to press their palms into the chair arms, meeting a bit of resistance, then back off. Others find relief by pushing a wall for three seconds or letting the body do a small shake. Too much movement can escalate things, so we titrate. If the edges blur, we pause and orient again.
Here is a compact practice you can learn with a therapist and then adapt at home. Use it well before full panic hits, and only as tolerated. If it intensifies fear, stop and return to what you know works.
- See three things that are not threatening, name one quiet detail of each, and let your eyes rest briefly on what feels easiest. Feel a triangle between both feet and your seat, notice where the weight is heaviest, then let the next exhale be 10 to 20 percent longer. Track one sensation you do not hate for five to ten seconds, maybe warmth in the hands or the shape of your back, then look around again and find a new detail. If your hands want action, press your fingertips together slowly for two seconds, release for two seconds, repeat three times, then pause and sense the afterfeel. Ask yourself what, if anything, feels one degree better than a moment ago. If you find even a sliver, rest your attention there for three breaths.
These are not magic tricks. They are ways to speak to reflexes that override frantic thoughts without fighting them. When practiced in calm moments, they build familiarity so you can reach for them when needed.
A brief vignette from practice
A software engineer in her thirties came in after a series of public transit panic attacks. She had already seen a cardiologist and was on a low dose of an SSRI prescribed by her primary care doctor. Crowded trains, fluorescent lights, and the vibration underfoot set off her symptoms. She stopped riding and was spending sixty to ninety minutes daily in a ride share, which she could not sustain.
In our early sessions we did not go near the trains. We mapped her pattern. Her panic started as a flash of heat in her face, then a strangled breath, then an urge to bolt. She braced her shoulders and locked her knees. Her words came fast and sharp. When I asked her to glance at the shelves behind me and find one object she disliked the least, her shoulders dropped by a centimeter. That was our first foothold.
Over six sessions, we worked at low intensity. She practiced identifying the first two seconds of heat and the first hint of breath change. She learned a slower exhale and micro-movements of her shoulders. We experimented with a firm press of her hands into her thighs when the urge to run hit. I sent her home with a two minute practice to do after brushing her teeth, never as a rescue, always to build skill.
At session eight, we walked to the station, bought a ticket, and stood on the platform for a single train arrival, then left. No riding. She named textures, felt her shoes, and did a two second hand press. Her heat rose, but her breath stayed freer. We repeated the exposure, gradually extending duration, and by session twelve, she rode one stop with me, then two stops the next week. She still had spikes of fear. What changed was her confidence that her body knew what to do, and that the spikes passed. Three months later she was riding most days, with a plan for the days that were too much.
This is not a template. Some people need slower pacing. Others benefit from involving a partner or friend. The core idea remains: build capacity in the body in titrated steps, and the mind has fewer reasons to panic at panic.
Where integrative mental health therapy fits
Somatic experiencing is one strand in a broader rope. Integrative mental health therapy brings together body-based work, cognitive strategies, lifestyle changes, and when appropriate, medication. Panic has drivers in sleep, nutrition, caffeine, hormones, and pain. I have watched one extra espresso tip a nervous system over the edge. I have also seen a regular evening walk and steadier meals shrink panic frequency more than any single technique.
Cognitive behavioral therapy has strong evidence for panic. It excels at helping people reinterpret sensations and face avoided places. When clients combine CBT’s clarity about catastrophic thinking with the body trust fostered by somatic work, outcomes tend to improve. Medication can widen the window so that learning is possible. SSRIs reduce baseline arousal for many. Beta blockers can soften the heart race that keeps some people trapped. Close coordination with prescribers matters, especially because some medications, like certain stimulants or decongestants, can provoke panic-like sensations.
Sleep is a major lever. Short sleep and irregular sleep times correlate with higher anxiety. Blue light damping in the evening, consistent sleep windows, and strategic morning light are small shifts with big returns. Breath work, strength training twice a week, and gentle aerobic work three to four times a week support regulation. The specifics vary by age, fitness, and comorbidities. The principle remains: build a physiology that can absorb bumps without spilling.
The role of the safe and sound protocol
Some clients benefit from auditory interventions like the safe and sound protocol. It uses filtered music designed to engage the middle ear muscles and favor frequencies of human prosody. The aim is to cue the ventral vagal branch of the autonomic nervous system, which supports social connection and calm engagement. Implementation requires care. For a subset of people with trauma histories, the increased sensitivity that comes with better auditory processing can be unsettling at first.
When I incorporate the safe and sound protocol, I do it in short sessions, often 10 to 15 minutes at a time, paired with orientation and resourcing. I monitor for signs of overactivation, like a sudden spike in irritability, headache, or dissociation. When it helps, clients describe feeling softer around the edges and more able to notice the room. That receptive state gives us more room to practice the somatic skills that matter between sessions.
Rest and restore protocol and the art of settling
Rest is not a prize, it is a practice. In my office we use a rest and restore protocol made of simple elements: longer exhales, heavy blankets for proprioceptive feedback, slow tracking of pleasant or neutral sensations, and brief guided imagery that highlights safety cues. Some clients add non-sleep deep rest recordings at home. The structure matters less than the sequence. Activation first finds a container, the body recognizes support, the breath lengthens, and then we allow settling to show up by itself rather than forcing it.
If you tend to dissociate or feel foggy when you try to relax, full stillness might not be the right entry point. A two minute standing sway with eyes open, followed by sitting, can land better. Some people need a room that is brighter than typical meditation spaces. Others prefer to keep one palm on the upper chest as an anchor. The protocol is personal by design.
Working with edges, not forcing breakthroughs
Pushing harder rarely speeds progress in trauma therapy, especially with panic. The nervous system has edges for a reason. If we blow past them, we risk reinforcing the idea that arousal is unmanageable. I often teach clients to spot three early edge signs: breath moving from belly to upper chest, a narrowing of the visual field, and the impulse to rush speech. These are our cues to pull back a notch, orient, and pendulate.
A related skill is consent, not only with others but with yourself. In session I ask whether the next step feels like a yes, a maybe, or a no. Maybe is not a yes. We respect it. This internal contract reduces the micro-betrayals that keep panic loud. Over time, the maybes become yeses, and action feels different.
Preparing for a session or a practice window
Panic can make people meticulous planners. Channel that trait into a few simple supports that reduce uncertainty and lower the slope at the start.
- Eat something with protein and complex carbohydrate in the last two to three hours, and check caffeine intake to avoid a late spike. Choose a time window where you can do five quiet minutes after, rather than racing to the next task. Set up a consistent chair and a small object that feels pleasant to look at, like a plant or a photo of a landscape, so orientation has easy targets. Let one trusted person know you are practicing, not to rescue you, but to anchor your plan with a witness. Decide in advance what your stop signal is, like placing a hand on your heart, so you and your therapist share the same map.
Consistency here builds familiarity. The nervous system learns faster when the context stays stable.
When panic is complicated by trauma
For some clients, panic is not a standalone issue. Past events have primed the nervous system to expect harm. In these cases, somatic experiencing unfolds within a broader trauma therapy frame. We still use titration and orientation, but we also track triggers linked to memory fragments, relational cues, and body positions. A client who survived a car crash may find that seat belts or the rumble of an engine are not neutral. Another client may react to certain colognes or the feeling of someone behind them.
The rule remains: keep it titrated and consensual. Sometimes we set up micro-exposures, like wearing a loose scarf that simulates gentle neck contact for ten seconds, with choice baked in at every step. Other times we do not touch the trigger at all for months, focusing instead on building the capacity to feel good without fear. It can be surprising how much panic softens when a person has daily access to a bodily sense of steadiness, even for 30 seconds at a time.
Medical collaboration and safety planning
Ethics require ruling out medical contributors, especially new onset panic in midlife or later, attacks with fainting, or those paired with chest pain that does not resolve. Coordination with primary care and, when indicated, cardiology or pulmonology gives everyone confidence. It also matters to discuss substance use openly. Nicotine, cannabis in some forms, and alcohol rebound can all inflame panic physiology.
Create a safety plan for severe episodes. Decide who you would call, what you would tell them, and when you would choose to ride it out with skills. Some clients keep a small card in their wallet with three steps of their practice and a note reminding them that the peak of an attack often passes within minutes, even if the aftershocks linger. That time anchor helps.
Measuring progress in real numbers
Progress with panic is not a mystery. Track it. A simple log for four weeks can reveal patterns. Note the number of attacks, average intensity on a 0 to 10 scale, duration, and recovery time. Also track sleep hours, caffeine, and exercise. A common arc looks like this: intensity drops first, then duration, then frequency. Recovery time often shrinks markedly. A person who once took hours to feel normal again starts to feel steady in 15 to 30 minutes. That change matters to quality of life.
Be realistic about variability. Hormonal shifts, illness, and major life events can bump the curve. Expect plateaus. They are not failures, they are consolidation. When a plateau holds for four to six weeks, we tweak inputs. That might mean adjusting practice frequency, layering in CBT homework, or changing the exercise mix. Small changes compound.
What first sessions are like
If you have never done somatic work, the first meeting often feels different from talk therapy. We will spend time getting clear on what you want different in your body, not only in your calendar. Then we test a few gentle experiments. Can you track your feet without your jaw tightening? Does looking out the window soften anything? We do not fish for panic. We build your capacity to notice and influence your state without pressure.
You can expect me to ask for constant feedback. Too slow, too fast, too much eye contact, not enough, need a break. The more you steer, the better the fit. We also plan for practice outside session. Two to five minutes daily beats 30 minutes once a week for this work. Skills like longer exhales and orientation are most effective when they are wired into muscle memory.
When somatic experiencing is not the main tool
No single approach fits everyone. If you have autism with significant sensory sensitivities, certain forms of interoceptive tracking can be overwhelming without adaptations. If you are in active benzodiazepine withdrawal, your nervous system may be too unstable for new practices for a while. Severe dissociation may call for a slower, relational focus before any internal tracking. If you have obsessive compulsive tendencies around bodily sensations, we design the work to avoid compulsive checking.
Good therapy is pragmatic. If a different door opens more easily, we use it. Sometimes that means starting with behavioral activation, sometimes nutrition, sometimes group work where social cues help anchor the nervous system. Somatic skills are tools, not a religion.
How this work changes a day, not just an attack
People often want the moment of panic to disappear, and that wish makes sense. Paradoxically, building a life where daily regulation is the default reduces panic more reliably than chasing the attack itself. That looks like taking three short regulation breaks at midmorning, midafternoon, and evening, even on days without anxiety. It looks like recognizing that your system is more vulnerable after a week of deadlines and planning less exposure for the following week. It looks like practicing pleasure, not as a treat, but as body training. The nervous system needs rehearsals of safety as much as it needs rehearsals of courage.
When a spike does come, the body has maps. You know what your feet feel like on this floor. You have felt your breath lengthen before and can trust that it will again. Your hands know the memory of a two second press. The fear is still fear, but it loses the extra layer of helplessness.
Final thoughts
Somatic experiencing meets panic where it lives, in muscle, breath, and reflex. It is not about suppressing a reaction, it is about completing one. In the context of integrative mental health therapy, it sits alongside CBT, medication, sleep, movement, and nutrition. Tools like the safe and sound protocol can prime the system for change, while a rest and restore protocol teaches the art of settling. None of it is all or nothing. Small, consistent practices widen your capacity to be with yourself when the tide runs high.
If panic has trimmed your world down to safe slivers, know that bodies learn. The timeline varies, and the work asks for patience, but the nervous system is built to adapt. With careful pacing, clear consent, and attention to the whole person, you can rebuild trust in your body and reclaim more of your day.
Address: 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483
Phone: 954-228-0228
Website: https://www.amyhagerstrom.com/
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Amy Hagerstrom Therapy PLLC provides somatic and integrative psychotherapy for adults who want mind-body support that goes beyond talk alone.
The practice serves clients throughout Florida and Illinois through online sessions, with Delray Beach listed as the office and mailing location.
Adults in Delray Beach, Boca Raton, West Palm Beach, Fort Lauderdale, and nearby communities can explore support for trauma, anxiety, chronic stress, burnout, and midlife transitions.
Amy Hagerstrom is a Licensed Clinical Social Worker and Somatic Experiencing Practitioner who works with clients in a steady, nervous-system-informed way.
This practice is suited to people who want therapy that includes body awareness, emotional processing, and whole-person support in addition to conversation.
Sessions are private pay, typically 55 minutes, and a superbill may be available for clients using out-of-network benefits.
For local connection in Delray Beach and surrounding areas, the practice uses 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483 as its office and mailing address.
To learn more or request a consultation, call 954-228-0228 or visit https://www.amyhagerstrom.com/.
For a public listing reference with hours and map context, see https://maps.app.goo.gl/VZTFSS2fq1YPv7Rs5.
Popular Questions About Amy Hagerstrom Therapy PLLC
What services does Amy Hagerstrom Therapy PLLC offer?
Amy Hagerstrom Therapy PLLC offers somatic therapy, integrative mental health therapy, the Safe and Sound Protocol, the Rest and Restore Protocol, and support for concerns including trauma, anxiety, and midlife stress.Is therapy online or in person?
The website describes online therapy for adults across Florida and Illinois, and some service pages mention limited in-person availability in Delray Beach.Who does the practice work with?
The practice describes its work as being for adults, especially thoughtful adults dealing with trauma, anxiety, chronic stress, burnout, and nervous-system-based stress patterns.What is Somatic Experiencing?
Somatic Experiencing is described on the site as a body-based approach that helps people work with nervous system responses to stress and trauma instead of relying on insight alone.What are the session fees?
The fees page states that individual therapy sessions are $200 and typically run 55 minutes.Does the practice accept insurance?
The website says the practice is not in-network with insurance and can provide a monthly superbill for possible out-of-network reimbursement.Where is the office located?
The official website lists the office and mailing address as 550 SE 6th Ave, Suite 200-M, Delray Beach, FL 33483.How can I contact Amy Hagerstrom Therapy PLLC?
Publicly available contact routes include tel:+19542280228, https://www.amyhagerstrom.com/, https://www.instagram.com/amy.experiencing/, https://www.youtube.com/@AmyHagerstromTherapyPLLC, https://www.facebook.com/p/Amy-Hagerstrom-Therapy-PLLC-61579615264578/, https://www.linkedin.com/company/111299965, https://www.tiktok.com/@amyhagerstromtherapypllc, and https://x.com/amy_hagerstrom. The official website does not publicly list an email address.Landmarks Near Delray Beach, FL
Atlantic Avenue — A central Delray Beach corridor and one of the area’s best-known local reference points. If you live, work, or spend time near Atlantic Avenue, visit https://www.amyhagerstrom.com/ to learn more about therapy options.Old School Square — A historic downtown campus at Atlantic and Swinton that anchors local arts, events, and community gatherings. If you are near this part of downtown Delray, the practice serves adults in the area and across Florida and Illinois.
Pineapple Grove — A walkable arts district just off Atlantic Avenue that is well known to local residents and visitors. If you are nearby, you can review services and consultation details at https://www.amyhagerstrom.com/.
Sandoway Discovery Center — A South Ocean Boulevard landmark that connects Delray Beach residents and visitors to coastal nature and marine education. If Beachside is part of your routine, the practice maintains a Delray Beach office and mailing address for local relevance.
Atlantic Dunes Park — A recognizable Delray Beach coastal park with boardwalk access and dune scenery. People based near the ocean side of Delray can learn more about scheduling through https://www.amyhagerstrom.com/.
Wakodahatchee Wetlands — A well-known western Delray destination with a boardwalk and wildlife viewing. If you are on the west side of Delray Beach or nearby communities, the practice offers online therapy throughout Florida.
Morikami Museum and Japanese Gardens — A major Delray Beach cultural landmark west of downtown. Clients across Delray Beach and surrounding areas can start with https://www.amyhagerstrom.com/ or tel:+19542280228.
Delray Beach Tennis Center — A public sports landmark just west of Atlantic Avenue and a familiar point of reference in central Delray. If you are near this area, visit https://www.amyhagerstrom.com/ for service details and consultation information.