Grounding Techniques for Panic Attacks: Somatic and CBT Tools to Help You Regain Control
By Katharine De Santos, MA, RP, Founder and Clinical Director, Healthy Minds Psychotherapy
Published October 2026
This article is for educational purposes only and is not a substitute for professional care. If you're in crisis, call or text 9-8-8 (Suicide Crisis Helpline) or call 911.
In this article:
What a panic attack feels like
How panic attacks affect daily life
Why combine somatic and CBT tools for panic attacks?
4 grounding techniques for panic attacks
Getting support for panic attacks in Toronto and Ontario
Frequently asked questions
Panic attacks can feel sudden and overwhelming. Your heart races, your breathing gets shallow, and your mind insists that something is very wrong. In those moments, it can be hard to trust your own body.
Grounding techniques for panic attacks can help bring you back to the present and to a sense of safety. The approaches in this post combine two kinds of tools: somatic tools, which work through the body, and cognitive behavioural therapy (CBT) tools, which work with your thoughts. Used together, they give you more than one way to steady yourself when panic hits.
What Does a Panic Attack Feel Like?
A panic attack is a sudden wave of intense fear or discomfort that usually peaks within minutes (Mayo Clinic Staff, 2026). Common symptoms include:
Racing or pounding heart. A sudden jump in heart rate that can feel alarming.
Shortness of breath. Feeling like you can't get enough air, or like your throat is tight.
Dizziness or lightheadedness. Feeling faint, unsteady or off balance.
Sweating, trembling or chills. Your body's alarm system kicking into high gear.
Chest tightness and muscle tension. Tightness in the chest, shoulders or jaw.
Feeling detached or unreal. A sense that you're outside your body or that things around you aren't quite real.
Catastrophic thoughts. Thoughts like "Something terrible is happening," "I'm losing control" or "I'm going to die."
If these symptoms sound familiar, you're not alone. Panic attacks are more common than many people realize.
When to get medical help: Some panic symptoms, like chest pain and shortness of breath, overlap with heart and other medical conditions. If it's your first time experiencing these symptoms, if they feel different from usual, or if you're not sure what's happening, call 911 or seek medical care.
How Do Panic Attacks Affect Daily Life?
Even one panic attack can leave a mark. Many people start worrying about when the next one will happen, and that worry can be exhausting on its own. Some begin avoiding places or situations where they've had a panic attack before, like the subway, a crowded store or a work meeting. Over time, this can shrink your world and leave you feeling constantly on edge, affecting your work, your relationships and your ability to enjoy everyday moments.
When panic attacks keep coming back and fear of the next attack starts shaping your life, it may be a sign of panic disorder. The encouraging news is that panic responds well to treatment (Kim, 2019).
What Is CBT for Panic Attacks?
Cognitive behavioural therapy (CBT) is an evidence-based form of psychotherapy that looks at how your thoughts, feelings and actions affect each other (Chand et al., 2023). It's one of the most well-researched treatments for anxiety and panic (Curtiss et al., 2021). CBT helps you notice three things:
Automatic thoughts. Quick, often unnoticed interpretations of what's happening. During panic, this might sound like "My heart is pounding, so something must be wrong with it."
Thinking traps. Patterns like catastrophizing, where the mind jumps to the worst possible outcome.
Core beliefs. Deeper beliefs about yourself and the world, such as "I can't cope" or "My body isn't safe," that can make panic feel more threatening.
With practice, CBT helps you catch these thoughts and respond to them in a steadier, more balanced way.
What Is Somatic Therapy for Panic Attacks?
Somatic therapy is a body-oriented form of psychotherapy that focuses on the connection between mind and body. It helps you notice what's happening in your body and use that awareness to calm your nervous system. Somatic work can include grounding, breathwork, gentle movement and other practices that help your body shift out of its alarm state. For a deeper look, read our post on somatic therapy for anxiety.
Why Combine Somatic and CBT Tools for Panic Attacks?
During a panic attack, your body's alarm system is running the show. When your heart is pounding and you can't catch your breath, it's very hard to reason your way out, because the part of your brain that handles careful thinking isn't in charge in that moment.
That's why many therapists use the two approaches together. Somatic tools help first by giving your body signals of safety, such as slower breathing and a steady connection to your surroundings. Once your body settles even a little, CBT tools become easier to use, and you can start to question the frightening thoughts. Over time, working with both the body and the mind can help panic feel less powerful and less unpredictable.
Grounding Techniques for Panic Attacks
These techniques work best when you practise them on calmer days first, so they feel familiar when you need them.
1. 5-4-3-2-1 Sensory Grounding
This technique brings you back to the present by engaging your senses. Slowly name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell and 1 thing you can taste. It gently shifts your attention away from fear and back to your surroundings.
2. Cool Water Reset
Splashing cool water on your face or holding a cool, damp cloth against your face and forehead can trigger your body's natural calming reflex, which slows your heart rate. This physical shift can interrupt the intensity of a panic attack and help you reconnect with your body. If you have a heart condition or another medical concern, check with your doctor before trying cold water techniques.
3. Diaphragmatic Breathing
Place one hand on your chest and one on your belly. Breathe in through your nose for 4 seconds, letting your belly rise. If it feels comfortable, pause for a moment, then breathe out slowly for 6 seconds. You can skip the pause if holding your breath makes you feel more anxious. A longer exhale helps signal safety to your nervous system, and somatic practices that include breathwork have been shown to support well-being and stress regulation (Nicholson et al., 2025).
4. Cognitive Reframing
Once your body has settled a little, gently remind yourself: "This is a panic attack. It feels intense, but it will pass." Naming the experience can reduce fear and help you feel more in control. This works best if you've had panic attacks before and your doctor has already ruled out other medical causes.
Getting Support for Panic Attacks in Toronto and Ontario
Grounding techniques can help you get through a panic attack, but if panic keeps returning, it's worth getting support. A therapist can help you understand what's driving your panic, reduce the fear of the next attack and slowly reclaim the places and activities you've been avoiding.
At Healthy Minds Psychotherapy, our Registered Psychotherapists use evidence-informed approaches, including CBT and somatic therapy, to help people with anxiety and panic. You can see us in person at our Harbord Street office in Toronto or virtually anywhere in Ontario. We also have supervised student therapists who offer sessions at a lower fee, including in Spanish and Hindi.
Starting therapy doesn't mean you have to have everything figured out. After you complete a short set of intake forms through our secure online system, your first session is a chance to talk about what panic has been like for you and what you're hoping will change. Your therapist will explain how confidentiality works, answer your questions, and work with you at a pace that feels manageable.
When you're ready, book a free consultation on our website.
Frequently Asked Questions About Panic Attacks
Are panic attacks dangerous?
Panic attacks can feel frightening, but they aren't physically harmful on their own. Some symptoms, like chest pain or shortness of breath, can overlap with heart and other medical conditions. If it's your first panic attack, or your symptoms feel different from usual, seek medical care to rule out other causes.
How long does a panic attack last?
Most panic attacks peak within about 10 minutes and then gradually ease (Mayo Clinic Staff, 2026). You may feel tired, shaky or on edge for a while afterward, which is a normal part of your body settling back down.
What is the difference between a panic attack and an anxiety attack?
A panic attack is a sudden surge of intense fear with strong physical symptoms, often without a clear trigger. "Anxiety attack" isn't a clinical term, but people often use it to describe anxiety that builds more gradually in response to a specific stressor. Both are real, and both are worth taking seriously.
Can you have a panic attack in your sleep?
Yes. Nocturnal panic attacks can wake you suddenly with a racing heart, sweating or shortness of breath. The same grounding techniques can help. Try sitting up, placing your feet on the floor and slowing your exhale. If they happen often, talk to your doctor or a therapist.
Will grounding techniques stop a panic attack?
Grounding techniques may not end a panic attack right away, but they can help take the edge off and get you through it. They tend to work best when you practise them on calmer days, so they come more naturally in the moment. If panic attacks keep returning, therapy can help you understand why.
Which grounding technique works best for panic attacks?
It depends on the person and the moment. When your thoughts are racing too fast to reason with, body-based tools like cool water or diaphragmatic breathing are often easier to use. Once you feel a little steadier, cognitive reframing can help. Try each one when you're calm to learn what works for you.
How can I help someone who is having a panic attack?
Stay calm and speak slowly in short, simple sentences. You can breathe slowly alongside them, remind them that the feeling will pass and ask what usually helps. Avoid telling them to "just calm down." If they have chest pain or you're unsure whether it's a panic attack, call 911.
Can I get therapy for panic attacks online?
Yes. At Healthy Minds Psychotherapy, you can see a Registered Psychotherapist virtually anywhere in Ontario or in person at our Harbord Street office in Toronto. Virtual sessions can be a good place to start if leaving home feels hard right now.
Is therapy for panic attacks covered by insurance?
Many extended health benefit plans cover services from Registered Psychotherapists. We offer direct billing to many insurers. We also have supervised student therapists who see clients at a lower fee, including sessions in Spanish and Hindi. You can ask about direct billing when you book a free consultation, and we recommend checking your coverage with your insurance provider.
Do I need a doctor's referral to see a psychotherapist in Ontario?
No. You can book directly with a Registered Psychotherapist in Ontario. Some insurance plans require a referral before they'll reimburse you, so it's worth checking your plan first.
About the Author
Katharine De Santos, MA, RP, is a Registered Psychotherapist and the Founder and Clinical Director of Healthy Minds Psychotherapy. She has more than 25 years of clinical experience supporting people through trauma, anxiety, depression, grief, fertility challenges and major life transitions.
Her approach is trauma-informed and integrates somatic therapy with talk-based work. This means paying attention to how stress and difficult experiences show up in the body, which can give clients another way to understand what they're carrying and begin working with it. Katharine is also EMDR-trained.
Katharine holds a BA in Psychology from Western University and an MA in Counseling from The George Washington University, and has completed postgraduate training through Johns Hopkins University and The Global Mental Health: Trauma and Recovery Certificate Program through Harvard Medical School.
Works Cited
Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2023). Cognitive behavior therapy. In StatPearls. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK470241/
Curtiss, J. E., Levine, D. S., Ander, I., & Baker, A. W. (2021). Cognitive-behavioral treatments for anxiety and stress-related disorders. Focus, 19(2), 184–189. https://doi.org/10.1176/appi.focus.20200045
Kim, Y.-K. (2019). Panic disorder: Current research and management approaches. Psychiatry Investigation, 16(1), 1–3. https://doi.org/10.30773/pi.2019.01.08
Mayo Clinic Staff. (2026, March 14). Panic attacks and panic disorder: Symptoms and causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/panic-attacks/symptoms-causes/syc-20376021
Nicholson, W. C., Sapp, M., Karas, E. M., Duva, I. M., & Grabbe, L. (2025). The body can balance the score: Using a somatic self-care intervention to support well-being and promote healing. Healthcare, 13(11), 1258. https://doi.org/10.3390/healthcare13111258