Book: When Panic Attacks

Overview
When Panic Attacks, by David D. Burns, presents a comprehensive, pragmatic approach to understanding and treating anxiety disorders using cognitive behavioral therapy (CBT) principles. Framed as a "drug-free" alternative, the book addresses panic attacks, generalized anxiety, social phobia, obsessive-compulsive tendencies, and specific phobias. It combines accessible explanations of how anxious thoughts and avoidance behaviors maintain distress with concrete, step-by-step strategies readers can apply immediately.
The book is organized to move readers from clarity about their symptoms to active self-treatment. Case vignettes and easy self-tests help readers identify the particular anxiety pattern they face, and Burns provides specific programs tailored to each disorder. The tone is encouraging and practical, emphasizing that measurable change is possible through disciplined practice of cognitive and behavioral techniques.

Core principles and techniques
Central to the book is the CBT idea that distorted thinking drives emotional suffering, and that modifying those thoughts changes feelings and behavior. Burns explains common cognitive distortions, catastrophizing, mind reading, all-or-nothing thinking, and shows how to challenge and reframe them through guided questioning and evidence-based rebuttals. Cognitive restructuring is presented not as abstract theory but as a repeatable skill: identify the automatic thought, examine the evidence, generate balanced alternatives, and test those alternatives in the real world.
Behavioral change is treated as equally essential. Exposure and behavioral experiments are introduced as controlled ways to confront feared situations and disconfirm catastrophic predictions. Burns emphasizes graduated exposure, homework assignments, and repeated practice so that safety behaviors and avoidance are dismantled. Combined with cognitive work, these exercises aim to retrain the brain's threat expectations and reduce the intensity and frequency of panic and anxiety.

Practical exercises and tools
The book is rich in reproducible exercises: structured thought records, stepwise exposure plans, role-playing scripts for social anxiety, and troubleshooting guides for setbacks. Burns encourages frequent self-monitoring to identify triggers, patterns, and progress, and he provides concrete ways to measure change. Many chapters include short, doable tasks that can be completed between readings, making the material suitable for readers who want an action-oriented self-help program or for clinicians seeking client handouts.
In addition to cognitive and behavioral tools, Burns addresses common obstacles such as procrastination, safety-seeking behaviors, and relapse. He offers techniques for managing physiological symptoms, improving problem-solving skills, and building confidence through behavioral success. Throughout, the emphasis is on skills practice rather than passive reassurance.

Audience and usefulness
When Panic Attacks is written for both lay readers and professionals. Its straightforward language and case examples make complex therapeutic interventions understandable without formal training, while the specificity of exercises makes it useful as a workbook adjunct to therapy. Readers who commit to the exercises are likely to see measurable reductions in anxiety and panic symptoms; those seeking a quick fix may find the work challenging, since lasting change relies on consistent application.
Overall, the book offers an empowering message: by learning to identify distorted thoughts, conducting real-world experiments, and facing feared situations methodically, individuals can regain control over anxiety. The combination of compassionate tone, clear rationale, and a wealth of practical tools makes this a popular and enduring resource for people looking to overcome panic and related anxiety disorders without relying solely on medication.