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"This had better work." to "It's OK if it doesn't work."

Thinking out loud with Camille helped me put a bigger piece of the puzzle together.

Camille N. called me from Florida four years ago. She said she had suffered from panic attacks for many years and found the first edition of Don't Panic in the library last year. She was wondering if, on her trip back to New York in a month, she could stop in for a consultation. We set up the appointment, and Camille arrived as scheduled.

Camille, it turns out, was similar to many of the people who see me from out of state. She was an impeccable student of the techniques. She practiced formal relaxation daily. She had her breathing skills down pat. She planned her practice sessions into the anxiety provoking situations and knew the most supportive self-talk during panicky times.

But she kept having trouble.

"Like last week, for instance . . . I was driving down the boulevard about 4:30, and the traffic was moderate. I needed to take a left so at the stop light I moved over into the turn lane, three lanes from the right curb, and pulled up behind four cars. Immediately three more cars pulled in behind me and the other two lanes filled with traffic. These lights are notoriously slow, and I've always hated getting trapped like that.

"When I felt my stomach get tense, I knew I had to work with my skills. First I reassured myself that I could handle this. If I needed to, I could even get out of the car, leave it right there at the light. I took a nice big Calming Breath, then started Natural Breathing. I dropped my hands from the steering wheel and let them relax in my lap. Nothing seemed to help!"

Outwardly I was attentive and positive, but inwardly I was frustrated, thinking, "Why? Why wasn't that helping? That should be working!" I felt like the Wizard of Oz. This woman has driven so far in anticipation of this specifically arranged meeting with the expert that wrote the book she depends on to get her well. Now, here we are, face to face, and I'm about to say, "Hmm, I'm not sure what else to suggest."

I'd love to say, "Then it dawned on me . . . ." In reality it took another thirty minutes of struggle to see the new opening. Both Camille and I were making the same error, and you can see it in our self-talk. She says, "Nothing seemed to help!" I said, "Why wasn't that helping? That should be working!" Despite all our combined years of study, we were unknowingly committing a basic mistake. Our immediate goal was for Camille to stop being anxious. We thought if she applied enough technique -- handle your negative talk, get your breathing straight, be willing to tolerate symptoms, wait -- she would get "results" of diminished anxiety.

What's wrong with that?, you say.

Here's the answer, which may be tough to accept. While the long-term goal is to diminish your anxiety, the immediate goal is to continually monitor your attitude -- to accept exactly what you are experiencing, as you experience it. As soon as you say, "This had better work," you are moving against this important task. It is fine to observe, study and learn from your current experience, but don't declare that your feelings must change on demand. Our bodies and minds simply don't work that way.

This is paradox in its purest form. The attitude to aim for is, "It's OK that I'm anxious right now. I'm also going to fool around with getting rid of this anxiety. I'm going to try every trick and gimmick I know. I'm going to apply all my concentration, my tenacity, and my commitment to the task of getting rid of this anxiety. I'm going to use what I believe is the best combination of skills and attitudes for this specific type of anxiety. If it works, that'll be great. And if it doesn't work -- if I'm still anxious -- that'll be OK too."

This is the attitude that even the best students of panic tend to miss. You must step up onto the platform of acceptance. Apply your skills from there. Maintain that stance through all the good and bad responses you get to your skills. And end up standing there in the end -- accepting exactly what you are experiencing -- regardless of the outcome.

The most important distinction here is that this position -- "It's OK if it doesn't work out" -- is not about passive resignation to the status quo. It is not surrendering to the fact that, "you have panic attacks and you better get used to it." Instead, it is a part of an active, dynamic process of healing. Consider this attitude as though it is a technique that you apply throughout the moments you are either anticipating or having trouble. When you say, "This had better work," you are testing yourself and you will respond by emotionally and physically tightening up. When you tighten up, you feed panic. By saying, "It's OK if it doesn't work," you pull yourself out of this testing environment. Crazy as it sounds, this action of removing the demand for success actually increases the likelihood of your success.