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Cognitive Behavior Modification

Are Your Thoughts Making You Panic?


Updated June 10, 2014

Donald Meichenbaum is a psychologist noted for his contributions to cognitive behavioral therapy (CBT). He developed a therapeutic technique called cognitive behavior modification (CBM), which focuses on identifying dysfunctional self-talk in order to change unwanted behaviors. In other words, Dr. Meichenbaum views behaviors as outcomes of our own self-verbalizations.

Panic disorder, agoraphobia or other anxiety disorders often result in certain thought patterns and behaviors that may hinder recovery. For example, let’s say you have to attend a meeting a work tomorrow. You’re anxious and fearful that you will have a panic attack at the meeting. You may tell yourself, “What if I have a panic attack and have to leave the meeting. I would be so embarrassed.” So, you call in sick to work the next day so that you can avoid the meeting.

But, what if you were able to change your thoughts? And, what if by changing your thoughts, you are able to attend the work meeting instead of avoid it?

How to Change Your Thoughts

Using CBM, changing thoughts and behaviors, including avoidant behaviors and panic responses, is a three-phase process:

Phase 1: Self-Observation

This phase involves listening closely to your internal dialogue or self-talk and observing your own behaviors. You want to be especially aware of any negative self-statements that are actually contributing to your anxiety and panic symptoms.

Phase 2: Begin New Self-Talk

Once you recognize your negative self-talk, you can begin to change it. As you “catch” yourself in familiar negative thought patterns, you recreate a new and positive internal dialogue. “I can’t” becomes “It may be difficult, but I can.” These new self-statements now guide new behaviors. Rather than using avoidant behaviors to cope with panic and anxiety, you become willing to experience the anxiety-provoking situations. This leads to better coping skills, and as your small successes build upon one another, you make great gains in your recovery.

Phase 3: Learning New Skills

Each time you are able to identify and restructure your negative thoughts and change your response to panic and anxiety, your are learning new skills. Because you are now acutely aware of your thoughts, you are better able to gauge your anxiety and react in a more useful manner.

When your negative thoughts control you, it becomes difficult to control your behavioral responses to unpleasant situations. But, CBM can give you back some lost control. As your thoughts change from negative to positive, you start to behave differently in many situations. And, you will likely find that others react differently to the new “positive” you as well!


Corey,Gerald. (2009). Theory and practice of counseling and psychotherapy. Belmont, CA: Thomson Brooks/Cole.

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