When Panic Attacks Strike: A Guide to ERP from an Anxiety Therapist in Melbourne

Experiencing a panic attack can be incredibly overwhelming, often making us feel out of control. However, there are various ways and strategies that these episodes can be managed. One effective treatment approach is exposure and response prevention (ERP). Originally developed to treat anxiety disorders, ERP is particularly valuable for those of us struggling with panic attacks and associated conditions like obsessive-compulsive disorder (OCD). In this guide, written by an anxiety therapist based in Melbourne, we’ll discuss more about ERP therapy and how it can help when those feelings of panic arise.

Understanding Panic Attacks and What Triggers Them

Panic attacks can feel like sudden waves of intense fear or anxiety that take over both our body and mind. These episodes typically last a few minutes, and can bring on physical symptoms like a racing heart, trouble breathing or feeling lightheaded. Triggers of panic attacks are different for everyone, but can include crowded places, stressful situations, or memories from the past. 

What is ERP?

ERP is a type of cognitive-behavioural therapy (CBT) aimed at helping us manage and reduce the anxiety caused by different triggers. The process involves slowly and gradually facing the things / situations that cause us anxiety, allowing us to develop healthier coping mechanisms without falling into patterns of avoidance.

How does ERP Work?

ERP involves two components: exposure and response prevention.

  • Exposure

Exposure refers to intentionally stepping into anxiety-inducing situations or environments, but in a controlled, supportive environment. This could involve virtual reality (VR) simulations, role-playing scenarios, or real-life situations in which a therapist is present to provide support. The idea is to gently, over time, help us become less sensitive to triggers, eventually reducing their impact  on us.

  • Response prevention

Response prevention involves resisting the natural urge to avoid or soothe the anxiety through habits such as:

  • Leaving the triggering situation,

  • Checking heart rate,

  • Seeking reassurance

Although these behaviours may reduce anxiety in the short term, they prevent us from learning that we can handle distress without needing to escape or rely on safety nets.

By preventing these responses during exposure, we gradually learn that we can sit with the discomfort of anxiety and that the feared consequences are often less intense and less likely to occur.

The Science behind ERP

ERP is based on two key ideas: habituation and inhibitory learning. Habituation is the process where, over time, our brain gets less reactive to what causes us fear. By repeatedly facing what triggers our anxiety (without relying on our usual coping habits) our anxiety gradually starts to fade. This allows us to manage anxiety without feeling completely overwhelmed, demonstrating our capacity to manage distress.

Inhibitory learning is the process of establishing new connections with previously feared stimuli. ERP helps us understand that anxiety is not as harmful or overwhelming as it seems. Rather than avoiding anxiety triggers or resorting to safety behaviours, we build new ways of effectively managing panic attacks. Ultimately, reducing anxiety's influence on us and allowing us to gain confidence in handling these moments.

Finding Support in Melbourne

Before beginning treatment for anxiety with an anxiety therapist in Melbourne, an initial assessment is completed to understand the nature of our anxiety and panic attacks. During this time, a therapist will help us in developing a hierarchy of anxiety-inducing situations. This will allow us to face these fears in a gradual and controlled way that feels manageable.


Throughout the process of ERP therapy, the therapist will be there to guide and support us, helping us to stay engaged with the exercises and manage the discomfort of response prevention or resisting old habits. Sessions are designed to ensure that you feel safe and empowered as your work through your anxiety. ERP therapy can be challenging because it requires us to face our feared situations. Nevertheless, the long-term benefits of reduced anxiety, fewer panic attacks, and improved overall well-being demonstrate its effectiveness in managing anxiety disorders.

Choosing the right therapist

A therapist's ability to create a safe, supportive environment and their understanding of our unique needs are critical factors that affect the success of ERP therapy. At Inner Eastern Psychology, we offer the opportunity to consult with an anxiety therapist in Melbourne who specialises in evidence-based treatments like ERP. Our team is committed to providing compassionate and personalised care to those who are struggling with anxiety and panic attacks.


If you’re ready to take steps towards overcoming panic attacks or anxiety, contact our team today. We would like to guide you on your path to recovery, one step at a time.

Kane Waters