Panic in the Therapy Room: Grounding vs. Internal Family Systems
When someone experiences a panic attack during therapy, the typical response is to help them “ground” — reconnecting with the present moment through the five senses, breathwork, or body awareness. This somatic approach often offers vital immediate relief. However, the Internal Family Systems (IFS) model invites a different, more curious stance: rather than soothing the panic directly, IFS encourages us to relate to the part that is panicking — or more often, to the protector trying to manage overwhelming emotions.
This article explores the contrast between traditional grounding and the IFS response to panic, and how each holds value depending on context and therapeutic intention.
Traditional Grounding: Reconnecting with the Present
Grounding is a widely used strategy in trauma-informed care. It works by bringing the client’s attention away from overwhelming inner experiences and back to the external, present moment.
Common grounding techniques include:
- Naming five things you can see
- Feeling your feet on the floor
- Controlled breathing or box breathing
- Holding a cold object like a stone or ice cube
- Engaging in rhythmic movement or tapping
Purpose:
These techniques are designed to de-escalate arousal, increase a sense of safety, and prevent dissociation or emotional flooding. They are particularly effective when a client is losing contact with their body, space, or time due to panic or traumatic activation.
IFS and Panic: Meeting the Protector with Curiosity
IFS sees a panic attack not as a problem to be stopped, but as a signal from a part of the system — often a protector working hard to prevent deeper emotional pain from surfacing. In IFS, we aim to get curious about the part that is panicking or triggering the panic, without fusing with it or rejecting it.
An IFS-informed response might sound like:
“Can you sense where that panic is in or around your body?”
“Is it OK to see if this part would be willing to let us get to know it a little better?”
“You don’t have to feel anything you don’t want to — let’s just notice this part and see what it’s afraid might happen.”
This approach assumes that the panic is not the Self, but a part trying to help — even if in a way that feels overwhelming. By getting curious, we open the door to eventually unburdening the part of its extreme role.
Comparison Table
| Feature | Traditional Grounding | IFS Approach to Panic |
|---|---|---|
| Primary Goal | Reduce arousal, restore regulation | Understand and build relationship with the part behind the panic |
| Focus | External environment and body | Internal parts system |
| Time Orientation | Present moment | Present moment, with openness to the past if parts allow |
| Key Assumption | Panic is dysregulation | Panic is a protective strategy |
| Intervention Style | Directive or guiding | Collaborative and curious |
| Somatic Awareness | Used to ground | Used to sense into parts |
| When Most Useful | When client is overwhelmed or dissociative | When client is resourced and curious about inner dynamics |
Integrative Practice: When and How to Use Each
These two approaches are not mutually exclusive. In fact, they can work beautifully together.
- If a client is too dysregulated to remain in contact with you, grounding is essential first.
- If the client can stay present but is engaged with intense emotion, you might invite an IFS-style dialogue.
- In longer-term therapy, you might help clients learn to self-identify protectors, so that panic becomes less mysterious and more relational over time.
Clinical Vignette
Ella, a 28-year-old client, begins to panic after describing a memory of being scolded as a child. Her breathing shortens and her eyes dart toward the door. Traditionally, we might help her feel her feet, name objects in the room, and slow her breath.
Using IFS, we might ask, “Is it OK to just notice what part is showing up right now? Maybe the one that’s making you want to leave?” Over time, Ella identifies a vigilant protector who fears punishment and humiliation. By forming a trusting relationship with this part, her panic lessens—not by controlling it, but by understanding its role.
Conclusion
Grounding offers vital containment, particularly in early trauma work. But once safety is established, the IFS approach adds depth by viewing panic as a relational signal from within. By engaging parts with compassion and curiosity, therapists can help clients move beyond managing symptoms toward transforming their inner systems.
References
- Schwartz, R. C. (2021). No Bad Parts: Healing Trauma and Restoring Wholeness with the Internal Family Systems Model. Sounds True.
- Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. W. W. Norton & Company.
- Fisher, J. (2017). Healing the Fragmented Selves of Trauma Survivors: Overcoming Internal Self-Alienation. Routledge.
- van der Kolk, B. (2014). The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma. Penguin Books.