Home·Articles·A Case from Practice
From Practice

Panic Attack.
A Case from Our Practice

11 May 2026 · Mark Vdovskikh

An acute panic response to the loss of a close friend.

A long-standing client came to us. Someone who has watched his condition for years, comes to us regularly, knows what working with the body actually is. This matters. What happened next rested on trust that had been built over years. Without it, work like this in an acute situation would not have been nearly as effective.

For several months before that, he had been living in mounting tension. A difficult situation, drawn out, with no resolution. A few days later, when the situation finally broke, something began that he had never lived through before. A panic attack. Suddenly, out of nowhere, with all the textbook signs: a racing heartbeat that felt close to a heart attack, the sense of not being able to draw enough air, the conviction that something irreversible was about to happen. The attack was very strong and very sudden, and he did not wait to see what would come next. He came straight to us.

When he arrived and told us what had happened, we recognised what we were seeing. And we recognised that this state had a physical layer that could be worked with right now.

What happens in the body during acute loss

The loss of a close person is among the most powerful stresses a human being can go through. This is not an "emotion" in the everyday sense. It is a state of the whole organism. The body switches into alarm mode and holds it. The heart beats faster, breathing becomes shallow, muscles tighten, rest no longer brings rest. The things that normally calm a person — sleep, food, the usual rhythm of the day — work poorly in this state, or do not work at all.

Studies of people who have experienced loss show that the organism really does "get stuck" in this alarmed state for a long time. Sometimes for months. It cannot come out on its own, because the rupture happened outside, while the body keeps reacting as though the threat were still present.

A panic attack against this background is not a malfunction. It is a logical next step. When alarm has been switched on for too long, at some point the system tips over into acute overload. The heart pounds, the breath catches, the brain reads the signals coming in as "threat to life", and the next loop begins. A loop the person cannot exit on their own.

The standard approach here is psychological support and, where needed, medication. This works, and we do not position ourselves against this path. But within that system, the body itself often gets bypassed. The work happens through the mind and through chemistry. The body has its own entry point, though. It is the breath and the physical work with the muscles responsible for that breath.

Why the diaphragm

The diaphragm is the main muscle of breathing. More than that: it is the main mechanism through which we can influence the state of our nervous system.

A careful note here. The diaphragm itself is not controlled by the vagus nerve. It is controlled by the phrenic nerve, which originates in the cervical spine. But the vagus nerve — the one responsible for switching the body out of alarm and into recovery — passes through the diaphragmatic opening and responds to the diaphragm's movement. So when we breathe deeply and slowly, especially with a long exhale, we directly influence the tone of the vagus nerve. And the body begins to shift from "danger" into "it is allowed to rest now". This is a well-described physiological mechanism, and the effectiveness of diaphragmatic breathing in anxiety and panic states has been confirmed by many studies.

Under acute stress and anxiety, the diaphragm physically locks. This is not a metaphor. A clinical study by Kaneko and Horie (2017) showed that patients with panic disorder have an objectively impaired capacity for diaphragmatic breathing and a reduced vital lung capacity compared with healthy controls. And, importantly, targeted training in diaphragmatic breathing brings these indicators back to normal.

In other words, the common phrase "panic took his breath away" stands on a measurable physiological fact. The diaphragm locked. And if it is released, a path to recovery opens.

What we did with our hands

For about half an hour, I worked with the zones that anatomically govern the release of the diaphragm.

The first are the points of attachment of the diaphragm to the lower rib arch, along the front and side surfaces of the rib cage. The places where, in chronic anxiety, tension accumulates — not visible from the outside, but holding the diaphragm so that it cannot fully open on the inhale.

The second are the reflex points on the front and side walls of the abdomen. Through them it is possible to "tell" the nervous system that the diaphragm is allowed to let go.

Thirty years of clinical practice and an understanding of how the anatomy and physiology of this process are built allowed me to apply, here, a known approach to diaphragm work — but applied deliberately and at the right moment. The method of manual diaphragm release has also been studied in current literature. Research on patients with chronic lung conditions has shown that a single such procedure, immediately after it is carried out, lowers resting heart rate and improves the body's capacity for recovery. In other words: through the release of the diaphragm, using the hands, it is possible to allow the whole organism to shift out of mobilisation and into recovery. And this shift is measurable.

That was our task in this case. To bring the body out of "still in danger" and into "it is allowed to begin resting".

What Olga was doing

Alongside the manual work, Olga was running her own line of work. It is her part of the method, and it cannot be described as clearly as the manual side — but without it, a description of the session would be incomplete.

Olga works with the person's state directly: through presence, attention and her own energy. This is not a supporting background. It is an independent layer of the work, one that holds the person in the state that the body begins to move into under the manual work, and deepens that shift.

In this session, Olga also used a sound frequency of 432 Hz, directed toward the area of the solar plexus. The solar plexus is a large autonomic nerve hub, and work with this area creates a condition in which the body more readily finds the right rhythm of breathing and keeps it.

We say this honestly: the scientific literature demonstrating a specific effect of the 432 Hz frequency in particular is, at present, not sufficient. This is part of our own method, based on clinical observations from our own practice. But we can say that, in this session, it was part of the set of inputs after which the patient reported the result.

What happened next

Immediately after the session, the person felt different. This was not simply physical relaxation. It was a shift in the overall tone of the system. And he held that state himself.

Over the following 72 hours, the panic attacks did not return. He described it like this: the desire to live came back, the desire to create came back, the sense of a normal day came back. Not the state he had been in before the loss — after a loss like this, the former cannot be returned, and that is a natural part of grieving — but a state in which life with this loss can continue.

In this specific case, we saw three conditions coming together: a long-standing trust between us and the patient, an obvious acute physical layer, and our readiness to work with that layer through a direct physical route, while consciousness was still struggling with what had happened.

Online conversation
If something in this text reaches you, the simplest next step is a short conversation online. No commitment — just to see whether there is a point for shared work.
Write on WhatsApp →
Frequently asked questions
Can you work this way with any panic attack?
No. A panic attack can have very different causes — from acute situational stress to systemic panic disorder, which calls for prolonged psychological and sometimes pharmacological work. We have described one case in which a specific physiological layer was visible and in which work with the body was possible. This is not a universal protocol. If panic attacks happen to you regularly, a reasonable first step is a consultation with a psychiatrist or a psychotherapist who specialises in anxiety disorders.
How long did the session take?
About an hour. Of that, roughly half an hour was active manual work on the diaphragm and the related zones. The rest was general work with structure and state.
What should I do if a panic attack starts right now and I cannot reach a specialist?
The simplest thing that genuinely helps in that moment is slow diaphragmatic breathing. Inhale into the belly through the nose to a count of 4, pause, exhale through the nose or pursed lips to a count of 6–8. Several minutes of breathing this way produces a measurable shift in the nervous system. This does not "treat" panic disorder, but in the moment of an acute attack it returns control over the physiology.
How is this different from what conventional medicine offers for such states?
We do not position ourselves against conventional care. Psychotherapy (particularly cognitive behavioural therapy) and pharmacological support have strong evidence bases for panic disorders. We work with a physiological component that is often left uncovered by these protocols — the structure and tone of the muscles that hold the organism in mobilisation. In an acute situation like the one described here, work of this kind can produce a rapid shift. In a systemic situation, it can be a useful complement to the main course of treatment.
References
Kaneko Y, Horie J. Recovery of Percent Vital Capacity by Breathing Training in Patients With Panic Disorder and Impaired Diaphragmatic Breathing. Behav Modif. 2017.
pubmed.ncbi.nlm.nih.gov/28670907
Breathwork Interventions for Adults with Clinically Diagnosed Anxiety Disorders: A Scoping Review. Brain Sciences, 2023.
ncbi.nlm.nih.gov/pmc/articles/PMC9954474
Hopper SI, Murray SL, Ferrara LR, Singleton JK. Effectiveness of diaphragmatic breathing for reducing physiological and psychological stress in adults: a quantitative systematic review. JBI Database System Rev Implement Rep. 2019.
pubmed.ncbi.nlm.nih.gov/31567462
Osterweis M, Solomon F, Green M, editors. Bereavement: Reactions, Consequences, and Care. Institute of Medicine (US) Committee for the Study of Health Consequences of the Stress of Bereavement. Washington (DC): National Academies Press; 1984. Chapter 3: Toward a Biology of Grieving.
ncbi.nlm.nih.gov/books/NBK217844