Dear Anne-Marie,
Let me address one question at a time.
First of all, if you 'peak' like a speeding bullet with no time to prepare for the 'fireworks' one thing you can do is find someone to help you - even if you are driving, pull over, try and find someone. At the time, it really does not matter who it is - just find a friendly face - a cop - a person walking down the road - someone in a mall - anyone who will agree to literally 'hold' you and promise everything will be o.k. This is a hard thing to do. However...I have found over the years people are becoming more and more understanding...when they hear the words "...please help me, I am having a panic attack and need someone to be with me right now..." people know what you are talking about. This is a relief. I have had to stop in public places about 9 or 10 times over the years and it was hard. The media has done a fine job covering this issue as famous people have come forth to tell of their bouts with panic and agoraphobia - this has helped educate the public. And, I might add, that many people have encountered panic attacks themselves.
One must become very alert you your body. If I feel in the least little way a panic attack is coming on - I immediately take my medication. If I do not have it on me, I just go home. I tell my superior at work, after I have been there awhile (and I feel I can trust them) about my panic attacks. This is a delicate area - usually, I don't want anyone to know unless they are good friends.
My good friends and family know how to deal with it - just ride it out with me, assure me I am not going to die, I have had them before and survived.
The strategy is to be aware - I have them and have had them since I was about 12 years old - they do not seem to be going away. And I don't think I am going to be instantly healed of my MVP - so...I must deal with this.
Now, on the cognitive level - self-talking your way out of one - one that is not a full blown attack - is possible if you practice. You say to yourself things like:
1. I must concentrate on something else! Now!
Get some icecubes and put them on your neck. Read really loud out loud - just to put in the back of your mind the feeling you want to run. (fight of flight) - I am trying very very hard to lean into t