What is the 333 method for panic attacks?

Panic attacks can be extremely frightening and debilitating events. A panic attack is an abrupt episode of intense fear and discomfort that reaches a peak within minutes. Common symptoms include a racing heartbeat, shortness of breath, dizziness, trembling, sweating, nausea, and an overwhelming feeling that something terrible is about to happen.

While panic attacks are not inherently dangerous, they can greatly interfere with daily activities and overall quality of life. Finding effective strategies to prevent and cope with panic attacks is critical for managing this condition.

The 333 method is a simple coping strategy that some people find helpful for interrupting the cycle of panic when an attack strikes. It does not prevent panic attacks or address any underlying causes, but it may help manage symptoms in the moment.

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What is the 333 method?

The 333 method involves focusing your attention outward on your surroundings to “ground” yourself during a panic attack. Specifically, the steps are:

Look around and name 3 things you see.

Listen for 3 sounds you can hear.
Touch 3 textures you can feel.

The goal is to get out of your head and connect to your environment using multiple senses. This can help shift your focus away from fearful thoughts and bodily sensations.

How does the 333 method work?

The 333 method aims to engage the logical, thinking parts of your brain to interrupt the overwritten “emotional” brain activity that occurs during a panic attack. Paying close attention to visual, auditory, and tactile stimuli around you requires concentration and analysis, which activates your prefrontal cortex.

Your prefrontal cortex is the control center of your brain. Among other things, it regulates emotions, focuses attention, and analyzes information. During a panic attack, the prefrontal cortex essentially shuts down as the amygdala (fear center of the brain) takes over. Purposefully activating your prefrontal cortex using the 333 method can dampen the amygdala response.

Benefits of activating the prefrontal cortex

Reduces emotional arousal

Lessens anxiety and fear
Enables logical thinking
Regains cognitive control

Additionally, the 333 method promotes mindfulness, keeping you grounded in the present versus spinning out worrying thoughts about the future. The sensation of touch is particularly powerful for anchoring yourself in the here and now.

Is the 333 method effective for panic attacks?

Research on the efficacy of the 333 method per se is limited. However, there is evidence supporting the general use of similar grounding techniques for managing acute anxiety.

For example, a 2016 literature review looked at 19 studies on grounding techniques for reducing anxiety, including tactical stimulation (using touch or smell), mindful breathing, and paying mindful attention to surroundings. The researchers concluded that these techniques are simple, quick to implement, and work by pulling limited attention resources outward versus inward.

Similarly, a 2019 randomized study found that provoking all 5 senses (vision, hearing, touch, smell, taste) was effective for reducing self-reported anxiety compared to no intervention. This lends support to the idea that engaging multiple senses, as the 333 method does, can help manage anxiety.

While not directly studying panic attacks, this research indicates that grounding/mindfulness techniques activating multiple senses are beneficial for acute anxiety. More studies validating the 333 method specifically would be helpful.

Anecdotal evidence

There is a wealth of anecdotal evidence online from people who swear by the 333 method for mitigating their panic attacks. While anecdotal, it suggests many do find it beneficial during a panic episode:

“I can’t tell you how much this helps me! It stops my irrational thoughts.”
“The 333 method has prevented many a panic attack for me.”
“Focusing outward interrupts my panic cycle so I can think clearly again.”

“This technique really short-circuits the panic response and lets me regain control.”

How to use the 333 method during a panic attack

If you feel a panic attack coming on, try the following 333 method:

Look – Look around and name 3 things you see. For example, you could say: “I see a tree, I see a bird, I see a stop sign.” Say the items out loud or in your head.

Listen – Listen for 3 sounds around you. For example: “I hear the wind blowing, I hear a car engine, I hear my own breathing.” Say the sounds aloud or silently.
Touch – Touch 3 textures near you. For instance, you could touch your shirt sleeve, your watch band, and your hair. Describe each texture out loud or to yourself.

Repeat the sequence as needed until you begin to feel calmer. The idea is to continue directing your focus outward instead of inward on panic symptoms.

Tips for using the 333 method effectively

Start using it at the very first signs of panic – Don’t wait until it escalates.
Describe each item specifically – For example, “smooth wooden table” instead of just “table.”
Keep repeating the sequence until you feel your panic subsiding.

Use the technique portably – It can be done anywhere, requiring no equipment.
Customize if needed – Use smells or tastes instead of touch if preferable.

Limitations of the 333 method

While the 333 method may be helpful in the moment, it has some limitations to consider:

It does not address any underlying causes of panic attacks or prevent future episodes. Other treatment is still needed.
Some find it difficult to focus outward when panic is severe. Practicing when calm can help.
Effects are temporary. Panic symptoms may return as soon as you stop the technique.

It may not work for everyone – Results can vary individually.

The 333 method should not replace professional treatment for panic disorder. Psychotherapy, medication, or both are often needed to achieve lasting improvement. This technique is simply meant as an acute coping skill.

Is the 333 method right for you?

The 333 method can be useful for anyone experiencing panic attacks who wants to try a simple cognitive-behavioral technique for temporary symptom relief. It may benefit:

Those having infrequent, sporadic attacks who mostly need “in the moment” help.
People hesitant to try medication or extensive psychotherapy.
Anyone seeking portable, easy coping skills to add to their toolbox.

Those with predictable panic triggers who can implement it early on.

The 333 method isn’t necessarily recommended for everyone. Other approaches may be better if you:

Have severe, frequent panic attacks.

Experience uncontrolled, rapidly escalating attacks.
Have panic attacks unrelated to specific triggers.
Need help preventing future panic attacks versus just managing symptoms.

Conclusion

The 333 method is a simple coping strategy that involves looking around to see 3 things, listening for 3 sounds, and touching 3 objects during a panic attack to ground yourself in the present moment. This mindfulness technique activates your prefrontal cortex to calm emotional arousal.

Research supports grounding techniques like the 333 method for acute anxiety relief. While not a standalone treatment, the 333 method may provide temporary panic symptom relief if used properly. It can be a beneficial “in the moment” coping skill for those struggling with panic attacks.

To get the most out of the 333 method:

Learn and practice it when you are already calm.
Implement it at the first sensations of panic.
Be specific in your descriptions of what you see, hear, and touch.

Repeat the sequence until you feel your panic subsiding.

While not a cure-all, the 333 method is one cognitive-behavioral tool that can be helpful for managing panic symptoms when they flare up unexpectedly. When combined with other professional treatment approaches, it may support greater control over panic disorder.