ABSTRACT
Lisa was a twenty-three-year-old undergraduate science student who presented to student counselling services because of recurrent panic attacks. The first attack had occurred about three months earlier, in the midst of a stressful series of university exams. Lisa had been quite anxious about the exams and had been staying up late studying. She had also been drinking a lot of coffee. Her first attack occurred the morning before the first of her exams. She suddenly felt queasy and light-headed and her surroundings seemed vaguely unreal. She broke into a cold sweat and her heart pounded like a hammer in her chest. Lisa thought she was about to die. Twenty minutes later the attack passed, leaving Lisa weak and exhausted. She attributed the attack to stress, lack of sleep and too much coffee. Accordingly, she cut down on coffee and tried to get more rest.
