“Overestimating risk” – overestimating the chances that a scary event will happen – is perhaps the biggest source of power for scary thoughts.  

One of the best ways to pull the plug on scary thoughts is to ask yourself  “What are the chances that (the scary thought) could actually happen?”  A scary thought is powered by the belief that it is likely to happen.  When you challenge that mistaken belief, the scary thought starts to run out of steam.  

Here’s an example:

Sensation:   Racing heart
Scary thought:  “Oh my God, I could be having a heart attack!”

Challenging the scary thought (using “What are the chances” and the “Q & A” style):

Q:  When you are having a panic attack, what do you think is the chance you'll have a heart attack?
A:  50-50.

Q:  How many times have you had a panic attack?
A:  Maybe a hundred

Q:  So you've had 50 heart attacks?
A:  Not exactly.

Q:  OK, then, how many?
A:  Actually, zero.

Q:  Do you have any heart problems?
A:  No. My doctor says my heart is in great shape.

Q:  And how fast do you think your heart is beating during a panic attack?
A:  I've read that it could go as high as 140.

Q:  How high does it get when you go running?
A:  Oh, about 120 to 160.

Q:  And have you had a heart attack when you were running?
A:  Of course not.  In fact, running is good for my heart.

Q:  Has anyone ever had a heart attack just because they had a panic attack?
A:  Well, I've read Barlow, Zuerker-White, Bourne and some others.  They all say the same thing.  No one has ever had a heart attack just because they had a panic attack.  That's based on thousands of people who've had panic attacks.  No one has ever had a heart attack as a result.

Q:  So, what is the chance you will have a heart attack from panic?
A:  Zero!