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The Traditional Treatment of a Panic Attack: 

The Coining Healing Ritual
Typically the Coining Ritual Consists of Six
Steps

Step I: Initial treatment
(“doing the vessels”)

Treatment of the head with khyâl
oil: dabbing khyâl oil below the
nostrils, where it creates a stream
of pungent odor; massaging the
temples in a circular motion with
a finger tip coated with khyâl oil;
various other khyâl techniques
such as cracking the joints

Step II: Coining

Coining with khyâl
oil or ointment along
the trunk and arms

[A few minutes]

[5–30 minutes]

Step III: Drinking warm
fluid, taking medication

Taking Advil or other
antipyretic, taking
khyâl medicine,
drinking warm water

[A few minutes]

Step IV: “Doing the Vessels”

“Doing the vessels,” such as
rubbing the body with khyâl oil;
massaging the limbs; pulling on
the ears and hair; twisting the
head; cracking the knuckles of
the hands and feet; snapping out
the arms; having someone “step
on the vessels”
[15–45 minutes]

Step V: Creating Bodily Heat by Eating
Hot Fluids and Wrapping the Body

Wrapping the body in blankets
and eating hot rice porridge

[5 minutes to an hour]

Step VI: Sweating

Sweating brings
relief (e.g., escape of
khyâl through the
skin pores)

The Possible Positive Effects of the Coining Ritual
Camphor is absorbed into the blood as a result of coining and may
increase vagal tone, which in turn appears to improve orthostatic
adjustment as well as having other effects
The coining rituals creates a space of interpersonal interaction, an
opportunity for affectionate care, a space for conversation
The coining ritual actually heats the body through coining and the
khyâl oil, activating metaphors of warmth and security (ko kdaw)
The coining ritual increases physical and psychological flexibility
through direct, body-work-type healing effects: the flexile body
resulting from massage and other techniques as an embodied metaphor
of flexible adjustment