Breadfish reminded me that I have also left the room for a couple minutes to stand in the bathroom to get myself together. But I try to avoid doing that, because with my panic disorder, my instinct is to run away and hide if I'm having a panic attack (so no one can see me). Which of course isn't always possible (if I'm riding in a car with someone on the highway, say). So I try to tough it out in a T's office so that I can practice that skill. It's kinda silly, but I feel self-conscious having a panic attack in front of a T, who should probably be the *last* person I have to worry about judging me for that...

I also agree with the writing something down and handing it to the T to read at start of session--that's helped me a few times. It was harder when ex-T wanted me to read some of it out loud. Another thing that can help is just saying, "I'm really anxious right now for some reason." Admitting it instead of trying to hide/suppress can be helpful, I've found.