Anxiety can be a crippling experience and I can recall a few episodes where my wife called me from the grocery store in a panic. Usually she was in the aisle and something set her off, where she began to feel closed in, heart racing, hyper-aroused and panicky.
It’s a situation where the fight/flight system has become excessively active and often is locked in a pattern of distress. It’s like being in a car and revving the engine and continuing to pin your foot on the gas.
To assist someone quickly, there are 3 things I tend to have them focus on:
1) Their breath
2) Reassuring them that I hear their concerns
3) Something in their environment they are certain about
I’ve encountered hundreds of instances where there was a panic attack happening, and I’ve found those strategies to be very helpful and available in the times where someone needs a helping hand to work through their struggles.
Focus on their breath.
Whenever someone is in a panic, whether it be my wife, or a patient, the first thing that it brings about is instant presence and calm. It allows them and gives them the contrast to slowly let their foot off their own gas pedal. If they are in a state of panic, I balance things out with an external state of calm. I quickly tend to guide people directly to their breath. Get them to stop talking if they can and focus their attention on the breath. The breath of in the nose and out the mouth is a grounding breath; a stabilizer of sorts. If you can guide them to pace their breath of 3-5 seconds in, and 3-5 seconds out, that is most beneficial. “Breath in, one-two-three-four-five, breath out, one-two-three-four-five”
Repeat the last few words.
I’m also listening very carefully to what they are saying, and often times reiterating that back to them the last few words of their sentence so they know I hear them. “Steve, I’m freaking out right now..” “You’re freaking out right now…okay…breathe for a moment..”
Hearing your words said back to you, is like giving a little hug of validation, knowing that your concerns are heard, creates a feeling of safety in the moment for the nervous system, and invokes an awareness of support (your words aren’t competing with theirs or you aren’t saying something that they have to believe or not)
Ground them with something in their environment.
Of course they are reaching out to you for the original stability, but if there is something in their immediate surrounding that can ground them great. Maybe a park bench, maybe just sitting in the grass, grabbing a hold of the shopping cart and gripping it tightly while focusing on it. They are looking for certainty, so I try to come up with things or ideas that can provide them with greater certainty in the moment.
“What colour are the tiles on the floor?”
“Name me what you have in your cart”
“How many people are in the line?”
“What colour paint is on the walls?”
The Goal is to help them find peace.
Bring their focus to something that they are certain about, because the experience of anxiety arouses massive amounts of uncertainty and chaos, just like being attacked by
a person or animal, and it’s unsettling and unstable. In the first, not the last, part of healing, the individual needs to feel safe and certain that the danger won’t take their life, and that they are okay. You’re goal, is to provide enough certainty and stability to help them access elements of their own inner peace, first by being the “peace” they are looking for, then by helping them focus on their breath, then reassure you hear them, and finally help them find certainty and stability in their environment to further access their inner peace.
The more you help them find their peace, it means the foot is coming off the gas pedal, they are slowing the inner engine, and they develop the capacity to gently apply the brake to reflect, calm, and rejuvenate their energy.
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