With everyone's stress levels heightened with the unfolding of the COVID-19 pandemic, discussing good coping skills for panic attacks is more relevant than ever. Here are some great mindfulness-based tips from my friend and colleague Gen Morley at North Boulder Counseling.
One thing I most appreciate is when I get to help people change their relationship to their panic attacks. The reality is that we can’t always make them stop. Sometimes our best bet is to learn how to get through them better. I wrote this because I and so many people I love, know what it’s like to suffer from panic attacks. I wrote this hoping to help diminish both the suffering and taboo of panic attacks.
This is how it starts for me. My breath gets tight, I can’t focus and I can’t think. Oh no, oh no, oh no! It’s a panic attack. It literally feels like I am dying. Maybe I know what triggered it, maybe I don’t, it doesn’t really matter now. It’s here, consuming me. So, what do I do now? Panic, right? There are some other options either in addition to panicking or instead of panicking.
What is a panic attack? To understand better what those options are and why they are the best choices, we should do a quick overview of what a panic attack is. There are quite a few ways to think of it, but for brevity and clarity, let’s think of it in terms of the nervous system. A panic attack is when something triggers our nervous system into fight, flight or freeze mode. This means that the animal part of our brain is turned on high and the rational part of our brain is turned low or off. Our brain begins sending out chemical messengers that will help us run from or fight the perceived danger. This process speeds up our heartbeat, it makes our breathing get shallow and our rational brain (prefrontal cortex) turns down/off because it’s too slow for the kind of response time we need if we are being chased by a lion. If there was actually a lion or real danger, this would be a great response because the hyperarousal of our nervous system would turn us into a super fighter, runner or enable us to hide in stillness. The only problem is the definition of panic attack means that there isn’t actually a lion, but our whole body is behaving as if there is one.
Where to be the change? So, here are some options for when our body tells us something life threatening is happening and really our partner just left for milk without telling us or whatever seemingly random thing has triggered our panic. These are three steps that are generally progressive over an extended period of time that will help us have more tolerable panic attacks.
Step One: Try to notice that we are having a panic attack. This sounds simple but often our rational brain is turned so low that we can’t even see what is happening, we just feel like we are dying. Beginning to say; ‘oh, this is panic attack’ is a significant first step in easing our rational thinking back online. Maybe over time we can say ‘this is a panic attack and it will end’. The panic attack still plays it’s course, but there is a tiny part of our brain that can see that it is a panic attack and this is the part that we want to grow. Maybe we begin to watch it and find the patterns even as it is happening. Things like; ‘oh, I start out anxious and then I always get angry and toward the end I feel sad and guilty.’ Panic attacks have cycles and patterns. If we can get to know your panic attacks, this fundamentally changes our perspective of the experience. We begin to notice when the attack is over. Even say it out loud; ‘that panic attack is over now.’ At this point we are not trying to stop them at all. As this part of our brain grows, the watching and labeling part, the observer, it will make the subsequent steps possible.
Then what? Change one thing. Once we can name it ‘panic attack’ when it’s happening and we can notice when it stops, then we may be able to make some small choice during the panic attack. Still, the choice is not to skip the panic, but maybe to stand outside in the sun and wait it out, or tell our partner that we are having a panic attack or even just say to yourself: ‘I love you just as you are.’ The small change in the panic attack cycle will not likely feel momentous when it happens, but be assured, to be able to consciously change any part of that cycle is indicative of momentous change in our brain. In the beginning we may find that we can make the change sometimes and other times we can’t. Be patient, this change is slow but it is lasting. Play with change for a while. Notice how different changes affect the panic cycle, notice what is easy to change and what is harder. This skill and the information we gather is changing our brain. Literally, we are changing the neural connections and therefore the way our brain functions. It even looks different in a high resolution brain scan. These changes will make the last step possible.
Finally, Step Three: More choice. In step two we have begun to exercise choice in the panic process. Now we go for more challenging choices. Some of which could get us out of a panic attack and some of which just won’t. It takes a significant amount of learning and patience to figure out what gets us into a panic attack and what can shift it. By this point we know our panic attacks. We know the awful parts and the parts that maybe even feel somewhat bad in a good way. By becoming familiar with our panic attacks we will know what choices we can make mid-panic to make it feel a little less intense. Everyone finds different points and styles to make their panic attacks more tolerable. Some folks will be able to direct it early so it doesn’t get as bad and others find ways to dial them down mid-panic.It is impossible to say that every person who has panic attacks could someday cease to have them, but these steps can be very effective in helping us have a better panic attack. Put another way, it becomes a panic attack that is a bit more on our own terms. Imagine getting to create some requests of our panic attacks. For most of us, panic attacks are a bit less scary and mysterious when we can name them, watch them and make even small requests, if only some of the time. May we all know our panic attacks and find some space for choice.
Gen practices at North Boulder Counseling in Boulder, CO. She focuses on major transitions and anxiety, giving clients of all ages practical ways to address the issues compromising their well being. She has a present centered approach that appreciates the complexities of life. https://www.northbouldercounseling.com/
The waters are choppy these days. What sort of boat are you sailing in?
As a whole society we have sailed into uncharted waters - a world where we are trying to remain protected from an ambiguous menace, have access to a limitless opportunities to take in media designed to spike the fight-or-flight wing of our nervous system, all with highly limited in person, face to face social support.
It's a recipe for waking up each day feeling very, very anxious and out of control.
Let's break this down to understand how these factors come together to cause such nervous system disregulation.
1. The ambiguous menace. COVID-19: it is invisible, yet highly contagious. Some people do not even show symptoms, and others - even young people - end up on ventilators in the hospital. I didn't wipe down the bread bag, but now it is in the refrigerator with everything else - did the cold air kill the germs or are they jumping onto other food? (I truly did worry about this).
Ambiguous threats trigger our fight-or-flight system by the very nature of being ambiguous. We lack clear information and so our brains become hyper-vigilant, constantly seeking out additional information to resolve the ambiguity. We are biologically wired to to this.
2. Your brain on media. Let's also remember that the news is designed to grab our attention so we engage with it. A very easy way to grab our brain's attention is through fear. Take a moment to just listen to a newscaster's voice without the content: tense, quick, serious. Then we have social media - which is, in many ways, a huge resource during these times of limited in-person contact.
But social media comes with a price - it can disrupt sleep, encourage comparison to others, shorten our attention span, and keep our nervous system on overdrive (ever thought your phone was vibrating but it wasn't? That's actually a real phenomenon and a sign of hyper vigilance).
3. Forgoing face-to-face contact. Here's the real doozie, and one that I try to remedy during therapy sessions. Face-to-face, skin-to-skin contact is enormously regulating for us human beings. We're apes. We are social beings that thrive on social interaction and our nervous systems regulate with each other.
We can be totally jacked up and freaked out and if we have a friend or partner (or even a checker at the grocery store!) that is calm and reassuring, even a brief face-to-face interaction can soothe us. A hug is even better. And these days, the checker at the grocery store is suddenly an ambiguous threat.
Let's go back to the boat metaphor. We're all sailing in choppy waters these days; we can't control that. But we do have a choice about what sort of boat we sail in. The boat is the state of our internal being - our consciousness and how we choose to direct it.
Here are three simple practices to explore while navigating the world this week:
1. Name it to tame it. Did you open up your facebook feed and suddenly become tense and hyper-focused on scanning through every scary article? Did you catch yourself skimming every news article searching for a clear answer? Great! You are very, very human. It actually calms your brain to name an experience - it is a kind of compartmentalizing that can help bring awareness and even control to a behavior. Simply NOTICE the behavior and give it a name in your mind. "Using Facebook. Heart rate going up."
2. Shift attention. Did you name it to tame it? Awesome! Since you are now aware of what you are doing, you have a chance to change your behavior. If you have noticed your muscles getting tight, your heart rate going up, your breath getting shallow - it is time to redirect your attention. Feel your feet on the floor. Take a deep breath. Look at a photo of a loved one, at a favorite plant, out the window at the sky.
3. Move your body. After our fight-or-flight nervous system has been activated, our bodies need a reset. We have a biological need to know that the threat has passed and we can now move on to more peaceful business. Otherwise we remain in a hyper-aroused state that is exhausting in a multitude of ways. Moving our bodies gives us this much needed reset. So: turn on some music and DANCE. Shake out every limb. Use your hands to vigorously brush off your arms, legs, torso, back. Look silly - it will help move the nervous energy.
Above all - remain compassionate to yourself. This experience is unlike anything any of us have ever gone through together. We're all doing the best we can - including me. Including you.
Yesterday evening, the moon was a perfect silver fingernail sliver setting over the foothills, chasing the setting sun. I was driving north watching the moon and kept joyfully catching glimpses at stoplights or any other opportunity.
This winter, my girls and I have developed an almost daily ritual around the moon as she* goes through her phases. We pause and sit on the front stoop when we come home from school and point out the gibbous moon. We turn out all the lights in the house and run to the window to watch the setting crescent moon. We go outside in pajama feet to see the rising full moon.
We also turn out all the lights in the morning and catch the changing of the light as the sun rises. A gift (albeit, one with pros and cons) of having small children is they often wake up before the crack of dawn. Around the winter solstice, my older daughter naturally and suddenly became interested in playing "dark," where we turn out all the house lights and sit in the dark, maybe lighting a candle or two. So we do this in the morning now and then - but letting the sunrise slowly light up the sky and our house. We lie on the floor in the living room and pretend we are camping, watching the sky change colors to the west. We run to the kitchen window and note the different colors of pink, yellow, and blue as the eastern sky lights up.
Nature connection can seem mysterious and out of reach in a way that does not serve us - that connection to nature means you feel special things, can tap into vague "energies" that only special people feel, or you have the skills to track a wild animal. The truth is far less glamorous but also far more accessible. Nature connection is turning off the lights in the house, slowing down, and noticing the beauty of the world. Full stop, it is that simple, and I promise you, also that profound. You just have to do it, and most of us think we are too busy - we are too entrenched in our routines of the human world.
The tragedy there is that then we loose a part of ourselves that is so deeply human. To know the colors of the sky as a new day begins. To know the phase of the moon and where and when it will rise and set. These are things that you can connect with, no matter where you live, no matter the weather, no matter your age. It is incremental, it is a small thing. And it slowly adds up, welcoming us back into the world that is our home.
*I've begun a practice of calling animals, plants, the moon, etc, by he / she / they. This is from a hunch that things we call "it," things we objectify, things we call "things" - feel disposable, not important, or less than (human). I want to use language that instead encourages myself and those around me to respect and build relationships with everything in the natural world.
When a new couple or a new individual client begins work with me, we always take time to explore "family of origin" - the family each individual grew up with. We are working together as detectives to understand each person's "history of relationship."
Many of us chug along through life without thoroughly examining our history of relationship. We assume that we are born knowing how relationships work, and we can figure it out via instinct, emotion, and attraction. Instinct, emotion, and attraction are all very persuasive, too! They feel BIG, they feel MEANINGFUL, they feel REAL. Oh, and they feel EXCITING, too! Of course they can get us into trouble if we don't (lovingly) question them. So let's go!
Your "history of relationship" is made up of many elements:
For the purpose of the "practice of the week," we're going to focus on how you experienced your parents or caregivers "doing" relationship in the home. This is of crucial significance because as social creatures, we learn how to do relationship by observing those closest to us.
This entails a lot more than a general "my childhood was great, I played outside, I was a happy kid, my parents were great." That's nice to hear but it's my job as a therapist to be curious if you're now walking into my office with relationship struggles. Enter the "lovingly question" approach. We're not trying to come up with all the ways you are broken, that feels horrible and just is not true. We're looking for clues as to what areas you learned productive relationship habits and in what areas you could use some coaching. This is about being humble, open, and gentle.
Practice of the Week:
Consider the following questions. Let them tumble around in your mind for a week. Journal on them. If you can / want to, talk to your parents or the folks that raised you. Talk to siblings if you have them. Look at old family photos. Let things cook inside you and see what comes up - some may be familiar territory - allow room for new insights to arise.
That's a lot to reflect on for a week - these are the sorts of questions that sometimes unfold over years as we begin to gnaw on them and stories and memories emerge. As you begin to put together your own "history of relationship" via observing the people who raised you, give some thought to the impact these experiences had on you, and your own skills in relationship. Where do you really thrive in relationship? Where do you chronically get stuck?
Often these "stuck points" have their origins in what we did or did not learn as a kid. Never saw your parents apologize to each other? Conflict meant two adults giving each other the silent treatment for 3 days and a feeling of walking on eggshells? It wouldn't then be a surprise if you struggle in conflict in your intimate relationships - you never learned how to do it well! (Don't worry, join the club, it's a big one).
I like this questioning process because, once again, it gets us curious and humble. Of course we don't know what we don't know! The magic lies in the learning. And that's one of the big points of therapy. Turns out there is a whole lot that you can choose to do differently (like learn to argue in a way that does not stir up threat and fear).
Ready to learn how to do things differently, or want to be furious or devastated about the way it was? There's space for you here. You can reach me at email@example.com or 720.738.3530.
"Crap! I guess we are taking the freeway, now," I said (though perhaps with more colorful swear words).
The road down the street from us is closed for construction, and we've now been driving about 30 minutes for what should be an 8-minute trip to school. I got distracted, let my mind wander, and took a left onto the freeway where I should have gone straight. I take a deep breath and try to be at peace with the fact we're going to be late for school.
This happened yesterday, too. Only yesterday the story was "Well, I guess I'm turning onto Elm street. Daddy warned me that Elm was backed up, but I thought we'd see for ourselves. And...yep, it is backed up."
So today the story evolves. I tell my daughter, "You know, people usually don't get things right the first time. Usually you make mistakes a couple times, and you just keep learning from them until you get it right. So let's practice for tomorrow. Tomorrow I'll go up the hill, take a right, then straight through past the freeway..."
I find myself thinking back to my own experiences growing up and I really wonder if I ever received any training on making mistakes. I've known all too well the shadows of shame, impostor syndrome, perfectionism, and hiding and holding back - all things that can be born out of the deep need to avoid making mistakes. Few of us talk about these experiences in public, but they appear in my office as guarded secrets that finally get the relief that comes with sharing.
So, as a therapist, parent, partner, friend and human, I am on a mission to normalize making mistakes - and therefore, what the process of learning actually looks like.
Learning involves making mistakes. Learning involves ideas, experimentation, trying, and failing. Putting together all the information of what worked, what did not, and continuing to try and try again. Sometimes a LOT. Amy L. Eva in "Why We Should Embrace Mistakes at School" offers a slew of ideas as well as research supporting this, with the super-cool example of "productive failure" as an approach to teaching math in Singapore, where students struggle through multiple failures as an eventual path to success.
I love the term "productive failure," as it strikes me as both humorous and a great re-frame. I could get frustrated and shut-down on my attempts to drive to school, and ensure that I'll keep feeding the negative cycle. Or I can call my navigation mishaps "productive failures," hopefully bypassing shame, creating a space to learn and move forward.
So will my mom-ologue (yes, I really just made that up!) about mistakes be a moment of stellar mom-ing or a moment that was completely unmemorable? Really the answer lies in how much I make normalizing - even celebrating and exploring - mistakes a regular part of MY life. Falling forward, again and again and again.
The practice of the week:
Noticing when it takes multiple tries to get something right, and making that process explicit by pointing it out, either in your head or out loud.
Actively re-naming these "mistakes" as "productive failure." Telling yourself, "Wow, I'm really learning here. What productive failures have I had, and what is the important information I have gathered from those experiences? Are there resources I want to seek out? What do I want to try next?"
Stick with it. Probably the first few times, or even 20 times, your brain will reply by telling you this is total crap. Notice what stories come up - more shame? Irritation? Strong adherence to the idea that you don't know what you are doing? Remind yourself that learning new skills - such as re-framing the process of making mistakes, or the practice of mindfulness - is a process.
Interested in delving deeper into your own experience with shame, perfectionism, or self-doubt? This is the stuff of good therapy. Get in touch with me at 720.738.3530 or via firstname.lastname@example.org and let's get to work.
Practice of the Week
Weekly practices in mindfulness, self-compassion, nature connection, and healthy relationship habits. Themes are personal growth, committed partnership, parenting, and greater connection with self and the earth.