According to the experts – scientists who study anxiety and treatments – the best way to deal with an anxiety or panic attack is to do nothing. Just let it be. Don’t run away from what triggered it, don’t use a safety behaviour so you’re not sick, don’t even think about it, which means don’t battle it in your mind and try to stop it. If you can do that, then the anxiety will come to a peak and then slowly dissipate on its own, all within 15-20 minutes. EASY FOR THEM TO SAY, EH?
There – you got my little bit of Canadian for today! The formula, according to said experts is:
Don’t engage with it
“Just notice it” my therapist used to say. It made me so mad. How the H-E-double-hockey-sticks could I NOT notice it? (I’m on a Canadian roll now, eh? Go Canucks!) But seriously, I used to go from 0-10 in 1/5000th of a second. I wondered if anyone who came up with these ideas had ever actually had a panic attack. It troubled me deeply as I sought to help others with their emetophobia because I assumed that everyone was like I used to be.
As the years and the clients clicked by I started to notice a pattern with them. They were not like me. In fact, I have met or talked online to very few people who reacted as I did to the triggers. I basically felt well and healthy every day of my life. I never felt nauseous, icky or “off.” So I’d be going along minding my own business when one of my three kids would come up to me and say, “Mom, my tummy hurts.” ZAPPO! 10/10. I had no time to “notice it” or “acknowledge it” – that was just crazy talk. Ironically, once I was successfully treated for the phobia and wasn’t afraid of vomiting anymore, I started to notice that I got anxious about other things. It’s like before – if everyone was feeling good – I didn’t care what else happened to me or anyone else in the world. No one was going to vomit, so everything was great! Once I got over the emetophobia I realized that I was still an anxious person, because I was born that way (and so were you). NOW, when the grandkids go to the playground I’m the one thinking OMG HE’S ONLY 2 AND HE’S AT THE TOP OF THE SLIDE!!!! My point? It’s not 10/10 – it’s maybe 4 or 5, and then the more I watch him the more it creeps up and up and up. I just let it be, and eventually it goes away on its own.
Many of my clients are like that with emetophobia. They wake up feeling “off,” so they’re a little nervous – maybe 3/10. Then they eat breakfast and start to feel icky – 4-5/10. Then as the day wears on icky turns to worried which makes the icky worse and the numbers creep up. Now, I understand that your experience may also be different than that, but the point is that if your anxiety moves up slowly, then the experts are correct: do absolutely nothing about it.
Today’s little acronym is “B.R.I.T.” (How do you like that, peeps in the UK? eh? eh?) BRIT is not for the slow climb – just notice, acknowledge, and don’t engage those. BRIT is for the times when it goes HIGH QUICKLY. Or when you just can’t “do nothing” about your anxiety, and so it continues to rise. BRIT are the ACTIONS (Remember last week’s “A” in the STAR plan?) needed to calm down. They’re all tools you carry with you every single day. You don’t need a safety kit in your purse. You just need BRIT. So let’s go through them one by one.
Your breath is your salvation! Learn to breathe slowly and evenly, deep into your abdomen. Let the out-breath be longer than the in-breath. Try “7-11 breaths” – breathe in for 7 counts, out for 11. Check out my YouTube Video on how to breathe properly to help bring anxiety down: https://youtu.be/PPkUWoloQog
“Relax” means to relax, soften and drop the large muscle groups in your body starting from your forehead and eyes, and extending down to your toes. In order to do this effectively you have to practice it. I give all my clients a sheet of paper with the numbers 1-90 on it so they can check off the number of times they listened to a 20-minute recording teaching progressive muscle relaxation. Just putting on a recording when you’re anxious will not help you very much. You need to learn the technique much like learning a piano concerto or an entire hip hop routine. You can’t just tell someone to do either of these – they have to learn the notes/steps and practice until it’s just “body memory.” It’s the same thing with this. Your body has to know where to go. Here’s a link to one of my progressive muscle relaxation recordings. There are many more on YouTube: https://youtu.be/XfF5Srxtj9M
Shout out to PianistMiri who improvised on harp with me to make these! https://www.youtube.com/user/pianistmiri She does WICKED piano covers of popular songs!
Studies have been done on the brain where a person was shown an object such as a cabbage in an fMRI machine. The next day the person was put in the MRI machine again and told to remember the object from the day before. The cool thing is that the brain lit up exactly the same way. Like, exactly. So of course the “logic” part of the brain knew the cabbage wasn’t there – that the subject was just imagining it on the second day. But the rest of the brain did not know. Psychologists got hold of this and used it for anxiety recovery. Imagine you are in the most peaceful, tranquil, calm and beautiful place in the universe. Really imagine it. Your brain won’t know you aren’t actually there.
Using the “imagine” tool may be helpful when sitting on in an airplane, but not as helpful if you’re at the front of the room giving a presentation. It’s ok – you have three other tools.
Sometimes when we’re busy emoting (aka freaking out) we fail to THINK. Thinking can calm the troubled mind and body. Use positive, calm and rational thoughts. I used to write mine down on a business card and carry it with me all the time when I was working on my emetophobia. I volunteered at the hospital, and one day I walked into a patient’s room and she was very nauseous, holding one of those cardboard bowl things under her chin. I could not take the card out and read it, but I reached into my pocket with my hand and just felt it. That really helped. Here are some positive thoughts (“positive cognitions”) that have helped me, and many of my clients. In fact, my clients came up with most of them:
- You’re not in any danger
- It feels dangerous but it isn’t
- Usually the worst doesn’t happen
- If it really happens, your anxiety will go down.
- Vomiting isn’t dangerous or harmful. It can’t hurt me, so I don’t need to be afraid of it
- There’s no point being afraid all of the time for something that happens so little of the time/rarely
- It doesn’t matter if I vomit
- Even if I get sick, I will be ok.
- I’m perfectly safe
- It doesn’t matter
- I can cope with vomiting