panic

How to Cope With a Trauma Response: Part 1

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Your day is progressing just like any other.  Waking up, getting the kids ready for school, going to work, preparing dinner…when all of a sudden, out of nowhere, you’re hit with a flashback of the event.  You feel a pit in your stomach, sweat breaks out on your forehead, and you feel your heart rate spike.  You’re having trouble breathing, and you feel the urge to escape. 

If you have post-traumatic stress disorder (PTSD) or symptoms related to PTSD, you probably know this experience well.  Memories of the trauma or triggers that remind you of the event can send you into a tailspin: you’re fine one moment, then in a panic or shut down the next.  For partners who have experienced betrayal trauma, this response arises with triggers related to their addicted spouse’s behaviors.

The experience of a trauma response can be scary, as it often comes on suddenly and feels impossible to stop.  It can be exhausting to go through one of these experiences as your body goes into overdrive, trying to protect you from a threat that (often) isn’t there.  To cope with your response, you might shut down into a depression, lash out in anger or irritation at the people around you, collapse into grief and sadness, or turn inward with shame.

How do I know I’m having a trauma response vs. pure anxiety or panic?

There are several common symptoms of post-traumatic stress disorder that may come up when trauma resurfaces:

  • Flashbacks to traumatic events (re-experiencing the memory as if it were happening now)

  • Mood swings and emotional volatility

  • Exaggerated startle response

  • Avoiding certain triggers or activities that you used to find enjoyable

  • Low self-esteem

  • Isolation and withdrawal from others

Trauma shares symptoms with anxiety and/or panic attacks.  Anxiety often includes worries that are more future-oriented than trauma.  While it is true that some anxiety centers around worry about events from the past, trauma responses are different in that they can be traced back to a specific memory of a traumatic event.

Panic attacks can also arise as a result of trauma, with symptoms such as racing heart rate, sweating, feeling faint, nausea, and worry that you’ll die (often related to the heart rate symptoms).  If you experience these symptoms, be sure to meet with your doctor to rule out any underlying medical causes.  However, if there is no obvious medical cause, see if you can connect your reaction to a specific reminder of trauma (as in a trauma response), or notice if the panic arises seemingly out of nowhere (as in panic disorder).

How to Manage Trauma Responses

There are two stages to handling trauma responses.  First, you need strategies to bring yourself back into your window of tolerance by calming the physical and emotional reactions you’re having.  Once you’ve been able to calm and self-soothe, the next step involves exploring the cause of the traumatic response and some options for processing and addressing that trauma.  Today, in Part 1, we’ll talk about the first step: reducing the intensity of your initial response. 

Reduce the physical and emotional overwhelm caused by the initial hit of trauma.

You can’t think straight when you’re in the middle of a trauma response, as your body and mind take you out of your prefrontal cortex (the part of your brain involved with decision-making, impulse control, and executive thinking) and move you into your limbic system (the emotional center; the fight-flight-freeze response).

In order to bring your thinking brain back online, it is necessary to calm down your nervous system enough to communicate to yourself that you don’t need to run from a threat, as the adrenaline response is prompting you to do.  Deep breathing, guided meditations, progressive muscle relaxation, grounding exercises, and other ways of calming down the nervous system are useful during these moments.

Use coping thoughts to calm your emotions.

Often, the traumatic event happened in the past and is not currently occurring, as in an experience of a car accident or a past experience of sexual assault.  In these cases, you can use words to remind yourself of your current distance from that painful experience.  They can help you ease the initial intensity of the trauma response.  These might include phrases like:

  • I’m safe now, in this moment.

  • I’m no longer in that situation.

  • I can get through this.

  • This too will pass.

  • That was a painful experience, and I am not living it now.

But what if the trauma is ongoing?  When you are in a relationship with a sex or love addict who has betrayed you and are working the process of recovery, the traumatic experience may feel more present and real due to broken trust.  In those cases, it may be more helpful to use self-encouraging statements to affirm the strengths you have that are carrying you through.  These might include words like:

  • I’ve been through painful moments before, and I’ve survived.

  • I’m strong enough to handle this.

  • I can’t control other people’s actions, but I can control my decisions and how I respond.

  • I can handle this one day at a time.

  • This is hard now, but in the long-term, I’m going to be okay.

Use a distraction technique.

If meditations and coping thoughts aren’t cutting it, use a distraction technique.  These are not meant to create unhealthy dissociation from your feelings or events, but instead are meant to help calm the intensity of your experience so that you aren’t as overwhelmed by it and can approach it with more curiosity.  It helps to think of this distraction as temporary, meant to bring your level of intense emotion down so that you can make sense of your reaction and respond differently. 

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Using strategies popularized by dialectical-behavioral therapy (DBT) can help create this distraction.  Find an enjoyable activity that you can engage in for a period of time that takes your mind off the trigger.  Engage in a self-soothing behavior that helps you connect to your five senses.  Use the acronym ACCEPTS to help you connect with ways you can distract yourself from the distress. 

In Part 2, we’ll delve into how to explore and process the trauma response, creating tools to help you navigate its impact differently in the future.

Rescue Meditations for Anxiety and Panic

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Have you ever experienced high levels of anxiety bordering on panic?  Symptoms like shortness of breath, chest pain or pressure, sweating, heart pounding, dizziness, and racing thoughts can be overwhelming when they arise.  And if it’s ever developed into a full-blown panic attack, you know the paralyzing fear that comes with that experience. 

When these symptoms arise for you, it’s a good idea to consult your medical doctor.  Some symptoms are shared in common with heart or lung issues, so you want to be sure there’s not an underlying medical concern that’s causing the symptoms.  But if you check with your doctor and you are otherwise physically healthy, your doctor might recommend psychological treatment and/or “rescue medications.”

Rescue medications, such as Xanax or Ativan, are anti-anxiety medications that help to bring your symptoms down to a manageable level when you are facing a high level of panic or anxiety.  I believe these medications can be helpful in crisis scenarios.

But if you don’t have these rescue medications or prefer a more natural approach, there are ways in which you can harness your body’s natural calming systems to relieve that anxiety.  Below are some suggestions for rescue “meditations” that you can do when you’re experiencing panic or even just feeling overwhelmed and stressed. 

If you find that these strategies aren’t effective or you’re continuing to experience symptoms, seek out help from your medical doctor or a mental health professional to address what is causing the panic.

Deep Breathing

When you’re panicked or anxious, breathing patterns are more shallow.  If you place a hand on your chest while you’re feeling stressed, you’ll likely find it rises and falls in short bursts.  The goal in taking deep breaths is to engage your diaphragmatic muscles in your abdomen.  This triggers your body’s natural calming system that helps you relax. 

To do this exercise, sit comfortably in a chair or lay on your back in a comfortable position.  Place one hand on your chest and one on your abdomen.  Take a few breaths and notice which hand moves.  Focus your breath so that your hand on your abdomen is rising and falling more with each breath.

Next, take a series of breaths with one of the following patterns:

  • 4-square breathing: breathe in for 4 counts, hold at the top for 4 counts, breathe out for 4 counts, and hold the exhale for 4 counts

  • 4-2-6 pattern breathing: breathe in for 4 counts, hold at the top for 2 counts, and breathe out for 6 counts

Do 10 repetitions of one of these patterns.  Using a breathing pattern that focuses on a longer exhale helps regulate the body. It activates the parasympathetic nervous system, the part of your body that calms the fight-or-flight response associated with anxiety and panic.

Guided Meditation for Anxiety (Yoga With Adriene)

On her YouTube channel, Adriene of Yoga with Adriene offers a playlist of short, guided meditations that can help you when your’e in a crisis.  She also has yoga practices designed to help you ground yourself or deal with anxiety on her YouTube channel.  If you have the time to do a longer workout or yoga practice, this might be a good fit for you.  Moving your body is a great way to deal with anxiety or panic.

Headspace or Other Meditation Apps

Headspace is a great app teaching the basic skills of meditation.  They include short videos describing how to approach meditation, and they offer their first 10 basic meditations for free. 

While you can only access those 10 meditations without a subscription, I’d recommend looking into their subscription, especially if you’d like to make meditation a more regular practice.  If you do have a subscription, here are a few of their “SOS” meditations I’d recommend:

SOS for Panicking

SOS for Feeling Overwhelmed

SOS for Flustered

There are plenty of other meditation apps that exist, such as Calm and 10% Happier. Try a few apps and decide which one you like best to use as a resource.

Visualize a Calm and Peaceful Place

Spend a few minutes thinking of a place you’ve been or that you create in your imagination where you can feel calm and peaceful. Identify what you see, hear, feel, taste, and smell in that image. Envision yourself there and notice what emotions it evokes. Pay attention to the pleasant feelings in your body and allow yourself to enjoy them.

5-4-3-2-1 Grounding Exercise

Start out by taking a few deep, abdominal breaths, as described above. 

Begin by noticing 5 items in the room around you that you see.  Say them out loud.  Describe the colors you see, Identify any textures you’re aware of on those items.

Next, notice 4 things you can feel without moving your body: it could be your clothing on your skin, the feel of the chair in which you’re sitting, or your feet on the floor.  Say these out loud as well.  Describe the sensation of those feelings. 

Then notice (aloud – catching a pattern?) 3 things you can hear.  Describe the sounds: whether they are consistent or intermittent, loud or soft, familiar or unfamiliar. 

Notice 2 things you can smell or two things of which you like the smell (as sometimes in a sterile environment there aren’t many smells).  Describe what these things smell like.

Finally, notice 1 thing you can taste or of which you like the taste.  Describe that taste to yourself. 

Regular Meditation Practice

What I’ve shared above are short, quick meditations that you can do in a crisis.  However, the strongest benefits of meditation have been shown when you implement a daily meditation practice over the long-term.  Daily meditation actually changes the structures of your brain associated with stress and calm.  If you find you like these strategies for calming yourself, I suggest that you try meditation daily.

 

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These “rescue meditations” are a way to distract yourself from the symptoms of anxiety and calm your body down so you aren’t so overwhelmed.  However, they are not meant to completely resolve the anxiety.  The panic will continue to come back until you recognize the source of the anxiety and resolve it.  If you notice the panic continuing, consult a mental health professional to begin examining the potential sources of your distress.