I wasn't planning on sharing this until the book was published, but with the outbreak of COVID-19, it struck me that some of this information was needed now. So here is a partial of a chapter that will be featured in my workbook.
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Grounding: Getting Your Head Above Water When You’re Having a Panic AttaaaaAAAAAGH!!
My Bible Study is having a late night pizza at the college watering hole. I’m a 22-year-old Junior, and I’ve been clean for three years. My nerves are shot from a horribly stressful week (In addition to having several big tests, an acquaintance was threatening suicide each night and lying to the counselor about it and, being the savior of the universe I had to handle it). Nightmares have been rampant so I don’t want to leave these people and go to bed. Ordinarily the image of hyperactive stability, according to Danielle my exhaustion has rendered me incoherent. I seem drunk. Beyond drunk. She texts my roommate, saying I’ve ‘snapped’ and to hurry over to watch because it’s really funny, watching me crack. Haha.
I’m not sure how much time passes, but through the fog I suddenly realize that when the clock strikes midnight, my car will be illegally parked. My hands shake as I dig through my purse and I mumble feverishly about moving my car. Someone snatches my keys away and sharply says I’m not driving anywhere. Are they joking? I can’t tell... I can’t see who said that... Why don’t I know who has my keys?! I start crying, grabbing at my chest because it’s suddenly gotten unbearably tight. Colors are blurred, I’m not sure where I am anymore. It’s so unbearably hot, but I can’t stop shaking.
“I hate when this happens.” Aleksander mutters across the table. “I never know what to do when girls cry.” The other boys murmur in agreement.
“Guys!” Arielle says impatiently. “She’s having a panic attack!”
“OH!” They jump up, still uncertain what to do. Danielle moves off the bench to let me out but I can’t move. I’m suffocating. The guys lift me out of the booth, people asks what I need and I stammer incoherently. Mismatched, unfinished statements flash through my brain. Can’t stand- give me a minute- I need to- I can’t breathe- it feels like I’m-
The room spins and I bash a table, nearly crumbling beside it as hands grab me. I can’t breathe. Someone asks if they need to call an ambulance. I can’t breathe!
“What do you need Kelsey?”
“What do we do?”
Don’t know what to-Can’t someone else have it togeth-Catch my breath, can’t catch my-
“I need someone stronger than me.”
To this day I don’t know who said that, though Danielle would swear for the next 2 years that it was me. If so, it was arguably the first time I openly admitted to any of them I needed help. In response to this request, hands on either side force me into the chair I smashed into, and hold me in a firm sitting position. I can’t see beyond my trembling hands on my lap. I’m drowning. Is this how I finally die, surrounded by my clueless Bible study, the smell of 11:45pm pizza in the air, my root beer yet unfinished, and my car about to be unfairly booted?
“...So uh... your toenails match your dress. Did you plan on doing that?”
It was probably the stupidest thing anyone could have said.
James? Is that you?
A hand vaguely close to the voice squeezes my shoulder and I know if I fall, this hand would catch me. More importantly, I recognize the voice. It’s attached to my friend, and I can trust him. My white tunnel vision expands slightly and I can see James’ sneakers standing beside my sandals.
“You know actually I did.” I gasp out.
James pats my shoulder awkwardly. My senses snap to the area, this physical exchange reconnecting my awareness to my body. If that feeling is his hand on my shoulder, then my arm and chest must be nearby. This newly reclaimed self-awareness spreads to my abdomen and pounding chest. I find my other arm, attached to at least two other firm hands who have silently promised to not let me fall.
“It looks cool.” Jamies continues. “I like the green. Kinda mossy, like your dress. Or I dunno, is it a shirt? You keep wearing pants and leggings with dresses so I’m not sure if it’s a dress or a shirt.” At this bizarre prompting, my mind slowly remembers I have legs, and does the necessary work of finding them.
“Do you need a paper bag to breath into?” James asks, his knowledge of fashion thoroughly exhausted. “Would that make you feel better?”
“No. Those don’t really work, it’s an old wives tale.” My breathing is a lot less strenuous and my chest doesn’t hurt anymore.
“Oh. Good to know. I don’t know where we would find one anyway.”
“I need a minute.” I mumble, as I wait for my mind to reconnect to those stupid green painted toenails, visible but unfelt against the floor.
“It’s ok. Take your time.”
“We’re here, Kels. We gotcha.”
“… Ok.”
Let’s Talk About Anxiety and Panic Attacks.
Setting the Stage: Understanding the Science
We would have briefly talked about fear in the Glad, Mad, Sad, Afrad chapter. As promised, here is the full chapter on anxiety and it’s nasty little side effects.
Let’s begin this section first and foremost by saying: If you’ve suffered from anxiety or panic attacks, you don’t need to be ashamed of them. Clearly, if you knew how to avoid them, you would. They’re mentally painful, can often feel humiliating, and they’re physically upsetting and draining. So, let’s enter this with as much kindness as we can; you’re doing your best.
Next, it is important to understand that while ongoing anxiety or panic attacks are nothing shameful, they also aren’t healthy or normal. They aren’t like sneezes or yawns where everyone gets them and you just power through it. It’s more like food poisoning: There’s something serious going on on the inside that needs attention, and if it persists you should tell your doctor. You may very well be carrying an anxiety disorder and need medication. It could be a sign of mental upheaval that needs to be talked out and properly processed. There’s no shame in either. That being said, don’t panic. Even if you’ve grown more or less used to anxiety and attacks (as well as you can, let’s say “resigned”), you don’t have to be doomed to regular bouts of anxiety on your own. There are ways to take care of yourself and let others in so you aren’t constantly lost to them.
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Fear, anxiety, anxiety attacks, and panic attacks are not all the same thing. Now, when you’ve experienced or witnessed either, you might wonder what the difference is and why you should care: They’re all upsetting, they all suck, and they leave you exhausted and hungry for pretzels. Fair point. So what’s the difference?
Imagine a lone sailor at sea, sailing a ship full of gunpowder. When they were first informed that their cargo would be explosives, they momentarily imagined the ship in flames. The sailor countered this image with a list of safety measures they would take to ensure the cargo remained safe. They are well aware the implications of an open flame, and they know how to safely man their ship. They set sail- aware but unfazed.
This is what healthy fear is like.
The same sailor has been at sea for several hours; land has long since vanished from view. They’ve sailed this rout countless times, and it isn’t even the first voyage they’ve carried explosives, but… today feels different. They keep glancing at the cargo, double, triple, and quadruple checking that everything is secure and there are no open flames anywhere… Everything’s fine. It’s going to be fine. Did they check the cargo? Everything’s fine. They suddenly realize they’ve been humming the Jaws theme song under their breath since they set sail. The cargo, did they check it?! Everything’s fine…
This is what anxiety is like.
Our sailor looks into the distance and sees the tides turn. A great wave is building. They brace themself, grabbing a rope as the water comes crashing down on them. They splutter, gasp for breath, they hurry to the cargo to make sure a lamp didn’t fall and catch anything on fire… Be ok be ok BE OK!!!! The winds die down, the waves steady, the sailor takes a few gulps of air and collect themself. They remain shaken, but it was just a passing thing. They continue to obsessively check the cargo, but everything should be fine. Everything should be fine… Dah-dun… daaaaa-duuuun…
This is an anxiety attack.
As the sailor keeps their eyes fixed on the horizon, seemingly out of nowhere their mast is struck by lightning with an earsplitting crack. Within moments the skies are black with storm clouds and the sails are ablaze. Sparks light upon the boxes of gun-power. The sailor has just enough time to see there’s no way to extinguish the flames, and they jump overboard into the raging ocean. They hit the water just as the ship erupts into fire and smoke. For a moment the sailor is beneath the water and everything is eerily quiet. Through the murky water they see blasts of light, and tell-tale signs of what surely would have killed them had they not abandoned ship. Debris sinks into the water around them as they tread water, holding their breath as long as they can for fear of a second explosion. A piece of sinking cargo hits them in the shoulder, and they loose their bearing. The lights on the surface have gone dark, and they are no longer sure which way is up. They kick desperately, praying this direction will bring them to oxygen.
Moments before assuming they’ve drowned, their head breaks the surface. They open their mouth to gulp in air only to be hit with the violent crash of waves as lightning splits the sky. Yards away, the ship smolders and thunders as the remaining cargo periodically explodes. The sailor is safe from the burning ship, but now they are lost at sea during a storm, with no way to radio for help, no flair to send into the thundering sky. There are no ships in sight, no one to hear them if they screamed, nothing to catch them, no one to save them. This may very well be how they die.
This is a panic attack. See the difference?
In my sailor-ship metaphor, the boat is reality. Notice how the anxiety attack was filled with waves and scares, but the sailor managed to stay on the boat. With the panic attack, they were forced to abandon ship.
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The National Institute of Mental Health differentiates between anxiety and panic attacks in a far less ship-explosion-themed way. Here’s a chart I made based on their descriptions:
As you can see, there are a great deal of physical similarities, but the greatest distinction is the mindset: An anxiety attack is the feeling of being near a ticking bomb, whereas a panic attack is when you are the bomb, and you’ve just exploded somewhere between your heart and throat. Before I knew what panic attacks were, I would call mine “mental breakdowns,” as the only way I could describe the feeling was the breaking of my mind and body.
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Dissociation
Your brain has various trails it has learned to go down. Some good, some neutral, others harmful. Like a hamster on its wheel going nowhere fast, once our thoughts get fixated on something, it can get pretty tiring, even hurt us. Eventually the hamster might loose its footing and get thrown from its wheel, crashing on the wood chips on the other side of its little hotel. Anxiety and panic attacks can begin in a similar fashion: Mental fixation, long dizzying spiral, nasty crash at the bottom. If the brain has not been trained to face the situation in a healthy and life-giving way, it will be prone to freak outs (anxiety attack) or clock outs (panic attack).
An important word we want to learn is Dissociation, to disconnect with reality.
Dissociation is overwhelmingly common with people who have anxiety, depression, or have survived trauma. It’s one of the brain’s clumsy ways of trying to spare itself from pain.
Dissociation can be mild “Woah, how long have I been staring at that guy?” and severe “I legitimately cannot recall anything from this past week… I think I went to class…When’s the last time I ate?” Dissociation with panic attacks are… interesting and intense. I can see myself lying limply on the couch, but I can neither sit up or call for help. My brain is going a mile a minute, over analyzing every single emotion, but unable to form a coherent sentence nor say for sure where I am. It’s very much an out of body experience. A panic attack is in essence when extreme anxiety and disassociation merge to become a mutant hybrid monster that makes you question your sanity.
A physical comparison to dissociation and panic attacks can be found in medical situations when the person crosses their pain threshold and clocks out or even feints. Recently I had a migraine that reached a point of pain so severe I literally blacked out for half an hour: One minute I was in the bathroom trying to cool myself off in the sink, then suddenly I was kneeling on the edge of my bed and thirty minutes had passed. When you’re trained as a first responder, one of the things you have to practice is engaging the patient in conversation. This isn’t just to assess their mental stability and gain their medical history, it’s also to keep them present with you.
Escapism is a milder form of intentional dissociation that allows for a bit more freewill in your mode of disconnect: “I’m so stressed out, I need a piece of cake and I’m not even going to enjoy it. I’m going to watch TV for a couple hours and not think about anything. I need a smoke. I need to mindlessly shop. I need to cut.” These are unhealthy things we willingly do to escape from our physical, mental, and spiritual stresses. In contrast, a panic attack forces you to leave.
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Why We Have Panic Attacks
So apart from anxiety disorders, mental spirals, or physical pain, why do anxiety and panic attacks even happen?
It’s because your three-legged stool is severely compromised.
As the Physical, Mental, and Spiritual legs act as our anchors to the world, ourselves, and beyond, we have a harder time keeping a grip on Reality when they’re damaged. Extreme? Not really. When we burn our tongue, our ability to taste is compromised. It’s the same thing here only… more.
In retrospect, my panic attacks are never (really) a surprise. Frustrated, agitated, and instinctively certain they couldn’t possibly be random, I logged every anxiety/panic attack I ever had to look for common denominators. And boy did I find them! It isn’t an exact science, but all of my attacks were largely spurred on by the below factors. Not unlike a mix and match “soup and salad” menu, if I experience at least one of these points from each of the physical/mental/spiritual categories below, my anxiety will rise. If I postpone the anxiety with escapism or dissociation, the anxiety will build until it graduates into a full-blown panic attack. If you realize there’s something not on the list you’re especially sensitive to, go ahead and add it yourself.
Physical Stressors
1. Sleep deprivation or nightmares.
- In the sleep chapter we examines all manner of things lack of sleep can do, but a lowered tolerance for anything is certainly at the top of the list. If I have a nightmare the evening before, anxiety is nearly doubled.
2. Low blood sugar or poor fuel
-Coffee on an empty stomach is a recipe for disaster. Running on junk food without making a point to eat fresh produce will make any body antsy.
3. Little to no exercise
- The body is made to move so it can (among other things) give you endorphins and burn off stress.
4. Severe physical pain
- Pain the self-harmer can’t control. A migraine, an especially strained muscle…
Mental Stressors
1. Strong, Unchecked Emotions
- Leads to heightened anxiety, depression, and The Hamster Wheel
2. Prolonged isolation
- For me, it’s being alone with my own thoughts for more than seven hours
3. Any form of withdrawal
- Self-harm, sugar, whatever.
4. Relationship insecurities
- A fight, family drama, breaking a glass at a friends house and wondering if I would be forever disowned…
Spiritual Stressors
1. The crippling sense of worthlessness as I fail to be a perfect daughter/sister/friend/human being…
2. Carrying the weight of sin on my own.
3. Shame
4. Lack of restorative quiet time with God, often in the midst of a stressful week…
With my three-legged stool foundation uneven and shaky, my anxiety will build up and my brain will enter into that hamster wheel of panic.
If I don’t take necessary steps to
do emergency self-care pronto, my brain will inevitably do a dramatic reenactment of the final moments of the game Jenga. You know, the one where you begin with a sturdy tower of tiny wooden blocks, and you take out one block at a time until someone causes the entire structure to topple. By the time the final block is taken out, there’s little left of the tower but a crooked haphazard stack of wood that vaguely looks like an insecure human spine. It’s obviously coming down, it’s only a matter of time before the right (teeny tiny, even inconsequential) block is removed.
Unfortunately, we live in such a hurried, stress-filled day and age where we think we’re supposed to be on edge all the time. We’re not. Yes, life is stressful. But we’re not made to be constantly looking over our shoulder, humming the Jaws theme song as we wait for everything to crumble around us. If that is our normal, if we are constantly operating with high anxiety and poor self-care, panic attacks are all but inevitable.
Looking at the wasteland of a Jenga tower that was my body mind and soul at the time of the opening panic attack (with the green toenails), what other choice did I have but to fall apart? I was experiencing Physical Stressors 1, 2, and 3 (sleep deprivation, poor fuel, and I wasn’t really exercising), Mental Stressors 1 and 4 (unchecked anxiety/depression, and relationship insecurities), Spiritual Stressors 1-4, and then some! Little wonder I fell to pieces! What else was my body supposed to do?? I mean, apart from take the time I needed to take care of myself. JENGA!!!!!
Application: What to Do
I’m climbing the stairs towards one of my university buildings, about to meet my Bible Study for ice cream. I’m 24, I have been clean for 5 years, and my senior year has just begun. A blur of a person runs past me, nearly clipping my arm. I whirl around.
“Katie! Stop!” The girl skids to a halt and buries her face in her hands. I run to her, fumbling with my purse.
“Katie, it’s your friend Kelsey. Sit down right now.” She thumps on the top stair and begins to sob.
“Panic-panic-panic attack.” A babble of tears and unintelligibles pour from her mouth. But I already recognized that look in her eye, and I know what to do.
“Katie, take my keys.” I hold them out for her.
“What?!”
“My keys. Take them, right now.”
“But-” I force them in her hands. They immediately begin to jingle as her hands tremble.
“See my keys? Tell me about them.”
“They’re keys.” She stammers.
“Good. Do they all look the same?”
“They’re keys!” She says shrilly.
“Yes, but are they the same?” She pauses and looks at them. Really looks at them.
“This looks like an apartment key, this is a car key. It has the plastic alarm button.”
“What are their texture?”
“Smooth. The edges are sharp. And I like your keychains.”
“Tell me about the keychains.”
“There’s… well, I didn’t think it was possible to have more keychain than actual keys, but you’ve seemed to pull it off. How many carabiners does one person need?”
“You’re doing great. What else is on them?”
“A stuffed hippo.” She laughs. “A fuzzy yarn puff-ball. A string of plastic gems, they’re pastel and clear. A flag, what country is that?”
“Brazil.” I say.
“Ok, and about twenty key tags to gas stations and stuff. A purple whistle. An orange ribbon. What are these, soda can tabs?”
“Dr. Pepper!”
“Why do you have… how many is this, like fifty Dr. Pepper soda can tabs??”
“Great. Now look at me.” She does, and her eyes are steady. “What do I look like?”
“Brown eyes, pale skin, black hair.” She frowns. “Or is it brown?”
“Brown. But is my hair all brown?”
“No, you have a blonde streak on your right, my left. You’re wearing a pink dress, and a locket.”
“Great. Can you take a deep breath for me?” She does. “And where are we?”
“We’re sitting on the stairs at the front of the school.”
“Well done. Let’s make the world just a bit larger. What can you see around us?” She looks around.
“Red trees. Main street. Grey stairs. Grass over there. That traffic light. Blue skies.” Katie inhales deeply and slowly lets it out. She opens her eyes, and her gaze is steady.
“What the eff did you just do to me?” She asks, stunned. I grin.
“My dear, welcome to Grounding. So what pushed you over the edge? Let’s talk.”
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After the panic attack with my Bible Study the year before, I reflected for a very long time on James and how his talking about my toenails strangely helped. I had a bunch of other friends who had anxiety and panic attacks and I started asking questions. For months I worked to develop a means to call us back. What you saw just now with my friend Katie was the result. It’s called Grounding.
In a nutshell, Grounding is the process of calling a person out of themself, and convincing them that reality is safe enough to reenter.
The sailor lost at sea is in two primary predicaments: First, they have just experienced an upsetting ordeal. Second, they are in a stormy sea and drowning. As the remains of their boat smolders around them, they clearly need to get into a safe vessel. Grounding is the equivalent of another ship seeing the wreckage and throwing the sailor a lifeline.
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Grounding Alone
Sometimes you don’t have easy access to trained loved ones, and you need to Ground yourself. I’ll include ways to do it in the Activities section. This section is primarily dedicated to teaching you how to Ground others.
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Grounding Others
If you suspect someone is having a panic attack, face them head on. Don’t come behind them. Ask directly if they’re having a panic attack. If they say no, find out what’s wrong. If they say yes or cannot answer at all, begin Grounding.
Identify yourself, even if you’re a friend. A sort of blindness is common when experiencing panic, and even if they’re staring right at you, they might not be capable of recognizing you.
Speak clearly, calmly, and kindly. Any hint of fear will be picked up on and feed the original panic, like bacteria feeds on sugar.
Give the person something they can hold. “Take my keys. Tell me about them.” Tell them to describe the item out loud with as much detail as they can. How many keys are on the ring? What type? What color? What is the temperature? Texture? Weight? Size?
Expand the world to you: “What do I look like? What color is my shirt? My hair?” Encourage them to touch for texture. If they don’t recognize you yet, don’t be discouraged, continue to have them verbally interact with you.
Help them breath as needed. “Take a deep breath for me.” If they struggle to do this, hold your fingers 1-2 feet away from them. Tell them to take a big breath and ‘blow out the candles.’ Repeat as necessary. Encourage them to match your breath. Keep breathing with them until they stop gasping.
Make the world grow. “What surrounding sounds do you hear? What’s the floor made out of?” The underlying message: You’re safe in your hands, you’re safe with me, you’re safe in this environment, you can come back now. Once they’re capable of describing the world, they should be ready to sit up, with assistance.
Give them water. Have them describe the water’s temperature, how it feels going down their throat. Give them food. Once they’ve had water, eaten something, managed to identify where they are, and are speaking coherently, THEN encourage them to stand, if they feel able.
Verbally assure them that they are safe, not disappointing anyone, not in the way. The negative opposites are already dragging them further into themselves, so firmly counteracting their fears goes a long way. They’re lost in their mind because reality was too dangerous... your job is to convince them it’s safe to come back.
Ask what set them off. Panic attacks tend to be a buildup of negativity but there is usually something that tipped us over the edge. “What made you afraid? Did something happen to make you sad? Did someone say something mean to you?” They know what it was. And now that they’ve been shown they are in a safe place with someone trustworthy, they can talk about and address the actual problem.
Take things easy. Depending on the severity of the panic attack, exhaustion afterwards is common. They may feel ready to get back to their activities shortly after eating something. Or they may feel so tired they need to lay down for awhile. I’ve experienced both: Rearing to go half an hour later, and bedridden for a week. Just because they’ve had a panic attack does not mean the anxiety is gone. Encourage self-care to circumvent another attack.
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Digging Deeper: The Self-Harm Connection
Notice how Grounding brings the panicked person back to reality by engaging the senses. A self-harmer (whether aware of it or not) does the same thing when they initiate physical pain. Instead of keys, it’s the limb interacting with the sharp. Rather than describing the texture of the keychain, it’s the patterns of the cuts, and so on. Self-harm is short-term, unhealthy and unsafe Grounding, but Grounding none the less.
As self-harmers, our stress tolerance is a lot lower than we believe. Don’t get me wrong, we’ve trained ourselves to survive in constant high stress levels indefinitely, but we don’t do very well there and we don’t know how to leave. For years I would address all my physical, mental, and spiritual stressors with a sharp. Overwhelming emotions I wouldn’t/couldn’t address? Cut. Shame? Burn. Fight with a family member? Cut. And don’t for a minute think that sleep deprivation or diet had nothing to do with things. Looking back at my cutting days, my sleeping disorder wouldn’t be diagnosed for another 8 years, and my diet largely consisted of refillable 48oz Dr. Peppers from the gas station. (How did I survive high school?) My point is, we harmers are universally more prone to cutting before stress reaches the panic attack levels. If self-harm historically held the line between living and suicide, self-harm also holds the line between anxiety and panic attacks.
Because self-harm served to Ground us for so long, panic attacks seem to “come up out of nowhere” when we give it up. What we don’t understand is this new-found anxiety isn’t remotely random or even new. The stressors were always there, we were always on that edge, but we used self-harm Escapism to postpone the inevitable. It isn’t until we are determined to not self-harm that we are forced to realize how on the edge we’ve been living all this time. As far as I can tell, I never had a panic attack until I stopped cutting. Once I entered withdrawal, they came hard, fast, and frequent.
So what then, are we doomed to a life of choosing between self-harm and panic attacks? It may seem like it at first. But by taking care of your physical, mental, and spiritual legs, your anxiety levels will have no choice but to chill the heck out. As you work towards health, and you become more in touch with your body’s true needs, you’ll get better at taking care of things as they come. You will even eventually start living in this blue space of health.
INTERCEPTION!!
Once I realized the factors that were nearly universally incorporated in my anxiety/panic attacks, my approach to self-care was revolutionized. After all, suddenly, not only were the causes traceable, but I could learn to recognize the warning signs earlier!! And if you can identify things before the panic sets in, 9 times out of 10, you can prevent the attack entirely.
For example, food (low blood sugar, or poor fuel) can be a pretty common factor for anxiety. If I look up and realize it’s 6pm and I haven’t eaten anything all day apart from coffee, I can have a glass of water, eat a snack, and arrange to have a well balanced meal. The Physical Stressor is cared for before it got out of hand, and the building anxiety can dissipate.
That’s physical stressors. What about the mental stressors that force us into those sickening hamster wheels? Just as we can make a plan to carry snacks, we can make a plan to intercept the mental anxieties!
One of my most frequent Mental Stressors is the concept that I’m “in the way” and “a burden” to my friends. That thought will pop up, it will hop aboard the neuron pathway and begin the spiral. My anxiety will grow, and when I make even the minutest of mistakes, this will be the final push to panic. I cannot count the number of panic attacks I’ve had where this was the Mental Stressor. But I also know that’s one of my weaknesses… When our anxiety is largely relationship driven, how can we work to address it?
Outreach: I’d Like to Phone A Friend
I’m volunteering at a youth group lock-in for the entire weekend. I am 26 years old, and have been clean for 7 years. It’s Saturday afternoon, and I’m in trouble.
My Physical Stressors are poor fuel (running exclusively on coffee and pretzels), sleep (we finished our movie at 2am the night before, and I had a nightmare) and I haven’t exercised in days (we’ve been staying in a cabin in the mountains). Mentally I am shot: I’m good friends with the other volunteers, but all my mental energy is on serving the youth (isolation). Spiritually the stress has been high, what with being locked in a cabin with youth who have deep questions and struggles with God, they’ve been asking me, and I wonder if I’m completely botching it. I also haven’t been proactive in taking my scheduled breaks to have my needed restorative Quiet Time with Jesus… I’m weighed down with anxiety and shame.
Mike, the youth group director, says I can opt out of the large group game and have a nap on the couch if I want. The youth leave for dinner, and I’m alone with my thoughts. The caffein in my system renders sleep impossible, but everything else leaves me paralyzed. Instead of rest, my mind begins to spiral.
Remember the sailor whose cargo exploded?
By the time dinner is over and a half dozen youth have returned with Mike for band practice, my brain is on full-throttle in a body that has no capacity to move. Unwanted memories, negative thoughts, and nasty images, unprompted like a dream keep flashing in my eyes and ears, an endless myriad of things that make me flinch underneath my blanket, whimpering softly, uncertain if my voice could even cry out, or what it would say. Am I dreaming? I can’t be... I’m fully aware of the world around me... but I can’t move or respond, not even open my eyes. Mike and the few youth begin to play the worship songs, and I try to listen.
I called, You answered
And You came to my rescue and I
I wanna be where you are - WEAK! IDIOT! FAILURE! FAKING! YOU’RE ENJOYING THIS! IF YOU CALL FOR HELP IT MEANS YOU PLANNED IT WHICH MEANS YOU PLANNED EVERYTHING AND YOU’RE A LIAR! YOU’RE IN THE WAY AND FAILING! IF YOU SCREAM THEY’LL THINK YOU HAD A NIGHTMARE WHEN YOU DIDN’T! YOU WORTHLESS LYING IDIOT! YOU’RE IN THE WAY! And on and on and on and...
And images of giant bugs crawling through my hair, on my skin. Memories of my most painful moments- my self-harm, molestation, nightmares, on and on and on and on and my hands are tangled in my hair, rubbing my neck, clutching the pillow, and my voice catches in my throat, uncertain what to do, unable to open my eyes... Sinking into the pillow. Down, down, down... down... Help. Help me. I know I look peaceful but I’m not, I’m not! Someone, please, find me…
A crashing sound announces the youth’s return. Laughter, shouting, whooping, all mixing in with the piano and drums. Then I hear Fr. John's voice.
John. My mentor, John. Prayer. These aren’t my thoughts. They’re in my head, using my voice, but it isn’t me. I need prayer. John will pray.
“John?” I call out into the hubbub. No answer. Louder. “John?!”
“Yes, hello?” Eyes closed, I can imagine him looking around, uncertain where I am. My eyes fly open, in a final attempt, I scream as loudly as I can.
“JOHN!!!!!!”
Immediately, I see a grey blur shoot across the room, running to me.
“Are you having a panic attack?” Mike. I realize I can’t respond beyond a gasped whimper. Well that answered that question. He takes my hand and starts Grounding me. “It’s alright, I know what to do- we’ve done this before. What color are my glasses?”
“I... I need mine to see.” He finds my glasses on a nearby table. “They’re blue, like mine.”
Outside my narrow line of vision, a student asks him if I’m alright. I must look strange: tangled in a blanket, clutching the youth group leader’s hand for dear life, blinking in a dazed way as though simultaneously exhausted, confused, and terrified, mere moments after screaming a priest’s name like a maniac. Mike ignores him, knowing these next few minutes are crucial. He asks what color his sweater is.
“...Grey.” I manage to gasp out.
“What color is your pillow?”
“Navy... Red...” I stroke it with my free hand. “With white swirls... It’s rough and firm.”
“Very good. You’re doing a great job breathing.” I take a steadying breath at his prompting. “You’re safe, you’re doing fine.”
“Mike, is she ok?” Another youth asks. He ignores them
“Kelsey, what voices can you hear?”
“Yours... and I think for the past hour... I’ve been listening to a really bad one.”
“I’m sure you have been. But you’re safe now. What instrument do you hear?” I close my eyes for a moment to focus, gripping his hand like an anchor.
“An ukelele.”
“Right. You’re fine, you’re safe, you’re right here with friends, and you haven’t ruined anything.” My breathing is normal. A hand squeeze and deep breath later my vision is clear. He’s smiling encouragingly down at me, aware that he’s successfully brought his friend back. “It’s like the song said... You called, He answered, and He came to your rescue!”
“Can I have some water?” Mike nods for someone else to get that, knowing if he lets go too soon, I might get lost again. “Can you help me sit up?” He hoists me up, and fellow friends and volunteers Danyel and Harry are on either side of me, holding water. I splash some of the water on my face and feel the cold bite, bringing everything into even sharper focus. I’m back. In a few minutes, I will take a walk outside with Danyel and we'll talk about that's been going on to push me over the edge.
More Application and Outreach
One of the best things I ever did in terms of getting real, was teach my best friends how to Ground me.
As I write this, the world is experiencing a global pandemic. COVID-19 is sweeping across the continents, and there have been confirmed cases in my neighborhood. Today the governor of Pennsylvania has issued a decree that non-life sustaining businesses are to close, and people should remain home to prevent the spread of this highly contagious disease. I live alone (plus my 2 cats) and 24 hours without human contact is a recipe for disaster. The day this blog is posted, I’ll have been home alone for 31 hours.
Needless to say, my anxiety is far from the blue zone of calm.
And yet I’m doing really well, because I am not actually isolated. Whenever my anxiety starts to noticeably rise, I address it both by myself and with others according to my needs. I’ve been on the phone, or FaceTiming people throughout the day, and I have more lined up for the weekend. My phone is dinging regularly with texts to and from friends who are checking up on me, seeing how my anxiety and depression is faring with the social distancing. And they know to call me, because I especially need it. And they know I especially need it, because I told them.
Remember at the beginning of this I mentioned that there was nothing shameful in anxiety or panic attacks? Regardless how you may feel about it, this remains true. Again, it’s like an allergy or any other medical situation: If we could snap our fingers and be done with it, we would. But since we can’t, we should let people in our lives know that it’s there, how to recognize the signs, and ways to love you through it. I know how to use my friend's epipen, she knows how to ground me.
In the story up top at the youth group event with Mike and John, there’s a sentence intentionally typed in bold: “It’s alright, I know what to do- we’ve done this before.” That was not the first (or last) panic attack my friend helped me through, and he knew what to do because I had taught him. We with anxiety, depression, etc. have a responsibility to let those in our lives know this is a part of us, just as much as our friends should tell us if they’re allergic to peanuts.
If you struggle with anxiety (and also if you don’t) teach your loved ones about Grounding. You can take turns describing keys or other things you would ordinarily have in your purse or pocket. If you’re hesitant to touch things, you can do what my friends and I did in the early developmental stages of grounding: “D’you see that chair? Tell me about it.”
Even if you will never need to be Grounded, it’s likely you will at some point come across someone in the midst or edge of panic. They’ll be really relieved that you know how to bring them back. My mom still tells the story of the day after I taught her how to Ground me, a woman ran into her office and only managed to gasp out she was having a panic attack before loosing herself to it. Mom, who had learned Grounding less than 24 hours earlier, grabbed her keys, handed them to the (very confused) woman, and brought her back within a minute.
Friends, we live in a scary world, and there will be things that continue to frighten us. And a lot of these things are valid. But we needn’t be slaves to it. I do believe with everything that I am that there is a God who sees us, knows us, loves us, and is there with us even and especially in troubling times such as these. When I’m alone and especially anxious (and for whatever reason unable to phone a friend) I especially like to turn to the Psalms and remind myself of the God whom I serve. My favorite Psalm of all speaks to this anxiety:
Psalm 121
I lift up my eyes to the mountains—
where does my help come from?
My help comes from the Lord,
the Maker of heaven and earth.
He will not let your foot slip—
he who watches over you will not slumber;
indeed, he who watches over Israel
will neither slumber nor sleep.
The Lord watches over you—
the Lord is your shade at your right hand;
the sun will not harm you by day,
nor the moon by night.
The Lord will keep you from all harm—
he will watch over your life;
the Lord will watch over your coming and going
both now and forevermore.
This God, the man Jesus whom we meet in the Bible, is a mere prayer away, and really even closer. The Bible talks a lot about anxiety, and it always says to call out to God in the midst of it, unashamed, as a child should be allowed to tell a parent they had a nightmare, or are afraid of the dark. We have this kind of access with God. Call out to Him. If you find yourself alone and close to the edge, you needn’t go through it alone. You don’t have to wait until you're lost at sea with a burning ship to call for help.
Imagine that sailor on the boat. What if, as their anxiety began to initially build, they sent out their coordinates to another ship? Nothing urgent, just a “Hey my boat is over here and I’m carrying extremely dangerous cargo… Could we periodically check-in? If you don’t hear from me in an hour, radio me?” The assurance that someone else knows where they are would take some of the edge off. And if something did go terribly wrong (because let's face it, sometimes it does) the sailor would have the confidence that before long, someone would know to come looking for them.
I’ll do that with friends sometimes, you can with yours. You don't have to power through it alone all the time... you can share with those who love you that your anxiety causes you to feel terror where others feel fear. You feel fear where others feel discomfort. Keeping it to yourself will only create unnecessary shame, and push you into a spiral. So get Real with people, and tell them where to find you.
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I’m at Giant Eagle, and it’s 9pm on a Sunday night. I’m 28, and I’ve been clean for 9 years and 11 months. My hands shake as I hold my phone, begging my friend to pick up.
“Hello?”
“Hey Dany? Are you finishing up youth group?”
“Nah, I’m out of town.”
“Okthanksbye.” I hang up the phone, trying to regroup. It’s hard work and I fail miserably. My phone rings and Danyel’s name appears. “Yes yes Dany hi hello?”
“Are you ok? Where are you?”
“I’m at Giant Eagle.” My voice is higher than normal and my stammer is in full throttle. “I was walking here and now I’m here and I think my anxiety is high or something - it’s not a panic attack- but I don’t think I should walk home because I’m not thinking straight, so I thought you might be nearby at church but now you’re not so I’m not sure what to do.”
“Ok, take a breath.” I do, and I can hear her snapping into gear. Over the years Dany and other best friends have learned how to handle me when I get like this. “Right, have you eaten anything today?”
“Does coffee a few hours ago and some grapes count?”
“So no, you haven’t. Have you called anyone else yet?”
“No, you were my first, so I’m not sure.”
“Hang up and call Natalie. If she doesn’t pick up, call Mike. He should still be at the church. Call me as soon as you reach one of them. You’re ok, stay inside, I love you.”
“Okthanksbye.”
“And tell him you haven’t eaten anything today!!!”
I call Natalie. Voicemail. I call Mike. His number is already memorized so I don't even have to look him up in my address book.
“Hello!” His British voice is chipper.
“Hey Mike, are you at church? Follow-up question, did you bike or drive with a car?”
“I am, and I drove! Why?”
“I…” I hate saying these words, but I promised Dany. I take a deep breath and rush out the words: “I’m at Giant Eagle and think I need you to pick me up.” (UGH that was so HARD!!!)
“Have you been drinking again?” I hear a hint of laughter in his voice. He knows I don’t drink. He also knows it’s been a crazy-stressful week and that this is likely a panic-induced call.
“It isn’t a panic attack, but my anxiety has been through the roof this week and I’m not feeling right and I walked here and I called Dany because I thought she might be at youth group but she’s in New York and Natalie isn’t picking up so Dany said to call you and if you can’t I could do an Uber or something but I wasn’t sure and I just called you and I’m at Giant Eagle.” I'm not sure if that was one breath or twenty, but it was very fast.
As I stammer out this jumbled run-on sentence, I can hear over the phone the small grin spread across his face in silent triumph that his friend managed to do the near impossible and call for help in real time. I can also sense his determination to remain casual and not whoop or make a big deal out of it.
“Yes ok, I can leave in a few minutes. You’re at Giant Eagle? Stay in the building. Go near the entrance and sit on the inside bench. Do not leave, do not wander off. I’ll come to you.”
“Ok. Bench. Yes I can do that. Thank you yes ok seeyousoon g'bye.”
Crap! I forgot to tell him I haven’t eaten. I’m so disoriented at this point that the fact I’m in a grocery store surrounded by food is completely lost on me. I leave my shopping cart in the produce section (abandoning my two containers of salad dressing) and find the bench.
“Are you ok?” Dany asks urgently, answering her phone on the first ring.
“Mike is coming. And I forgot to tell him about food.”
“It’s fine, I just called him and he’s bringing you leftover pizza.”
“Ok.” I’m rummaging in my bag and find a can of V8 and an old-ish clementine that I must have put in earlier that week for such a time as four hours ago. I scarf them down with indecency.
“Do you want me to stay on the line with you?”
“I think I’m ok. I have water, Mike is coming, and he said to not move so I won’t.”
“Ok, good. If there’s something going on that sent you over the edge that you need to talk to someone about, do not get out of his car until you have, you got it?”
“Got it. I think it’s mostly just this week. You know what’s been happening, and then I haven’t eaten. It should be fine. But if I can think of anything I’ll tell him.”
“Good. I love you.”
“You too.”
"Call me when you get home."
"K!"
Even in hyperdrive, I am able to call to mind what I’ve trained myself to do in moments of anxiety, because I've practiced so often in moments of stability. I place a hand on my tummy, the other on my chest, and begin breathing. My eyes are fluttering dangerously, so I bring out my notebook and start drawing a pattern I read helps reduce panic, merging it with the paced breathing. Ten seconds or ten minutes or maybe ten years later, a pair of running shoes enter my line of vision and they stop, facing me. I look up blearily to see a grinning face.
“You Uber is here!” Mike says cheerfully. “And today, business has merged with Grubhub!”
“…Huh?”
“I brought you pizza.”
Mike takes my bag and pushes me toward the door where his car is waiting. He helps me in and sets a box of leftover pizza on my lap. It's the most beautiful thing I've seen all day. He plays bluegrass music on the radio as he drives and doesn’t attempt to engage me in conversation until I’ve had an entire slice.
As we talk, we both agree my Physical Stressors are the fact I haven’t eaten anything but coffee that day, I’ve been battling migraines again, and I’m sleep deprived. Mental Stressors (apart from being a full-time grad student) include my friend committing suicide that week, and student housing having just informed our entire building that we need to move in 3 months. I’ve seen 15 apartments that week. My Spiritual Stressor (shocker) is I haven’t been taking the quiet time I need with God.
But we also agree it wasn’t a panic attack. If I hadn’t called for help, it most certainly would have devolved into one, but I caught it in time while I was crossing over from high anxiety to an anxiety attack. Infinitely more bearable and easier to handle, both for me and Mike.
“Good job again, calling.” Mike says when we pull up to my apartment. He gets out and hands me my bag and the pizza, grinning proudly. He and I both know that had this happened even two years ago, I wouldn’t have called anyone. I would have probably wandered into a booth in the Giant Eagle cafe and feinted or something. Or eventually had the wherewithal to order an uber, but it would have taken hours. It would have also taken days to recover. As it is, I'll be right as rain tomorrow morning.
“I’m glad I knew I could.” I say, clutching the pizza, already planning on devouring it the second I get upstairs. “Thanks a ton. See you at the meeting tomorrow.”
As I mount the stairs, Mike gets into his car, calling after me one more time:
“Well done, asking!”
I enter my apartment and call Dany while I eat the rest of the pizza. When I wake up the next morning, Mike and Dany have texted me, checking in. I'm able to tell them I'm legitimately fine.
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Before we get into activities, let's dissect a few points from the grocery store adventure...
1. Even though I was nearing a panic attack, I knew what to do because I had regularly practiced during better days. Step one: Phone a friend.
2. My friends Danyel and Mike also knew what to do, because I had taught them. Natalie (had I managed to get ahold of her) knew how to Ground me as well. So when the phone call came, they were neither surprised, nor powerless.
3. I had numbers memorized, so even if my phone died I could have borrowed someone else's phone and reached someone.
4. I had food and water on hand (that I had forgotten about, but it was there.)
5. As I waited for Mike to pick me up, I was able to do calming and Grounding exercises that I already knew, because again, I'm constantly practicing them.
When you're in the midst of panic, the only resources you have are the ones you already know. Grounding is infinitely easier when you have someone with you who knows how to do it. But sometimes, you don’t have access. And yet, you aren’t doomed to just riding the panic attack out through its entirety. As we read earlier, there are ways to circumvent and attend to them! So teach yourself (and others) what do do before you need it. Now that we're nearing the end, let's take a look at things we can do to Ground ourselves and attend to our anxiety!
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Activities and Resources
54321
One of the best self Grounding techniques is the 54321. I have no idea who came up with it. From wherever you are, identify and verbally name…
5 things you can see
4 things you can touch
3 things you can hear
2 things you can smell
1 thing you can taste
Notice how this is similar to someone handing you keys and you describing them.
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Breathe
… The following tempo: inhale for 4 seconds, hold for 7, exhale for 8. This triggers the parasympathetic nervous system, lowering heart rate, and relaxing the body.
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Infinity Circle
Following the pattern with your eyes but without moving your head, trace the infinity circle. While you trace, slowly inhale for one loop, hold for two, and exhale for two. Repeat as necessary. When you don’t have the book, you can take a piece of paper and draw a horizontal infinity circle, or trace a flat surface with your fingers.
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Examine Past Panic Attack Stressors
Panic attacks are often filled with shame, especially when examining the seemingly minute factor that pushed us over the edge. Take some time and write out the panic attacks that are causing you the most pain, and write out all the stressors that were in play. Of the Physical, Mental, and Spiritual Stressors, do you find that you are especially prone to any of them? Seek to better understand what was going on in your life the days and even weeks leading up to the break down. Remember to be kind… You probably weren’t having the best of days leading up to this…
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Stressor Check-In
At the moment, which of your Physical, Mental, or Spiritual stool legs are the most compromised? How can you take care of it?
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Recommended Playlist for Anxiety
Songs by For King and Country:
Shoulders
Busted Heart
Sane
It's Not Over Yet
Priceless (Ballad version)
Light It Up (Live Performance version)
Songs by Lauren Diagle:
Rescue You
Trust in You
O Lord
Songs by Skillet:
Anchor
Stars
Lions
Other Songs:
I Won't Let You Go -Switchfoot
Carry Me- Josh Wilson
Fall Apart - Josh Wilson
Steady My Heart- Kari Jobe
Quiet- Matilda the Musical
Beautiful Beautiful - Francesca Battistelli
Hold On- Secret Garden the Musical
Music
Any piano by Yiruma
Oogway Ascends -Kung Fu Panda
Long, Long Time Ago -Pan's Labyrinth
Weightless - Marconi Union
- Written and produced to actually slow down your heart rate, reduce blood pressure, and lower cortisol levels.
And with that, I must sign off until next week. Tune in March 25 as I post and celebrate a very special 10-year anniversary!
Wash your hands, bow and curtsey in greeting, and know that this too shall pass.
Stay safe, my lovelies.
You are wanted and loved more than you could possibly imagine.
Goodnight, DearHeart.
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