I begin my work with you by assessing your degree of anxiety on a scale of 1-10. After that assessment, I use various techniques to reduce the level of activation or charge in your body. Since anxiety is a physiological experience of too much energy or constricted energy often in the abdomen, upper body or in front of the body, I often start with a physical technique to bring your energy down into the lower body or towards the back of your body. For example, I may suggest pushing down with your feet into the floor as you inhale, and releasing the feet as you exhale. Or we could have you stand up on your toes and repeatedly allow your feet and body to plop down onto the floor, feeling the reverberation in your body. Another useful exercise is to stand with most of the weight on one foot, feeling how that leg holds up the pelvis and in turn holds up the spine, etc. Then you shift onto the other foot to feel the body supporting itself, often bringing a sense of alignment and strength. All of these are grounding exercises created to counteract anxiety.
When working with your body feels too overwhelming, I'll ask you to look around the room or out the window and notice what your eyes (or other senses) are drawn to. Your eyes may wander for a while or focus on something right away. Sometimes, just the act of looking can be calming. Generally, as you focus outside yourself, your body begins to relax and feel more present to the "here and now". This can be very important to some people as they start to realize they are safe in this moment and don't need to do anything but breathe and take in the environment.
Another successful technique is focusing on a memory that is comforting, relaxing, or pleasurable in some way. Once you come up with a positive memory, I help you recapture that same feeling by bringing the memory into more detail. For example, I may ask: “What was the temperature? Who was there with you? What do you see, hear, smell?” As we do this, usually the pleasurable feeling returns. People often use the same memory or image over and over again to recapture a feeling.
These techniques are the ones I most often use to reduce a client’s anxiety. Others that I use are described in the Resources and Trauma Healing article (included on this site).
With all the above-mentioned methods, once you begin to relax, it is important to give yourself time to settle and assess how you may feel different from before. It is also important that you remember this feeling and know that you can return to this state again. In addition, we reevaluate your anxiety level from 1-10. That measurable difference gives people a concrete sense of accomplishment.
An example of helping a client recover from an anxiety attack:
Recently I had a client who became very anxious every time someone left her house after they had spent time together. We had been working in her sessions to understand why this was happening, but in this one particular session she was extremely anxious. I had her do the first exercise mentioned above-- raising her heels and letting them plop back down onto the floor many times--until she felt her awareness drop down into the lower part of her body. I then suggested she rub her feet on the carpet and feel the texture of the rug on the bottom of her feet. Every time she started to worry about going to work or began thinking about something that was anxiety provoking, I suggested she return to rubbing her feet on the rug. She realized that it was very difficult to be anxious when her attention was focused in her feet.
Next, I asked her about a soothing memory. She thought of a time she had spent with her boyfriend, looking into his eyes and feeling loved. I suggested she continue to feel her legs and feet and notice her breath, which was beginning to slow down and deepen. Then I suggested she look around the room and notice what felt soothing. She started looking out the window--at the trees blowing in the wind--and felt further calming in her body. At that point, she said she felt ready to go on ahead to work. I suggested she continue to look at the trees or listen to the birds as she walked to work. I reminded her to keep feeling her feet, legs and body each time her feet touched the ground. Using these reminders, she was able to go to work and complete her day successfully.
With this example, I used all three methods mentioned in the beginning of the article. Generally, as people use the 1-10 scale and different anxiety management techniques, they feel much more in control. When a client already has a successful anxiety management technique, we focus on reawakening their awareness and use of that method. The ongoing task in therapy then becomes continuing this type of work until the client has developed the inner and outer resources required to truly master their state of anxiety.