I was having a panic attack myself when the client walked in stating she had been having one for 4 days. There were a lot of things to consider.
First things first. Put on your own oxygen mask before you can help anyone else. So I put my anxiety in a box and saved it for later that night (oh joy).
She had a history of anxiety since her first diagnosis of a life-threatening medical problem 10 years ago (knowing your client’s history is so important!). Coming up on its anniversary didn’t help. She had to be vigilant. So every worry starts to turn to PTSD.
What do you mean worry is PTSD? I’m not a war veteran. I wasn’t sexually assaulted, thank god. But it’s true. I have been studying the brilliant and radical therapist Bessel Van Der Kolk. Run to the bookstore and get The Body Keeps the Score. You will recognize your worry/anxiety/panic on every page.
According to Yoga International,
- While we often think of PTSD as the intense and unexplained symptoms military men and women experience coming home from battle, this anxiety disorder can take many forms and touch a much wider population. Being raped, getting hit by a car, witnessing a violent crime, being in a war zone, losing your best friend to cancer, or even being scared of the possibility of something bad happening can all contribute to PTSD. How you deal with how you feel in the aftermath of such events determines the level of trauma that gets lodged in your cells.
So I explained to my patient that she probably got frozen. That the manual override of her worry (eg. her intellect) had failed her because she got “flooded.” This is what happens to animals in the wild. Fight or flight we now understand as our body’s false-alarm of danger. But what about FREEZE. Freeze is the part that makes you stop in your dream in sheer panic. Freeze is the part that feels like it will never end. Freeze is the part where you loose all sense of time.
- “Traumatized people chronically feel unsafe inside their bodies: The past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.”
Van Der Kolk goes on to say that the time distortion, basically, that this will last forever, is what talk therapy CANNOT fix. That’s where the yoga comes in. Not power yoga, not hot yoga, but gentle yin or restorative yoga. Yoga that allows your body to reset and respond and come back online slowly, without fear. Then you can process what happened.
- it’s not still happening
- it’s not the same as before
- you are not the same as before
- you are in control now
- you can allow yourself to feel
- this is not life-threatening
I went over all this with my patient. We did some belly breathes, some square breathes, some visualization, some metta (I am safe, I am ok), some alternate nostril breathing for balance, and finally some tapping to settle the ruminations. We sent the breathe to where it was tight, constricted and afraid. Once she was thoroughly convinced she wasn’t dying we talked some more about what it was like when she was first diagnosed. How frightening it was because her mother wasn’t there. We reiterated how intense that was then, but how that couldn’t happen now. It’s over. She is safe.
- No matter what poses survivors choose to do—or how much they experiment with the breathing exercises—they benefit from knowing that each exercise comes to an end, that they won’t get stuck in emotional overwhelm. A pose might feel uncomfortable, a round of pranayama might bring up feelings they would much rather stuff back down, but the sensations are temporary, only around until the next posture or the next exhalation.
I am currently working on a new curriculum for yoga and anxiety. Much like trauma, but just for every day obsessions like how am I going to pay my bills, I can’t believe I said that at the party, where is my dog, I don’t have time to do everything, I texted to the wrong person, what if he’s cheating — this is where we can also apply gentle yoga right in the session. Stay tuned!