Anxiety first aid

Although unpleasant, anxiety and panic is a normal biological reaction to perceived threat. It is part of our innate ‘fight-flight-freeze’ response and manifests as a mixture of thoughts, feelings, behaviour and physical sensations.

Anxiety first aid does not address the causes of anxiety that therapy can help with, but it can be a useful way to manage the often intrusive symptoms that accompany anxiety. I have highlighted three examples of anxiety first aid below, but it’s worth remembering that there are many examples out there, and it is important to find the one that works best for you.

Being present

When we feel anxious, our thoughts tend to revolve around negative future scenarios or worrying how we are going to be judged by others. Anxiety has an uncanny knack of hi-jacking the present moment. Being present is often referred to being ‘mindful’. But you don’t have to meditate to be mindful. It’s just the process of disentangling yourself from intrusive negative thoughts by bringing your attention to your non-thinking, here-and-now experience.

For instance what sights do you see around you? What can you smell, or hear? What textures can you feel? Coming out of your thoughts and into your senses is an antidote to the adrenaline fuelled by anxiety. Sensory self-soothing calms the nervous system and reminds the body it is safe in the here-and-now, rather than under threat in the imagined future.

Being an observer

When we feel the symptoms of anxiety (racing or intrusive thoughts, shortness of breath, heart palpitations, feeling too visible - to name but a few) it’s difficult not to get caught up in them. A vicious circle of extreme thoughts and physical symptoms then occurs which antagonises the anxiety and panic; for example we may feel palpitations or short of breath and then think ‘I am going to have a heart attack’.

A way to break this circle is to re-direct our attention from these extreme thoughts and try to observe and describe the sensations of anxiety alone, without judgement. Using our 'observer ego' in this way can stop us being completely embedded in and thus overwhelmed by the anxiety. For instance, is the sensation heavy, still, tingly, sharp? How does it move through the body? At the same time we may be able to remind ourselves that the sensation is passing through, that it will not last forever. Observing the sensations of anxiety and panic can be likened to observing a train thundering through a station – loud, scary, intrusive, but something that that does not last.

It can also help to observe other parts of the body that are not affected by the anxiety sensation, parts of the body that feel ‘OK’. For instance your feet on the floor, or your hands. How do they feel different? Is there a posture or a movement that can help these ‘OK’ parts of the body feel even better? Being an observer of our physicality in this way can be a resource for some people with anxiety, as anything that keeps us grounded and embodied will ultimately help calm us down.

Being in our safe place

However, for some people the opposite is true – being in the body can be more triggering than calming. In my experience of working with trauma, (which, like anxiety relates to the body’s innate ‘fight-flight-freeze’ response) I often work primarily with ‘safe places’. This means shifting our focus from the anxiety to a relaxing place (real or imagined) and describing it in detail using all our sensory awareness. Some people may choose a memory, or a peaceful location, or even a particular object that has meaning for them. The nervous system responds to sensory imagining; when we really focus on a relaxing place (the smells, sights, sounds and textures of it) our body responds as if we are there in reality and the intrusive symptoms subside.

This can be helpful for anxiety because when we feel anxious we can feel hyper-vigilant, visible or on show, as if everyone is watching and judging us or that something terrible is going to happen. By shifting our focus from the external world of threat to the internal place of safety, we can begin to self-soothe and think more 'clearly' about our experience.