Following my recent post about Trauma-Related Fear, this is the first in a series of articles exploring some of the ways in which we can manage the anxiety, panic and fear emanating from the trauma of losing our loved one.
It can be very tempting when we're feeling anxious to escalate the sense of distress by becoming emotionally dysregulated, and even angry. This might take the form of shouting at others, rushing around manically, or just by telling ourselves that we simply can't cope. Sometimes, if the anxiety is very intense, we can just shut down emotionally. All these responses are completely understandable, and can allow us to express something of the pain and fear we are experiencing in that moment, but they tend not to be very helpful to us in either the short, or the longer term.
When someone we care about is visibly distraught, we feel upset. So we know that when we ourselves react with high expressed emotion, it's liable to distress our loved ones. But what we don't always realise in the moment is that it also intensifies and prolongs our own suffering. Despite having learned and understood this intellectually many years ago, it nevertheless took me a very long time to really recognise it intuitively, as a felt sense. It took even longer to begin to change my emotional and behavioural responses, and of course, there are still occasions when I give in to that urge to escalate, because in that precise instant, I am just scared, or upset.
By far the most effective technique I have found for regulating my immediate emotional and physical response to any perceived threat, is to focus on my breathing.
Because regulating our breath to calm our threat system works.
And mindful breathing on a regular basis, whether through formal meditation, as part of yoga practice, or just a few quiet minutes sitting calmly and quietly when we have the chance, can have a significant impact on reducing our overall stress response (more about this in my forthcoming post on meditation).
Regulating our breathing is the first step to regulating our emotions.
There are many methods for doing a quick breathing practice, and I can't honestly say I've found one that works best; I think its just a question of personal preference. There are lots of well known apps that have inbuilt breathing, calming or relaxation practices, and many more specifically designed for the purpose (Insight Timer is a free one), but you don't really need an app. Below are a few things to try when you notice you've been triggered, or are feeling anxious and want to calm down your threat system, that only take a minute or so.
Option 1: Take a few deeper breaths, inhaling through your nose and exhaling loudly if possible through your mouth, allowing your body to relax as you breathe out. Then consciously slow down your breathing, by concentrating on each breath, noticing where you feel it most strongly in your body, and regulating the breath so that it is steady and even.
Option 2: Focus on making the out-breath longer than the in-breath, counting to say, 3 or 4 on the inhale, and then to 6 or 8 on the exhale (no need to be exact).
Option 3: Square breathing - breathe in to the count of four, hold for the count of four, breathe out for the count of four, hold for the count of four, and repeat, imagining your chest as a square and breathing into each corner of the square in turn.
Option 4: Start to count your breaths at a certain point in the cycle, e.g. the beginning or end of each exhale. Count to ten breaths, and then start from the beginning again. If you lose count, simply start again from 1.
The counting is simply a way of helping us to focus, because our busy minds have a habit of taking off somewhere the minute we close our eyes. If you find your mind wandering a lot, just keep bringing it back to the breath in your body, without self-criticism or judgement. Each time you do this is a moment of mindfulness.
Once you've been able to regulate your breath, the next step is to check in with the rest of your body. Notice your feet (they're often overlooked) and how your toes feel, whether they are bare or wearing socks, slippers, shoes or boots. Then gradually take your attention slowly through your whole body. Try to engage as many senses as possible. If you're sitting down, observe the weight of your body resting on the support beneath you, paying particular attention to the areas in contact with the floor, the chair, and where your hands rest in your lap. If you're standing, notice how the earth or ground feels under your feet, and if you're outside, take note of sensations such as the feel of the sun, wind or rain on your face. The general idea is to take our focus of attention out of our minds and into our bodies.
If you're on the verge of a panic attack Using grounding techniques such as naming 5 things you can see, 4 things you can hear, 3 things you can touch, 2 things you can smell, 1 thing you can taste, can also be helpful. Once you have been able to reduce your panic, you can continue with a breathing practice and then tuning into your whole body. As anyone who has ever had a panic attack will know, it is an extremely frightening, even terrifying experience. I remember my first one very clearly; I felt as though I was on the very edge of a precipice and in danger of toppling off into a black void of insanity. Before Anton died I had no idea just how awful panic could feel but I have had several panic attacks since then, and wouldn't wish them on anyone. The good news is that over time, using regular calming breathing and/or meditation can help soothe our autonomic nervous system and reduce the occurrence of panic attacks.
The breathing is important, because its only when we are reasonably calm that we can re-engage our rational brain, re-evaluate the existence of actual threat, and if necessary, problem-solve. If you're interested in the science, there are two really interesting and very accessible Ted Talks by neuroscientist and leadership expert Dr Alan Watkins here (part 1) and here (part 2) about the impact of anxiety on our frontal lobes (and therefore our ability to think clearly and reasonably) and the power of simply regulating our breath.
Just as importantly, being aware of the existence of our threat system during times when we are not feeling afraid encourages us to strive for good emotional balance, which can help us regulate our feelings and prevent us reacting with such intensity when something triggers us. I've talked in a previous post about the ways that stress leads to anger and how having a high ongoing stress level means it doesn't take much to propel us into a feeling of panic, a sense that we have lost control. Paying attention to our bodies gives us the clues and the cues we need in order to maintain a sense of balance and calm.
The concept of Emotion Regulator Systems was developed by Professor Paul Gilbert, a pioneer of Compassion Focused Therapy (CFT). I think its a really useful way of explaining the need for emotional balance in our everyday lives.
Ideally we try to keep some equilibrium maintained between our drive system, our soothing system and our threat system, as shown in the diagram, where all the ovals representing the different systems are the same size.
Take a moment to consider what your different systems would look like, represented in this way. Are your ovals all the same size? How developed is your soothing system? Is your threat system drowning out the other two?
Many of us keep our threat system at bay by building a very powerful drive system (e.g. working too hard; constantly striving for more success; exercising manically; distracting ourselves with new, shiny possessions) which can have the effect of squashing down the threat system, at least whilst we continue to perform/succeed/buy stuff. But what happens when we are prevented from doing these things, or they suddenly fail to give us the lift they once did? What works fairly well in the short term isn't always sustainable longer term, and living predominantly in any one system can make us physically and/or emotionally unwell. For many of us, the oval that's smaller than the others is the soothing system, which often tends to be under-developed and under-nourished.
There are myriad ways to develop your soothing system and you will almost certainly have your favourites. Think of the things that bring you calm, and help you recharge your batteries. Virtually anything that takes us into nature, soothing music, a jigsaw, gentle exercise, a hug, a warm bath, a cup of tea or mug of hot chocolate, a good book, a moonlit walk, a snuggle on the sofa, a game, a feel-good film, time with a pet, the smell of freshly washed laundry, the sight of flowers, a word puzzle, candlelight, a meditation practice...
Remember, it takes a fraction of a second for the nervous system to register threat, but a lot longer for us to begin to relax once the moment has passed. Regularly listening to our minds and bodies, and finding time to self-soothe, and take care of ourselves is crucial for our ongoing wellbeing. There are so many and varied ways of self-care, and in this series of posts I'll be exploring more of these, including meditation, mindful movement such as yoga and Tai Chi, and some of the different calming activities that have helped me find some balance during the most painful and tumultuous of times. Self-compassion is key.
"Healing doesn't mean the damage never existed. It means the damage no longer controls our lives." Akshay Dubey
Sources & Further Reading
Babette Rothschild (2021), Revolutionizing Trauma Treatment: Stabilization, Safety & Nervous System Balance, Norton Babette Rothschild (2000), The Body Remembers, Norton Bessel van der Kolk & Licia Sky (2023) , 2-Day Trauma Conference: The Body Keeps the Score-Trauma Healing Through the Senses (Digital Recording) REFERENCE
Bessel van der Kolk (2014), The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma, Penguin (2014)
Deborah Lee & Sophie James (2011), The Compassionate-Mind Guide to Recovering from Trauma and PTSD, New Harbinger
Deborah Lee (2012), Recovering from Trauma using Compassion Focused Therapy, Constable & Robinson
Arielle Schwartz (2022), Working with trauma: Somatic-based interventions to move clients from surviving to thriving (Online course May, 2022)
Siegel, Daniel J.(1999), The Developing Mind : toward a Neurobiology of Interpersonal Experience. New York: Guilford Press
Helpful thank you.
The main problem perhaps is that, as you said in the previous post, life keeps throwing curve balls & multiple challenges making it impossible to have space to embed /practice coping strategies after traumatic loss. Today’s society can present so many difficulties for people day to day whether it’s caring for elderly relatives without support - or housing issues, low pay etc. Successive Govts haven’t been focussed on building people-friendly systems.
Still there are always great people trying their best to help others, so that’s encouraging. And peer support is important from people who have been through similar experiences.