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anxiety

Use your voice

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And use your voice, every single time, you open up your mouth.

(My Chemical Romance)

One of the most empowering moments of each week is at the beginning of my yoga class. We stand at the top of our mats, with strong legs, rooted down. As we reach up and bring our palms to heart center, our teacher invites us to gaze down or close our eyes. She tells us we are going to open class with the sound of a single ohm, and then she says:

“And as I always remind you: of all the things to fear in this world, do NOT let the sound of your own voice be one of those things.”

That reminder, that statement, sends chills up my spine. It makes me grow a little taller, breathe a little deeper.

I used to fear the sound of my voice. I used to keep opinions and thoughts and worries and fears and dreams and desires and stories to myself. It’s scary and it’s vulnerable to speak, to make noise. It invites in the possibility that we may be quieted, diminished, dismissed, ignored, berated. Amidst those possibilities, it seems safer to wilt and hide from the sun.

The thing is, nobody is every really ready to use their voice. Nobody walks into yoga thinking, “Today I’m ready to chant ohm with my class.” Nobody wakes up thinking, “Today I’m ready to tell the world my story.” If we wait until we’re ready, we will be waiting our entire lives. This is the truth.

So instead, we have to just do it anyway. Sometimes in small whispers and sometimes in loud bellows. Last winter I posted a baby step post, and then I told my stories, and then one day I just said, “It’s time.” And then I wrote it and sent int into the world.

Turns out, using your voice, speaking your truth, doesn’t break you. Quite the opposite, in fact. It sets you free. It connects you with others. It invites in conversation. It helps dispel others’ shame. It sets off a ripple of bravery. It’s all good, wonderful things.

The other day I said to Laura, “Remember when we thought that we would go to the grave with it as a secret? I never, not in a million years, thought I’d be here. But look at me – standing in the sun.”

Using our voice gives us power. It raises us up. Makes us grow. Dispels fear. Washes away shame.

So, maybe you don’t feel ready. It’s okay. Go ahead anyway. Chant that ohm. Tell your story. It will not break you. Stand tall, root down, turn toward that warm sun.

On not fleeing

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Last week, my husband and I were flying home from vacation. I hadn’t been feeling well the morning of our flight – my stomach was a little upset and I felt slightly dizzy. On the way to the airport the car was warm and I overheated and felt faint, my pulse was high, and I was emotional about vacation being over and leaving loved ones. When we walked into the airport, Husband asked if I was okay and if I needed a minute, and I said I was fine – because I was, in that moment.

But as we waited in the line for security, I felt it start to come on. Fight-or-flight kicked in. While it almost always happens during medical situations, it can also occasionally happen for seemingly no reason at all. Shit, I initially thought. It’s panic or it’s a vasovagal syncope, but either way this is not good. My heart began to beat too fast, I started to sweat, and I felt that horrible hot sickening feeling wash over me – the one that signals, You’re going down. Literally. So I tried to lengthen my exhales as I took off my coat and shoes and put my carry-on on the conveyor belt. But that hot feeling kept coming in waves and I felt my stomach start to tighten – I was going to throw up, or faint, or need to use the bathroom immediately.

I evaluated my options – I had one person in front of me before I could go through security, and for a second, I turned around, deciding to let others go before me and sit down before it overcame me. But the security guard motioned to me, and told me it was my turn. One minute, I told myself. Hold on for one minute. And then, whatever happens, happens. I made it through security. And the minute it was over, I ignored my belongings, knowing Husband behind me would gather them, grabbed a nearby trashcan, and sat down on the ground, dry-heaving, spots floating in my vision, bowels clenching.

I stayed seated for a while and Husband came to check on me, but I was okay. A few people glanced at me but most didn’t give me a second look. One woman asked if I was okay, and I told her I wasn’t feeling well. She sympathetically smiled and moved on.

And then I was okay. And I didn’t spend the next hour ruminating on what happened and why and trying to understand every part of it. Instead, we got some cold water, walked to our gate, and then moved on.

Years ago, I would’ve fought. I wouldn’t have even made it through security because the thought of Oh heavens, somebody is going to see and someone is going to know, and they’re going to wonder what’s wrong with me, and I don’t even know what’s happening or why, and it’s going to be humiliating would magnify it immensely. And that fear of someone seeing, of knowing, and therefore of deciding I needed to fight it, just made the situation worse. But facing it, letting myself be vulnerable, is what helped it pass quicker than it ever would’ve years ago.

A few weeks ago I was talking with my therapist, discussing an upcoming situation in which realistically I am likely to have one of these attacks/situations, and she asked what my goal was in envisioning how I’d like it to happen. Was my goal to “be okay” with what was happening in the situation and therefore not panic/not have my body respond in this physiological way?

No, I realized. The point isn’t to make it go away. Maybe it will, maybe it won’t, but the point is to be okay with whatever happens. So if I have a panic attack – it’s okay. If I throw up – it’s okay. If I pass out – it’s okay.

And deciding to float, to face it, and not to run or fight it – that’s what gets you through. That’s the bigger life lesson anyway, right? That we will be okay. Whatever happens. And we don’t have to run, because it will not destroy us.

Advertising Anxiety

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When working with a client who stutters, we often talk to them about “advertising”. By that, we mean being open about their stutter. Sometimes we’ll have a client go into another therapist’s office and tell them, “I was hoping to talk to you today about stuttering. What do you know about it?” Or they might ask to borrow a stapler, but stutter while they’re doing it (on purpose). Other times they’ll be ready to tell a new adult, “I stutter, and this is what I’m working on.” The idea being that the more they are open about stuttering, the more their own internal stigmas are broken down. Additionally, the more open they are, the less likely they are to have avoidance behaviors (avoiding people, places, and words, because of their stutter).

This is the type of advertising I have learned to do about my anxiety when I’m in a medical setting.

I don’t do well in a doctor’s office of any capacity, and I have recognized that I likely never will be able to be present in those settings without any anxiety. But for many years, this knowledge, this belief of I have panic attacks in medical settings directed my behavior. I was completely out of control – or rather, my anxiety was completely in control.

[Apologies in advance – the next part is gross but hey, it’s all about being real, right?]

For years I passed out every single time that I had blood drawn, or a TB test. But passing out wasn’t the worst part. I knew people who fainted from things like that, and let me tell you, I would’ve paid money to only have fainting be the issue. What would happen to me is that a heavy, hot, feeling of unreal-ness would pass over me. I’d start to get tunnel vision. And then instantly, nausea and an urgent stomachache would follow. My body would go directly into flight-or-fight mode, and shut down, trying to empty. And this meant maybe by vomiting and maybe from my bowels. Well, you can’t really do both at once, or else it’s going to be messy and disgusting. And it’s even messier and more disgusting if it happens in an exam room. So in this split second, I’d realize I needed to bolt to the bathroom before any or all of these things happened. Usually I’d make it to the bathroom, my system would empty in one way or another, and I would pass out on the toilet seat.

Lovely, right?

The memories of these unpleasant panic attacks combined with my pre-existing fear and anxiety about a doctor’s office in general led me into a cycle for years: knowing it would happen, therefore it would, therefore confirming that it happened, therefore knowing it would happen next time, etc. I’d sit in the chair, and wait for the needle, hoping I could fake it this time around, never succeeding.

Until one day about 5 years ago I realized that I didn’t have to be helpless.

I began to advertise.

“I need to lie down when you take my blood,” I started telling the techs. “I am a fainter and do better reclined.”

“I’m going to listen to my ipod while you do that procedure,” I told a dentist.

“I appreciate you telling me exactly what you’re doing while you’re doing it, but can you actually talk to me about anything else instead?” I’d ask the doctor.

“I am about to pass out,” I told a doctor once. “I need to recline and I need something cold for my head.”

“I know you’re not doing an exam today, but I just need to let you know that I tend to get very anxious in medical settings. So if I step out into the hall or something, I’m fine, I just need a minute.” I told a new specialist I was seeing.

“So do you think it’ll snow tomorrow?” I’d ask a technician, not caring about the weather and not knowing if she did, but knowing I needed to distract myself from what was happening.

And it began to work. I had a TB test where I didn’t faint. I had blood drawn where I didn’t pass out. I sat on an exam table without the white-hot unreal fog coming over me. Breaking the cycle, making me believe I could be in control of this.

My expectation was never – and is not today – that I will never have these episodes again. But more that in being up front about it, the fear is out of me and into the world. They know what to expect so there are no surprises if I rush off to the bathroom or suddenly dart out of the room. One lab technician thanked me, saying, “I’m glad you said something. We’d always rather know, just in case.”

I used to not speak up out of – you guessed it – shame. Feeling that I should be able to handle this and it shouldn’t be such a big deal and what was my problem, anyway. But guess where that got me? Correct. Nowhere.

So now, I advertise.

Dispelling a piece of that shame, each time I speak up.

I’ll take it under advisement.

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You know how sometimes someone gives you a thought or anecdote and you appreciate it, but move on, but sometimes someone gives you a random thought or idea and it REALLY sticks and kind of changes everything for the better?

This is that.

Several months ago, I sat in a therapy session discussing a really frustrating pattern I had been having lately.

“I KNOW it’s not a big deal if I wake up really anxious or really down,” I said. “But a part in me kind of panics and is like Oh my god this is a really big deal because what if you don’t ever feel better and what if this lasts forever and how will you ever get things done and be a good wife and be a good mother some day and we have to worry about this and solve it right away and only focus on this.”

“Well,” she responded. “It sounds like your Self is trying to say, ‘It’s okay, don’t worry’. But this other part of you is trying to protect you by ensuring you think about each possible horrible outcome. And it’s very sweet of that part to do so. The problem is, it’s creating fires where they don’t exist, and trying to solve a non-existent problem in a very unhelpful way.”

“YES!” I agreed. “Exactly. And my Self believes all those things: I can be where I am, feelings come and go, this moment is just this moment, but then I start to worry and spin and before I know it, I’ve only been awake for ten minutes and I’ve already come to all these dramatic conclusions about the probability of how successful I’ll be in my life and what the hell is up with that?”

“So, let’s acknowledge that little panicky part,” she said. “Because really, it has good intentions. It’s trying to protect you. But you don’t really need its constant chatter. So allow it to speak, hear what it has to say, and humor it. Respond to it and say, ‘Thank you for your concern. I’ll take it under advisement.’ It’s up to you if you actually take its content to heart and spend the rest of the day pouring over the worries it brought to the table. But this way it’ll be happy, because it got heard, and your Self is still the one making the decisions and calling the shots, so it’s a win-win.”

I loved it.

And I’ve been doing it constantly. Rather than getting upset when I have a thought, or a worry, or a fear, rather than immediately following its instructions (We need to worry about x, panic about y, analyze z) I calmly listen to the suggestion. Because after all, it’s a part of me. And has anyone really had success with internal hatred?

(Years ago, in the midst of a panic attack, I said to a friend, What the f***! I shouldn’t be feeling this way! I just need to snap out of it, this is so stupid!!  She responded with her loving sarcasm: Ohhh, so you’re going to berate yourself out of a panic attack? Yeah, let me know how that goes. Right. Point taken.)

So anyway, yes, I listen. And then I play the role of Leader of the Council Board, and I acknowledge it. Telling it, “Thank you for your concern. I’ll take it under advisement.”

Only, usually, I don’t spend any more time on it than just that. And I move on. Because I am the leader, and I call the shots, and while I am an excellent listener, I certainly don’t have to take all of the suggestions I am given.

Not anymore.

Acknowledging it

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You know how some days you feel down and blah, and sometimes you’re okay with that, but sometimes it makes you panic, Ohmygod what if this feeling doesn’t pass, what if I never feel happy again, what if this is my new normal, I don’t know why I feel this way, the walls are closing in, I’m drowning, I’m regressing, all my hard work is undone…..and you go from 0 to 100 in about three milliseconds? (Or maybe you don’t know….but humor me).

Anyway, in processing that idea the other day, I was saying how cognitively I KNOW it always passes, I know that even months of a hard time don’t last forever, and therefore one day of feeling down doesn’t automatically equal a lifetime of it, but that it’s hard to remember in the moment. So one thing I said (half jokingly but also half totally serious) is that maybe I need a note on my phone that’s called “When I feel Crappy or Low”. Under that super creative title (…..) would be a few to-do items.

First is acknowledge what is contributing. Because as humans we can feel blah and we can feel down and we can feel upset for no reason, but as I am learning, there’s almost always one contributing factor. So first up is to figure out what the factors are. For me, there’s a list of “high-flyers” – events, people, thought patterns, or memories, that, more often than others, contribute. So first would be a checklist of those items (which would be more specific than this): Is it the weather? Is it a family member? Is it that grief? Is it that memory? Is it that anticipation of a change that’s coming?

I’ve found that almost always acknowledging it makes a difference. It instantly helps me feel back in control. It’s the flipped switch from Ohmygod I’m drowning, I’m out of control, everything is pressing on me, I’m infused with tidal waves of chaos to Oh. I’m in control. It’s just x, y, and z, and it’s not everything, and it’s not an internal malfunction, it’s an external rainshower that’s getting me a little wet but I’m fine, we’re fine, I’m fine.

Do you know that feeling I’m talking about? Kind of like in grad school when there was a huge paper to write or test to study for – it initially feels so big and so impossible to ever figure out. But as soon as a to-do list is made and it’s broken down, it’s manageable and you return to I can do this, this is doable.

The next thing to do, after acknowledging to myself what it is, is to focus on it more. This is so damn counter-intuitive. When something is upsetting, we want to ignore it, want to push it away, we don’t want to spend extra time and energy thinking about and talking about it. But – it works.

With the disclaimer that it often initially feels worse.

When you choose to focus in on it, whether it’s to write about it or talk about it or draw about it, or whatever it is for you, you might feel that tightness in your chest get tighter. The tears that you’ve held back might come. You might end up gasping for air, or you might feel the pain even stronger. Hold on. Because if you continue talking, continue writing, continue letting it out – you will then feel the release. You’ll feel your chest relax, you’ll notice the tears stop, you’ll notice you feel lighter, you’ll notice you feel better.

In the moment? So hard to do.

But maybe that’s what the reminder is for, that’s what the list is for.

Because it’s worked before. It’s been true before.

It applies now.

Toolkit

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I  said this the other day:

I don’t know about you, but in the moment, tools are really hard to remember to use. Also sometimes hard to believe that they’re going to do anything. So I find that practicing strategies and tools during calm moments, and semi-stressful moments, make them much more automatic to use during the super hard times. I think I could probably write a whole post on tools, and I think I will.

And I did.

Here are the three main tools in my toolkit lately that always help:

1. Move
Sometimes this means moving locations. Walking out of my apartment to go sit by the reservoir. Going to a coffee shop. Usually a change of location and scenery makes a huge difference and abates some of the heaviness I had been feeling.

Sometime this means physical movement, like going for a walk, going to the gym, or going to yoga. During this type of movement, I usually feel “it” moving through me. As I move my body, however vigorously or gently suits that moment, I’m moving it out. Moving the heaviness around, dislodging it from where it had taken root. More often than not, the tears or panic stop once I move – and this is something I have to re-learn each time. This morning I kept trying to wait it out. I said to myself, I’ll leave the apartment once I feel calmer, I’ll go to the gym once I’m not teary. But after a while I decided to just go – and by the time I got downstairs and into my car I was already a bit calmer. Just move. Now.

2. Visualize
I used to hate the idea of visualization, and that’s because I thought visualization was only “imagine yourself on the beach listening to the waves.” And while that type of visualization certainly has its time and place for me, it doesn’t do it all, and I needed more than that. I have since learned way more about this idea, and visualization has quickly become a go-to.

I usually visualize “it” moving. “It” can be panic, anxiety, memories, fear, whatever it is for you, or for me. Lately “it” has been a general heaviness that holds itself in my chest, in my throat, or in my head. It feels like a dark murky thick smoggy cloud. I like to envision a white, sparkly light coming in as I breathe in, swirling around, and clearing out the murky darkness as I breathe out. To those of you reading this and rolling your eyes: This works.

The other visualization I’ve done stems from something I read in an amazing neuroscience book [this is an affiliate link]. This chapter of the book discussed chronic pain and how visualization can help decrease the pain. And, I’ve used those ideas before, when I get a headache – I imagine the pain center in my brain, and I imagine a barrier around it, so that any pain signals my head tries to send are blocked and don’t reach the pain center. This works. I have practiced it so much that it now decreases the pain of a headache fairly quickly.

Anyway, I decided I could probably use the same principle around my heart, for those times that I’m feeling too much of my own feelings and all of everyone else’s feelings. So I imagine a barrier around my heart – not shutting myself off from the world, but protecting my heart when it needs a break.

3. Grounding
I could give you a zillion grounding tools (i.e. tools that help you stay present, focused on the moment), and there are another zillion out there on the internet. The ones that work for me best lately:

Mantras. I like mantras a lot, and I don’t like affirmations a lot. Mantras seem to be more relevant to me in the moment, whereas affirmations just…don’t work for me. [Side note: does anyone else feel like there’s a difference between the two?] For me, a mantra is a grounding statement, often what someone else would tell me in that moment, or what I would tell someone else, and ultimately, what I am aiming to trust and believe in that moment.

Sometimes my mantras are on post-it notes (there’s about 8 of them in my moleskin notebook right now) or in my pocket (the day of my wedding I texted my dear friend a picture of the post-it note in my purse that read, I am worthy) or just in my head. One that works in a moment of hypersensitivity: “Those are not my feelings. I don’t have to feel them.” Another one that works in a moment of panic: “I am breathing through this moment. I am breathing through this feeling.” They have become comforting statements that bring me focus and relief.

I also find narrating what I’m doing to be very calming. If I find myself starting to get spinny in my brain while I’m driving, I focus on what’s going on: I am in the car. I am driving home.

The one specific visualization that I do love, seems to fit better into this “grounding” category for me. It was an exercise I once learned in a therapy session, and the idea was to find a calming, safe place that could be thought about in such great detail that it would eventually be neurologically strengthened in my brain as calming, the minute that I pictured it. The place that has been consistently safe and calming for me is a specific location at my summer job. So after formally talking about the place in great detail (5 senses), it has been so strengthened in my brain that in a moment of overwhelm or panic or heaviness, I fairly automatically start thinking, I am on the back porch. I am rocking in the chair. I see the sunlight, streaming through the trees. I see the green grass, I see the blue skies. I hear the crickets, I hear the birds.

Calm.

For all of these mantras and narrations, I find pairing it with my breath crucial. I don’t really know how to explain this in writing, but basically, I breathe in for one piece of it, and breathe out for the other part, so it has some sort of rhythm to it. For example: Inhale for the entire length of I am breathing through this moment and then exhale for the length of I am breathing through this feeling. Does that make sense?

And there you have it. My current set of tools. As I’ve said, I really find that in a hard moment, it’s equally hard to remember to use these tools. Generally because I initially think, That’s not going to work. That’s not going to make this feeling better. But they always do. Not always right away, and not always fully, but they always help. And the more I practice them during less intense moments, the more automatic they become during hard moments.

I would really, really, love to know: do any of these tools work for you? What are your go-to tools and strategies these days? Please share with us – anonymous is always an option.

Inside a hard time

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[Editor’s note: I feel compelled to preface this by telling you how vulnerable I feel in posting this. I realize that vulnerability comes from fear of being met with shame. Being shut down, being quieted, being negatively talked about. But, I will write it anyway. Because I channel that feeling that I have when I read a blog post that deeply resonates with me, that makes me think, “Wow, someone else really gets it. Someone else was brave enough to write about it.” And I hope that maybe I can evoke that feeling in just one person. And should that be the case – should one person feel grateful, relief, companionship, then the vulnerability was worth it.

I have written and re-written this post many times, ever since my wonderful dad suggested that I write. During many versions, I added in something at the end to the effect of, “But I am okay! Don’t worry about me! I’m fine!” Which speaks to my fear of worrying others, of wanting to do everything I can to keep those in my life calm and happy. But I am gently putting those fears aside. And writing what’s real.]

Time doesn’t heal all wounds. Not if they are wounds that were never processed. Events from a month ago, a year ago, two decades ago, can and will still affect you.

Events and memories that you had buried deep within you, taped up, and topped with a sparkly pink bow, will not be fooled, and will still find their way to the surface, claw their way out, and demand to be acknowledged and processed. Gates will be broken down, dams will be breached, and it will rush at you, over you, through you, just as a flood does. Five weeks later, you will still be waiting for the waters to abate.

Old habits and behaviors will rear their heads. You will initially welcome them back without a second thought. You will initially forget to question them.

You will initially try to fight it. You’ll think things like, I shouldn’t be feeling this way or What is wrong with me? and I’ve been fine for so long, I should still be fine.

Your chest will constantly feel constricted. So will your head and stomach, but it’s in your chest where you’ll notice it at all times.

You will sleep, a lot. You will have little energy. You will throw your energy into work, and collapse after. Weekends will be hard.

You will inwardly laugh when one of your students says, “You are just so happy! Are you ever NOT happy?” and you will respond honestly but simply, and say, “Sometimes I am happy, but sometimes I am mad or sad, too.”

You will remind yourself to eat, despite a lack of appetite.

You will go to new types of appointments and cry. You will cry a lot. You will realize your voice is flat. You will talk about events and memories. When she asks you if you want to process x, y, or z, you will laugh, and tell her, “No. So I guess we should.” You will realize that these appointments, this new methodology, might be the key to your lock.

You will start to have a few minutes, an hour, maybe even part of a day here and there when the tight compression in your chest lifts. When you notice that you can breathe. When you haven’t cried. When your voice is a little more sing-songy. When you can think about people and places and memories without waves of nausea and dread.

And then those moments will end.

You will feel a true acceptance of where you are, of what’s happening. You will understand that it was kind of inevitable. You’ll get that while it might not have happened this year, it would’ve happened eventually. You will trust that it can’t last forever. Eventually the waters will subside. Eventually the floods will stop.

And so you will just keep going, minute by minute, day by day.

Because there’s no other option.

And you remind yourself of your beloved poem that you post every solstice, and you take to heart the words:

So do not lose heart
when vision dims.
Journey forth
as best you can-
bloom when you are able,
rest when you must,
keep faith,
keep always
towards the light