Practical Advice: Managing Acute Anxiety

Anxiety episodes are no fun whatsoever: racing thoughts, elevated heartbeat, dizziness or lightheadedness, an inability to think clearly. We face a lot of uncertain situations in sex work, resulting in worry, stage fright, or just a general sense of dread. If you’re in immediate danger, you must get yourself to safety right away. However, if you are safe in the moment but fear of the future is overwhelming you, here’s my advice on how to feel calmer:

  • Realize what you are feeling.  The first step to confronting panic is to acknowledge it. Many of us would much rather ignore our anxieties, so we chatter, obsess, drink, overeat, or hypnotize ourselves online for hours. However, denial only exacerbates feelings of paralysis and powerlessness.
  • Voice what you are feeling.  Try saying aloud: “I feel super scared and wound up right now.” Speaking the truth won’t make whatever you fear more real. Instead, it will bring you into the present moment.
  • Breathe deeply.  Slowly inhale to a count of three, filling your belly first, then your chest. Gently hold your breath while counting to three, then slowly exhale to a count of three. Repeat as often as needed, until you feel your body soften. It’s common to take shallow breaths when we’re afraid, elevating the body’s stress hormones. Breathing deep from the diaphragm activates the relaxation response of the parasympathetic nervous system, countering the adrenaline-fueled fight/flight/freeze response of the sympathetic nervous system.
  • Reconnect with your body, focus on the here and now.  Clenching an ice cube, snapping a rubber band on your wrist, or curling and uncurling your toes are ways to get you out of your head and back into your body. Even if you’re in serious trouble, focusing on what’s actually happening in the present moment will improve your ability to manage the situation.
  • Realize that your brain is playing tricks on you.  If you’re in a panic mode but facing no immediate danger, your mind is outrunning reality. Say to yourself: “I am safe in this moment. I am healthy and whole. These feelings will pass.” A friend of mine, when she’s drowning in anxiety, puts on loud music, dances wildly, and sings, “This is silly, this is silly, this is silly,” until she can get on top of how she’s feeling. Acknowledging that our brains are in hyperdrive can help free us from any shame, guilt, judgment, or pressure we put on ourselves to “just get over it already.”
  • Use positive self-talk.  Oftentimes during panic attacks, self-hatred tags along, fueling all those hideous whispers inside our heads telling us we’re no good. I call those voices “hate radio.” Talk to yourself with the same compassion you’d show to your lover or very best friend. Say, “This feels terrible right now, but I’m going to get through to the other side very soon. I don’t let fear rule my life.”
  • Visualize a calming situation.  Close your eyes and imagine yourself in a peaceful place out in nature, sitting in a park or by the beach or in the forest. As you inhale and exhale, imagine any thoughts or emotions that come into your mind are like leaves blowing on the wind—notice them, but let them go right on by. Just observe—don’t judge or fixate on them in any way. This practice of acknowledging feelings without engaging them can be very powerful.
  • Question your thoughts.  When we get worked up, all kinds of horrible future scenarios can ricochet through our brains. Once your body and mind have calmed down for a few minutes, and you are in a safe place, try challenging your worries with these scripts:

¨     My anxious reaction is out of proportion to the reality of the situation.

¨     I have friends and loved ones who can listen, soothe, and provide perspective.

¨     If the worst possible thing did happen, I am safe and strong and could handle it.

¨     I can alleviate anxiety today by preparing for a better future. Is there anything I need to be doing right now?

  • Focus on meaningful activities.  When you’re past the critical stage, a meaningful goal-directed activity like going to the movies or the gym or making dinner can help focus your attention elsewhere. It’s fine to distract yourself—don’t sit around obsessing about how you feel. Get back to the business of life.
  • Listen to your body.  After an anxiety attack, it’s common to feel wrung out and exhausted; give your body the rest it needs to recover. If you have excess adrenaline to burn off, working out, taking a long walk, or sex can be relaxing and grounding, bringing body and mind back into balance.

~~~Worry pretends to be necessary, but serves no useful purpose.

—Eckhart Tolle~~~