Psychotherapist and Counsellor, MBACP CIPD MSc MA


You feel as though you are about to have a heart attack and your heart is ready to leap out of your chest.  You feel hot and sweaty, your legs have turned to jelly and your hands are shaking.  Your mouth feels dry and at the same time you think you’re going to be sick as well as wanting to rush to the loo.  You think you’re going to die.

Sound familiar?  Well, it was a very familiar story to one of my clients who I’ll call Sam.

When Sam arrived for his first session, he had taken a taxi for what should have been a short walk.  He couldn’t walk as he thought he was going to be sick.

The first thing we did was to use a range of strategies to manage the anxiety.  These included doing simple but really effective things like deep slow breathing to slow down his racing heart.  Known as 7-11 breathing, you breathe in for a count of 7, hold for a couple of counts and breathe out for a count of 11.  The counts don’t have to be exact as long as the exhaled breath is longer than the inhaled breath. Chewing gum also helps as it sends a signal to the brain to release digestive juices and therefore that it’s safe to eat, there is no imminent danger and the threat response can be switched off.  Distraction techniques involving all 5 senses helped Sam enormously too, he had to name 5 things he could see, 4 things he could touch, 3 things he could hear, 2 things he could smell and 1 thing he could taste.

Sam also recognised that he needed to learn to relax and he did this by engaging in mindfulness using a handy little app called Headspace.  He also did a visualisation which involved recalling a time in his life when he felt happy, relaxed and carefree.  He re-imagined this time by remembering who he was with, what he was doing and what he could see/touch/hear/smell and taste to engage his senses.

Sam immediately felt less anxious and over a number of weeks we continued to hone down these strategies along with some lifestyle changes for longer term management of anxiety.  We also looked at his triggers and underlying causes of anxiety and dealt with these.  Often, these related back to a period of time in Sam’s life when he felt out of control, frightened and felt his life was at risk.  Once that link was made, it was much easier for Sam to understand where his fear came from and to remind himself that he was safe now and not in any danger which in turn made the anxiety subside.

When I saw Sam last week, he told me that he had been able to attend a job interview without being sick and had successfully been offered the job which he was delighted about.

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