Walking Breathing Exercise for Distress

When we’re anxious or in distress or starting to have a panic attack, it can be hard to sit still and breathe. Here’s a breathing exercise that helps slow our breathing down while incorporating walking in with our breaths. We begin walking at a slow-ish but comfortable pace, and then tie our breathing in with our footsteps. So we breathe in for three or four steps (or maybe more, or maybe just two steps, depending on how quickly we’re walking), and then breathe out for the same number of steps.

This breathing exercise can be very relaxing, and help ensure we’re not breathing too quickly. And paying attention to our footsteps reconnects us with the present moment, and helps get us out of our heads, which reduces anxiety. Paying attention to our footsteps can also shift our focus away from any distressing physical sensations that are feeding in to our panic. And it helps disengage the catastrophic thoughts we’re having about these sensations that can bring on a panic attack.

Guided Walking and Breathing Meditation Instructions

Extended Guided Walking and Breathing Meditation

If you have any questions or comments, please leave them on the YouTube video page.

How to Manage Panic Attacks

Man Having a Panic Attack

Having a panic attack can be one of the most terrifying things in the world. In this post we’ll learn how cognitive behavioral therapy (CBT) helps us respond to panic, and calm panic before it can escalate into a full-blown panic attack. Or, if we’re already in the middle of panic attack, how we can deescalate panic.

Panic attacks are so scary because we’re reacting to our anxiety as if it were a life-threatening situation. This engages our sympathetic nervous systems, setting off the fight or flight response. And this leads to a number of intense and distressing physiological symptoms associated with panic attacks such as:

  • Chest pain or discomfort
  • Elevated heart rate and/or racing or pounding heart
  • Heart palpitations or our hearts skipping a beat
  • Breathing faster or hyperventilating
  • Feeling like we’re choking or suffocating
  • Dizziness, light-headedness or feeling weak in the knees
  • Nausea and other stomach symptoms
  • Feeling detached, or like we’re floating away or watching ourselves from outside our bodies
  • And many more …

And these physiological symptoms increase our anxiety, leading to catastrophic thoughts that are common during a panic attack, such as:

  • I’m having a heart attack
  • I can’t breathe
  • I’m going to suffocate
  • I’m having a stroke
  • I’m about to pass out
  • I’m losing control
  • I’m going crazy
  • I’m going to be sick
  • I’m going to embarrass myself
  • And so on …

In order to prevent or deescalate a panic attack, we need to come up with more accurate and less catastrophic thoughts about what’s going on in our bodies. And we need to reverse the effects of the sympathetic nervous system and the fight or flight response that’s driving our panic attack, by engaging our parasympathetic nervous systems.

In the video below, we’ll learn how to do all of this and more to manage a panic attack with techniques from CBT, which is the most effective way to treat panic attacks:

The Best Way to Stop Panic Attacks

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

In this video we’re going to learn how panic attacks get started, what happens during a panic attack, and how we can calm and de-escalate a panic attack once it does start to happen.

Panic attacks arise when we feel so anxious that our sympathetic nervous systems kick in and set off our fight-or-flight responses. And this brings on a wave of intense physiological reactions: we get a rush of adrenaline; our heart rates and breathing speed up; our pupils dilate and our muscles become tense; we start to produce more sweat; and so on. And these are all great ways for our bodies to react when we’re in a life-threatening situation. But during a panic attack our bodies misinterpret our anxiety as a life-threatening situation and react accordingly, setting off this fight-or-flight response as if our lives were in danger.

And if we were in a life-threatening situation our bodies would use this physiological response to help us fight off or flee from whatever the danger is. But when these physiological reactions arise in response to our anxiety, there’s nothing for us to do with them, there’s no outlet for them, because there is no life-threatening situation to fight off or escape. So we’re left with all of these intense physical symptoms and they don’t make any sense. We don’t understand why this is happening.

And so we start having catastrophic thoughts about what’s going on, and misinterpreting this physiological response as symptoms of some sort of health or medical crisis. And these thoughts cause more anxiety, that intensifies our physiological reactions, leading us to have more catastrophic thoughts, and so on, setting off a vicious cycle that can lead us into a full-blown panic attack. So let’s look at how this happens in more detail.

Sometimes our anxiety builds throughout the day and we might have moments of panic here and there that don’t escalate into a panic attack, but then at some point all of this anxiety becomes too much and it does set off a panic attack. Other times it can be an extremely anxious thought or distressing body sensation that sets off a panic attack. Or we may not even know what sets it off and it just seems to happen out of nowhere.

But regardless of the source when we have a panic attack something at some point signals to our sympathetic nervous systems that we’re in danger, which sets off the fight-or-flight response, initiating all of those physiological reactions we mentioned earlier, which again, are great to have if we’re in an actual life-threatening situation.

But if the threats are something like: we’re standing up in front of a group of people about to give a presentation; or we’re in an airplane or on a bus or in a mall or at the dentists and start feeling trapped or claustrophobic; or we’re sitting down about to write an exam; or we’re in a social situation where we’re really uncomfortable because we don’t know anyone; in these sorts of circumstances this intense physiological fight or flight response serves no purpose and can often set off a panic attack.

So at this point what’s driving our panic is a vicious cycle between what’s going on in our bodies—the physiological fight-or-flight response—and our thoughts about what’s going on in our bodies, and what all of these symptoms and sensations mean. So first let’s look at some of the most common physical and physiological symptoms associated with panic attacks.

A lot of these symptoms occur in our chests or hearts: like a feeling of tightness or tension in our chests; or an increased heart rate or a racing heart; or heart palpitations; or the feeling that our hearts are skipping a beat.

Symptoms related to our breathing are also common. We start breathing faster or even hyperventilating, and we can feel a tightness or lump or choking feeling in our throats, and it can start to seem like we can’t breathe or are suffocating.

Stomach symptoms are also common. We might feel nauseous or get cramps or have butterflies in our stomachs. Or get a sinking feeling in the pit of our stomachs. Or we might start to feel dizzy and like we’re going to pass out.

And we can start to feel warm or start to sweat or get sweaty palms. Or our hands may become cold or clammy or start to shake and our hands or feet might start to tingle or feel numb.

And then there are symptoms like feeling detached or like we’re in a dream or floating away or watching ourselves from outside our bodies.

There are any number of physical symptoms we can experience during a panic attack, and if yours didn’t get mentioned, the way we deal with all of them is similar enough that hopefully you’ll be able to find something that applies to your situation as well.

And then the other element involved in setting off a panic attack are the thoughts we have in response to these physiological symptoms and sensations in our bodies. So for example if we’re having a lot of symptoms in our hearts or chests we might think: I’m having a heart attack; I’m going to die.

For symptoms related to our breathing: i can’t breathe; I’m going to suffocate; I’m going to start choking.

For symptoms related to dizziness or feeling weak in the knees: I’m going to pass out; or I’m having a stroke.

And for symptoms related to our stomachs: I’m going to be sick; I’m going to throw up; or I’m going to have diarrhoea.

For symptoms like feeling detached or outside of our bodies we might think: I’m going crazy; or I’m losing control.

And then there are a number of common thoughts that can kick in regardless of the specific symptoms we’re experiencing: I’m so scared; i can’t stand this; this is never going to end; i don’t understand what’s happening to me. Or there’s something really wrong with me; something terrible is going to happen; I’m losing control; I’m going to need to run out of here; or I’m not going to be able to get out of here and I’m going to make a scene; I’m going to embarrass myself; what are people going to think of me?

And all of these types of thoughts increase our anxiety. And as a result our physiological and physical symptoms become more intense, leading to even more catastrophic thoughts, initiating a vicious cycle between our physiological and physical symptoms. And these catastrophic thoughts we have related to these symptoms that can lead us to start to panic.

So if we want to avoid this vicious cycle escalating into a full-blown panic attack, as soon as we start having these catastrophic thoughts about our physiological symptoms, we need to come up with alternative and more accurate explanations for what’s going on in our bodies that can help us reverse this cycle, making it less likely that we have a panic attack. So let’s look at some specific examples.

Probably the most common type of panic attack occurs when we experience something like a racing or pounding heart, maybe with some palpitations or some tightness in our chests, and we think we’re having a heart attack. And so we start panicking because we think we’re about to die. And it’s not uncommon for people to call an ambulance during a panic attack because they think they’re having a heart attack.

And if you ever do think you’re having a heart attack you should call for help. But if you’re watching this video it’s very unlikely that you’re going to have a heart attack anytime soon, because you’re probably under 55, an age at which heart attacks are very uncommon. But again if you do think you’re having a heart attack you should call your emergency services number. And if you’re worried about your heart’s health in general please consult your doctor.

And so this is a tricky thing for me to talk about because i don’t want to discourage anyone who thinks they’re having a heart attack from calling for help. But assuming we know there’s nothing wrong with our hearts and we’ve had panic attacks before, and we know what they feel like, and we know that this is just a panic attack, when we start getting these symptoms in our hearts and chests we need to remind ourselves that all of these symptoms are associated with anxiety and especially with the fight or flight response that gets activated when we start to panic. It doesn’t mean we’re having a heart attack. It doesn’t mean we’re going to die.

And by replacing a thought like, oh my god i think I’m about to die, with something like: I’m having extremely intense and uncomfortable feelings in my chest and heart because I’m panicking and my sympathetic nervous system has initiated the fight-or-flight response, we start to reverse the vicious cycle between our physical symptoms and our catastrophic thoughts about these symptoms that’s driving our panic.

And so we start to feel less panic. And as a result the intensity of our physiological symptoms begins to decrease. And because the physiological symptoms are no longer as strong, our thoughts about these symptoms continue to become less catastrophic and more calming, which further reduces our levels of panic.

And these physiological responses like a racing heart aren’t dangerous. They’re not going to cause a heart attack and they’re not going to damage our hearts. They’re just going to feel really uncomfortable, but then they’ll pass without causing any lasting harm.

And everything I’ve said about panicking or having a heart attack applies to panicking we’re having a stroke or any other sort of life-threatening medical crisis. All of our symptoms can be explained by anxiety and panic and the fight-or-flight response. And so if we’re in a heightened state of anxiety and start having these symptoms, it’s very probably just a panic attack. But if you think you’re actually in the middle of a life-threatening medical crisis then you should seek medical attention.

Now let’s look at symptoms related to our breathing. If we feel like we’re choking or can’t breathe or starting to suffocate, we need to reassure ourselves that this is nothing dangerous. It’s been set off by the fight-or-flight response, and it’s not physically possible for us to suffocate ourselves—when we need oxygen our bodies will reflexively breathe—so there’s no way we can suffocate during a panic attack.

But we can start to hyperventilate during a panic attack, which can lead to low levels of carbon dioxide in our blood, which can cause many of the symptoms we can have during a panic attack. So again if we start to hyperventilate we need to replace any catastrophic thoughts like, i can’t breathe, I’m going to suffocate, with reassuring thoughts that these are all normal symptoms of a panic attack and they’re nothing dangerous. And this can help calm our panic.

And then the second thing we can do about symptoms related to our breathing is to slow down our breathing, often we’re told if we’re feeling anxious we should take some deep breaths. But if we’re having a panic attack and we try taking deep breaths we often do this without slowing down our breathing as well. And then we start panting, taking lots of quick deep breaths, which can lead to hyperventilating. So we want to make sure that we’re taking slower rather than deeper breaths.

And there are all sorts of breathing techniques we can use to slow down our breathing so if you already have one that works for you there’s nothing special or magic about my technique. I just find it’s the easiest one for people to be able to do on the spot without any practice in the midst of a panic attack.

So i think the most effective way to slow down our breathing during a panic attack is to breathe into our nostrils for a count of two; pause for a count of two; and then breathe out of our mouths for a count of four through pursed or puckered lips, which slightly restricts the airflow naturally slowing down our exhale.

And then as our breathing slows down we can increase the length of the count breathing in for a count of three; holding our breath for a count of three; and then breathing out for a count of six, and so on. And i have a couple of videos that present this as a guided breathing exercise that you can try out if you are panicking and are finding it difficult to slow down your breathing.

So when we slow down our breathing like this not only does our breathing become easier and more comfortable, we engage our parasympathetic nervous systems. The autonomic nervous system is responsible for regulating our body’s unconscious actions. It includes the sympathetic nervous system, which is responsible for the fight-or-flight response; and the parasympathetic nervous system, which is the opposite of the sympathetic nervous system. And instead of a fight-or-flight response the parasympathetic nervous system is responsible for the rest and digest response, which helps our bodies recover and get things back to normal after a stressful situation.

And so slowing down our breathing helps not just with our breathing related symptoms, but since it engages our parasympathetic nervous systems, it reverses the effects of our sympathetic nervous systems and all of the physiological reactions brought on by the fight-or-flight response, so slowing down our breathing is a great way to help reduce panic.

This brings us to feelings of dizziness and fears that we’re going to pass out. A panic attack can’t cause us to pass out unless we have one of two phobias—a fear of blood or a fear of needles—in which case if we see some blood or get injected with a needle we might pass out. But otherwise we can’t pass out during a panic attack, because the fight-or-flight response elevates our blood pressure. And we pass out when there’s a sudden drop in our blood pressure. So having a panic attack is the opposite of being about to pass out. So the dizziness we feel is a result of anxiety and it’s not going to cause us to pass out or fall over.

Let’s look at symptoms related to our stomachs. Yes anxiety can cause us to get sick. We can throw up or have diarrhoea. But these aren’t life-threatening. They’re unpleasant and potentially embarrassing. But if we’re able to reassure ourselves that these feelings in our stomachs are the result of anxiety and the fight-or-flight response, which does affect digestion. And even if we’re not hyperventilating, slowing down our breathing still helps us engage our parasympathetic nervous systems, and the rest and digest response, which helps calm our anxiety, and our stomachs will start to feel better.

And we can’t go crazy or lose control during a panic attack. Symptoms that feel really weird or can be really scary like feeling detached or in a dreamlike state, or floating away, or watching ourselves from outside our bodies can make us feel like we’re going crazy, but we can’t go crazy (whatever that means) during a panic attack. Again these are just physiological symptoms brought on by our anxiety. And they’ll pass as the panic passes.

We can also try a grounding exercise called 54321 to help us reconnect with reality and we name: five things we can see; four things we can touch; three things we can hear; two things that we can smell; and one thing we can taste. And i have a video that helps guide you through this process if you want to try it out.

And for any other types of physiological or physical symptoms the strategy is the same. We replace our catastrophic thoughts about these symptoms with more accurate thoughts and explanations. And when we’re able to change our thinking then our anxiety and panic and the related physical symptoms we’re experiencing will begin to subside.

And then for the remaining thoughts we talked about earlier, we just need to come up with alternative and more accurate ways of assessing the situation that aren’t so catastrophic and therefore will reduce our anxiety.

For thoughts like, I’m so scared, i can’t stand this, this is never going to end, i don’t understand what’s happening, there must be something really wrong, with me something terrible is going to happen; instead we need to find a perspective more along the lines of, yes this is really scary and uncomfortable, but i know it’s a panic attack and it’s going to end, and the worst case scenario is that I’m going to feel really scared and uncomfortable for maybe 20 to 30 minutes. But then it’s going to pass and everything’s going to return to normal and I’m going to be fine. Or any similar perspective that helps calm our anxiety a little bit and makes it less likely that things continue to escalate.

For thoughts like, what if i can’t get out of here, what if i can’t escape, I’m going to end up making a scene; we need to remind ourselves that this is a panic attack. It feels really scary and uncomfortable but it’s not dangerous. These feelings are all because of anxiety, and slowing down our breathing can help us engage our parasympathetic nervous systems and the rest and digest response, which will help ease our feelings of panic. And doing a grounding exercise can also help, as well as replacing any of our catastrophic thoughts with more accurate and calmer ways of thinking about the situation we’re in. And even if we do have a panic attack, using these techniques can help reduce the severity and duration of the panic attack which is sometimes the best that we can do.

And for thoughts like, I’m losing control, I’m going to embarrass myself, what are people going to think of me; we need to tell ourselves we don’t lose control during a panic attack. It can feel like we’re losing control because of all the intense things going on in our bodies. But that doesn’t translate into acting out of control. And it’s unlikely that we embarrass ourselves during a panic attack, because most of the time nobody even notices. But even if people do notice, the fear “what will people think of me?” Is generally unfounded, because most people will have empathy and sympathy. So we may feel embarrassed, and that’s a natural reaction, but having a panic attack is not something the people around us will think we have any reason to feel embarrassed about.

But sometimes none of these things work and our panic escalates and we find ourselves in the middle of a full-blown panic attack. And so if this happens the best thing we can do is to just accept that we’re having a panic attack. Not because we don’t mind having a panic attack, but because at this stage there’s nothing we can do to prevent it from happening, because it’s already here.

And because trying to fight the panic attack is a battle we can’t win. And is only going to increase the fight-or-flight response, prolonging the panic attack and making it more intense. But the paradox is, if we’re able to just accept that we’re having a panic attack, and we just allow the panic attack to happen, it loses some of its power. Because since we’re accepting it rather than fighting it or trying to escape, there’s no need for the fight-or-flight response anymore—there’s nothing to fight and there’s nothing we’re trying to flee from—and so our physiological symptoms brought on by the fight-or-flight response begin to subside. And as a result our panic stops escalating and can begin to subside as well.

The Panic Attack Worksheet will help you plan how to respond to your physiological symptoms and catastrophic thoughts when you start to panic, in order to prevent or deescalate a panic attack. You can download the Panic Attack Worksheet in PDF or Word format. If you have any questions or comments, please leave them on the YouTube video page.

Improving Communication In Your Relationships

Regardless of how strong are relationships are, there will always be times when we have a complaint that we need to talk about. So it’s important that we’re able to have these discussions without sparking a conflict, or having things escalate into a fight or argument. The best best way to do this is to learn how to soften our startups.

The term softening your startup was coined by relationship expert John Gottman. And you can learn more about softening your startup, as well as many other self-help strategies to improve your relationship, in Gottman’s book, The Seven Principles for Making Marriage Work.

Improve Communication by Softening Your Startup

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

One of the most common reasons people come for couples counseling is to work on communication issues. Now communication issues can refer to all sorts of different things. And there can be lots of different reasons why these communication issues are arising. But regardless of the types of communication problems you’re experiencing, if you and your partner aren’t able to communicate with each other about how you’re feeling or about issues that arise in your relationship, it is going to be almost impossible for that relationship to work.

So the first and maybe most important step in improving communication is to learn how to bring up difficult topics of conversation with our partners in ways that help lead to a resolution rather than to a fight or argument or any sort of escalation. And the key to bringing things up with our partners effectively is to make sure that we’re starting things off in a gentle manner rather than harshly.

Jon Gottman calls this softening your startup. He’s one of the most influential psychologists in the field of relationships. And in his research observing thousands of couples he’s found that discussions between couples generally end with at least as much tension as they began with. So if we begin our discussions by criticizing our partners or attacking them or coming at them from a place of anger, these discussions are probably not going to lead to a nice resolution. And it’s much more likely that they end with us still criticizing each other attacking one another and being angry at each other.

So instead of bringing things up harshly we need to soften our startups, and find ways to bring things up that invite discussion and resolution rather than provoking a conflict. Now when we do bring things up harshly the other person tends to respond in one of four ways:

They get defensive and start making excuses.

Or they fight and respond back harshly.

Or instead they opt for flight and just leave because they don’t want to continue being attacked, or they don’t want to talk about this now.

Or they freeze, either because they don’t know how to respond, or because they’re hit with a strong emotional reaction that’s overwhelming and prevents them from being able to think clearly and figure out what they want to say. And I’ll have a video coming out soon that looks at what we can do in these situations so please subscribe so you don’t miss it and I’ll put a link in the description once it comes out

So the key to a soft startup is to be able to express how we’re feeling and whatever’s on our minds without provoking one of these types of reactions from our partners. And one of the best ways to do this is to make sure that we’re communicating assertively, rather than aggressively or passive aggressively or passively, which might be the softest way of starting things up, but passive communication usually doesn’t lead to much communication at all, and we don’t get to say it was actually on our minds.

And a good way to think about assertive communication is with the acronym dear which describes the main communication skill in dialectical behavior therapy that i talk about in more detail in another video. Now dear stands for describe, express, assert, and reinforce.

So we start by describing the situation we want to talk about in as neutral and objective terms as possible. We want to stick to the facts without providing any interpretations or commentaries about the facts. The goal is simply to let the other person know what we’re talking about in a neutral manner that doesn’t provoke any emotional or defensive reactions from our partners.

So a harsh way of describing a situation who would be something like, you never help with anything around here, you’re an absolute slob, i don’t know how you can live like this. So if we start off harshly like that it’s going to be really hard for our partners to respond without getting defensive we’re getting upset and escalating things.

So instead we want to describe things more softly just sticking to the facts. I had to clean up by myself after dinner tonight. I had to go into the living room to get your dirty dishes from lunch. The distinction between describing the situation softly and describing it more harshly is that here, while we’re still complaining about the situation, we’re trying to do it in a way that isn’t explicitly criticizing our partners, such as i had to clean up by myself after dinner because you’re so lazy or because you’re such a slob. Because anything that comes off as criticism rather than simply as a complaint is almost always going to be met with defensiveness or with some sort of escalation as they criticize us back.

And then after we describe the situation, we express how we’re feeling about the situation. It’s important that we don’t assume they know how we feel, so we tell them directly. And we do it using i messages. So with i messages we simply use the word i to express how we’re feeling, often prefaced with a statement like, when this happens or when you do that, i feel like this.

So when I’m left doing the dishes by myself i feel neglected and angry.

Or when you don’t help clean up after dinner i feel alone and sad.

When we use i messages since we’re speaking about our own experiences and our own feelings, it can be easier for other people to hear without reacting negatively or getting defensive. Because we’re not criticizing them, we’re just expressing how we feel. And compare this to a harsher way of expressing how we feel about the situation like, i spend half my life doing housework, it’s like you think I’m your maid, which is not going to be received well and is more likely to spark a conflict than to lead to a resolution.

And then we assert what we’d like to see happen again using i messages. So instead of something harsh like you better start doing your share and stop expecting me to pick up after you all the time, I’m not your mother, we assert what we’d like more softly. It would be nice if you would help more around the house. I’d really appreciate that.

And finally we reinforce the changes we’d like to see. And in psychology reinforcement refers to rewarding desirable behavior. So in a harsh startup instead of reinforcing behavior we’d like to see with a reward we might threaten a punishment. You better start helping out more with the housework or we’ll see how you like it if i stop doing any work around here.

Whereas a softer startup could be something like, I’d really appreciate it if you’d help with the dishes, and then I’d spend less time cleaning after dinner and we could spend more time together in the evenings.

It would be nice if you would help more around the house, and then i wouldn’t be so tired and cranky all the time.

So a soft startup doesn’t necessarily mean our partners are going to like what we have to say or even agree with it. But it makes it much less likely that they react defensively or feel like they’re being criticized or blamed or attacked and have to attack us back.

Now one thing that can make softening our startups difficult is that we often bring things up with our partners when we’re upset about something. And when we’re upset it can be hard to start things off softly. Or we may even think we’re starting things off softly, but when we’re feeling really emotional our compasses for what comes off as gentle and what comes off as harsh can be a little bit off. And maybe we’re being really gentle compared to how we’re feeling inside yet are still coming across as harsh.

Or maybe our partners are just really sensitive and defensive, which often happens if we’ve been arguing a lot lately. So even though we are starting off relatively softly our partners perceive it as too harsh and things start to escalate almost immediately.

And so if we are really upset or annoyed or angry and want to bring something up with our partners, it’s important to take some time to make sure we’re feeling a little bit calmer first, and do whatever we need to do to manage our strong emotions before starting the discussion. Because the calmer we’re feeling, the more naturally a softer startup will come, which makes it easier for our partners to respond without escalating, and makes it more likely our discussion is going to be productive.

But why do we have to be the ones who go out of our ways to soften things up even when we think our partners are the ones to blame? Well it comes down to whether we want to resolve the situation or just make sure our partners know how upset we are with them. And if that’s our goal then we can blurt out whatever we want. But if we’re hoping to resolve the situation then the more we’re able to soften our startups the more likely it is we’re going to be able to work things out.

And before bringing up a sensitive issue it’s helpful if we can set the stage for the discussion signal to our partners that there’s something we want to talk to them about instead of just hitting them with it out of nowhere. This could be some expression similar to, we need to talk, but that’s often associated with a breakup talk, so we want something without that connotation, some code we have with our partners that means hey there’s some stuff I’d like to talk about with you.

So we could just say that, or can we talk about something, or even I’d like to have a conversation with you about something that’s been on my mind. And then we can ask if they’re okay talking about it now, or if we should plan something for later when we both have time and won’t be distracted. Maybe just after dinner but not too late when we’re both feeling tired and thinking about bed. And certainly not once we’re already in bed and at least one of us is trying to fall asleep.

So let’s look at a couple more examples. Nice to see you made it home in time to help put the kids to bed. Oh wait they went about an hour ago.

You don’t care about your kids. You don’t care about me. All you care about is your job. I might as well be a single parent.

You’d better start coming home in time to help put the kids to bed or me and the kids are gonna go stay with my parents for a while. I just can’t do this by myself anymore.

So this type of opening is obviously harsh. It’s not neutral. It doesn’t just describe the facts. We’re criticizing and being sarcastic and it’s not going to be well received. No one’s going to react well to this type of opening.

So a softer startup would be something like: you promised to start leaving work in time to help put the kids to bed they went about an hour ago and you weren’t here.

When you’re not home to help put the kids to bed i feel lonely and overwhelmed and i worry that they don’t get to spend enough time with you.

I really need your help in the evenings with the kids at least a few nights during the week. And if you’re not going to be able to make it home in time to help I’d really appreciate it if you could call and let me know and just talk to me for a few minutes so i don’t feel so alone.

If you were around more in the evenings i know it would mean a lot to the kids and i wouldn’t be so tired and cranky in the evenings when we’re together.

So this softer startup is much more likely to spark a discussion that leads to some sort of solution to our complaint rather than turning into a fight or argument like we could expect if we use the original harsher startup.

And one last example: you never want to do anything fun you just watch TV or stare at your phone all night.

You’re so boring all the time no wonder we don’t have any friends.

If we don’t start doing more stuff together that i enjoy I’m not sure how much longer this relationship can last.

And so again this sort of harsh startup isn’t going to be received well by our partners. And instead they’re probably going to get defensive or fight back flee or freeze.

So we need to soften the startup: we’ve stayed home watching TV every night this week and when I’ve suggested we do something else you’ve said you’re too tired maybe tomorrow.

When we sit around watching TV all night i get bored and i feel sad and lonely.

It’d be really nice for me if we could do something else together a couple of times a week. And then I’d be happy to watch TV with you the other nights.

So softening our startups and bringing things up more gently with our partners is one of the best things we can do to improve communication in our relationships. But it doesn’t guarantee that the conversations will go smoothly and our partners may still get defensive or start a fight or flee the discussion or freeze and not say anything.

Disagreements tend to end with at least as much tension as they begin with. If we bring up the subject of a conflict with angry words, blaming and criticizing our partners, it’s likely the discussion will end in even more anger, blame and criticism. However, if we’re able to soften our startups—the way in which we broach the topic—we can improve communication and have productive discussions with our partners on even the most sensitive subjects.

If we’re feeling too angry and upset to discuss things gently, then it’s better to wait until we’ve calmed down enough to approach the discussion from a less angry and more calm perspective. But once we’re ready to have a conversation, rather than an argument, below are some ways to soften our startups, avoid fighting, and improve communication and promote discussion with our partners.

Four Steps to Improve Communication in Your Relationship

1. Complain, But Don’t Blame

Tell your partner what’s bothering you rather than blaming them. For example, instead of blaming your partner and saying something like:

This place is such a mess. You said you’d clean up but I should have known better to listen to you. You never do any chores around here.

Phrase your complaint like this:

You promised you’d clean the kitchen before you went to bed, but when I woke up this morning the kitchen was just as messy as it was when we finished dinner.

When we bring up difficult topics in terms of a complaint instead of assigning blame, we open the door for a discussion rather than merely provoking a defensive or angry response that leads to a fight.

2. Use “I” Statements

Phrase your complaints in terms of “I” statements instead of “You” statements. In other words, begin your statements with “I” instead of “You.” For example, instead of, “You’re not paying attention to me,” say something like “I would appreciate it if you could pay attention to what I’m saying right now.” Instead of, “You don’t care about me or my feelings,” say something like “I’m feeling neglected.”

You statements are a type of blame, and they are difficult to respond to without becoming defensive, which shuts down any chance to have a discussion. I statements can get across the same message, but in a softer way that invites a conversation.

3. Simply Describe What’s Happening”

When bringing up a complaint, instead of judging or evaluating a situation, just describe what is happening. Judgments use words like “always,” “never,” and “should” such as a statement like, “You never do anything fun with me.” Describing what’s happening involves simply stating of facts of a situation, for example, “I’m staying home by myself tonight while you’re going out with your friends. That’s the third time this week that’s happened.”

Instead of making a judgement like, “Why do I always have to do everything around here?” simply describe the situation in terms such as, “I’ve been cleaning the house for the last half hour while you’ve been watching TV.”

4. Be Clear

When making a complaint, be clear about what’s bothering you. Don’t expect your partner to be able to read your mind. Be as specific as you can about your complaint and what you would like from your partner. Make sure you don’t just talk about what you don’t want them to do, but ask for what it is you want them from them instead.

Just because you know what something means doesn’t mean your partner will understand. If you say something like, “We never spend any time together,” you may know exactly what you mean by that and what you want your partner to do. But it might mean something completely different to them, or they may be confused because they already think you spend time together.

So instead of saying, “We never spend any time together,” be clear and be specific about what you want. Say something like, “I’d really like to go out to dinner with you this weekend and then come home and watch a movie”; or “We used to go for drives in the country and have picnics together. I wish we could still do that once a month or so.”

If you’d like your partner to be more tidy, instead of saying, “You’re such a slob,” be more specific and say, “When you’re done making lunch, I’d appreciate it if you could put your dishes in the dishwasher and wipe down the counter.” Make requests in clear statements that tell your partner what you want and don’t leave them having to guess.

Improved Communication in Action

When you put these four steps together, you learn to begin complaint conversations with softer start-ups. You use statements such as:

I’ve been feeling a little neglected lately. Last week you went out with your friends three nights in a row but we didn’t go out together at all. I would like it if we could spend more time together. Could we pick a time next week to go out for dinner and then see a movie.

This is much softer and inviting startup than something like:

You’re always do things with your friends and never with me. Why don’t you care about us anymore? How come we never do anything together?

The first statement is softer and opens the door for further discussion. The second leaves your partner feeling attacked, defensive, and likely to respond by attacking you back or just shutting down and not wanting to talk at all.

If you have any questions or comments, please leave them on the YouTube video page.

Deescalating Conflicts In Your Relationships

Sometimes discussions start off on the wrong foot. Other times things start to escalate and we start attacking or blaming each other. In order to communicate more effectively, we need to learn how to deescalate these sorts of conflicts. One of the best ways to do this is with what relationship expert John Gottman calls repair attempts.

Repair attempts are attempts to repair any damage we’ve done with something we’ve said during a discussion. Maybe we’ve been a little too harsh, or said something unfair or mean. Or maybe the other person just reacted poorly to something innocent we said that they took the wrong way. No matter why tensions have started to rise, repair attempts can help ease tensions and get things back on track.

Although this video focuses on how to improve communication in a romantic relationship, like with the last post, these same skills can help improve communication with friends, family, co-workers and bosses, and so on.

Deescalate Conflict With Repair Attempts

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

In my previous video on communication in relationships we looked at how to start off conversations with our partners more gently or softly. Softening our start-ups is probably the most important thing we can do to communicate better and make our discussions more likely to lead to a resolution rather than escalating into a fight or argument.

But even if we have good intentions we don’t know if we start things off softly and even if we do start off softly discussions can still escalate into an argument or fight. So in this video we’re going to look at what we can do when we find ourselves trying to talk to our partners and things start escalating and seem to be heading towards a fight or unproductive argument. And how we can de-escalate conflicts so we can try to work things out in a more productive manner.

So a very common dynamic is that when someone brings up a complaint at some point in the discussion one of us gets offended or feels attacked or maybe just takes something the wrong way and then they take things up a notch and respond back a little more harshly. This usually leads the other person to respond back equally harshly or take things up another notch.

And once this sort of escalation starts if we don’t make a conscious effort to relieve this tension things often continue to escalate until we’re left yelling and screaming at each other. Or with one of us in tears. Or with one of us so upset we storm out of the room and slam the door behind us. Or maybe one of us shuts down and goes silent and refuses to talk anymore. Or any number of variations on this theme at which point the discussion isn’t going any further and nothing’s getting resolved and we’re left with anger and hurt feelings and resentment towards each other.

So how do we deal with this? How do we manage to keep discussions from escalating like this, and to de-escalate things once tensions do start to rise?

In my last video on communication i mentioned the psychologist and relationship expert john Guttmann. In his research observing thousands of couples he’s found that once tensions during a discussion start to escalate, couples who communicate well with each other relieve this tension with what he calls repair attempts. In his book the seven principles for making marriage work, which i think is one of the best self-help books about relationships and I’ll link to it in the description, he describes repair attempts like this:

When you take driving lessons the first thing you’re taught is how to stop the car. Putting on the brakes is an important skill in a relationship too. When your discussion starts off on the wrong foot or you find yourself in an endless cycle of recriminations, you can prevent a disaster if you know how to stop. I call these breaks repair attempts.

So a repair attempt is simply a statement that we use to try to ease the tension a bit and de-escalate conflicts. So for example I’m sorry that came out a little harsh what i meant was ….

Or I’m feeling a little defensive right now could you please try to rephrase that?

Or i think I’m starting to understand what you mean.

Or you’re right i was being a little unfair or i think we’re getting a bit off topic.

Each of these statements is like a peace offering we’re making in the middle of the conflict. And if our partners hear this peace offering and accept it, then tensions can start to de-escalate and we can get the discussion back on track. And there are a couple of posts on the Guttmann institute’s blog that have a long list of examples of phrases we can use as repair attempts that I’ll link to in the description, so you can look through these and find a few that sound good and make sense to you that you can use in your discussions with your partner.

And it’s not enough to just make a repair attempt; our partners need to be able to notice and recognize when we’re making repair attempts. And likewise we need to be able to notice and recognize our partner’s repair attempts. Otherwise our repair attempts are just flying over each other’s heads and they don’t accomplish anything and nothing changes.

And if we’re arguing with someone. Sometimes we stop listening to what they’re saying, or at least stop paying that close attention maybe because we’re thinking about what we want to say next. Or maybe we feel like we’ve heard it all before so we’re just waiting for them to stop talking so we can say our piece

And so it can be easy to miss our partners repair attempts. But if they are making repair attempts and trying to ease the tension, we need to be able to pick up on this. So it’s important that we be on the lookout for our partners repair attempts and do our best to recognize them when they do happen.

And if our partners have missed our repair attempt then maybe we need to repeat it or find a way to rephrase it so that it’s more obvious to them and they receive the message that we’re reaching out and trying to ease the tension.

And it’s a good idea to try to phrase repair attempts as i statements because i statements are more likely to be received graciously than a you statement, which often comes off as blaming or attacking even if that’s not the intention. So when we’re able to express things in terms of i instead of you there’s a better chance our repair attempts will be well received. So let’s look at some examples.

Instead of a you statement like, you’re getting off track try to stick to the point, it’s more effective if we can phrase it in terms of an i statement: i feel like we’re getting a little off track, can we try to refocus on what we started off talking about.

Instead of, you seem to be getting really worked up. Can you try to calm down a bit? I feel like things are getting a little worked up. Can we just try to take it down a bit?

And even if we think our partners are the ones being unreasonable, and let’s face it that’s usually the case, we can’t control what they’re doing or what they’re saying. So if we want to de-escalate we need to focus on what we can do to help simmer things down rather than calling them out for not listening, for attacking us, for getting defensive, and so on.

Or playing some sort of game of chicken where we’re not going to start de-escalating until they make a peace offering first. Because even though it’s a natural reaction to want them to have to acknowledge that they’re the ones being unreasonable, they’re the ones at fault, if both of us have that attitude and neither of us are willing to reach out with a repair attempt first, then the argument is going to just keep escalating and nothing’s going to get resolved.

Now ideally when we say something harsh we can catch ourselves right away and make a repair attempt before our partners even had a chance to react to it. Are you just going to sit there and ignore me all night? Sorry i didn’t mean to snap at you. What i meant to say is i had a rough day at work could we just talk about it for a bit.

Now sometimes during a discussion things seem to be going fine and then one of us says something that the other person takes the wrong way and then that just sets them off. And so if we can catch things right away before there’s any further escalation our repair attempts are much more likely to be successful. So for example let’s say we’ve been arguing a lot lately about chores and just how much work around the house each of us are doing and we say something like, thanks for cleaning up after dinner tonight.

And because this has been a sensitive issue lately our partners take it the wrong way and say, you don’t have to be all sarcastic about it. I told you i was going to clean up after dinner. And so now we have a choice and we can respond back to our partners in the same sort of manner they responded to us and continue escalating things: what are you getting so defensive? About i was just thanking you.

Or we can choose to use a repair attempt: oh I’m sorry if that came off as sarcastic. I really meant it i really do appreciate you cleaning up after dinner tonight.

And then because we were able to use a repair attempt as soon as things started to escalate it’s going to be easier for our partners to respond positively to it since the level of tension is still relatively low at this stage and it’s pretty likely that we’re going to be able to prevent things from escalating any further oh okay i guess i took that the wrong way.

Or another example. How was work today?

My boss was being such an idiot.

I wish you two could get along better get along better.

He’s an idiot. Why should i have to get along with him? Why can’t you just take my side for a change?

And then we can feel unfairly attacked and attack back: i was just trying to be supportive there’s no need for you to blow up at me like that.

Or we can try a repair attempt: I’m sorry i was just trying to be supportive. I know that came out the wrong way. What i meant was i wish your boss would stop being such an idiot.

Yeah he’s the worst. I just hate him.

So again, if we’re able to intervene almost immediately with a repair attempt as soon as things start to go off the rails, there’s a good chance we’re going to be able to get things back on track without too much trouble.

So it’s great if we can catch things right away and offer a repair attempt early on before things have a chance to escalate, but that doesn’t always happen. But we can still use repair attempts in the middle of arguments that have been going on for a while and gotten really heated. So let’s look at a couple of examples where we’ve been going at it for a while.

So things have been escalating and they say, stop attacking me. And instead of using a repair attempt we respond, I’m not attacking you. You’re the one attacking me, and you’re just not listening to anything I’m saying. Then things will most likely continue to escalate you’re impossible to talk to when you get like this and then keep escalating from there.

But if when they say, stop attacking me, even if what we’re thinking is, stop attacking them, they’re the ones attacking me, if we’re able to respond with a repair attempt like, I’m sorry i should have phrased that better. I didn’t mean to attack you. Let me try again. We’ve made a sort of peace offering and made it much easier for them to de-escalate as well. Yeah okay i get that now.

Now if they continue to escalate and respond with something like, yeah you always get like this. Why can’t we just have a discussion without you attacking me? So in that case they didn’t respond to our repair attempt. So why might that happen and what can we do about it?

Well if we or our partners are really upset or angry or having any sort of very strong emotional reaction to what’s being discussed it can be hard for a repair attempt to even register. And even if it does register we can’t always disengage ourselves from fight mode or attack mode and take things down a notch. Sometimes our emotional reactions take over and overwhelm our abilities to process information and respond more appropriately.

So anytime we’re feeling so upset angry anxious or overwhelmed that we’re only able to respond to each other emotionally, then we need to take a break until things calm down enough that we’re able to talk things out more rationally. But there are a few challenges with taking a break in the middle of a heated argument, and so in my next video we’re going to look at these challenges and learn some tips on how to take an effective break or timeout in the middle of a heated argument or fight with our partners.

There are a couple of blog posts on the Gottman Institute website with more examples of repair attempts: R is for Repair and Repair is the Secret Weapon of Emotionally Connected Couples. And you can learn more about repair attempts, as well as many other self-help strategies to improve your relationship, in Gottman’s book, The Seven Principles for Making Marriage Work.

If you have any questions or comments, please leave them on the YouTube video page.

Best Breathing Technique For Panic, Anxiety and Distress

When we’re having a panic attack, or feeling anxious or in distress, our breathing generally speeds up. This elevates our heart rates, making things feel more intense, and creating even more panic, anxiety and distress. The advice in these situations is often to take deep breaths. But deep breathing can actually make things worse.

If we start breathing deeper without slowing down out breathing, we can end up panting or hyperventilating. And this can feel like we’re having trouble breathing or starting to suffocate, which leads to more panic, anxiety and distress. So instead of trying to breathe deeper, we want to breathe slower. The video below describes the best breathing exercise to slow down our breathing, deescalate panic attacks, and reduce anxiety and distress.

Best Breathing Technique for Panic Attacks and Anxiety

Breathing Technique for Panic and Anxiety Longer Version

Someone requested a longer version of this breathing exercise, so the video below is the same as above, but looped a few times.

The actual best way to learn how to breathe during a panic attack is with Capnometry-Assisted Respiratory Training (CART), but this requires a portable capnometer device. If you’re interested, you can read about (along with a video demonstration), or read the the academic study. But if you’re like me, and don’t have your own capnometer, the breathing technique in this video is a simple and effective way to slow down your breathing during a panic attack.

If you have any questions or comments, please leave them on the YouTube video page.

5-4-3-2-1 Grounding Exercise

The 5-4-3-2-1 grounding exercise is a grounding technique that helps us connect with the outside world through our senses. We can use this coping skill whenever we’re feeling anxious or overwhelmed, our minds are racing, or we’re stuck in our heads dwelling or ruminating. The 5-4-3-2-1 exercise can also help if we’re dissociating or experiencing depersonalization.

The 5-4-3-2-1 grounding technique brings us back into the present moment as we identify and name:

  • 5 things we can see
  • 4 things we can touch
  • 3 things we can hear
  • 2 things we can smell
  • 1 thing we can taste

5-4-3-2-1 Grounding Technique

If you have any questions or comments, please leave them on the YouTube video page.

Cognitive Fusion and Defusion

Another way to be mindful of our thoughts is with cognitive defusion. Cognitive defusion is a technique from Acceptance and Commitment Therapy (ACT). Cognitive fusion refers to a state of mind in which we get so stuck in our heads and caught up in our thoughts that we become fused with them. Our thoughts become our entire reality. We often enter a state of cognitive fusion when we’re anxious and worrying, or depressed or angry and dwelling and ruminating on things.

Cognitive defusion is the opposite of cognitive fusion. Cognitive defusion is a way of letting go of our thoughts before we become fused with them. Or if we’re already in a state of cognitive fusion, cognitive defusion allows us to get out of our heads and de-fuse ourselves from our thoughts.

Cognitive Defusion

This transcription was auto-generated by YouTube. I’ve only added minimal editing, so I apologize for any errors, run-on sentences, etc.

There’s a type of mindfulness based therapy called acceptance and commitment therapy. And an important concept in acceptance and commitment therapy is the idea of cognitive fusion and defusion.

Cognitive fusion describes those times when we’re so tightly stuck to our thoughts that we become fused with them. We can’t separate ourselves from our thoughts and so our thoughts become our reality. And when we’re in a state of cognitive fusion we can feel removed from the world outside our thoughts, and from what we’re doing, and from the people around us, and it can be hard to pay attention to anything outside our head.

The opposite of cognitive fusion is cognitive defusion. Cognitive defusion involves taking a step back from what’s going on inside our minds, and detaching ourselves from our thoughts. In this state of defusion we can observe our thoughts without getting caught up in or lost in them. And we can just allow them in and accept them and let them be and let go of them if we want.

One way we can practice cognitive defusion is to label your thoughts. Anytime you notice that you’re starting to become fused with your thoughts, you can simply take a step back from your thoughts by labeling them as thinking, or daydreaming, or worrying, or ruminating or planning—just labeling whatever type of thought you’re having with a one or two word description.

And doing this helps you take a step back from the thought and focus less on the content of your thought and more on just the fact that you’re thinking, or worrying, or daydreaming, or whatever the nature of your thought is. And this makes it less likely that you’ll get sucked in by those thoughts, or carried away by them, or become fused with them.

Or you can say to yourself: I’m just thinking, just worrying. And putting the qualifier just in front of the thought helps take away some of the power of that thought and makes it easier to let go. Or you can label the content of your thought as being “just a thought.” So if you’re thinking, “i can’t do anything right,” you can reframe this as “I’m just having the thought i can’t do anything right.”

Or if you’re thinking “this is going to be terrible” you can reframe that as “I’m just having the thought that this is going to be terrible.” Instead of “,nothing ever goes my way,” “I’m just having the thought that nothing ever goes my way.” And by prefacing our thoughts with the disclaimer that this is just a thought, we reinforce the idea that our thoughts are not facts. And every time we remind ourselves of this we take away some of the power that our thoughts have over us.

Or if you’re having trouble letting go of your thoughts you can imagine yourself writing down each thought on a balloon, and then releasing that balloon up into the air and just allowing that thought to float from your mind as the balloon floats away.

Now sometimes instead of just letting go of our thoughts, it can be helpful to look at the content of our thoughts, and just get a sense of how accurate or how biased that thought may be, and see if there may be a different way of looking at things and thinking about them that’s more helpful to you, which is something we’ll explore in the next video about reframing your thoughts and cognitive restructuring.

If you have any questions or comments, please leave them on the YouTube video page.

Watching Our Thoughts

Mindfulness of current thoughts is one of the DBT distress tolerance skills. I put my video about Mindfulness of Thoughts in the mindfulness skills section. But I have a couple of videos about specific mindfulness of thoughts techniques that I’ll include here under distress tolerance skills.

When we’re feeling distressed, we often get stuck in our heads, thinking in circles with our minds racing, completely detached from anything outside of our thoughts. This is the opposite of being mindful. It’s very stressful, and can leave us feeling even more distressed. When we’re able to get out of our heads, and simply observe our thoughts mindfully, we reduce our levels of distress. In the video below we’ll learn how to be mindful of our thoughts by just watching them and letting them go.

Watching Thoughts and Letting Them Go

If you have any questions or comments, please leave them on the YouTube video page.

DBT Distress Tolerance and Reality Acceptance

This video on reality acceptance follows up on the radical acceptance video in the previous post. When we allow in our unpleasant experience, accept them, and let them be, we take away their power. Reality acceptance doesn’t make distressing experiences go away, but it makes them more tolerable.

Reality Acceptance, Allowing and Letting Be

If you have any questions or comments, please leave them on the YouTube video page.

The Difference Between Pain and Suffering

One goal of distress tolerance in DBT is to learn to replace suffering with ordinary pain. The video below explains the difference between pain and suffering with the parable of The Two Arrows, and shows us how we can experience pain without it leading us to suffer.

DBT Distress Tolerance Skills: Difference Between Pain and Suffering

When we’re able to accept the fact that we’re experiencing pain, we avoid causing ourselves additional suffering. In the next post, we’ll look at the role of acceptance in DBT. If you have any questions or comments, please leave them on the YouTube video page.