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When I was in first grade, I was riding bikes with a friend and managed to do a front flip over my handlebars when my bike hit a stone. I broke the fall with my chin. It actually didn’t hurt. However, when I saw all the blood, I started to scream. It turned out that the reason it didn’t hurt was that I cut through the nerves.

Needless to say, chaos erupted as parents came to help. My dad reached me with impressive speed. It was obvious we were bound for the emergency room.

I will never forget the ride there. I sat on my mom’s lap while my chin bled through towels and my dad drove. They offered all types of comforting and rational comments. I wanted nothing to do with it. I was terrified, and my fear came out in a string of “I hate my bike, I hate hospitals, I hate roads, I hate you…” Must have been a fun ride for my parents!

What I now know about that ride to the hospital is that my poor parents had no shot at comforting me with completely logical reassurance. Panic had driven me into a state that DBT refers to as emotion mind. My intense fear had taken over my capability for rational thought. I was at the whim of every urge caused by my fear.

From a biological standpoint, when we perceive danger, our amygdala begins the fight-or-flight response. At the same time, this response in the amygdala shuts down the cortex. Guess what the cortex does…it allows you to think clearly about the situation.

All hope of regaining rationality is not lost. It is simply delayed. When a person is this panic-stricken, they will benefit most from techniques designed to slow down some of their physiological responses such as increased heart-rate, blood pressure and breathing.

Don’t underestimate taking some slow, deep breaths. If you are trying to help someone  through  intense fear, do it with them. It is also helpful to focus someone on mindfulness of the current moment. For example, name things you can see, hear, smell, touch and taste. Alternatively, pick one item to focus on and describe it in as much detail as possible.

Just as importantly, avoid trying to talk the person out of their fear when they are in a state of panic. As I said, they are not capable of rational processing. Of course, you don’t want to tell them they should be scared either 😉 It is sometimes helpful to validate their fear by just observing “I can see how scared you are.”

The one thing I hope my parents knew…don’t personalize what a panicked person is saying and don’t assume that they will believe what they are saying when the panic subsides.

I honestly don’t remember how my parents got me through that emergency room visit. I was too worked up to process any of it. What I do remember is the ride home. Leaving the hospital, with my first set of stitches and minimal discomfort, I let my parents know “I don’t really hate everything.” My ability for rational thought had returned.

It is at this time that we can help someone process their fear and the thoughts that led to it.

As an aside, while I wrote this from the perspective of helping someone else, my comments apply to helping ourselves as well.

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