[rhcpchance]

In an e-mail T said, "I keep trying to think of a way to try to let you talk without it getting you anxious. There’s got to be a way, method, or medium that will allow you to talk without it triggering you."

Does anyone have any tips, tricks, or suggestions on what I or T could do that would allow me to talk about sensitive material, without it putting me over the edge? For example, my T does their best not to stare at me because it makes me nervous. Anyone else have anything you've done to make it easier?

[MoxieDoxie]

I hold and roll around in my hand polish stones. Colorful ones. It is a grounding technique.

[RaineD]

Diaphragmatic breathing.

[maybeblue]

Are you anxious with him regardless of what you are talking about, or are there particular topics that bother you? Do you have the same problem with other people too? I guess what I'm trying to get at is if you have kind of an underlying shyness or if there is a trauma that you are having trouble thinking about?

In either case some relaxation, or deep breathing exercises might help. If it is shyness, reassurance from him that he isn't judging you, that he likes you, etc. might help. Doing something else while you are talking might help too. I've heard of some people who do puzzles or color during sessions. He's got to do it too though, so you don't feel that intense attention which can kind of make some of us nervous.

[LonesomeTonight]

Not sure if this is an option--I see you're in NY so probably not the best season for this--but a couple times when I was having a panic attack in session and wanted to go hide in the bathroom for a bit, my marriage counselor suggested us all walking outside in the courtyard. The fresh air and walking, so not staring at each other, was very helpful to me.

Otherwise, I tend to wear a bracelet and necklace that I can fidget with. Another thing is, sometimes I've realized when I'm really anxious, it's because I need to get the emotions out. So if I can let myself cry, that can help.

Ex-T also sometimes used to do grounding exercises with visualization for me, so maybe your T could do something like that?

[healinginprogress]

Often writing it down and letting her read it first, either through a journal or an email takes the pressure off of me to start the conversation.

But I agree with what other people are saying about something to occupy your hands while you talk.

I use a fidget cube most of the time. I find that helpful. She also will pause things and have me doing some deep breathing when things get too bad.

If it becomes too much, I take a break. I don't leave the room (well, I've done that two or three times too), I just ask (literal translation is 'for a minute, not?' meaning: can we not talk for a minute?. Or sometimes I hold up my hand), usually turn my head away, and then we sit in silence until I'm ready to continue. Usually no more than about 2 minutes. If they talk anyway and it's unhelpful or 'too much', I'll indicate) 'Not now' (verbally or by shaking my head
I've also moved position in the past - to sit on the floor.

It happens more with pdoc than with T I think, but that has more to do with session content than the persons involved.
(Now at least. In the beginning every pdoc session was a panic attack and I mostly said 'yes sir'. Well, I didn't say sir, no one says 'yes sir' around here as it sounds ridiculous, but you get what I mean. Pdoc is a doctor, I fear doctors, so I used to fear him)

Eta: or I just take a deep breath. Usually eyes closed. Breath in deeply, hold for about 2 heartbeats, exhale slowly. Then go on. If it isn't enough, I do it once more.
Also, I repeat what they say - slowly and in a few words - or ask them to repeat themselves/explain again. It's often enough to manage an immediate issue (sometimes issues, e.g. med stuff or agitation, have to be handled/discussed THAT session) and it requires less focus.

Also, bad jokes help. I make a bad joke or something and my pdoc or T will respond also with a joke, but within the sphere/scope of my joke - which I like, because it means they will joke, yet not make a joke that's inappropriate, triggering, unhelpful.

[growlycat]

Last session t hit the pause button as he saw I was getting too anxious. He asked me to put my palm outward but open and take deep breaths. It helped that he did them along with me, and he said he uses this himself. He never pushes if anything he asks me to slow down and breathe. He also gave me a squish ball and had one for himself too. I don’t know if that is mirroring for my benefit or the material was causing him anxiety too

[LonesomeTonight]

Breadfish reminded me that I have also left the room for a couple minutes to stand in the bathroom to get myself together. But I try to avoid doing that, because with my panic disorder, my instinct is to run away and hide if I'm having a panic attack (so no one can see me). Which of course isn't always possible (if I'm riding in a car with someone on the highway, say). So I try to tough it out in a T's office so that I can practice that skill. It's kinda silly, but I feel self-conscious having a panic attack in front of a T, who should probably be the *last* person I have to worry about judging me for that...

I also agree with the writing something down and handing it to the T to read at start of session--that's helped me a few times. It was harder when ex-T wanted me to read some of it out loud. Another thing that can help is just saying, "I'm really anxious right now for some reason." Admitting it instead of trying to hide/suppress can be helpful, I've found.

[skeksi]

Sometimes my T will move to a chair beside me so I don’t have to look at him or feel his gaze. That helps a lot on the worst days.

There really isn't a way. Thsts what makes therapy difficult.
When we talk, we feel the Emotions and I think it's right we do. If we sit them of by smoke and mirrors, how do we heal them.
With time, it lessens because we've trudged though them.

[Fernwehxx]

I have felt anxious a lot, but I think it's normal talking about deep emotions I had buried for decades. I sometimes tell her I'm anxious, most of the times she probably realizes it anyway (by my fidgeting, or my laughing, or whatever I do).... I have never had a panic attack during therapy, but they've become rare anyway. If I had one, I might have to leave her office tho, due to some unpleasant symptoms. Anything else, I'd sit out with her and be glad to have support in that situation. Usually, I get anxious when I am about to go to a very uncomfortable place inside me, and there are a lot of those, but I think that's exactly why I go to therapy - to get through it, not around it.

[BonnieJean]

Writing things down for t to read, grounding and fidgeting objects all sound good. My t has started some somatic techniques lately like holding my hand over my heart when I'm experiencing overall distress. It might help to engage in an activity like drawing or coloring while you're talking - to distract yourself from the tensions of talking. I hope you find something's that work for you.

[nottrustin]

Sometimes I just close my eyes and and take a few long deep breaths. I also wear bracelets and a necklace I sometimes will play with them.

[Elio]

I use a wide range of methods/tools due to disassociation if things got too emotional for me. Over time, I have been able to use these other things and stay connected. At the beginning very little would work. I would caution about emailing it to your T ahead of time if not knowing how your T would respond could cause more anxiety. I ran into this problem so I rarely bring up a stressful topic initial through email.

Some methods I use:

1. forms of communication
   

   • writing it out and having her read it in session
   • writing it out and me read it in session
   • writing about elements of it in my journal that she reads between sessions
   • directly stating that I have something I am uncomfortable talking about
   • talking about talking about it

2. Alternative ways to bring up topic
   

   • picture books
   • songs
   • articles
   • sections from books
   • movie/video clip

3. Somatic/grounding

   • deep breaths
   • tactile stimulation - blanket, drawing/tracing lines, petting something
   • sitting on floor
   • focus my eyes on a specific item while I talk
   • clasping my hands
   • repeating specific words that have meaning to me/her

4. Distraction
   

   • coloring
   • doing puzzles (100 piece seem to be doable within an hour)
   • doing games or playing with toys
   • spinning a ball

Other methods I heard of others using:

• Writing out what you want to say in the moment
• tossing ball back and forth

At some point you do just have to go for it and allow your emotions to do whatever they are going to do. I learnt that my T can handle my disassociation, and through exposing myself to this level of anxiety and having my T respond consistently every time with compassion, understanding, caring, and empathy; I learnt my world would not fall apart to talk about these things. I still use all of these methods at different times, I no longer dissociate to the point that I am completely gone. I can let her know when I am losing touch and we can ground before it is too late. She has also learnt to read signs of problems and can call me back if she feels I have started to go too far away.

ETA: yes, it is much more helpful if my T participates in the actions with me.

[starfishing]

I think a certain amount of anxiety is unavoidable when talking about difficult topics, but it sounds like you're getting anxious enough around specific subjects that it's becoming impossible for you to discuss them? Or is your therapist the one who's concerned about your anxiety response more than you are?

My go-to coping mechanisms are deep breathing, saying out loud that I'm feeling anxious, letting myself adopt whatever physical positions seem to help no matter how silly they look or feel, and ultimately trying to forcibly knuckle through at all costs and get whatever I can of whatever it is out in the open, bit by bit however long it takes. But your mileage may vary, and if by anxiety you mean something that's making it utterly impossible to talk, more grounding tools may be called for.

[MRT6211]

I write in a journal to her and send it to her via email and she writes comments back on it and then has an idea of what we need to talk about during session. I find this helps me because if I don’t do that, I don’t bring up anything “real” in session. Aka I’ll just talk about funny things that happened in my week or just be mopey and quiet. This allows her to direct the session more but still with my input of what’s actually bothering me/without her just guessing. I’ve made remarkable progress since I’ve started doing this and we’re both a lot less frustrated.
I also have a fidget cube that I use during session. It helps a lot. I definitely need things to fidget with.