Step One: Nourish

Your mouth is dry. Your palms are sweaty. You may feel dizzy or nauseous. When crisis hits, our bodies react. This is just as natural as bleeding when you cut your finger.

However, you can’t move on to the mental or psychological aspects of working through your crisis until your autonomic nervous system simmers down. The autonomic nervous system is a fancy word that we’ll refer to as “nerves.” Our nerves control things like:

• Digestion (Butterflies in your belly? Knot in your stomach? Tummy ache? Diarrhea?)
• Muscle tension (Cramp in your neck? Ache in your shoulders?)
• Breathing (Short shallow breaths? Quick, panting breaths? Hyperventilating?)
• Heart rate (Heart racing? Chest pains?)

In a crisis, you’re going to do three things to nourish yourself. These things will make the difference between behaving in a way that is reactive and proceeding in a way that is productive and intentional. The few minutes you take now to complete these steps, nourish yourself, and recognize your physical symptoms will pay off.

1. Take three long, slow, deep breaths. Fill up your lungs and exhale slowly. Regulating your breath is crucial to stopping your spiral of panic and preventing physical symptoms like dizziness. Count slowly to four as you inhale, and count slowly to eight as you exhale.
2. Drink a glass of water. Drink the whole thing, at least eight ounces, and you should drink water, not coffee of soda. I’ll say it again: Water. It will be tough to make solid decisions if your body is dehydrated.
3. Eat something. Grab a granola bar or a handful of nuts. Some crackers, a small yogurt, or piece of fruit will do, too. A car can’t operate without fuel and neither can you. Eat slowly, take small bites, and consciously nourish your body.

Once your physical symptoms are under control, you’ll have increased capacity to think clearly and understanding what is happening.

Step Two: Assess

During this step, you’ll develop a solid picture of what’s going on based on the information you have. With just four questions, you’ll be able to focus on what has happened and put the event in perspective.

Blank clipboard with paper on white desktop.

1. What are the facts? Review the details and the specifics of what has happened:
   this is what I was told, this is what I read, or this is what I saw. Think of the solid, indisputable facts that would be admissible in court. List them for yourself.
2. What am I making up? Review the judgments, conclusions, and inferences you
   have made. What have you read between the lines? Remind yourself that these additions are just fabrications. List the things you are making up and set them aside. They will not be of service to you right now.
3. What am I scared of? Review your worries about the future. Even your worry
   that the past will repeat itself is based on something that may or may not occur. List the things that you fear will unfold. This list is generating all sorts of scary, upsetting thoughts. List all of the fears associated with the facts from part one. Take this list and set it aside. It will not be of service to you either. You can worry when the time comes.
4. Will this matter in one year? When your imagine yourself a year from now, how much do your think this moment will impact your life? We spend a great deal of emotional time and energy worrying about things that will have little bearing on our future. Sometimes, the answer to this question will be, “Yes, in fact, this will matter a great deal.” Other times, even in the midst of a crisis, you can take comfort in knowing that the issue you’re facing will fade into obscurity.

Step Three: Action

During this step, you will shift from fight or flight to fix. What you are fixing is not necessarily the problem at hand. These may be irreparable in the moment of crisis. What you are fixing is your panic. The way you can combat that panic is with the question:

What can I do about right now?

In this very moment, what can you do? What can you offer? The words “right now” are key in this stage. Know that the answer may be “Nothing. Absolutely nothing.” On the other hand, you may be able to create a three-­‐step process detailing what you need to do first, second, and third. When you have taken care of these immediate actions, you can look at the next three steps.

The key here is to avoid feeling overwhelmed. Simply focus on what is right in front of you. Timing is everything. Some things that you may be able to do in the moment include:

1. I need to gather more information. I can get the information I need from.
2. I will need to set up an appointment with my (doctor, lawyer, counselor, massage therapist, naturopath).
3. I need to arrange childcare so that I can talk to my partner about
4. I need to establish support for (my friend, my parent, my colleague) right now.

Support

Having a support system to lean on when crises hit is vital. Selecting whom to call, for what, and when will make a huge difference in how you cope with the issue you’re facing. If your best friend thrives on drama and becomes overwhelmed easily, she is not the person to call. If your parents will worry and make you more anxious, they are not the people to call either. Don’t hesitate to reach out for help, but do ask the right people. Ask yourself, “If my friend Susie was facing this situation and called me for help, would I help her?” If your answer is an unequivocal “yes” and Susie is calm, thoughtful, and pragmatic, then Susie may be someone to lean on. When selecting support during stressful moments, run through this checklist:

1. Who can help me with this now, tomorrow, or the following day? Do I have their contact information?
2. Who would have the information I need?
3. Who can I delegate some of my responsibilities to for the next 24 hours?
4. Who can I lean on that is calm, thoughtful, and pragmatic?

Expect your handy “Simmer Down” reminder card to arrive in the mail shortly. When panic strikes, slowly walk through each of the steps. Eventually, the process of simmering down will become second nature and you’ll be secure in the conviction that even when feeling overwhelmed, you’ll be able to manage.

Rachel

Rachel is a 27-­‐year-­‐old medical intern. Three months ago, a close friend named Sheila asked Rachel to be her maid of honor. Rachel is generally exhausted from working long hours, and she knows that Sheila is a difficult, temperamental friend. Not wanting to disappoint Sheila, though, she accepts the honor. But following a twelve-­‐hour shift at the hospital one day, Rachel opens her e-­‐mail to find a message from Sheila with the subject “Worst Maid of Honor EVER.” The e-­‐mail is a scathing, expletive-­‐riddled diatribe on the numerous ways that Sheila believes Rachel is letting her down and not being excited enough about her role in the wedding. Rachel bursts in to tears and schedules a therapy appointment for the next day.
Step 1: Nourish
Rachel has been a client for a few months so she is familiar with this process. She comes prepared with a bottle of water and a protein bar. After a few slow, deep breaths, she applies the system.

Step 2: Assess

1. What are the facts? Sheila is incredibly angry and is lashing out. She has not asked Rachel to do anything specific in her e-­‐mail; she is just on a venting rampage.
2. What am I inventing? Sheila will refuse to meet in person to discuss her accusations, and she never apologizes for anything. Nothing that Rachel does is ever good
   enough for her, and Sheila has totally unrealistic expectations.
3. What am I scared of? Rachel is afraid that Sheila will kick her out of the wedding and that she’ll be embarrassed and humiliated. Rachel will have wasted hundreds of dollars on shower gifts, the bachelorette party, and her bridesmaid dress. She fears that they will never get past this, and all of their friends will have to choose sides.
4. Will this matter in one year? At this stage, Rachel’s main priorities are her career,
   her patients, and learning as much as she can. Rachel doesn’t aspire to be the “Best
   Maid of Honor Ever.” If this doesn’t work, or if Sheila is disappointed in me, she can live with that.

Step 3: Action

Rachel is not interested in discussing this issue over text or e-­‐mail. She is exhausted and has another long hospital shift tomorrow. Rachel sends Sheila a brief e-­‐mail to say that she has received the e-­‐mail and that they can meet over the weekend to discuss it. She keeps telling herself, “There’s nothing more I can do about this right now.”

Step 4: Support

Rachel usually discusses things like this with her roommate, but she’s out of town presenting at a conference. Rachel doesn’t want to share the outburst with any mutual friends and entangle them in this upsetting situation. She calls her sister Stacey, who is calm, grounded, and a great listener. She affirms Rachel’s choices and encourages her to put this issue aside until she can speak with Sheila in person. Coincidentally, Rachel had a session booked with her therapist, and she can spend a bit of time during that session focusing on how to move forward with Sheila.