Coaching practices for My Chest is Tight and My Breathing's Gone Shallow and Quick and I Can Feel My Pulse Climbing I Want to Physically Turn the Dial Down on This Surge of Arousal to Slow My Body Itself Rather Than Just Distract My Mind From it

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Does this sound like the set of challenges you might be facing?

• My chest is tight and my breathing’s gone shallow and quick, and I can feel my pulse climbing
• My heart’s pounding, my thoughts are racing, and I keep trying to think my way calm but my body is still floored
• My heart is pounding and I can feel my whole body revved up, and I need to bring it down fast and quietly
• My chest is tight and my heart’s pounding right now, and I have about ten seconds before I have to walk in there
• The second I feel my heart pound or my chest tighten I clench up and try to force it to stop, and the fighting just cranks it higher

Practices that may help

1. Paced breathing as grounding
   Slow and lengthen the exhale to bring acute arousal down while you ground.
   Grounding Techniques for Acute Distress
2. Come down from hyperarousal
   When you are over the top edge, use the body to bring arousal back down.
   The Window of Tolerance: Your Optimal Arousal Zone
3. Extended-exhale breathing
   Lengthen the exhale relative to the inhale to down-regulate the nervous system fast.
   The Anxiety Toolkit, Made Practical
4. The physiological sigh (double inhale, long exhale)
   Inhale fully through the nose, sniff in a second time to top off, then exhale slowly and completely.
   The Physiological Sigh, Made Practical
5. Allow the sensations without resisting
   Let the physical feelings of anxiety be present instead of bracing against them.
   The DARE Response to Anxiety, Made Practical
6. TIPP — change your body chemistry fast
   Use Temperature, Intense exercise, Paced breathing, and Progressive muscle relaxation to drop overwhelm from the body up.
   Distress Tolerance Skills, Made Practical
7. Allow the sensations instead of fighting them
   Do not try to stop the racing heart, the dizziness, the breathlessness — allow them and observe.
   Panic Surfing
8. Cold and intense sensory grounding
   Use cold water, ice, or a strong taste/smell to jolt attention out of an overwhelming spiral.
   Grounding Techniques for Acute Distress
9. Interoceptive awareness
   Practice noticing and naming body sensations neutrally, so they stop reading as alarms.
   The Anxiety Toolkit, Made Practical
10. Temperature: use cold water to activate the dive reflex
    Submerge your face in cold water or hold a cold pack to your face and hold your breath for 30 seconds.
    TIPP: DBT’s Crisis Skill for Rapidly Lowering Emotional Intensity

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