“…The longer I sat in the doctor’s office waiting for my test results the more anxious I became. My stomach was full of butterflies.  I had trouble sitting still.  My heart was racing, and I felt like I couldn’t catch my breath. I could only imagine the worst case scenario…”

Many of us experience anxiety on a regular basis.  Anxiety is a normal and adaptive system in the body that tells us when we are in danger. This means that dealing with your anxiety never involves eliminating it, but rather managing it. However, just because you are experiencing anxiety does not mean you are in a dangerous situation.  Cognitive Behavioral Therapy (CBT) believes that what you think becomes what you feel, but just because you think something does not mean it is accurate. Thoughts are random and sometimes insignificant. Many times our minds can run wild creating situations of “what if”- that may not have any factual basis at all.  Suddenly your mind is running in the wrong direction, and your body begins to feel anxious.  

Panic attacks cause catastrophic thinking which means your thoughts are most likely irrational and out of proportion to reality in the moment. However, the symptoms of a panic attack cannot be ignored.  Panic attacks can increase with time, and prevent you from participating in every day activities.  

To prevent your anxiety from increasing and interfering with daily life, grounding exercises are recommended.  Grounding exercises help you manage the symptoms of anxiety.  As you feel your body becoming anxious, you can do these exercises to reduce the “spacey” feelings and prevent the spiral downward to a panic attack.  

What Is The 5,4,3,2,1 Technique (grounding exercise for panic attacks)?

One of the most common grounding techniques is the “54321” exercise.  It goes like this:

Start with deep breathing. Breathe in for 5 seconds, hold the breath for 5 seconds, and breathe out for 5 seconds. Continue this pattern until you find your thoughts slowing down. 

5. Acknowledge 5 THINGS around you that you can SEE– Maybe it’s a clock on the wall, chewing gum on the floor, clouds moving past, however big or small, recognize 5 items you can see with your eyes.

4.  Acknowledge 4 THINGS around you that you can TOUCH– Maybe it’s your computer at work, the park bench you are sitting on, your cell phone, your wallet or purse.  Recognize 4 items you can feel with your hands or body.

3. Acknowledge 3 THINGS around you that you can HEAR– Maybe it’s the buzz of the copy machine, the laughter of children at the park, birds chirping, construction work down the street.  Use your fine tuning and see if you can hear ambient sounds you may not normally tune into- the hum of the air conditioner, clocks ticking, cars going by.  Name 3 things that are audible to you. 

2. Acknowledge 2 THINGS around you that you can SMELL.  This one may be tricky if you are not in a stimulating environment. If you cannot automatically sniff something out, walk nearby to find a scent. Maybe you walk to your bathroom to smell soap or outside to smell anything in nature, or even could be as simple as leaning over and smelling a pillow on the couch, a pencil or hey do a check to see how your deodorant is working today. Whatever it may be, take in the smells around you.

1. Acknowledge 1 positive THING around you that you can taste is the most common way to end this exercise, but I like instead that you acknowledge one positive thing about yourself.  Anxiety can leave us feeling inadequate, or silly that we are getting “worked up over nothing”, but taking time to address your feelings is an accomplishment.  There are many good things about you.  Positive thinking can help bring about a positive feeling in yourself.  And finally at level 1, I also recommend taking one more big deep breath.  

At the end of the exercise celebrate your success.  Recognize you were able to ground yourself and prevent the anxiety spiral.  This will help you remember coping with anxiety is possible and that you successfully completed the exercise once before. The next time you feel your anxiety returning, remind yourself of your previous successes. If you are new to grounding and the 54321 exercise, here are some tips to remember: 

Tips for Grounding:

1. Eyes open. When doing grounding techniques, make sure to keep your eyes open, so that you can see and focus on what is around you right now. It is also a good idea to speak out loud, describing what you are seeing and doing.

2. Practice: Like any other skill, it is important to practice grounding techniques. It will be most useful if you have tried using this skill when you were calm, and you practiced it often. That way, when you find yourself needing to use it, you already know how.

3. Enlist help: Teach a friend or family member about grounding and why you need to use it. If someone you trust understands when grounding is useful, they can remind you to use it (and do it with you) if you are starting to lose touch with the present. For example, they might say, “I think you might want to do some grounding now… can you describe what you are wearing? What am I wearing? Where are we right now?”