Getting Out of the Panic Spiral - A Step by Step Guide

Anxiety can be a (chronic) pain. Here’s something you can do about it.

Chronic pain and anxiety tend to go hand in hand. Dr. John Sarno links the two in his book The Divided Mind, and when I first came across his work through the Curable app, it immediately made sense. As a long-time migraine sufferer, my most common headache trigger is what I call “the panic spiral.”

Maybe you know what I’m talking about. The panic spiral is like a traffic jam of anxiety triggers in your mind. It might start with an overwhelming to-do list of family obligations that collides with a seemingly insurmountable pile of paperwork from your boss and… do you feel what’s happening in your body just reading this? The panic spiral can hamstring your logical reasoning, limit your sense of what’s possible, and even bring on physical constriction and pain.

If you’re all too familiar with this scenario, you might be wondering, “How do I make the panic spiral STOP?”


Before we can tackle this beast, we need a little background on how the nervous system functions - because it's the key to understanding what you're experiencing. You see, when the nervous system perceives a stressor, it "hijacks" the brain. It takes the controls away from the prefrontal cortex - that lovely lobe at the front of your brain responsible for curiosity, creativity, empathy and logic. And it puts the amygdala, or "Lizard Brain" into the pilot's seat. That's the emergency responder part of our brain, developed way back in the days of our reptilian ancestors. And we need it to deal with immediate and temporary emergencies - like being caught in a burning building or chased by a hungry tiger.

The problems arise when this primitive part of the brain mistakes an everyday stressor for a legitimate survival threat. And once the Lizard Brain jumps into the pilot’s seat, it does not like to give back the controls. You can't reason with it, it's prone to black and white thinking, and its only response to the situation at hand is to lash out, run away, shut down or submit to injustice. Sound familiar?

So how do we get out of Lizard Brain mode and gain back our resourceful thinking and clarity – so that we can find productive solutions and relief from tension and pain?

I’m going to share with you a 6-step process that I developed through my own personal healing journey and that I now teach to clients.


Getting Out of the Panic Spiral

Step 1 - Notice your state. Identify the first physiological clues that your nervous system has been activated.

Do your neck and shoulders tighten or does your breath become shallow? Maybe you get sweaty palms or a certain feeling in the pit of your stomach? Some people find that it starts with “brain fog,” while others go straight into a headache or back pain. Stress shows up in our bodies in a variety of ways. Learning your early warning signs can empower you to take the next step before panic and pain become full-blown.

Step 2 - Establish safety. Hit the pause button on stressors for just a few minutes.

The simplest way to take a break from anxiety is to identify its primary trigger and literally walk away from it. For example, if your boss is stressing you out, step outside the office for a moment and take a walk – or at least a bathroom break. Even if your anxiety centers on something you can’t literally get away from – like intrusive thoughts about the past – getting up and changing scenery can sometimes create a temporary sense of space between you and your worries. You only need a brief window of safety to move into the next step.

Step 3 - Reset your brain. Practice a mind-body technique that interrupts the panic spiral.

Here’s the thing about anxiety: It usually centers on anticipating future stress or ruminating on past stress. So, one way to calm the Lizard Brain and give back control to the prefrontal cortex is to connect with the present moment by noticing your felt sensations in real time. This can be done through mindful breathing, wiggling your fingers and toes, stretching or shaking out your body, splashing cool water on your face, or whatever feels right to you.

Step 4 – Identify your feelings and needs. Uncover the underlying causes of the panic spiral.

Once you’ve turned down the alarm bells going off in your head, you can invite your prefrontal cortex back onto the scene by putting language to your feelings. A handy tool for this is the list of universal feelings from the Center for Nonviolent Communication. Just scan the list of words and see what fits your current state.

While the feelings you’re having may be unpleasant, you can think of them as helpful messengers alerting you to some vital needs that require your attention. Those needs might be as simple as eating an overdue meal or catching up on sleep. But did you know that things like compassion, understanding and support are also on the list of universal needs?

As you scan the list of needs, think about each need as having its own fuel tank. And just like a car, when your fuel tanks get depleted over time by cumulative stress and exertion, you’ll eventually get an “emergency low” alert. The panic spiral is your signal that you’re running on empty and it’s time to pull over and fuel up!

Once you get clear about the unmet needs underlying the panic spiral, you can set about addressing them in these final steps:

Step 5 - Set boundaries. Get clear about your limits and how you’ll protect yourself.

This can be tough for panic-prone folks, because difficulty setting boundaries is often a key driver of the panic spiral. But that’s why this step is crucial! And you can take it one piece at a time. First, just concentrate on articulating your boundaries on paper. Later you can put them into action.

Here’s an example: The situation – an overscheduled weekend. What is my limit or breaking point? More than 3 social events in one weekend. How will I protect myself? I will cancel two of the five events I planned to attend – even if it means disappointing someone.

Writing it down helps make it concrete. And it holds you accountable – to yourself!

Step 6 - Take action. Create a game plan to consciously address your needs.

Pick out just one of the needs you identified in step four. Then ask yourself: What person, place or activity in my life nurtures this particular need? When will I connect with that person, place or activity? Make a plan, put it on your calendar and follow through. As you do, visualize your need’s fuel tank getting filled back up drop by drop. And you don’t need perfection – just getting past the “emergency low” mark will do.


If this process sounds like a lot, remember that these are tools, not rules. Use what works for you and feel free to discard the rest. You may want to try out the entire sequence once or twice and then decide which pieces work best for you.

And if it feels too daunting to try this on your own, enlisting the support of a coach, counselor or trusted friend can be a great idea. Sometimes just having a benevolent sounding board will help you gain perspective and clarity – not to mention empathy. At the end of the day, the panic spiral is no match for a fuel tank full of self-compassion!

4 Steps to Pain-Free Communication in Relationships

Make talking to your partner a painless experience by identifying and working through your feelings.

Have you ever noticed a chronic pain syndrome flaring up right in the middle of a big fight with your partner? Or while stewing in silent resentment about something they did? If so, you’re not alone. Not only have I heard this from my clients, but I’ve experienced it first-hand.

Early on in our relationship, when my partner and I were navigating conflicts, I’d often fall into a pattern of “playing it safe” by holding back what I really felt – only to find myself knotting up into an agonizing migraine. Without finding constructive expression and release, the anger I felt would take up residence in my head and neck, tightening like a vice.

Other times, when we’d argue openly, we would get locked into a self-perpetuating cycle of blame, each of us holding the other responsible for the feelings we were having. During those fights, we’d sometimes both double over in head and neck pain at the same time! As awful as it was, I can’t help seeing the humor in it as I look back on our poor tortured souls. 

Happily, things are a lot different in our household these days. As we’ve learned to express our emotions effectively, our life together has become much more enjoyable and navigating conflict is, literally, less painful. I’m still on my journey of recovery from chronic migraines (I’ve managed to cut my headache frequency in half, thanks to Curable). But conflict with my partner has ceased being a pain trigger.

That’s because we’ve learned to communicate in a way that follows these three basic principles:

Be direct: Say what you’re actually feeling, not what you think your partner wants to hear.

Be constructive: Help your partner understand which specific behaviors – not broad personality traits – are impacting you, so that you can work together to find a concrete solution.

Be safe: Remember that you are on the same team. Don’t add fuel to the fire by blaming or attacking.


Shifting longstanding patterns of communication isn’t easy, to be sure. But the good news is that with education, practice and a healthy dose of self-compassion, you can make this shift too – even if you’re a life-long conflict avoider like I was.

To help you get started, I’ve constructed a step-by-step guide loosely based on the principles of Nonviolent Communication (NVC), a conflict resolution method developed by psychologist and author Marshall Rosenberg.

Step 1: Figure out what you’re feeling.

It can be challenging to put names to our feelings, especially when there are many layers of emotions all tangled up together. Naming each one with specificity helps us begin to untangle the knots and let each emotion breath.

A great tool to help you do this is the NVC list of universal feelings.

Step 2: Figure out what you need.

According to Rosenberg, unpleasant feelings come about as a result of having unfulfilled needs. You might think, “I’m angry because I have an unfulfilled need for my partner to wash the damned dishes!” But what Rosenberg means is something more basic – like the need for cooperation, or appreciation.

The NVC list of universal needs can help you identify what’s underlying your emotions.

Step 3: Step into your partner’s shoes.

Before sharing with your partner, take a moment to revisit the NVC lists. This time imagine what your partner might be feeling and needing. A little empathy will go a long way when you’re trying to get them to see your side too.

Step 4: Communicate your feelings and needs.

This is the hardest part. You may need to revisit Steps 1 through 3 until you feel prepared to approach your partner. When you’re ready, invite them to have a conversation without blame or demands – and stay curious about their feelings too. A starting point might sound something like this: “After our fight last week, I’ve been feeling really sad and lonely. I’m longing for some support and understanding. I wonder what you’re feeling?”

Once you and your partner are able to empathize with one another’s feelings and needs, you’ll then be ready to collaborate on finding a constructive solution.


Extra tips!

You may be thinking, “That all sounds great in theory but if it were really that easy, I’d be doing it already!” And you’re right. Emotions are messy. They don’t conform to logic. Working with our feelings is like working with small children: it requires an incredible amount of patience, flexibility, and a willingness to accept that things won’t go the way we planned nine times out of ten.

Here are some tips for working effectively with feelings:

1. Practice in the mirror. Before you express your feelings to your partner, practice what you’re going to say first. If you want, run it by a trusted friend. Practicing beforehand will help you stay on track when those unruly emotions start rising up in your throat.

2. Context is everything. Catching your partner when they’re about to head out the door to a stressful job interview is a recipe for disaster. Choose a time and place to talk that feels relatively calm and safe for both of you. You might even want to schedule a time in advanced. We’re much more open and receptive to each other when we don’t feel rushed, distracted or ambushed.

3. Stay grounded. Do a grounding practice like physical exercise or mindful breathing to regulate yourself before you initiate a conversation. Our nervous systems are like tuning forks, and we’re very sensitive to each other’s vibrations – especially with our intimate partner. The calmer your presence, the safer you will feel to your partner. Taking a warm shower is another easy way to soothe your nerve endings before having a talk.

4. Set your partner up for receptivity. Start with appreciation and frame your request as being in service of greater connection with your partner. Here’s an example: “Honey, I love you so much. Right now, there’s something getting in the way of me feeling as connected with you as I’d like to. I’d love to talk about it because I don’t want to feel distant from you.”

5. Small doable pieces. Often, when you’ve been avoiding conflict habitually, there’s not just one simple thing to work out but a whole tangled web of issues that have built up. Address one piece at a time and start with something small. Then work your way up to the bigger stuff as you gradually build your conflict resolution skills as a team. Just like training for a marathon – start with a jog.


One final word on this practice: It’s okay if you “mess up!” Communication is hard. It doesn’t have to go perfectly. Every rupture is an opportunity for repair. Pat yourself on the back for breaking out of your routine and trying something new. And afford your partner the same patience and appreciation as well. They might not respond exactly as you’d hoped the first time around. Give them a while to let it sink in – this is new for them too.

If communication in your relationship feels too volatile to manage this practice on your own, enlisting the support of individual and/or couples counseling is a great idea. As long as you and your partner both have an underlying intention to feel more connected, you can eventually get there even if things get messy – and you can expect that they will!

It’s all part of the journey. Along the way, you just might discover that conflict doesn’t need to be a – literal – pain in the neck.


This blog post was published by Curable, the app for chronic pain.