Dear Grace Q &A: what can I do if I’m outside my home, like shopping or working and I have anxiety? If I encounter a painful/difficult situation or I have an intrusive thought or memory that throws me off balance? I can’t use my usual tools like meditating or grounding exercises and I’m stuck on how to handle this.

I really hear you, my dear. On how difficult it is to cope with these difficulties when out and about. When you are in an environment you can’t control or make healing choices that fit you, it’s tough to handle these difficulties like anxiety, triggers or painful memories.

N.B: What I am hearing in this question is how to handle triggers, including for anxiety. And while this is a larger question, and my answer can’t constitute medical advice, I can give my opinion on options that might be available/useful. I am addressing interpersonal difficulties here rather than micro-agressions from systemic prejudice like racism, transphobia, disablism, sexism, homophobia and similar. While all too often these are at the root of the interactions that wound and wear on us daily, they are more indepth and nuanced than I can address in this single blog.

When we encounter someone/thing that throws us, several things might be happening. Our boundaries might have been crossed, we could be feeling shaken, our feelings could be hurt or overwhelming. The situation could also be triggering a mental/emotional/sensory flashback.

All these things can, I believe, be handled, but they can be handled differently. I think it’s important to break it down as it explains why something so ‘small’ can actually be really, really big.

In the case of boundaries being crossed, I think a very helpful thing to do is to get to safety as much as possible.

This might mean calling a friend who is safe, moving to another area, leaving the rude person or situation etc.

Sometimes we don’t realise a boundary has been breached until a lot later. That’s totally understandable, at that point, we can still take action to make ourselves as safe as we can. To reassure and comfort ourselves.

Sometimes it can be as small as stepping away to ‘take a phone call’ and leaving a message with a friend, or going to the bathroom to doing a breathing exercise, journal, listen to music, read a few pages of a favourite book you carry in your bag or similar.

If feelings are overwhelming, taking care of ourselves is paramount.

Read: How to cope with emotional overwhelm

If we have been triggered or flashback, then it can be helpful to come back to the present if that’s possible and safe.

Things like counting all the blue objects in a room, or the ceiling tiles or floor tiles, or noticing where we are now and what’s present in this situation for all our senses, can help bring us back.

So can things like gripping the chair we are sitting on, flexing our feet/legs or hands, if that’s possible. Rocking a little or wiggling bottom on the chair can be very grounding…

In terms of a memory emerging that we have trouble coping with, it can be useful to contain the memory safely, without trying to push it down into ourselves.

Remember the Pensive in Harry Potter? Can a journal be a Pensive? Can a note titled Pensive on your smartphone contain the memory for now, and hold it until you are in a safe, held place to process it? Can you take a selfie of that moment and let the camera contain what’s happening. To witness it for you. And then you can still be able to be in the present and get yourself safe?

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One thing that can be useful is to have a more extensive grounding ritual and then each time you practice it, have a small movement that feels like the beginning/completion.

Say, you might begin by putting your hand on your belly and taking a breath. Then the whole grounding ritual could unfold as you need e.g body scan, mindfulness, rooted visualisation. You could end the ritual with the same small gesture.

This then becomes something very evocative of the overall grounding. And it’s such a small movement that you could potentially do it in any situation, using it as a helpful association to bring the sensation of grounding to the fore.

Another option is to use an anchor. Often my clients have used a photo on their phone, or a piece of jewellery they always wear, as something that symbolises the now, comfort and stability.

If triggered they focus on it – it’s very discreet, just looking at your phone, you can have an ‘anchor album’ of photos on phone – and looking at the picture, thinking about the senses, the love for the image…it could be a landscape you feel safe in, a safe space in your home, picture of a nest, picture of a loved one or animal.

It’s an anchor if triggered/spiralling thoughts, to help bring you back.

How do you take care of yourself in challenging situations? Let me know in the comments. 

P.S You might also like Dear Grace Q & A: How do I explain that my chronic illness and life aren’t a tragedy? and Dear Grace Q & A: 7 steps to your business come back after chronic illness. Read all the Dear Grace columns here.