Anxiety is something most of us have experienced at least once in our life. Public speaking, performance reviews, and new job responsibilities are just some of the work-related situations that can cause even the calmest person to feel a little stressed. This five-step exercise can be very helpful during periods of anxiety or panic by helping to ground you in the present when your mind is bouncing around between various anxious thoughts. Before starting this exercise, pay attention to your breathing. Slow, deep, long breaths can help you maintain a sense of calm or help you return to a calmer state. Once you find your breath, go through the following steps to help ground yourself: 5: Acknowledge FIVE things you see around you. It could be a pen, a spot on the ceiling, anything in your surroundings. 4: Acknowledge FOUR things you can touch around you. It could be your hair, a pillow, or the ground under your feet. 3: Acknowledge THREE things you hear. This could be any external sound. If you can hear your belly rumbling that counts! Focus on things you can hear outside of your body. 2: Acknowledge TWO things you can smell. Maybe you are in your office and smell pencil, or maybe you are in your bedroom and smell a pillow. If you need to take a brief walk to find a scent you could smell soap in your bathroom, or nature outside. 1: Acknowledge ONE thing you can taste. What does the inside of your mouth taste like—gum, coffee, or the sandwich from lunch?

The internet tells me this is called the "5-4-3-2-1 Method of Grounding:

www.urmc.rochester.edu/behavioral-h...

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And consider using this reference to enhance narrative descriptions! Don't forget about other sensations:

A cool wind. A tapping foot. A whistled tune. The smell of rain. The taste of dust.

Where do these descriptions sit with the reader? How close are you bringing them?

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A character who can only taste the blood in their mouth is so in their body it's not effective to describe any other sensations.

On the other hand, a character we are more distant from or who is more separated from their body may only see and hear things (or be overwhelmed by them!)

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For instance, describing the look of a sweater doesn't bring a reader in as close as describing a character *feeling* it being scratchy.

Closer is not always the right choice! It's a cool scale to play around with, though.

Another example would be --

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How "in their body" is a character? How aware of the world around are they?

So much surface-level writing focuses on what a character can see, or what a reader should picture.

As a writer describes sensations further down the list, we get closer to the character and more visceral
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It is a tool (which probably has a name?) for centering oneself which goes:
- Name 5 things you can see
- 4 things you can touch
- 3 things you can hear
- 2 things you can smell
- 1 thing you can taste

If you wanted to apply this to writing in general --

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I use the "Five things you can see..." method to help calm patients' anxiety attacks pretty frequently and it strikes me as a cool way to think about descriptive writing. If you aren't familiar with the method --

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Lastly, think about why your character is having difficulty breathing and what work they need to do. Someone panicking is breathing to escape danger. Someone having an acute breathing problem is scared. Someone who has been struggling for a long time is tired.

Hope this is helpful!

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What do their breaths sound like? An airway obstruction wheezes, a higher pitched sound. Mucus or fluid in the upper airway gurgles. Fluid from an illness may not be easily audible in lung sounds without a stethoscope but as the lungs fill up with fluid, gurgling becomes more audible

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As the blood becomes deoxygenated, skin becomes pale and then blue, especially where there are a lot a capillaries, like the lips, eyes, and fingers. This is most easily observed on darker skin tones around the lips and mouth.

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When writing a breathing emergency, think "work" of breathing. A person may be restless or anxious at first when working to breathe, positioning themselves and moving on instinct as they seek air. Then they slowly tire until the muscles can't work any more and they stop breathing --

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Panic, anxiety or shock may also result in hyperventilation. Bodies perceiving themselves to be under threat channel resources to body parts that can fight or flight. Increased blood flow triggers the brain to signal for more oxygen, so it can feel like you can't catch your breath.

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"Working" for air, on the other hand (accessory muscles, tripod position, gasping, etc) is often the result of the body feeling "starved" for air, engaging backup mechanisms to seek as much air as possible. There is usually an obstructive or metabolic reason the body feels starved.

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Coughing, for instance, might happen when the body senses an obstruction, like mucus or dust. Coughing may also be an attempt to moisten and soothe irritated airways, perhaps in the presence of a chemical or ultra dry air.

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I talked a little bit about the mechanism of the lung already and some examples of things that can stop/hinder breathing. Think about the source of a character's breathing emergency and how it might manifest --

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The body does these things instinctively in an attempt to open up airways & make space for air. In many situations, providers are told to allow a patient to remain in a "position of comfort" (how they have placed themselves)

It's usually NOT lying flat, which compresses the airways.

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Another thing the body can do instinctively when struggling to breathe is engage accessory muscles. If you're breathing without effort, you can do so almost imperceptibly. A body struggling engages shoulders, neck, nostrils, mouth, and sometimes areas of the clavicle and ribs

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Another thing observable when someone is having trouble breathing is instinctual positioning to open the airways. We call one of these positions "tripod position" where a person is sat bent slightly forward with their hands on their knees. People do this on their own! --

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Asthmatics have described to me a severe attack as the sensation of being squeezed all over. The inflammation of the airways results in a situation in which air can be more easily drawn into the lungs than exhaled and the person "wheezes" audibly on exhale --

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One thing that always tells me an asthma attack is serious is when a patient meets us at the ambulance. It seems paradoxical: why would someone who needs help be up and running around? I'm not your doctor, but asthma patients are often very clear about the relief they need

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I did write a bit about this already, but I'd like to talk about different types of breathing emergency. To start: if difficulty breathing is the result of a medical condition (ie asthma or pneumonia) the person is likely taking steps to remedy the situation

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How to write about a breathing emergency?

Is your character hyperventilating in panic? Do their breaths rattle from a wasting disease?

Are they having an asthma attack? Have they been stabbed in the lung?

Here's what to think about in some of these cases --

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Lazy writing relies on simplistic characterization of #weight (skinny, fat, bouncing boobily, etc).

Elevate your writing by ignoring "weight" and looking at gravity. Are characters plodding through the world? Floating through it? Slithering? Crashing?

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Think also about where people carry their #weight as they move through the world. A common acting consideration is a character's "walk" & how they hold themselves. Do they come at you head first? Chest first? Pelvis first? Sideways? Look at people on the street: how are they moving?

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When writing a fight, or a fall, or some other dramatic movement of a body, think about the force required to move it in that manner and direction. Martial artists, dancers, and athletes work on their "core stances": that is where the power of movement and stability come from.

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To bring realism to how how your bodies move in your writing, note that the #weight and center of gravity is in the core. Think about the more stylized action films (i.e. Crouching Tiger). The action in these feels fantastical because the sense of gravity in the body is shifted. --

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Working in emergency medicine, one develops a sense of where bodies hold gravity. We are often lifting, carrying & moving people who can't move themselves & we have to do it efficiently & safely. You'll see us grabbing people from the belt & shoulders vs arms & legs, for instance. --

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Another #WritingBodies, inspired by my using my EMS sense of body center of gravity to...have an interaction with a rude man on the train. This is a thread on #weight, but I will be talking about how to think about where characters carry weight, not "weight / health"

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I had a big organic chemistry exam this week and I was not able to sit down with the #WritingBodies tag of #WritingTips. Hopefully can do some more posts in it now

When #writing illness and injury to the #heart, think about this as a perfusion (blood getting oxygen and nutrients to organs) issue. Someone might be pale, struggling to breathe as their organs are deprived of oxygen and signal they need it.
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