How to Work With Fear
My pulse is racing. I am lying down on a mat, on a bright summer day in Colorado. There is soothing music around me, and I chatter nervously to my trip sitter. My fingers worry a smooth stone. Fear courses up and down from my chest to my stomach.
As a part of my training as a psychedelic therapist, I’m about to experience ketamine for the first time. What’s taking so long? I’m waiting for a nurse practitioner to inject it into my arm. The What If Machine in my brain operates at full tilt: what if I lose it around the other trainees? What if this screws with my brain? Or see something I don’t want to see? What if I have a heart attack? What if I never come back?
Many of my psychotherapy clients experience the dampening effects of fear in all different ways: not applying for a job; not asking somebody on a date; not asking for time off, appropriate boundaries, a raise or promotion; not leaving the house. This last fear response, that keeps people staying home, has heightened since the pandemic, and has given rise to the social pandemic: increased isolation, depression, substance use issues, and social anxiety disorder.
How do we work with fear? During my own ketamine experience, I used this method, and it’s one I teach my psychotherapy clients.
Acknowledge the fear as it shows up in your body. Perhaps say out loud: “this is fear.” In Whole Brain Child Bryson and Siegel famously wrote that kids need to “name it to tame it.” Name the emotion, say it aloud: this is fear. Sometimes the tiny act of naming an emotion helps us feel better. Naming fear can kick in the smart, sophisticated parts of our brain that can remember “oh year, I’m afraid. What do I usually do to feel better?”
Sit with the fear. Really, truly sit with it. Notice where it shows up in your body. Does it have a shape? Perhaps trace a border of that shape with your finger. At this moment, you aren’t trying to dispel it. Much of the time, we do something to distract. When I get nervous I chatter like a caffeinated monkey, as I did before my ketamine journey. This chatter was distraction, a distraction from the unpleasant feelings in the body. We all distract, it’s normal. If you spend just a moment noticing the experience of fear, and not telling yourself the story of why you’re afraid, you might notice the fear recedes.
Thank the fear for trying to protect you. Show fear some gratitude. Our fears keep us alive. How cool is that? We receive evolutionary benefit from fear. If our ancestors didn’t experience fear of 10-foot tigers with laser eyes, well, we probably still wouldn’t be here. The thing is, there are no 10-foot laser-eyed tigers anymore. So often, we get in trouble because it’s not a fear that’s attempting to keep us alive, but a fear that’s keeping us from living. Acknowledging and thanking the fear lets it know you’ve heard it.
Find your ground. There are many ways to ground: Yoga, breathwork, Five Senses exercise, repeating mantras, looking at a picture of a pet, prayer, reading, being in nature. All of those things can ground us.
For many years I rock climbed outside, sometimes incredibly steep walls over 1000 feet high. When I got scared before rock climbing, I developed a few mantras. The first I borrowed from Dune: “Fear is the mind killer.” It sounds cool, but it didn’t really work for me. The next mantra I tried was “Kaliyuga.” This is the name of a climb in Yosemite Valley on Half Dome. I had no specific plans to climb this, but the mantra was aspirational: I aspired to hard climbing, so my mantra to get through it referenced a hard climb. Little did I know at the time that Kaliyuga came from Hindu cosmology, and reflected a dark age, an age dominated by the demon Kali. These days I work with Green Tara, the bodhisattva who embodies fearlessness. A mantra can be as simple as “I can be safe.”
Check in with safety. When I was on my mat in Colorado, I considered my resources: did I trust my sitter? Yes. Did I trust the crew of trained psychotherapists, nurses, and doctors who were running the training to take care of me if something happened? Yes. Had I given my body and brain plenty of time to prepare? Yep. Did my body have experience with other psychedelics? Yes. Would I trust my deepest self that this was something it could handle? Absolutely. It was Friday. I knew that by Sunday night, I would be home snuggling with my dogs, Monday I had a yoga class, and Tuesday I’d booked a session with my own psychotherapist.
As I reviewed my sense of my resources, I kept breathing deep breaths. I played with the grounding stone in my hand, connected with the physical sensation of fear in the body. After waiting for fucking ever, the NP came over to me. We had connected the day before: I had told her I was nervous, and she offered to be the one to administer the medicine. She embodies warmth and care, and as I regarded her smiling face I relaxed. She asked if I’d like to hold the syringe in my hand and offer the medicine gratitude. The gratitude ritual, one I’ve practiced before, was another form of grounding. I offered thanks to the medicine, recalled my intention around it, and nodded. The nurse smiled again, injected the ketamine into my upper arm, and as one does, I shot off into the stars.