A good friend called me for help last week. Just before she dialed me, she had felt a rush of dizziness which we later hypothesized may have been caused by a temporary low blood pressure after standing quickly from her seat. The sensation reminded her of physical symptoms she had experienced during past panic attacks, and she began to escalate into a panicked state in response.

Our phone call began with rapid breathing and her quick explanation. She had made it to the lawn of her backyard, she felt dizzy, and she thought she may be having a panic attack. I followed with, “Ok, tell me five things you can see, and I want details.”

We had performed this exercise together once before, and I think I heard a sort of choked, breathy laugh of disbelief both times. Her first sighted item was a blue car. “Is it a sedan?” I asked. She confirmed. “Is it one of those ugly shades of blue that really doesn’t belong on a car or one of the good ones?” She laughed a bit, still choppy, “No, it’s actually a really nice shade; a midnight blue.” “Oh, I love that. What else do you see?” The next item was the blades of grass at her knees. We briefly discussed whether they needed to mow and if there was morning dew.

We’d only made it to the fourth item she could see when, with slowing breath, she incredulously asked, “Why does this work?”

I often teach clients the 5, 4, 3, 2, 1 method of grounding. It’s simple, easy to remember, feels a little silly to perform, and often fulfills its intention.

The exercise is simple: first, you list five things you can see, including as many details as you can; color, shape, texture. The grass was tall, wet, and bright, leafy green. Next, you list four things you can touch and describe how it feels. Maybe your hair is dry and silky, and your sweater feels fuzzy and course. Nest, you list three things you can hear. Perhaps, the wind is rustling leaves, the neighbor kid is squealing, and you notice the sound of your own breath. Then, you acknowledge two things you can smell. Feel free to sniff your own hair or clothes, pick up objects or pets, or find the nearest candle if you’re up for it. Finally, you identify one thing you can taste, which unfortunately may be your saliva or what you had for breakfast but could also involve a mint in your bag or a sip of your nearby drink.

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

When panic starts, it is often then accelerated by the very symptoms it causes. Symptoms onset, and then worrying about those symptoms, what’s happening, when it will end, how will others react, feelings of fear and embarrassment… My friend expressed rapid thoughts of concern over what was happening, why it was happening, apologies, and statements of shame and embarrassment all over the course of a couple of minutes. That building, often compounding anxiety keeps the brain and body in a heightened state of fight-or-flight for longer. Abandoning those natural but unhelpful thoughts to instead focus on your present surroundings allows you to ground yourself. Eventually, your breathing slows, and your heart rate follows, and your brain is able to recognize that you are safe enough to calm your nervous system and call off the cavalry of symptoms.

I highly encourage anyone who feels anxious sometimes (everyone) to learn the 5, 4, 3, 2, 1 exercise. You don’t have to be in the throes of a panic attack to benefit from grounding yourself; it is recommended for moments of anxious thinking of all sizes, and it is also a great tool to be able to guide others through. I encourage clients to teach members of their support system the exercise as well, because it can be beneficial to have someone coach you through it. 

As a brief caveat, I was aware my friend appreciates humor as a coping strategy, so I shared humor with her as I asked her to give more descriptive details (i.e., “Is the blue car ugly?”) I would defer to your judgment when considering incorporating humor to assist someone with the exercise. For some, that could feel insensitive to their current state of distress.