Panic Attacks in Scene

by Amaranth and Lamentation

Practical Tips for what to do when a submissive is having a panic attack

As many of you might be aware, BDSM play itself can be an altered mental state (without drugs) with many endorphins and other hormones coming into play. "Sub space" and "top space" can also be thought of as types of trance. We will not be discussing these states in this piece, but instead referring to altered states that are usually called panic or anxiety attacks, where fear is the strongest factor. Panic attacks are a part of PTSD (Post Traumatic Stress), they are part of DID/MPD (Multiple Personality or Dissociated Identity Disorder), and they are part of several anxiety "disorders" like social anxiety, agoraphobia, and other phobias. They can also happen without any diagnosed "disorder", and people without diagnosed mental health issues also sometimes get panic attacks.

Amaranth is a submissive who is dealing with PTSD and multiple personality (MPD/DID). Amaranth's Dom Lamentation also deals with phobias, and we've both spoken to many others with similar things going on, so together we have dipped into that experience to share our ideas and tips in this piece.

How to recognize a panic attack

Panic attacks differ in how they look from person to person, and can sometimes look different for one person from one situation to the next. Here we will list the most common things that can be noticed if someone is having a panic attack, but there are things that will not be on this list that you might run into, and some things on the list might not be a panic attack for the submissive you are trying to help. The best way to know what a panic attack looks like for a specific person is to ask them. But in case they didn't (or can't) tell you, here are the most common signs:

Body posture: If your partner's body stiffens completely, that is usually a pretty clear sign. The sub rolling their body into a small ball, or even suddenly starting to use their hands to defend themselves - for example, covering sexual areas or their face - can be a clear sign. Shaking can also be a sign of panic, both when the whole body is shaking or shivering (not from cold) or when your play partner is shaking or moving one body part (like repeatedly moving their foot back and forth). Other signs are excessive sweating (drops of sweat on the forehead or somewhere else not from warmth), very fast breathing, or very shallow breathing. Eyes glazing over can also be a sign of panic, but that could also be a sign of "sub space", so don't use that as the only marker for recognizing a panic attack.

If you are doing physical play, watch for the sub narrowing the area on which you are focusing, trying to minimize that contact area. This can be a very early sign of something going to the edge of difficulty. It could simply be that whatever is done hurts a lot, and that it's a reaction to that; but it could also be a first sign of panic, so it is a good idea to look closely at how your partner is feeling in this situation while not stopping the play. On the other side, if your play partner makes the area you are focusing on larger, spreading their back wider when they're being flogged there for example, that's usually a sign it's a good feeling and they're doing well.

Of course the clearest sign is if your partner is actually crying or screaming, and then it will become pretty obvious very fast. Unfortunately some subs become unable to speak or make sound or be coherent while having a panic attack, so being completely wordless can also a sign. However, it can also be a sign of subspace, so again it is good to not use as the only marker. A cracking voice, or a voice that is much higher or with more tension than you're used to can also give a good sign. Another sign that usually has to do with triggers from forced oral sex in the past is if your partner starts to heave or throw up when something is forced into their mouth.

Personally, for Amaranth, because she has DID and is a multiple, panic attacks can look very different, depending on which one of her inner people are panicking. So we've seen some of her insiders do the little ball thing, some of her insiders stiffen up, some of her insiders start shaking their leg really hard or pounding on it. For Lamentation, the sweating and fast breathing is usually the clearest sign, and Amaranth can sometimes recognise it before Lamentation himself does.

What to do as your first line of defense

If your play partner is no longer coherent, the first thing you want to do is get any triggers (things that might have caused the panic attack or mental state that is not wished) out of the way. Triggers could be all kinds of things - a word, a feeling, a sound from outside, an unexpected situation. Amaranth knows her triggers very well because of the PTSD and there are a lot of them. We will share them here to give examples: Triggers for her are body moisture (or cold water), feeling a male sexual organ against her, having things forced into her mouth, feeling like she's being strangled or cannot breathe, loud noises, alarms outside, angry voices, the idea that people are upset with her, children crying or screaming, sometimes children just playing normally ... as you can see it is a long and exhausting list. One of the things to remember is that what is a trigger for one person does not have to be a trigger for the next. We know someone who panics when blindfolds are used, whereas for Amaranth a blindfold is very effective to help her calm down and stay calm.

If your partner is in bondage, you might want to remove that as quickly as possible. If the bondage is complicated, it might be wiser to use your voice to calm down the sub and spend a little more time to remove bondage safely and calmly than to cut them loose and cause a jarring fall. When Amaranth is in a panic, sometimes bondage can actually feel safer than otherwise. If she's coherent Lamentation usually asks her what she'd like best, and sometimes she actually manages to tell him. If you know that bondage usually makes your sub feel good and floaty, it might not be the cause of the panic attack and it might be worth it to first look for other triggers (a splash of wet cold water, for example, could set Amaranth off).

Once all triggers are removed, make your partner feel safe. You can use many things for this. You can use a toy stuffed animal if you're dealing with someone who is open to this, you can wrap a blanket around them, you can use your voice and speak in a very soft calming tone. You can stroke their hair, or touch their body in other reassuring ways. You want to make sure here that you're not using anything that could be a possible trigger for the sub, because then you will cause the panic attack to grow instead of to become less. If you're trying to help your partner feel safer, it can really help if you know him or her well, so you know what things generally make them feel safe, treasured and taken care of, and which things make them nervous. In general, a blanket that the sub can use to wrap themselves in the way they like best is pretty safe, as long as you don't push it down on them anywhere specific. Talking to them in a quiet, calm voice without using trigger words is also generally pretty safe.

If the trigger is part of the environment and cannot be removed and you cannot remove the sub from the environment, try to reframe what the trigger means to the sub. For example, when Amaranth was having a panic attack because there were a lot of sirens going on outside, Lamentation managed to reframe them by saying, "Those are sirens. Take a deep breath, I know they make you nervous but they just mean someone else is having a much worse day than you are," and being reminded of that helped a lot. Remind your partner that a perceived trigger in their environment does not mean a danger directly to them, but is only bringing up a bad memory or a fear that they don't have to be afraid of right here, right now. It can help to remind your play partner what day and time it is, and where they are, if you're trying to reframe a trigger for them. An ongoing trigger in the environment can make it very hard for some subs to realize they're not trapped in the memory that set off the panic attack, and that they're in a different time and place.

Orienting the sub to the present

It is a good idea to first check if your partner has 'come back to earth again' and grounded themselves. Ask them their name, what day and time it is, where they are, and who you are. If they give answers you're not expecting and seem to be stuck in either another identity, a memory in the past, or do not know you, you are still dealing with a significantly altered state of consciousness. If your play partner gives a different name that you don't recognise, ask if you can speak to the person who you know them as (Lamentation will say "Can I please speak to Amaranth?" if he wants to make sure he is talking again to her and not to another inner person). If you do recognise the name as belonging to another inner aspect of your partner, or if you know he or she is a multiple, you might want to continue with the person you are dealing with; they have stepped in for a reason. If they're giving a different time or place, it can help to first quietly ask more information about where they are and why they are there, but if you get the idea that your play partner is about to relive some past trauma or a bad memory, you might want to remind them of the here and now and not ask more about where they are at that time. If your partner seems to feel safe in the time and place they've returned (regressed) to, it can be useful information to them later, as some subs might have trouble remembering these details. If you can remember the details to tell the sub later on, this information can be very useful in future therapy. Then gently bring them back to the here and now.

Another method to help someone calm down is to have them control their breathing. Do not immediately ask them to go from fast, shallow breathing to long counts in and out; that is too fast. Have them go one step calmer in their breathing then they are now, and once they can do that, another step, making the time between breaths very gradually longer, until they have calmed down. If your partner is hyperventilating this will not help them calm down and you may need to have them use their cupped hands to breathe in so they can limit their oxygen intake and instead breathe in the air they just breathed out. A paper bag is better for this purpose, but cupped hands can work if no paper bag is available; just keep the hands close to the face and over the nose. If your play partner cannot control their breathing, sometimes it can help to actually start breathing with them (as long as you're feeling pretty stable, because if you match your breathing to theirs you might feel some of their panic). Then when you are in rapport with them, slow your breathing down and help the sub by giving an example. Because you're breathing with them, the example will be easier for your partner to follow from your own breathing pattern than if you're just telling them how to breathe.

Unfortunately, it is not always possible to bring your partner back to the here and now, which is why the deliberate inducing of these kinds of regression/flashbacks (as opposed to the accidental types) are better done with a therapist nearby, if at all possible. If it is clearly unavoidable, just try to stay with your play partner, keep reminding them that you care about them, and try to find a role for yourself in the memory (protector, friend) who can help the sub watch the painful memory and feel all the intense emotions, and give them time to feel the depth of it. Keep reminding them that they are safe, even if it feels to them like they are in the middle of it. The fact that your partner unconsciously feels safe enough to relive something like this with you as their support, even if it is a shock to you and was not planned, is a great compliment and a very significant sign that they trust you. Apart from trying to find a role for yourself in the story, something else you can do that sometimes works is to remind them that though it looks like they're inside it, they're actually watching this like watching a movie in a theater. Try suggesting to your partner to make the screen smaller, turn of the sound, or change the movie into black and white. This can make the relived memory a little less powerful and intense.

Once the flashback is over, they will be exhausted and should be ready to calm down. Talk to them quietly about what they just experienced. Do not try to continue the scene after a regression, because what was just experienced is very, very intense and continuing play is asking for trouble. Just immediately move to aftercare - cuddling, staying together, gently touching if your partner can handle that, and the other further grounding and centering techniques that follow.

Further Grounding and Centering techniques

Once your partner is back to the here and now without being overwhelmed with panic or anxiety, and knows who they are and who you are, take some more steps to ground and center them. Water and food are a good idea, as the act of eating and drinking can bring someone back into their body. Use similar methods as you would use for aftercare, but if the sub has not had a full regression (just a light panic attack), it might be no problem to continue the scene. It is a good idea to ask your partner if they'd like to continue. If you want an honest answer, for some subs it might be good to explain that you are fine with either a yes or a no, or you might get the answer they think you want to hear (yes, Amaranth tends to do that very regularly).

Make sure not to use any methods that could re-activate the trigger that caused the panic attack. The sub will be more sensitive to this and other triggers than in their "normal" state. For example, Amaranth likes milk, so milk would be a good thing to give her during aftercare, but not if she was triggered by the male-bodily-fluids trigger and has been heaving. In that case, even showing her milk will only set her off again. Again, it is good to know these things, so make sure your partner tells you as many of them as he or she knows about.

If you do continue with the scene, you probably want to stay away from the activated triggers and maybe from any other triggers. The sub could be more on edge now, and once one anxiety or panic attack has been triggered others may more easily follow. But it might make your partner feel good to continue the scene, because having an anxiety or panic attack and then having to stop the scene can make them feel very bad about themselves, their limits, and their worth as a play partner. Still, you might want to adapt the play and not continue with the level of intensity you started out with, but just go a little slower or lighter. That way you can reassure your partner that they're still worthwhile to you while not setting off another attack.

How to prevent panic attacks

Not all panic attacks can be prevented, but it is possible to prevent a large amount of them if your partner is dealing with a lot of anxiety. One thing is to listen closely and take them seriously when they tell about their limits. Please, please do not make the mistake of thinking you can help them get over something they're telling you is causing them trouble. Unless you've had the training to do so or are a therapist, please don't try to push a trigger on someone. Amaranth has had a lot of experience with doms who wanted to push her limit concerning bodily fluids. Sometimes they wanted to do this to help her, sometimes it was for selfish reasons. Every time it ended up in a major panic attack that went beyond the first hour into hours of heaving and trying to throw up, and the aftermath of this could last months. Now that we both decided from the start to leave this limit alone Amaranth finally feels safe and calm in the knowledge that she will never be asked to do anything like this; even if she is willing to try it, she just can't. Please listen to your partner and take them seriously. If what he or she tells you sounds like too much trouble, then just don't get involved, but don't try to push a sub who is actively communicating their issues as limits, whether you're trying to do it for their own good or not. You're not a therapist, and even therapists will often wait with trying to help with these limits until a really stable balanced relationship is created.

If you know your partner's triggers, try to make sure that the environment is as free of them as possible. Sometimes a trigger will happen despite all your efforts, but attempting shows the sub that you do care about their mental well-being. If you know your play partner has a trigger you cannot control and it goes off, you can acknowledge it and their reaction to it, and sometimes this can prevent a full scale attack from happening. For example when there are sirens audible during a scene Lamentation might say "I hear the sirens too, I know you'll be a little nervous now. Just take a deep breath, it's okay, I'm with you," thus acknowledging the trigger and giving ideas on how to channel the reaction to them.

If your partner is dealing with PTSD or DID or anxiety disorders or phobias, panic attacks will and do happen. It's not a sign of whether or not you're a good Dominant, although how you deal with them may show how good you are for this particular sub. Many, many triggers are completely out of your control, and reframing them doesn't always work. About 80 percent of the scenes of Lamentation and Amaranth include dealing with anxiety or panic at some level or another, often at a level where Amaranth is still coherent and is able to talk about it, but sometimes beyond that. We've learned to take precautions, take care, and then just continue lighter or in a different direction or go to after care, because if we'd stop every time for a panic attack we'd never get any play done. If a panic attack is a very rare thing for your partner you might want to take a little more notice of it, though.

As a sub, in order to help your Dominant work with any panic attacks you may have, it is absolutely vital that you communicate any triggers that have ever played a role for you in starting up a panic attack. If the Dominant doesn't seem to take the triggers seriously, either do not play with them, or ask someone you've played with before whom you trust to be there so they can step in if something goes wrong. Sometimes Dominants may not understand how incredibly intense panic attacks can be, and they'll be surprised at a reaction they didn't expect, even if you warned them. Communicate to the best of your ability. If you're not that good at communicating, try and find ways to learn more skills in that area, either with a therapist or friends or in other ways, to be able to tell others what they need to know. Without the right information, no matter how well-meaning and competent the Dominant is, they cannot help you. We hope this information will be of use to you; please use any hints and tips that work for you and disregard the rest.