If you are reading this it is probably because someone in your life, or someone you hope to help in the future, is showing signs of unresolved distress. It may even be you. Some of the exercises in this first module will help you determine if the problems are likely rooted in past events.

     The person has probably tried to deal with their distress in a number of ways. People have often turned to prayer, family, friendship, self-help books, therapy, counseling, groups like AA or Al-Anon, and numerous forms of distraction. Yet, despite finding the strength to stay functional each day, perhaps their underlying problem has remained. Often the person has developed unhealthy or isolating habits for coping with their internal distress. All of this can actually be organized, understood, and resolved. 

     The lessons and exercises contained here are not in conflict with any major religion or spirituality. They can be applied by followers of Islam, Christianity, Judaism, Buddhism, Latter Day Saints, Taoism, Hinduism, atheism, agnosticism, and many other belief systems.

     I equate my work to that of a car mechanic, simply pointing out typical sources of obstruction, conflict, and leaking of resources; then suggesting ways to tune up and harmonize what is actually a robust assembly when operating as a whole.

     Rather than emphasize theory, I have tried to introduce exercises as immediately as possible. By analogy, if a repair or even surgery were required it would be ideal if the operation could happen within minutes of that realization rather than spend 3 months talking, stressing, and supposedly "preparing" for it, whatever that means. The sooner one goes in, the sooner one gets to the other side.

     Theory is provided later for those who want the additional joy of understanding, but it is not placed up front here since that could serve to distract from, and collude with procrastination of, the exercises themselves.

     I have written this using language that keeps the goal of helping others at the forefront. However, we often learn best by testing whether theories, concepts, and exercises apply to our own situations first, before we expect them to do much for others. This is both a self-help and other-help program.

     The next step here is to explore for potential relationships between current problems and past events, to help confirm whether this series of modules is something that can benefit a person. I hope you'll take a nice relaxing breath and dive in.

     Hesitation is very understandable since most people avoid dealing with these things out of fear they will make their experience worse.

     Yet I want to plant the seed that all of the above might just be rumors many of us have been believing for years but that are very worth challenging.

     NOTE: The presence of fear does not confirm the presence of danger.

Further Identifying Avoidance & Coping Behaviors (Add any of the following to the above box if not included already.)

     People use many activites to calm, distract, or numb themselves from unwanted memories, feelings, and concerns.

     Coping behaviors can include achievement-oriented activities like work, exercise, food restriction or weight loss, and cleaning things, taken to extreme, unhealthy levels.

     They can be fairly neutral activities like focus on entertainment and games, but taken to degrees that have started to feel embarrassing to admit.

     They can also be more typically shame-inducing activities like reliance on drinking, cannabis, overeating, purging, unromantic sex, gambling, and impulsive spending.

     All of the above tend to offer some brief alleviation or distraction, yet often prolong underlying problems and result in isolation and friction in relationships.

Moving into Module 2

     You have nearly finished Module 1. If the above has suggested there is a good chance that past event(s) are still causing negative impacts on the present, I recommend you move into Module 2. In that module you will learn about reducing fight-or-flight reactions. 

     The obstacles to recovery are surmountable!

If you are a licensed provider, I encourage you to use measures like these for PTSD, anxiety, and depression symptoms to establish a baseline symptom score NOW, and to repeat it at 2 weeks and 1 month after completing this workbook. 

     While breathing richly and trying to relax, take a moment to imagine a big, ripe, juicy lemon. Can you picture one?

     Imagine bringing this lemon to your nose and smelling it, taking a nice long inhale of its tangy aroma. Can you imagine that smell?

     Now imagine tearing into the lemon with your fingernails, peeling it back, and some of the juice landing on your face or lips. Can you picture all that?

     Now imagine bringing the lemon to your lips, the aroma coming through clearly, and then taking a nice big bite of it. Does your mouth begin to water?

     (If your mouth has not watered yet, try to increase your use of visualization and imagination about what each of your senses would experience with a real lemon. If that still does not work, perhaps consider something very salty, or a smell that is absolutely disgusting to you.)

     The point of this introduction is to show the power of words, memories, and associations to trigger physical reactions in us. There does not have to be an actual lemon in the room (or other objects we react to) to get our bodies to react as if they are present.

     When it comes to life experiences that have been traumatic or disturbing, there is the initial pain and suffering of the event itself. It can be an injury, a loss, a death, a huge disappointment or rejection, a humiliation, a violation of our sexual or other integrity, or more.

     But when we continue to suffer or react after a significant period of time has passed, something else is occurring. The pain is no longer coming from a current sting (like an actual lemon biting), but rather other things have taken on the full presence and meaning of that past event (or past biting of a lemon). A mere sound, symbol, reminder, image, flash, word, memory, taste, smell, or touch can each unleash a flood of reactions in ourselves.

     For example, after a combat tour in a foreign land, a Veteran reacts to fireworks in a peaceful suburb as if they indicate gunfire. A victim of sexual assault experiences terror with a certain cologne scent. A survivor of a car accident jumps every time tires screetch. Someone who was cheated on can't help thinking every text their partner gets is from another lover. 

     We know over-reactions are happening if we can imagine a cat or dog watching us and wondering what just happened, what we are reacting to (other than the fireworks and tires screetching, they may not like those either). Today, texts, emails, and letters have the power to trigger heart attacks! Songs and movies can unleash a flood of tears. An unexpected touch can cause conflict and damage a marriage. Yet all these things exist as mere signs, gestures, or symbols and are not harmful in themselves; the most a letter can do in the immediate present is give you a papercut. 

     We are not naïve to the fact that a letter may announce the death of a son, or loss of a job, or foreclosure of a home. We will get more into the topic of the actual content of letters and emails later. 

     For now it's important to consider that most letters we receive are not very important, and many are even junk. I want to help you not be at the mercy of extreme reactions that can easily and unfortunately become prompted by ALL mail, or ANY letter from a bank, or any crowded store, or the color and brand of car, or hospital waiting rooms, or sirens, and many other things that tend to become EQUATED with the bad experiences themselves.

Understanding the Body's Reactions to Perceived Loss and Threat

     For most animals, survival often involves escaping, fighting, or playing dead.

The first 2 options, "fight or flight," require muscle.

     Well, it turns out muscles need 2 things: adrenaline (think gasoline)   and oxygen (think any fire needing air). 

     It's no coincidence that you start panting when you run: that's your brain telling your lungs to get more air into the system.  

     Under extreme stress your brain commands for abundant air and adrenaline to be shoved into the bloodstream as quickly as possible (think highway or river system). 

     Next, the brain commands the heart to beat like crazy so the blood can deliver the goods out to every muscle. 

     Soon the "engine room" calls up to the brain and says the pace cannot be maintained, that the system is overheating and may soon collapse. The brain then commands opening of the pores, to begin sweating and reducing heat. 

     The whole process is actually very coordinated, not random at all.

     Sometimes there is an "override" command to not move a muscle, to simply allow another organism to do what it wants, as a path to survival. If that works then this "freeze" response tends to repeat later in life since the brain will not change a formula that resulted in survival -- which often leads to revictimization experiences.

     It is not uncommon that a child freezes or appears to cooperate under abuse, and later blames themself for not fighting or yelling. Or they become an adult who yells and fights when they wish they wouldn't.

     It's important to remember that often these are not choices made in the conscious brain. Neither is laughing when tickled; it's just a reaction, and not necessarily a sign of enjoyment.

     Under duress, our brain's "frontal lobes," which do our rational thinking, are basically "hijacked" by the lower brain when a situation is perceived as life-or-death.

     Yet many of our reactions are actually prompted by false alarms. Not every fire alarm turns out to be accurate.

     We need to learn to slow our reactions until levels of threat and problems are verified.

There are at least 5 types of false alarm.

     1. Simple misperceptions, like mistaking a hose for a snake. We need to learn to stop and get a second look. 

     2. Reminders and anniversaries of heartbreaking or threatening situations. Reminders can be music, TV, movies, and many sounds, smells, visuals, tastes, and touches, plus anniversaries of events. Our event is not re-occurring, but our brain confuses the sounds or images as if they are indicators that a new loss or event is upon you. We need to point out to ourselves that we are simply watching or listening to a story, and remind ourselves of where we are and what we are doing right now (vs. what was occurring in the past). 

     3. Nightmares can trigger these reactions, such as waking up sweating or with our heart pounding. Often the lower brain cannot tell the difference between what is being experienced currently or simply in memory or dreams. 

     4. Modern "30-day" problems. These come by email and regular mail, with bad news from a bank or landlord or employer. Are they problems? Yes. Are they in-your-face threats of life-and-death? Not usually, and so they are not best solved by muscle and adrenaline. In fact, we need our frontal lobes to think clearly, consult advice or resources, and solve them. But our lower brain often gets tricked into regarding them as matters for fight or flight.

     5. Fear of physical distress itself. Our brain is like a rumor mill. A person can absent-mindedly run up a flight of steps, then think they are having a heart attack rather than acknowledge the very recent sprint. Another part of the brain seems to hear this concern ("I must be having a heart attack!") and starts reacting for survival. Then another part of us observes that and believes death must be coming, so it works to do something but without any clear direction of what is actually needed. The human being conscious brain needs to step in and tell everyone to calm down, take deep breaths, and lean on something or sit down until the heart returns to its normal rate.  

     This knowledge, and exercises like the ones below, have helped many, many people learn to de-escalate from fight/flight/freeze and thus allow their frontal lobes to make more optimal, conscious choices.

     The opposite is to "give in" to knee-jerk reactions, which usually involves some kind of escape or avoidance, which then actually extends the problematic pattern. This will be explained more below.

Module 2c. Calming Exercises to Practice and Make Routine

     Naming past events may have been distressing in itself. The reactions identified previously are not random or without explanation. They are logical responses to perceived major threats. The reason they occur is that when your "lower" or autonomic brain perceives a major threat it begins calling the shots for survival. Those preparations are far from comfortable.

     One of our main goals is to reduce such reactivity to all of the above, and we are providing tools and experiences for that to occur. We will not be able to delete any memories, but with these exercises many of them can end up like the couches in our living rooms: still large yet barely noticed as much.  

     In preparation for interacting with disturbing events of the past, practice learning to do each of these. They are all ways to break out of fight-or-flight.

     1. When your breathing feels constricted, or like you are holding your breath, practice pushing out long exhales for 15 seconds. Use your stomach muscles. You are bound to then get good, deep breaths to refill.

     Involving the stomach muscles may be why the ancients said laughter is the best medicine. Forcing a "reset" at our gut level can be very helpful. It certainly contradicts the feelings of worry and anxiety.

     2. Break out of tunnel vision, blur, etc. Look around and name the objects you see. This can be for anxiety or road rage, flight or fight. It helps to get your attention away from your worries and away from a singular source of anger. By identifying ordinary objects that you see with your eyes, your brain begins to realize there is no immediate danger. Normal breathing then tends to resume on its own.

     3. Do not ignore thirst. Drink cold water. 

     4. Do not ignore your temperature. Blast the air conditioning if you can. 

     5. Address tense muscles. Stretch your jaw, neck, shoulders. Rub your eyes. Go for a walk. These are all incompatible with the belief that your life is in danger, and so your system will calm down. 

     One exercise I love for my stiff or sore neck muscles is to sit up straight and allow myself to feel the full weight of my head (first check with a doctor, chiropractor, or physical therapist if you have injuries or damage in that area). For this exercise I never need another "dumbell;" mine is built right in; human heads weigh about 10 lbs. I then add a little bounce from my hips, and preserve the goal of not using neck muscles and letting them stretch. Then I rotate my head slowly and send up tiny bounces from my hips, giving my head a chance to stretch the muscles all around my neck and shoulders. I keep breathing throughout, and usually stretch my jaw and eyebrows in the process.

     Sometimes I follow this up with lifting my shoulders for 15 seconds, as if try to get them to reach my ears.

     Or I will stand in a doorway with one hand on each side of the frame and lean in, causing my shoulder blades to almost touch. I find those stretches helpful and soothing.

     If your leg is shaking, challenge yourself to shake it even faster for a minute. This tends to use up the adrenaline that was released. It may take more exercise than that, but try not to do much cardio at the end of the day since it may interfere with sleep.

     6. When your thoughts are racing it can help to repeat the phrase introduced above, "Yes I am uncomfortable, but I am not in danger." Say this to your lower brain many times.

     I encourage you to set alarms or use other reminders to remember to PRACTICE these when you do NOT need them. If left untrained, you will probably not remember to use them while you are in a fight-flight-freeze state. As an example, imagine not learning how to load bullets into a gun until you're actually in a battle; with all that noise and danger you would probably be dropping most of them, plus have questions about whether you are doing it right. These things should be practiced while calm so they become second-nature. 

The Problem with Flight from False Alarms

     If something launches you into fight-or-flight, and you deal with it by escape, avoidance, keeping busy, getting high, or any method other than staying put and letting adjustment occur, then your lower brain is going to believe your escape-behavior saved your life. 

     Why is this? Because all it knows is that you had stopped breathing, or your heart was pounding, or you were sweating, and by removing yourself physically or mentally you then started to feel better. It's hard to not want to repeat that the next time.

     The problem with this pattern is that your were not in actual danger, so the myth of lethal danger from that memory, or smell, or image, or idea, is kept alive and well by "giving in" to the misperception or other miscalculation of threat. Our puppy brain is saying, "Get me out of here!" and the intelligent human brain needs to say, "No, it only feels like we're in danger. We can get through this."

     After a while, the urges to run and hide become weaker and weaker, and the person starts to have trouble believing they ever used to be afraid of such things. It's life-changing.

Moving into Module 3

     The above exercises will be especially helpful in the third module as the person is challenged to confront emotions themselves that can be unpleasant. The above techniques can help with staying put and allowing the needed adjustments to happen in our mind and body.

     In theory, during Module 2 you learned about over-reactivity to what are essentially false alarms. New dangers need to be confirmed or disconfirmed, and past losses and disturbances need a different response.

     We also discussed how the pattern of sudden high distress in the context of a memory or sensory experience can continue for decades for the simple reason that, by running away or getting high, we never give our brain a chance to learn that memories and emotions are harmless. 

     By allowing memories, images, feelings, and more to come and go, WHILE staying put, taking deep breaths, looking around, drinking cold water, and stretching tense muscles, we are then able to retrain our brain to no longer believe escape is necessary in order to feel relief. And the relief we experience becomes longer lasting and skips the harmful side effects of escape-based coping mechanisms.

     It's time to stop letting our brains celebrate for getting us out of situations that turn out to be mere reminders, images, symbols, or anniversaries. Was the person's suffering awful in the past? Yes, we are never questioning that. But the lower brain's reactions show that it believes there is a new event happening, a new loss, a new disaster, a new setback -- not simply recalling a prior one. That is an unnecessary roller-coaster.

     Before we get into education and exercises specific to adapting to painful feelings, please complete the next two questions.

About Feelings and Emotions

     Feelings and emotions are like customers. If they are ignored, blocked, or kept waiting they will keep ringing your bell and trying to get your attention in other ways. And they are certainly not going to let you sleep, concentrate, or go about a normal life unless you at least say hello and acknowledge them. Many of them actually settle down a bit if they know you are going to attend to them. They don't even always have to know when, some will take a number and sit down! The really important thing is to welcome them and get used to having them around. Other efforts end up costing you far more than you may realize. And people in your life suffer the consequences.

Remember the Lemon Exercise

     During our introduction of the lemon exercise there was no actual lemon in the room, and yet many of us were led to salivate at the words used to visualize and imagine biting into a ripe, juicy, tangy lemon. Maybe it just happened to you now, as it did for me in writing this. Yet that effect will not continue to occur if the words are repeated over and over and no real lemon ever follows. Try saying, "Lemon, lemon, lemon, lemon, lemon, lemon, lemon, lemon..." up to 50 times! Are you still salivating after even 20? Usually not. Why? Because if the saliva repeatedly goes unused your brain starts to wonder, and then it stops anticipating that an actual lemon will follow that word. This only happens if we stop running away and just stay there.

     Similarly, the exercise below is designed to put you in contact with various feeling and emotion words which at first may stir actual feelings and emotions. And yet the fact that there is no new injury or loss occurring today will help train your lower brain to understand that there is no need for the fight-flight-freeze mechanism to occur. 

     NOTE: This exercise is not intended for use by people who are still in actual immediate danger (e.g., living in domestic violence). It is for reducing the power of words and symbols to evoke unnecessary reactions in people who are SAFE but experiencing distress from what at this point are distant threats or possibilities, memories, images, sounds, smells, tastes, touch, or anniversary dates.

End the Reactivity to False Alarms

     The goal is to end the lower brain's confusion that is resulting similar levels of intense reaction whether experiencing an actual loss, assault, or other disturbing event versus now only experiencing a memory, anniversary, or other representation of such an event.

     As the person does the exercise below they may need to stop occasionally and take deep breaths, look around at their environment, stretch their neck or jaw, rub their eyes, use tissues, or remind themselves that the events were in the past and are not happening all over again. 

     This process of recalling the past, then stopping and recognizing the present, then recalling the past again, then acknowledging the safety of the present has helped a lot of people to finally stop this pattern of depleting all their internal resources on false alarms.

     Adjusting to the presence of strong negative emotions is much like introducing a puppy to a new guest. At first the puppy is very suspicious and guarded, but by reassuring the puppy and allowing the guest to comes closer and even pets it, little by little the puppy adjusts, and our brains can do so as well.

     The need to hang in there during the initial discomfort is similar to when starting a new exercise routine. The lower brain may object at first to the new rapid heart rate — and beg you to stop. Yet with time and repetiton comes a healthy conditioning of the heart and lungs.

Instructions

     In the exercise below, the person should be instructed to choose any and all emotion words that help express feelings they felt when the event was actually happening, or that they felt soon afterwards, including with how it was handled (if applicable).

     Even if a feeling was only slight (e.g., 5%) it should still be included. It is better to include more words than only a few. Some may seem redundant but they usually express nuances that are important for our brains to acknowledge.

     Have the person complete the following sentence with as many words as fit, even if only a little.

     By now the person you are helping should have learned and begun practicing exercises for de-escalating from fight-or-flight reactions that get prompted by memories, emotions, and worries that do not involve actual immediate threats. 

     In addition, they should have experienced naming the many emotions that came with their 1-2 most distressing events. In that process they should have experienced staying put and slowly recovering from escalations of fight-or-flight reactions.

     Now we turn to ways in which our interpretations of events and the meanings we attribute to them can negatively affect our present and future. 

When a disturbing event or trauma does not heal with time, one contributing factor is often that the event has changed our way of seeing things.

     For example, perhaps we had never worried much about safety before the event. It's not that we were careless, but perhaps we had confidence in our ability to stay safe, and had a fairly balanced approach to evaluating situations. Then something terrible happened and we find ourselves constantly feeling vulnerable, regardless of actual circumstances; we can lose our ability to evaluate threats in a balanced way. Small risks can seem major.

     A change can also come in the form of solidifying an extreme view that was already in place. For example, we can be left saying about an assault, "It serves me right for thinking I could leave my door unlocked for five minues. That will teach me!" In that example, we interpret what occurred as proof that our original perception was correct, no matter how unusual or extreme. It may be the only time something like that occurred in that town in 30 years but we can no longer differentiate between risks in that town versus a city that has crimes occurring frequently.

     This is trickier territory than it may seem at first.

As human beings we cannot help but frame things.

     The term framing comes from painting and photography, in which there are literal edges that include some things and exclude others. Low budget filmmaking relies on careful framing so we don't see cars or telephone poles in movies about King Arthur. That is not a problematic use of framing.

     Yet sometimes framing is used less innocently. Have you ever gone to look at a house or a business that has a gorgeous building in an ad or website, only to discover that the inside or the area around it is in major disrepair? Would your impression remain the same, or would you feel like they weren't telling the whole story, once you saw beyond the frame of the photo?

     Our brains are selecting information all the time. This is helpful most of the time. For example, in a noisy restaurant we can usually still pick out what a friend is telling us, and treat other conversations as "background." Similarly, our eyes (or really our brains) are continually differentiating between foreground and background.

     Yet disturbing events can affect our effort to accurately process information. We can suddenly start to think every noise is a sign of threat, or that every possible possibility is as equally likely to happen as not, and we disregard (or filter out) important information that formerly helped us determine the difference.

     For example, U.S. military Veterans with untreated combat PTSD tend to react to small town July 4 fireworks as if they were back in combat. In those moments their brain is unable to differentiate one setting from another. In addition, that person is typically unable to go to stores during crowded hours because they get overwhelmed by the number of possible threats they calculate or believe are just out of sight. Plus they worry there just aren't enough exits within easy reach. Yet most other people function just fine in completing such mundane errands like shopping. The difference is not in the actual environment but in how our brains view or frame situations, which is affected by our past if that tendency is left unnoticed or unexamined.

     Of course, we are not ignorant of the fact that for some people, a visit to Walmart or an elementary school has resulted in injury, death, or loss of others. Those events in some communities often make many of us fear similar environments in our own. 

These exercises are not designed to lull you into a false sense of security. They are designed to promote noticing, identifying, and examining extreme assumptions and conclusions that can rob us from positive and generally safe things in life.

     The point may be made more clear (or less debatable) by using a positive example. Imagine you had a friend that became so enthused with the lottery that they quit their job and bought some phenomenally luxurious real estate before winning anything. Most of us would believe that was premature, even if they pointed out that three family members had recently won big.

     Each of us is like a judge or jury. It is the job of opposing lawyers to present information and try to sway belief. Many of us are left not knowing what to believe. Yet we have the power to question whether we have all of the information, or only pieces. We can question.

     Often we also need to make peace with the reality of not having clear answers to all our concerns. Using "odds" or "likelihoods" is one "life-hack" many of us apply to uncertainties. Surgeons use that all the time; they cannot guarantee the success of a procedure, but they can offer a track record. Many decisions require gathering data, and in that process it's also important to question the quality and sources of that data. 

     The following exercises are designed to help people add rigor to how they interpret their experiences, what they take as knowledge, how they estimate threat, and what doors to potential happiness they may be closing prematurely.

     The author's beliefs about the above are 1) fact, 2) opinion, 3) guess and feeling, 4) habit and guess, 5) guess, 6) opinion, 7) opinion, guess, habit, feeling. Hopefully we at least agree that only one was a fact.

     The above is not meant to stir debate but rather to prompt rigor in thinking. In contrast, to allow one's thinking and perceiving to cruise on "autopilot" can lead us down unnecessary dark or painful paths. We can learn to catch, question, and correct our perceptions and thus suffer less in our reactions. 

     Even though we intellectually grasp that many things are false alarms, it can be hard to not jump at the sound of firecrackers, or for a domestic violence survivor to not shiver when hearing loud arguing and banging sounds.

     Intellectual understanding is not enough. We need retraining. This can be accomplished by the same process we used for "getting used to" negative emotions. Both involve a kind of "wearing out" of the reflex system.

     As a young boy, I used to hang out and help at a Park Police horse stable; they used horses to patrol the large beach and park area near my home. Many of the horses were retired thoroughbreads that had been retrained for police work. One part of that training involved making it impossible for a horse to move away, whether by leash or small enclosure, and repeatedly firing many blanks from a gun. Eventually the horse would stop reacting to that sound since experience taught it that nothing harmful would follow that sound. The expectation of harm became no longer associated with gunfire.

     That is not an easy process to experience. Yet it works. Another example is playing a game in which you and a friend take turns trying to slap or avoid the hands of the other. The "slapper" has their hands hovering with palms facing up, while the "avoider" keeps their palms face down hovering over the slapper's hands. Since the avoider gets penalized for every false move, little by little they get better at not reacting to every little flinch by the slapper. That is a very close representation of what the exercises in this module can accomplish. 

     Be confident that, despite initial unpleasantness, human beings can acclimate to all sorts of things. Consider that people can even work in a morgue despite the horrific smells that would turn any newcomer away. With enough time we acclimate, unless we interrupt that process by keeping away. We need opportunities to learn and practice, much like in the hand-slapping game. 

      Fortunately, some acclimation can even occur entirely by imagination, without needing the actual object present. Simply making the list below may be produce some of that effect, depending on how vividly you choose to imagine and sit with the sights, sounds, etc., related to your distressing events.

     Be sure to use deep breathing and even stretch your neck as you do these, to contradict any belief that you are in danger.

What to do about the above.

     In order to reduce our reactivity to the above, it can be helpful to intentionally and safely experience the sights, sounds, smells, tastes, and touches that affect us.

     In addition, it can help to "spread out" the when and where we experience them. The goal is to break up the current pattern by which a certain sensory perception or calendar day is only ever associated or "locked in" with a horrible event. It helps if things like ambulance sirens can become associated with all sorts of things, hopefully even positive things, like someone being rescued. 

     People used to jump at the following before we did this work together. It became a game-changer when they began to INTENTIONALLY SEEK THESE OUT, even on YouTube at first, rather than continue only experiencing them by surprise and then being instantly on the defensive. They took the offensive strategy. 

- Visuals of car accidents, torn wallpaper, films with unpleasant fights, ambulances, poilce, Black Ford Mustangs, needles, and more.

- Sounds of sirens, loudspeakers, car tires screetching, arguments, fireworks, and more.

- Smells of cologne, aftershave, gunpowder, alcohol, musty wood.

- (Very slowly, no swallowing the first few times) Tastes of pizza and other foods that initially cause a gag reaction.

- Having a partner gently touch, caress, and eventually hold them when the reactions became much weaker and touch became welcomed again. 

     Some of the above take more practice sessions than others. Most should be done several times in the imagination first so that the lower brain can already understand that these are choices you are making and that they are harmless. Also to practice remembering to breathe and stretch muscles that may begin to tense up. 

     If you do not choose to pursue these exercises then it makes sense that you will remain caught off-guard when they occur, and probably react strongly.