“Watch out for my leg.”
I could barely make out Rob’s words over the crashing roar of white frothing river all
around us. We were an odd pair: me, clutching a paddle and shivering in second-hand
rain gear, and Rob, a red-bearded pirate, with gleaming white teeth, eyes scanning the
water ahead. We sat on opposite tubes of a two-person raft, our legs wedged inside, and
paddling arms extended out. Jammed with us in the tiny raft were a small tote with cans
of beer, wallets, and other essentials, and Rob’s leg, an aluminum and molded plastic
prosthetic attached to his stub of a leg that enabled him to walk on land. The tiny raft
hurtled down the river at a speed that made the dense Appalachian jungle canopy blur
into a steady stream of green.
Readjusting his prosthetic, he said, “Just don’t push on it too much, if it gets stuck I’ll be
It wasn’t the first time Rob had convinced me that I would enjoy a trip with him. Over the
years together we had climbed, biked, and canyoneered our way around the mountain
west, and many times I had found myself in completely uncharted territory, following the
red beard into some crucible of the wild.
The river has titles for its apotheoses: names like the Iron Curtain, Lost Paddle,
Shipwreck, and others, hint at the consequences of the rapids that twist and groan
through labyrinths of rocks. The consequences of making an error here are always high,
and a fatality the previous day was a sobering reminder of the danger of falling in the
water and being trapped in the rocks beneath.
I was reflecting on this fact as we skirted a benign-looking rock early on our first day on
the river. Most of the rocks on this river are composed of limestone, and have been slowly
carved and polished for eons. Many are undercut, meaning rocks that look round on the
surface often hide a cavernous snare underneath, and currents will swirl, boil, and dive in
confusing patterns. Our raft barely kissed the rock, but the brief sideways momentum
gave the river an opening to grab ahold of the raft, and Rob’s side was devoured in a
I had enough time to notice Rob, experienced boater that he is, grab the stayline on the
bow of the boat so that even if the boat flipped, he would have a hold of something
floating. I had no such instinct, and as Rob’s side of the boat suddenly sank straight down,
my side engaged in an equal and opposite force. From my perch on the outermost edge
of the boat, I noticed butterflies in the pit of my stomach from the G-force of being
catapulted vertically, up and over Rob. For a brief moment, at the apex of my flight
between gaining altitude and crashing back into the river, the blur of the misty forest
canopy stopped, and I could almost make out the individual leaves in oak trees along the
bank as my body completely flipped upside down in the air. Next, I was submerging head
first into the river.
Down, dark, muffled, violent. The water seemed to stretch me into three directions at
once, before changing its mind and somersaulting me, squeezing all of the air out of my
lungs. Then quiet stillness again. My hand brushed a rock, barely, but through the brief
contact I noticed the high speed at which I was actually traveling. Time passed, and there
was still no sign of light, just a dull, green hue. I wondered how long the river might have
my body, and if it would ever let me go.
I became aware that surfacing was not the only inevitable outcome of being underwater. I
did not seem to be on track to surface any time soon, and I desperately wanted to. I was
running out of air. I began to alternate how I held my body, from curling into a fetal
position to fully extending every limb, taking every chance I could that some movement
would snatch an aberrant current and pull me in a new direction. Doing so, my hand
chanced upon something smooth and cylindrical. It was the leg. Rob’s leg was still
attached to his body, and he was still holding onto the floating raft. As I held onto it, I
could feel Rob on the other end pull me back to the surface. The river had let me go.
After both of us safely got back in the boat, I asked him, sputtering, “What was that rapid
“Nothing, that one doesn’t have a name,” came the reply.
The harrowing experience I had just encountered was so insignificant that it did not even
merit a name. I caught my breath, and grimly, my attention turned to a crescendoing roar
as we rounded the next bend in the river. We were rapidly approaching the first actually
named rapid, a class five. Then I noticed the onset of a familiar feeling. My heart began
to pound, rhythmically and hard. Breaths became shallower. I felt as though someone
were sitting on my chest, and my thoughts became disorganized; they were fast, but
scattered, and fearful. I suppose fear is the right word, or possibly panic. To be honest,
knowing the exact right word felt very irrelevant in that moment.
It was actually a very familiar feeling for me. It was the same exact feeling I have had in
situations of public speaking. I am well acquainted with this feeling from uncounted
group experiences with colleagues at workshops, conferences, meetings, and so on. If
the group is going around in a circle, no matter how present I am with whomever is
talking, I frequently have found this same feeling show up about 2 or 3 people ahead of
me in the queue: a pounding heart, difficulty breathing, and even more difficulty organizing
my thoughts or verbalizing them.
Having been in mental health for over a decade (indeed a relatively short time compared
to some folks I know), I have been exposed to several schools of thought about how to
approach this. Cognitively oriented approaches have described this kind of issue being
one of thinking, that if I can change my perspective then I can change this feeling.
Dutifully, I have reframed these experiences: no-one present is going to hurt or judge me,
any contribution I make will be just fine, and realistically in the moment I have no need to
fear. Mindfulness and body-centered approaches would name that this experience is one
of fight or flight, and that if I just use deep breathing with long exhales, or box breathing
alternating between holding my breath between inhales and exhales, then I would be able
to return to my parasympathetic nervous system and therefore feel calm. Several trauma
based approaches would invite me to resource by imagining myself in a pleasant
experience and draw upon the feelings associated with that.
I must say that I have really worked hard on this piece. Not only have each of these
approaches utterly failed to influence my state when this feeling arises, I was always left
with a complicated additional piece to hold (the “second arrow,” as one person I’ve worked
with calls experiences that have a second piercing wound): somehow I wasn’t doing it
right, or the tools I was told “should” work simply weren’t going to work for me.
On the river, dripping wet, shivering slightly from fear and from the cold, and questioning
the life choices that led to me being on the raft, I had a lightbulb moment. What if in that
moment I had everything backwards? Instead of slow breaths and long exhales, I decided
to take five full, but quick breaths, inhaling and exhaling entire lungfuls of air about a
second each. After the fifth breath, I took a slow breath. To my surprise, and even shock,
my heart returned to a normal, active rhythm, my breathing was slightly deeper, and my
thoughts began to organize better. It was as if I had flipped a switch. I almost couldn’t
believe it. What I had discovered was the way I was experiencing dysregulation wasn’t an
issue of too much sympathetic activation (often associated with being in fight or flight),
but of too little. I attempted to celebrate this discovery with Rob, but I was cut short by the
raft hurtling into its first major rapid of the day, and I now remember the entirety of the trip as a thoroughly enjoyable peak experience.
Following this trip, I have recognized a few areas where this knowledge has already been
well known for a long time: several yoga exercises, including fire breath and many
exercises of kundalini yoga, stimulate the sympathetic nervous system and then return to
rest, almost like stretching a rubber band for a moment and allowing the nervous system
to snap back into place. One well-researched type of therapy advocates the use of holding
ice cubes in hand, putting ice packs on the face or neck, or plunging one’s face into cold
water as a way to stimulate the nervous system and try to bypass tendencies toward
self-harm. Even in the climbing world, rapid breaths might be used to help someone
activate enough to get through a particularly difficult part of a climb.
It turns out that often how we talk about the nervous system is not fully correct. The idea
of “sympathetic bad, parasympathetic good” is a common one, and I hear it frequently in
circles of psychotherapists, as well as in the general population if people are hip to the
autonomic nervous system. In fact we actually need both sides of our nervous system to
be balanced, and it is when we go “too far” in one direction or the other - parasympathetic
or sympathetic - that we end up feeling quite bad. I would estimate, based on the people I
see, that perhaps only half of people enter fight or flight states (too sympathetic) when
they are triggered or stressed by something in their environment. This could look like a
rapid heart rate, sweaty, cold hands, hypervigilance, stress, anxiety, and a plethora of other
symptoms. This leaves the other half of people who are in essence “too parasympathetic”: their heart feels like it is pounding, their hands might be quite warm, breaths are shallow, they may experience nausea, feelings of collapse, and certainly anxiety, sometimes with depression. This can come about from a phenomenon known as “sympathetic withdrawal”, which in more extreme cases can look like fainting or collapsing, but seems to have several lower grades as well.
Both sets of cases may appear to have the same outcome on paper: anxiety, disorganized
thinking, fear, and general dysregulation. However, it is the qualities, the nuances, of that
feeling that indicate what set of tools may enable someone’s nervous system to feel
better in the moment. Here are some of the “tells” that might help us understand this
better, and some tools that are at least worth a try:
For too much sympathetic, a person might experience any of the following: increased
heart rate, constipation, cold hands, dry mouth, dilated pupils, difficulty comprehending or
responding to verbal communication, hypervigilance, active fast thoughts, low appetite,
tension (especially in the jaw), aggressive communication, anxiety, stress. Here, breathing
in deeply through the nose for 3 seconds, and exhaling for 6 seconds, and repeating at
least 4 times, may help trick your body into slowing down and grounding.
For too much parasympathetic, a person might experience any of the following: pounding
heart, but not necessarily increased heart rate, diarrhea, nausea, fogginess, feeling heavy
chested, difficulty taking a full breath, tearfulness, disorganized active thoughts, very
warm hands, anxiety, overwhelm, depressive anxiety, and a tendency to freeze or collapse.
If you check a lot of these boxes, try taking several of the rapid, deep breaths (not
hyperventilating breaths) I described earlier. The goal is to stimulate a sympathetic
response, so imagine you are breathing as if you have just sprinted up a flight of stairs.
Alternatively, you might try taking an ice cube out of the freezer and holding it for at least
a full minute.
No single thing works for every person, although I sincerely wish something did. These
tools can be helpful to get more regulated in the moment, so that behavior and
relationships are not fully influenced by the nervous system blaring an alarm signal that
something is wrong. I’m also aware that these tools are a drop in the bucket for a lot of
people, and that actually shifting nervous system behavior in perpetuity truly represents a
much larger project. Thankfully, there is an increasing focus on shifting the behavior of
someone’s nervous system among different types of therapy . Finding a therapist that
feels like someone you can click with is crucial to this process. Fear, anxiety, attachment,
and most other issues are representative of how the brain is working, and the best forms
of therapy help someone make a change on this level.
For me, although I still occasionally get this same feeling, it has gotten tremendously
better, and an ice cube or a few breaths later I am good to go. Probably not back to that river anytime soon.