Little Bit of A Touchy Subject

[Azeeza]

Hi Everyone:

I wondered if I could pick your brain for some advice?

How do you handle a student who has anxiety issues?

A particular student has had several breakdowns in class which involve crying and leaving class early. It disrupts the classroom because other students end up missing some important dance education.

Is there a good way to handle a situation similar to this?

Azeeza

 

[BetsyPage]

From personal experience with severe anxiety and mood disorder, theres nothing you can do. When a panic attack comes on theres nothing to do but try and make them breathe and sometimes just hold them and tell them everythings ok.

I would recommend private lessons and strongly suggest the student get help, because it is ONLY going to get worse. I just recently went through one of my "Downfall breakdowns" which happens when my meds arent right, so the feelings are still fresh on my mind.

Deep calming breaths that start filling deep in the belly and then your chest is the best way to calm her, but sometimes the fits are too bad to do anything but let it go.

Sometimes there's something that triggers it. Like with mine whenever I got frustated in a situation I would just freak out.

See if you can find the trigger.

This probably wont help much, but any questions you have please ask me. I'm more than willing to try to help people understand that havent gone through it themselves.

But I'll keep thinking on this and mention it to my psychiatrist and get her quick input too.

good luck!

 

[Salome]

Typically, there are signals that build or accelorate before a person experiences a full blown anxiety attack. Restlessness, nervousness, tightness in the chest... I'd ask the student to pay attention to those early signals and to remove herself from the class room, either temporairly or for the rest of the class, before the attack was in full swing.

Not to seem uncaring but in a group class situation it is really not fair for the rest of the students to go through that experience over and over. If a person is not stable enough to function in a group situation, private lessons might be more productive and flexible.

 

[PriscillaAdum]

Panic attacks are usually triggered by something specific. Different people react to different triggers. It might be helpful to place her near the door, not right in the middle of a large group of people. Many panic attack victims need to have an "escape" route in plain sight, even if they don't use it. Try not to single her out in front of the class to correct her, panic attack victims hate to feel like they're the center of attention or that all eyes are on them. I'm sure her crying episodes must leave her mortified afterwards. Allow her to take a short break about halfway through class. This helps ALOT. She can quietly slip out and go to the bathroom for a few minutes or get some coffee or whatever, just let her get away for a bit and then come back.
You might also suggest to her that if she feels that she needs to leave quickly, that she do it as quietly as possible so as not to disrupt the rest of the class.
Once she gets to know everyone better, and feels more comfortable among familiar faces, her panick attacks are likely to subside. You also might want to ask her what it is that is making her uncomfortable.


Regards
Priscilla

 

[Azeeza]

I really, really appreciate the advice I'm getting.

I've noticed that the student with the anxiety attacks seems to get them more often when it comes time to practice a group dance. It's worse when she is asked to perform the dance without fellow students. If there is any audience at all, she starts crying and walks off the floor.

We have a big performance coming up in one day. She wants to perform, but she couldn't physically in our last class together. However, she did commit to the performance the day after her big breakdown.

I wonder if she is going to have a last minute anxiety attack right before the performance and not dance? This will really not be good for the other dancers.

Sigh,

Azeeza

PS We should have come up with an alternate plan, but we thought she wasn't going to perform and now she wants too. It's a no win situation.

 

[PriscillaAdum]

Ahhh, ok. That's likely her trigger, the feeling that everyone is watching her. Poor thing.
This can be crippling when it comes time to perform. I'm sure she really wants to participate with her classmates, but since panick attacks are for the most part beyond the person's control, it doesn't sound likely that she'll be able to when the time comes. A full blown panick attack can come on in an instant, without any previous warning signals.
Can you place her in the back where she won't feel as conspicuous? If you place her in the front, you'll have a panick attack on your hands for sure.
You might want to ask her before the show if she REALLY feels she can do this, and do have an alternate plan because from what you've explained, I honestly don't think she'll be able to once she gets a glimpse of the audience.

Regards
Priscilla

 

[Aisha Azar]

Anxiety disorder

I really, really appreciate the advice I'm getting.

I've noticed that the student with the anxiety attacks seems to get them more often when it comes time to practice a group dance. It's worse when she is asked to perform the dance without fellow students. If there is any audience at all, she starts crying and walks off the floor.

We have a big performance coming up in one day. She wants to perform, but she couldn't physically in our last class together. However, she did commit to the performance the day after her big breakdown.

I wonder if she is going to have a last minute anxiety attack right before the performance and not dance? This will really not be good for the other dancers.

Sigh,

Azeeza

PS We should have come up with an alternate plan, but we thought she wasn't going to perform and now she wants too. It's a no win situation.

Dear Azeeza,
I suffer from anxiety disorder and have since my early 20s. It is a horrible thing, and anyone who has never had an anxiety attack can not even begin to imagine what it is like. However, this girl seems to be more about phobia than anxiety. She seems afraid and threatened by things you want her to do in class. First, she should go to her doctor and make sure there is no organic cause for her issue. I have anxiety disorder because I have a problem with my mitral valve in my heart. It turns out this is pretty common in people with anxiety disorder and it is a physical ailment, not a psychological one. there has also been some findings that support the idea that certain phobias MIGHT be caused by an ailment in the inner ear.
Now.... as a teacher, you have to think about what is good for the class and what is not. You might ask her if she has any phobia issues that she is aware of and ask her to please quietly leave the class before things get to the really awful stage if that is the issue. I agree with Salome about this. And, as far as performing, I am not sure she is ready right now and it would be unfair to the rest of the class to have her freak out at the last minute. I say this from an understanding of what it is like to have anxiety and from a teacher's point of view. You want thnings as good and calm backstage as possible.
Regards,
A'isha

 

[belly_dancer]

Hi... I have not had panic attack students... but I have had tempermental, flaky, unreliable, students..., students gety sick all the time, students with unreliable transportation, students who may be on call during a performance time...
& what I do with them is place them in a place where it will not matter to the integrity of the choreography, or throw off the other students.. sometimes this means they cannot be in every dance.... I try to gently explain to them, that I have made extra effort to include them, but ultimately it is not fair to the other students....
I say something like,
"Jenny, you've been sick alot lately ( missed class alot, whatever), & chances are high that this may happen during the performance.... the other students are nervous enough already, & need to practice consistently in the formation we will use on stage, so I have needed to make the decision not to include you in this dance.. however I DO want you to come th rehearsal to learn it for a later date.... ALSO there is a space in dances #2 & 3 where I could put you in which your absence would not throw off the other students...."
& with your student.... it sounds like it is too late to include her for this show????
maybe you could gently say something like (in private of course!).... "I am sooo sorry it is my mistake.... but every time I mentioned performing, you burst into tears, & ran from the room, so I just assumed you did not want to perform.... , now it is too late FOR THIS SHOW... but please come to rehearsal to learn the dance for a future show!"
& I don't know,,, maybe you could give her a job in the show (sort of "non-essential", in case she cannot do it... I had a super shy student once & this is one way I sort of eased her into it..) like placing props on the stage, or something... so she could at least get used to walking up there in front of people...
good luck... it is great that you are so sensitive to the needs of others...

 

[Azeeza]

This student has other stresses going on outside of class too, but I don't know all of it, just some of it. She has gone to the doctor and is supposed to be on medication, but isn't taking any right now.

She so badly wants to perform and she has, but the idea of her peers being the audience has her freaked although she did tell me that she prefered dancing for people she knew rather than not. But, like I said she performed, a solo, none the less, for people she didn't know.

As far as the line up is concerned, she will be in the back, so hopefully she won't lose it at the last minute. We are all keeping our fingers crossed.

Azeeza

PS We do have a small adjoining room in the back of class where she can be alone. The next time this happens, I think it wise if I show her the room and have her sit and calm down. But, I can't really babysit her when there are other students in the class. Perhaps some small calming words, such as, "Take all the time you need and when you feel ready to join us, please do." Does that sound good?

 

[BetsyPage]

This student has other stresses going on outside of class too, but I don't know all of it, just some of it. She has gone to the doctor and is supposed to be on medication, but isn't taking any right now.

She so badly wants to perform and she has, but the idea of her peers being the audience has her freaked although she did tell me that she prefered dancing for people she knew rather than not. But, like I said she performed, a solo, none the less, for people she didn't know.

As far as the line up is concerned, she will be in the back, so hopefully she won't lose it at the last minute. We are all keeping our fingers crossed.

Azeeza

PS We do have a small adjoining room in the back of class where she can be alone. The next time this happens, I think it wise if I show her the room and have her sit and calm down. But, I can't really babysit her when there are other students in the class. Perhaps some small calming words, such as, "Take all the time you need and when you feel ready to join us, please do." Does that sound good?

that sounds like a great idea.

as far as the performance goes... just keep your fingers crossed and hope for the best!

*positive thoughts being sent your way!*

 

[PriscillaAdum]

I think its very kind and thoughtful of you to be concerned about your student's needs. Most people who've never had a panic attack or suffered from a phobia such as agoraphobia, don't understand how terrifying and humiliating it can be, and they're usually just baffled by a panic attack victim's sometimes odd behavior.
You might want to point out the back room to her before it happens again, so that she knows beforehand that there's a "safe" place for her retreat to if she feels the need. After that, there probably isn't any need to say anything else to her, as she'll know when she needs to use it. And you're absolutely right, you cannot be a babysitter either.
On the other hand, if none of these measures help her, and if her panic attacks (or phobia) continue and/or are so severe that they are disruptive to the rest of your class, then private classes might be a better idea.

Regards
Priscilla

 

[Azeeza]

I think its very kind and thoughtful of you to be concerned about your student's needs. Most people who've never had a panic attack or suffered from a phobia such as agoraphobia, don't understand how terrifying and humiliating it can be, and they're usually just baffled by a panic attack victim's sometimes odd behavior.
You might want to point out the back room to her before it happens again, so that she knows beforehand that there's a "safe" place for her retreat to if she feels the need. After that, there probably isn't any need to say anything else to her, as she'll know when she needs to use it. And you're absolutely right, you cannot be a babysitter either.
On the other hand, if none of these measures help her, and if her panic attacks (or phobia) continue and/or are so severe that they are disruptive to the rest of your class, then private classes might be a better idea.

Regards
Priscilla

Thank you.

I just hope it works and she's able to continue taking classes because this dance means a lot to her.

Azeeza

 

[Shanazel]

Last time I looked at my college degrees, none of them said anything about psychology, but I cautiously agree this sounds more like a phobia than panic disorder (where are you, Bronnie? Feel up to some long distance diagnosing?)

Panic attacks are usually triggered by something specific.

I've been dealing with anxiety disorder as long as A'isha has (wouldn't we have been great college room mates?) and my attacks usually come out of nowhere for no apparent reason. Azeeza'a student sounds like she is specifically terrified of having an audience of any kind. Some people overcome phobias by gradually exposing themselves to what they fear and building up a sort of emotional immunity to it. I'm not sure, however, I'd want someone to utilize my classroom to gain immunity until they had a little control, at least. I'm a reasonably compassionate person, but like I said: no PhD in psych is hanging on any of my walls.

A couple of years ago, I had a wonderful student who loved belly dance and did well, but would occasionally be visited by the anxiety monsters from out of nowhere. She led a very stressful life, which didn't help, but bless her heart, she usually managed to hold it together long enough to get out of the studio and out to her car. She eventually quit coming, but every semester, I hope to see her in class again.

I wish you and your student both a happy ending, Azeeza.

 

[Azeeza]

Shanazel:

I'm hoping things will work out for this student too.

She has some emotional issues as well as some stress and phobias and anxiety issues. Gosh, that seems like a lot all of a sudden when I write it down!

If the dance goes away from her life, she may curl up into a little ball and not ever come out. She loves it so much. But, the class sort of comes to a stand still when she has a breakdown and we can't have that. It's not fair to the other students.

Hopefully, the ajoining room will help when she starts crying and wanting to leave and hopefully the performance goes well.

YIKES and big hugs to you,

Azeeza (is there a scaredy cat face I can find?)

 

[adiemus]

Hi there
Yes panic disorder, phobia and 'agoraphobia' etc are all part and parcel of an anxiety disorder. They occur to anyone and everyone, and lots of people live with the worry that they will have a panic or similar in public where everyone will see them.
The main treatments are:
Good medication usually one of the SSRI's or antidepressant medications which will help reduce the biochemical problems
Sometimes for short term panics people are put on bupropion, or propanolol which reduces the heart rate...
In addition, almost all anxiety disorders respond well to cognitive behavioural therapy including working with the thoughts that lead to panic symptoms (increased heart rate, respiration, sweatiness, tremors etc)... plus direct management of those symptoms by doing breathing training, relaxation etc.
And finally, working to actually expose yourself to the things that you fear, while not allowing yourself to leave before your anxiety symptoms drop.

This shouldn't be YOUR job as a teacher to manage - she needs to learn how to cope with the symptoms with the support of a good psychologist or mental health occupational therapist.

There are some things you can do - help her remain in the room with the other students, but not making a scene... reminding her that she is in control and that she can cope by breathing OUT slowly (we always breathe in, but when we panic we just don't breathe out!!).

She sounds like she has a social phobia which develops from an overdeveloped (and inappropriate) sensitivity to 'what other people will think', so it might be good for her to need to stay in the group during class, and have other people in the class be primed to say that she's doing fine...

BTW most of us would recognise this in ourselves just before a performance - it's normal to be aware of 'what might happen if things go wrong' and how 'horrible' it might be!! The difference is that when we have an anxiety disorder our bodies just go waaaaayyyy overboard and the physiological arousal kicks in which only propels our negative thoughts even further!!

There is a great book called 'Performance Anxiety', I can't remember the author, it's got some great ways to learn how to cope with this problem. The best thing is that it can and does respond well to treatment, and most of us only get troubled by it intermittently. this site: WebMD Anxiety and Panic Disorders - Find panic disorder and anxiety information and latest news. is quite a good one, and this one: Anxiety Attacks and Disorders: Symptoms, Types, and Treatment

Cheers
Bronnie

 

[KuteNurse]

Shanazel:

I'm hoping things will work out for this student too.

She has some emotional issues as well as some stress and phobias and anxiety issues. Gosh, that seems like a lot all of a sudden when I write it down!

If the dance goes away from her life, she may curl up into a little ball and not ever come out. She loves it so much. But, the class sort of comes to a stand still when she has a breakdown and we can't have that. It's not fair to the other students.

Hopefully, the ajoining room will help when she starts crying and wanting to leave and hopefully the performance goes well.

YIKES and big hugs to you,

Azeeza (is there a scaredy cat face I can find?)

Azeeza, my desk at work is right next to someone who has anxiety and depression issues. I totally understand what you are going through and how difficult this issue is to deal with. Everything everyone else has suggested is great. I focus on positive...Which is what you are doing. Not kicking her out of class etc. When we lose our human compassion for these issues, things get out of control for these people are caused more pain than good. However, her interruptions for her classmates should be at a minimum. Would you feel comfortable pulling her aside and telling her how much you enjoy her in your class, say other positive things, but then tell her you are concerned for her about her health and you think she should be using her anxiety meds? Also, if she has a friend in your class, perhaps they can sit with her in that quiet room when she has an attack? She probably should not be left alone in that state.

My coworker cries on a daily basis when the tiniest little problem comes about. She simply cannot deal with more than one thing at a time. I do try to help her when she has trouble, but when I am busy myself, this makes my job very stressful. She has a family history of severe mental illness and I see her spiralling downhill fast. All you can really do is be supportive and caring of the problem, but the problem should be addressed in a kind and caring way. If the problem is not dealt with, that is when trouble begins. Good luck to you and I will look forward to hearing how things happen.

 

[adiemus]

The shame is that so many of us have mental health problems, and it's so often a difficult thing to admit to, and many people who haven't had the experience can be unforgiving and critical. I've had depression treated by meds for 26 years now (I'm 43) and without the medications and the therapy I wouldn't be here today - and it's people like you guys who make it easier to deal with, especially the compassionate way you've been talking about helping this person cope in the class (and Azeeza for raising the issue in the first place).
When we deal with a mental health problem, we are reminded of how fragile our humanity is, and how special. Although I wouldn't say I am grateful for having depression, I have learned a lot about myself that I wouldn't have any other way...

 

[Azeeza]

Awe, thank you.

The student performed to the best of her ability and everything went smooth as silk. She was a trooper and her whole mind set was positive.

I'm so proud of her and the rest of the girls! Everyone looked and performed fantastically!

Azeeza

 

[adiemus]

Great to hear Azeeza! That must have been an incredible step for her to do - and wow! your encouragement must have made a real difference.

 

[Reen.Blom]

This is so great to hear! I am really glad that she managed.... I really felt sad about her... it must be horrible to be an outcast.... :-S She is very brave and you really gave her the right support!

Blessings,
Reen.blom