*Sarah came to see me in the grip of terrible anxiety which she had suffered for as long as she could remember.

In Sarah’s case her anxiety was very specific. She had a debilitating fear of not being able to find a toilet when she was away from home. If she needed to leave the house, even for short trips, she would plan her route around the locations of the nearest public toilets.

Even before she left the house she would start to feel a sense of panic and dread about not being near a toilet. She would go through a routine of making sure she used the bathroom before she left the house even if she didn’t really need to, and having an emergency kit with her at all times, consisting of toilet paper and an empty bottle “just in case”.

While short journeys were somewhat manageable, long journeys in the car or on a plane or having days out with the family were incredibly difficult. Consumed by anxious thoughts of not being able to find a toilet, Sarah could never relax and enjoy herself. Long trips were punctuated by frequent stops at public restrooms. Traffic delays, getting lost or delayed sent Sarah into a panic,  so much so that she would sometimes ask whoever was driving to stop suddenly so she could dash out to  find a place to go to the toilet wherever she was.

Needless to say anxiety was ruining her life. She couldn’t enjoy days out with her husband and children. She felt limited by her anxiety to the extent that it was controlling her and her entire life. There was also a deep sense of shame about the anxiety and it was not something she felt safe talking about to many people.

The first thing I knew I needed to do was find out how Sarah’s mind was trying to help her by keeping her in a constant state of anxiety about needing to be near a toilet.

It sounds bizarre to suggest that Sarah’s anxiety may have been trying to help her. But one of the absolute rules of the mind is that our minds are always trying to protect us from harm – but sometimes they do this in really odd and unhelpful ways.

I suspected the roots of Sarah’s  issue lay in childhood, most likely related to an incident where she was made to feel shame or guilt about natural bodily functions. So Sarah agreed to have a Rapid Transformational Therapy session with me to see if we could help her break free from the toilet anxiety once and for all.

Even though Sarah was keen to have RTT she was also sceptical. The only incident she could remember regarding being anxious about needing to use the toilet was in her late teens in the car with her boyfriend , when she had to ask him to pull over urgently so she could find somewhere to use the toilet. She remembered a feeling of blind panic and dread crashing down on her. But that was her only memory,

During her RTT session, however, she started to remember scenes from her childhood where she had experienced terrible shame about herself associated with needing to go to the toilet.

The most significant of these was as a four-year old girl, waking up in the middle of the night and needing to use the toilet. To get to the bathroom however she had to walk through a dark house, down a series of corridors, through several doors, past the kitchen. The corridors were dark and, to a four-old’s mind, very scary. She was terrified.

So instead, her little four year old mind came up with a solution. She shared a bedroom with her two younger sisters, one of whom had a potty which sat in the corner of the bedroom. She could use that. Problem solved.

The next day when her mum found that she had used her sister’s potty, she was angry. She screamed: “Why did you do this? That’s disgusting. You dirty girl. I’m so disappointed with you”.

It’s worth stating at this point that Sarah never felt loved by her mother.  Her mother was often angry and took it out on Sarah.  In a situation where Sarah should have been treated with love and compassion, she was made to feel dirty, disgusting and worthless.

From these scenes it was clear that there was already fear and anxiety associated with using the toilet (having to walk through dark and scary corridors to get to the toilet); and then, added to this, the shame at being called dirty and disgusting about not being able to get to a toilet, but using her sister’s potty instead.

In that moment, Sarah’s mind made a decision, to never put herself in a position where she was made to feel those same terrible feelings of shame and self-disgust ever again. Her mind decided in no uncertain terms:  “You have to protect yourself, Sarah. So make sure you are near a toilet at all times. Never let yourself  get caught out .”

Now that we knew where the root of the issue was, I helped Sarah change her belief about herself and to see that little four-year old girl through adult eyes. Rather than being dirty and disgusting, she was just a scared little girl, but also incredibly smart and resourceful to find a way to protect herself from being scared of going to the toilet.

We talked about how children have toilet accidents all the time – it’s part of growing up. And how if that had happened to one of her own children she would have responded in a completely different way to her own mother – she would have been understanding and loving.  I worked with Sarah to help her feel incredible love and compassion for that little four-year old – and to understand that the event was not her fault.

We changed the belief Sarah had about herself. She is not dirty, nor disgusting, No one would ever tell her so, even if she did have a toilet accident. I also encouraged her to see that unless there is a physical condition present, adults are pretty good at being able to control their bladders. I helped her realise that she is in control of her body including her bladder at all times.

Following the session Sarah listened to her transformation recording for 21 days as instructed. During this time I coached her in specific techniquesto develop new ways of coping with anxious thoughts so that they became less and less troubling.

One week later, I checked in with her to see how she was getting on. There were already signs of improvement. When she was out with her children she felt more relaxed and was no longer thinking about where the nearest toilet was.

Then came a long car journey when the family went on holiday, after which I checked in with her again. And this is what she wrote:

“I never ever thought I would get to this stage! You have truly helped give me a new lease of life. I have broken free from those chains. I was so sceptical about RTT, thinking that it’s something that works for other people but not for me. How I smile at this not being the case. I’ve learnt also to trust in the process. I can’t thank you enough for providing such a safe, non judgemental space for me to dig deep and be totally honest and open about some of my darkest experiences and memories. Not worrying every time I walk out of the door is so refreshing and I know things will only get better and improve even more as time goes by.

What a miracle you have worked on me Dawn. This is something I never thought I would be free of. I can’t thank you enough”.

During moments of stress, anxiety and even panic attacks, the common advice tends to be to "take deep breaths. "But that advice is now being seen as outdated, and in some cases might make stress and anxiety worse.

About a year ago, I learnt of a breathing technique that really does nix moments of stress, not just in the short-term but also long-term, and relatively quickly too. It worked for me (I'll show you a fascinating little self-experiment in a mo), and it has also worked for my clients, so much so that this is the only breathing exercise I teach, and I teach it to all my clients for general wellbeing regardless of whether they're suffering from anxiety or not.

Coherent or resonant breathing is a technique that helps bring both emotional and physiological systems in the body into balance in order to boost overall health and wellbeing. The idea is to make breathing slower and more rhythmic by making sure every exhalation is the same length as every inhalation.

I've read a couple of different accounts of how and why this works. The creator of the trademarked Coherent Breathing method, Stephen Elliott proposes the theory that moving the diaphragm in a rhythmic manner stimulates the phrenic nerve thereby promoting optimal circulation, better brain function and "nourishing every cell in the body in a positive feedback loop".

Other research shows that coherent or resonant breathing helps bring Heart Rate Variability (HRV) into a smoother, more even pattern which promotes the better functioning of every organ in the body, most importantly the brain.

HRV, by the way, is the measurement of the gaps between heart beats - and is now recognised as a far better way of measuring overall health and fitness, compared to just measuring heart rate. If you're intrigued by HRV there is excellent information over on the HeartMath website.

First, a bit of science
Our Autonomic Nervous System is the part of our nervous system that governs automatic bodily functions like breathing, digestion and our heart beat, The ANS is in turn divided into two parts: the sympathetic nervous system and the parasympathetic nervous system. Both regulate the same bodily functions but have opposite jobs. The sympathetic nervous system prepares the body for intense physical activity (fight or flight); while the parasympathetic nervous system prepares the body for relaxation and rest.

While we are awake, our optimal state is when both the sympathetic and parasympathetic nervous systems are in balance. When  brain function, heart rate and breathing are all in balance, we cope with stress better, we are more sociable and positive, and tend to be more resilient.

When we are stressed, however, our bodies stay in high alert, with our sympathetic nervous systems constantly firing. Although still evolving, research into HRV and coherence is showing a link between lower coherence and disease and aging.

Coherent or resonant breathing works by hacking the ANS to bring both sympathetic and parasympathetic systems  back into balance almost instantly.

You can find a number of apps that help you track your own personal coherence index and HRV.  I use WellTory.  The results below show my body before and after 5 minutes of Coherent Breathing.

A measure of wellbeing before coherent breathing (using WellTory app)

The coherence index is very low.

and after coherent breathing. The coherence index has more than doubled.

How to Practise Coherent Breathing

Relax and find a quiet spot where you won't be disturbed. Breathe in for 6 seconds. Then breathe out for 6 seconds. If 6 seconds feels too long, start with 4 seconds and build up to 6 seconds. Make sure both your inhalation and exhalation are the same length.

Start with a minute or two then build up gradually to however long feels comfortable. Some recommend a daily practise of 20 minutes, but I tend to follow the principle of "little and often" as a guide,

You can find a number of apps that help guide you through a timed breathing technique. Calm's Breathe setting allows you to set the timings for your breath and plays a different note for inhales and exhales (so you can practise with your eyes closed.).

The Breathing App by Deepak Chopra and Eddie Stern (with music by Moby) allows you to choose from a pre-selected format of breathing patterns with five different screens. 

Try a guided meditation