Panic attacks in BDSM scenes

Among the many problems that can happen in a scene, panic attacks can be a serious one, especially if the Top doesn’t know how to handle them. They are more common that you may think. Last month, during a talk I gave at Threshold (the BDSM organization of Los Angeles), I asked my audience to raise their hands if they had experienced a panic attack in a scene, either themselves or their play partner. About two thirds of the 45 people present raised their hand.

What does a panic attack look like? It happens more or less like this… The scene seems the be going well and is approaching its peak. Both the Top and the bottom are completely immersed in it. Then the sub stops reacting. She does not moan with each lash, doesn’t move, has closed her eyes and seems lost in her inner world. Then, all of a sudden, she explodes. The panic attack is characterized by an inability to speak - so in this case the safeword is of little use. There is also difficulty to breathe, uncontrolled moves, evasive gaze, crying and rejection of being touched. Inside, the person that experiences the panic attack feels extreme anxiety, terror, tunnel vision and inability to think and express himself. That state can last an undetermined amount of time, from minutes to hours. Returning to the scene is normally impossible and, in any case, not recommended.

What can we do when this happens? The first thing, of course, is to stop the scene. Discontinue immediately any type of painful or stressful stimulus. If there is bondage, it must be released immediately because physical restrain is one of the main triggers of panic attacks. If necessary cut the ropes with scissors or a knife being extremely careful not to cut the sub, who is probably moving unpredictably. If he is wearing a blindfold, remove it. Turn on the lights. Being able to see provides a strong reassurance. You should speak clearly with a calm voice, explaining everything you are doing, even if it looks obvious to you, even if the sub doesn’t seem to understand. If he is having trouble breathing, you can try guiding his breathing with your voice. You should warn her before you touch her, because sudden physical contact can be alarming for somebody suffering a panic attack. If you are in a public space, try to keep people from crowding the sub. However, if there is somebody around who is intimate with the sub, bring her in, perhaps she can reassure the bottom better that you can. After all, you were the one just beating her, remember? Encourage the sub to cry, which is healing and releases tension. Once the worse part of the attack is over, when the sub can speak again, you should give him  the option of talking about it or staying quiet to process it internally. Some people need to spend time alone after they suffer a panic attack. If that’s the case, your mission is to provide a safe environment in which she is not bothered or can hurt herself. Listen for any signs of danger.

Why do panic attacks happen in scenes? A scene puts the sub in an altered state of consciousness, and he may have a good trip or a bad trip. That state is normally experienced as something nice and enriching, but sometimes it brings forth traumatic experiences that pack such a powerful emotional charge that they trigger the panic attack. We call them “emotional land mines”. Paradoxically, endorphin release can produce the “freezing” state that is often the precursor of the panic attack. Animal studies have found that endorphin release can be triggered by uncontrollable stressors, so if the sub feels that she is losing control in the scene this can trigger the panic. Yes, endorphin release is not always a good thing. It has been linked to the “learned helplessness” paradigm, a state in which the person or the animal gives up and doesn’t fight anymore. Learned helplessness causes immune suppression, cognitive disabilities and a host of other unhealthy effects.

A person who suffers panic attacks is not crazy, neurotic or traumatized. The panic attack is just the manifestation of the power that a BDSM scene has to profoundly alter the mind. If handled right, a panic attack may even be beneficial in the long run. Mobilizing negative psychological contents allows them to be processed consciously, which can be healing.

I think it’s important that everyone who practices BDSM realizes that encountering a panic attack is a real possibility and to know what to do when that happens. It is even possible to prevent the panic attack from happening if we are alert to the freezing behavior that precedes it. When we flog or tie somebody, it’s normal for him to moan, complain and squirm. What is not normal is complete immobility in the face of pain. That is a sign that something is wrong. The Top should talk to the bottom from time to time. If she doesn’t answer, you should stop and look the sub in the face to make sure that everything is all right. There are, of course, people who prefer to “go inside” and not react to pain, but they should warn the Top during the negotiation that that’s the way they function. Conversely, I don’t think is advisable that the Dominant orders or trains the sub to be still and quiet when he experiences pain. Not only that would not let us detect an imminent panic attack, but it’s even likely to provoke one.