Safety Cards – Aid for Anxiety and Melt Downs
As I was admitted at the Psychiatric Ward, Department for Psychoses, I had to mention three things that would calm me down when I had “fits” (that was the technical term I had for it at the time). It was a sort of an intro-interview, supposed to help the nurses if/when the mood took turns for worse (although at that point, “worse” is a rather odd term to use, as it was really almost as bad as it could get). Also I should mention things that triggered me at the interview, so they could try to avoid exposing me to those triggers.
During my hospitalisation I continued working with these words, decorating the noteboard in my hospital room with papers with meticulously scribbled brainstorms, lists and mindmaps (covering things that soothed me, things that triggered me, differentials in priorities depending on moods and plenty more), that one day led one of the nurses to say: “I think your head is probably the busiest head I’ve ever witnessed!”
I suspect that that wall decor (which was less than I wanted, due to lack of tape and being too polite and well mannered to write on the walls) paired with my answers at some interviews with the Doctor in Psychiatry, was the thing that led him to suggest that we’d do some other tests, rather than focusing on schizophrenia. A week and a half later, having scored high on the RAADS-R test (autism/Aspergers test) and some basic tests, I don’t know the name of, he concluded that this was not schizophrenia.
This was a very clear case of Aspergers, “and I’m surpriced no one has caught on to it sooner, because it’s pretty clear if one just talks and listens to you”.
He explained to me about co-morbids, and how the things I was hospitalised for (anxiety, hallucinations, depression, selfharm etc) were linked to having been exposed to numerous things that triggered me. He explained about camouflaging, urges to self soothe (stimming), coping strategies and masking and explained the importance of being aware of triggers (which I have also named “the red flags”).
After this, a nurse suggested that we could make safety cards of those “soothers” I had listed on my wall.
And that is the story behind my safety cards.
How to Use Safety Cards
The use itself is pretty straight forward.
During anxiety attacks and melt downs rationality can sort of get lost in the chaotic mind. While you in a state of well being may know which things can soothe you or calm you down, anxiety attacks and melt downs can be so overwhelming that your mind simply can’t reach that type of knowledge.
I think you can compare it to the freeze-fight-fly situation – when all is good there may be a particular one you’d know was “the right thing to do”, but that doesn’t mean that this is the way you’ll ultimately react.
The safety set is basically a little stack of collected cards upon which you write your soothers. The point to safety cards is that when you feel anxiety starting, a melt down coming – or any other situation where you may need the reminder – you can go through the cards that will tell you how you can calm down. They can also be used by e.g. a loved one, who reads the soothers out loud to you or simply chooses one for you, depending on the state you’re in. Your soothers can be words, little sentences or even images, if you prefer that. For instance, if going for a walk soothes you, you can have a little picture of a walking person.
I have a lot of cards in my collection, because there is just a lot of things that soothes me or rubs me the right way – but not for one specific situation. So I have collected all of them and then I go through them when things go down hill and my gut feeling – as I explained in my YouTube video “Strategy Tool Kit” – is usually on point, not just in regards to melt down, but in general. The trouble is listening to it – but that is another story and another blogpost. So going through the cards I can suddenly get this overwhelming feeling of “yeah, that’s IT. I want to do that. I need to do that!” – and then I do it and slowly but surely my mind eases up a bit.
You can watch the video here:
So what these cards essentially do, is they help create rationality and overview in situations, where you might struggle to maintain it. And as said, they can easily be used by a loved one, as long as said loved one knows what to do. Sometimes it can actually be quite helpful that someone else reads the cards – or even in some cases, make the decision for you. Of course, this is my opinion – and you might be feeling very different about it.
And I must say that if you are not feeling safe with others either reading the cards or making the decisions for you, then it’s important that you listen to that feeling. I haven’t tried it, but I can imagine if I had a melt down and someone I didn’t trust should decide what I should do, it wouldn’t exactly make me feel safe. So always trust your gut feeling.
A Short Walk Through of the Making of Safety Cards
As promised in the video, I will do an actual tutorial-ish vid on how to make these cards, when I get to the point of updating my own cards. When that is done, I will put the link into this post. But you can easily get notified by following me on YouTube or subscribing to my blog or following me on Instagram.
But let me give you a quick walk through to those of you who do well with just the words:
I started out with a brain storm, just simply putting on paper the things that could calm me down, soothe me or cheer me up. As my mind goes nuts on brain storms I always end up with a huge amount of options – these words no exception. So if you get a shitload of options (more than 15) you might want to consider narrowing down the options and prioritising. You see, if you need to go through them while having an anxiety attack or being on the verge of a melt down, you don’t have the energy for too many options. Again, trust your gut feeling – YOU know best, how much you can or cannot take in, when your mind crashes. Do you want 5 options? 10? 15? If looking at these numbers, make you feel like one is too few and the next too much then find a number in between. For instance, the numbers 5 and 10, gives you the extra options of 6,7,8 and 9 – so look at those numbers and go for your gut feeling. And remember, if it turns out after a few uses that you want to add some or need to take a few away it can be done easily. There are no “no backsies” on this one.
After choosing your words/pictures, you can put them into a table in a program like Word or Excel, make the borders visible, so you can cut by the lines after printing, to make every piece the same size (if that matters to you – it does to me). I used the size for business cards, because you can buy laminate pockets that size, so it eased the process, rather than putting all the little notes into an A4 or A5 sized pocket and cutting them out from there (it messes up the sizes and again – that is crucial to me).
Then you punch a hole in the corner of each of them and tie them together with some kind of wire – I used green garden wire, because I knew that it wouldn’t risk breaking like e.g. a yarn string and I could shape it like a sort of key chain, as you might be able to see in the video.
If you are really crafty, I bet you can sow some sort of pocket for them, so they are kept together in a deck. Think I’ll try that actually. Uhh, ideas for the upcoming vid!!
And after this, it’s pretty much just keeping them in a place where you need them (or make several sets, if necessary). In my case, it’s usually around bedtime that my mind starts racing and contemplating every single fucking second of the day, questioning myself, tones of voices I’ve heard (just to mention a few) – and that often leads to feeling even more overwhelmed or triggers highly depressive thoughts. So I keep my set of safety cards in the drawer of my bedside table. But I should actually make another set to take with me for grocery shopping and stuff like that. It could definitly come in handy.
If you occasionally need someone else to read them to you, then it’s important you let them know where to find them (and how you want them to be used).
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A List of Inspiration
My most important and crucial card is the first card in the deck: the number for the local Psychiatric ER.
It’s absolutely crucial that I have it, due to what I refer to as dark thoughts (selfharm and suicide). If I find myself in a state, where those thoughts become overwhelming, the last thing I need is to have to google for that number first – I’m not even capable of considering Google at that point.
After this comes the card that holds four different phone numbers for people close to me, to remind me not only that I can call them, but also that there ARE actually people in my life that CARE. Sometimes just seeing that card can be helpful, because my mind can occasionally convince myself that no one cares. The card tells me another truth.
I have collected a list of words and sentences that might serve as an inspiration. It’s not “all-inclusive” and you can probably add some of your own, just like some of the ones I’ve written will not have a calming effect on you.
But I hope that the list will help spark the thought process and your own brain storm and help you get sharp and precise feel on what works for YOU.
You can find the list for download and printing here and if you like it, please consider pinning the attached image to Pinterest to share the list:
To me the cards are sort of a self-care reminder. And the words you create, should work as such. Alternatively you can have an emergency card deck/red flag deck (like the one I consider making for grocery shopping) and a set of cards for the times, where you can sense where it’s going, but you haven’t “crashed” yet/yellow flag. Plus there’s a difference on what can be doable, depending on whether you are in public spaces or in the comforts of your home.
I work a lot with the terms green/yellow/red flags both in relation to melt downs and anxiety attacks, but also when it comes to weighing risk factors in upcoming events, or when I look in my calender, I refer to my weeks as green, yellow or red, depending on how packed or trying my scedule is. I first learned about green/yellow/red zoning as a Restaurant Manager, when I should determine which hours of the opening hours had the most customers and which few – and which colours the various managing tasks were as far as my comfort zone goes (sacking people were a red zone, for instance). So I kind of just adjusted it to mental health recovery to help me determine when to take extra caution. So obviously I talk about those colours every now and then – and I hope that it makes sense to you. Otherwise, let me know, because there is no point in making things overly complicated.
Why Safety Cards Became an Epiphany
Prior to my hospitalisation I actually never considered safety cards or even a strategy tool kit – I don’t even think I’d ever heard the word before.
I have throughout my life been in plenty of situations (more than I can count) where I’ve thought “if only I had my headphones”, “if only I had a book” or “if only I had 5 minutes to myself to breathe” for the times where the world became a bit too much.
But I could see that everyone else around me could deal with e.g. background noise, certain sounds, lots of people and so on – I kept evaluating myself on what others could do – and pushed myself even further, because if everyone else could, then why couldn’t I? I actually multiple times, throughout three decades, have called myself stupid, weak and even dumb for having the reactions I had. So I hid them behind masks and coping mechanisms. I faked a smile – and apparantly was good at it – and pushed through. I excused myself to the bathroom and stayed there for extra 5 minutes, often crying silently. I took a detour home, if I needed solitude. I made excuses about having a hard day with dumb customers, when instead my sensory levels where just overwhelmed. I was so ashamed that I couldn’t just “buckle up”. I became a master of silent crying; crying with no noise and controlling the consequential running nose to an easily excusable level, where I could always blame a potential flu or something. I developed strategies for hiding tears and excusing potential red eyes with a bad mascara or something similar.
I’m still to this day using strategies and coping mechanisms and masking – the most honest version of me, you will find on this blog. In real life, I still need the bits of courage and confidence it takes to let the masks go completely. I still lack the knowledge that I am enough. I mean I know it rationally – but I need to move that knowledge to my heart too.
Diagnoses in themselves doesn’t change who we are. They are really just new words given to label an already existing condition.
However – and it’s a BIG however – getting a diagnosis does change the way you understand yourself and especially how you judge yourself.
To me, understanding that the triggers I had were totally legit and that plenty of other people in the world had them too, has made me be a lot kinder to myself than I was before. The extreme calmness of psych hospitalisation brought me to a place where I – maybe for the first time in my life – actually could FEEL the extreme fatigue and exhaustion I dealt with. This has in turn brought an enheightened selfawareness as far as my energy levels goes.
Some might say that I’ve become “more ill” or “more autistic” after the diagnosis. But the only difference is really that I don’t camouflage as much anymore. I can actually FEEL – most of the times – when things are getting too much for me. The diagnosis has given me words to describe to others how I feel. Before, I hid, because I felt like I was being dumb and stupid and incompetent. Well, as said, I still hide to a certain degree. But at least not to the levels I did before. Baby steps…
The safety cards became an epiphany for me for those above mentioned reasons.
The words themselves were not new to me – I knew that drawing eased my mind and that doing jigsaw puzzles seemed to organise my mind too – but what the safety cards did for me, was to take that sort of dorment knowledge and activate it into a constructive tool.
As you go through your own words, I’m sure that there won’t really be great surprices there. Maybe a few moments where you realise that the thing you do, hobbywise, actually give you some of that calmness you need in stressful situations. But for the most part, the words will not be new to you. It’s adding them to a card for a safety card deck that makes it more constructive – and I will even say legitimate – to use. Because at those moments of extreme stress/pressure, pulling out that card deck indirectly tells you that it’s okay to do this. You need this right now to pull through.
At least that is the way I’ve experienced it. Before I would keep pushing, and almost literally tear myself to shreds, because I didn’t want to be a failure. Pulling out the cards – the simple movement in doing so – became a very physical way for me to acknowledge that while I might rationally feel there were better things to do, emotionally I needed to calm myself – and that was okay!
So no, diagnoses doesn’t change who you are per se – but it can help you make different choices in your life, that can – potentially – be life saving. Had I not had the diagnosis of autism, the conversation about soothers – who’s to say if I would EVER have considered or known about safety cards at all?
No fucking way I would be without them today!
If you’ve subscribed and read the STRESS LESS BLOGGING booklet, you will know that I once made a SoMe scedule, because social media was stressing me out big time. And then you might also remember that I wrote that after a while the scedule wasn’t that necessary, due to me actually figuring out how to do it efficiently and where I was wasting time.
Safety cards work the same way for me. I used them a lot more in the weeks after I got home from the hospital, than I do now. Considering my melt down in the grocery store, I might have used them a little too little, granted, but there are a lot of situations now, where I’d normally take out the cards, but these days I don’t: The cards have taught me how to FEEL what it is that I need at that particular moment. Mostly.
Which is why I need to change my set up a bit, to adjust them to my current needs.
So, if you have a condition, be a physical or psychological, that occasionally requires you to hit a pause button, but for some reason you are unable to, I will encourage you to try it out. The risks or side effects are – to my knowledge – non-existent. If it doesn’t work for you, you just stop doing it.
I would absolutely love love love it if you would report back on your own experiences with the cards, should you choose to use them. You can use this comment section or the comment section in the video – and you can always reach me by mail, if you prefer to be incognito. Or if you already have something similar, do tell and let us know, how it’s worked out for you.
If you follow me on Twitter, you might have found out that I owe a few award posts, I have been nominated for by some lovely ladies. So I will work on that next, while I simultaneously get the Tune In Autism category under control. So – plenty of cool stuff is in the mold – and until I get around to write you next time, take the very best of care, give someone a hug or make someone smile a little and never forget that for the very reason that you bother to read my scribbles….
I luv ya :-*
Thank you to Dawn at Crazy Organic Mama for being a dear friend and giving some input and thoughts on images. You, my dear, should go check out her site, if you have a love for gardening, indoor OR outdoors.
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My name is Linda and I set my eyes on the world for the first time back in the summer of 1978.
In 2017, after decades of struggling with various mental issues and illnesses, I was diagnosed with Aspergers Syndrome, an autistic spectrum condition. My most dominant co-morbid illnesses are depression and anxiety.
Born in Copenhagen, living several places throughout Denmark in my life, I’m currently settled in Northern Jutland, in the rapidly growing city of Aalborg. Here I worked a handful of years as a manager in high performance environments, until a mental break down in 2017.
Rocking the Spectrum is not a knowledge base on autism per se, but rather a peak behind the scenes, showing the life of someone autistic – in the hopes that it will help conversations and understanding along elsewhere on this blue planet.
I am not a professional health worker and any views and statements must be viewed as personal opinions and experiences only.
My special interests are languages and codes, music, books, urban gardening, animals – and writing is my way of breathing.
Proceed into the blog with caution – I swear a lot. Don’t blame my parents – they HAVE tried to improve my behaviour!