A client with dependency or addiction problems is likely to need some immediate help arresting the relentless experience of anxiety. We can’t regulate our emotions as if we are adjusting a thermostat, but we can do certain things that will likely have helpful effects.

Try this. I’ve organised this as a series of numbered steps. As ever, however, you’ll find the format struggling to contain my thoughts, which is me refusing to struggle with the format: which is what I wish more clinicians would do. Process never occurs. Events do.

1.     Help your client to learn how to take their pulse by touch. When I learned how to take my own I found the whole business rather repulsive. However, I persisted, trying to keep in mind that overcoming my reservations at touching my own body and experiencing a feeling that in fact guaranteed I was alive might not be a bad thing. The more I did this, the more I discovered I could learn. Sometimes I was ‘hypo’ – my pulse was low when I expected it to be high. My skin tension on these occasions felt weird – and I still don’t know if that was because of something to do with a level of dissociated awareness in my touch, or a degree of extra tension in my skin. However, the point is that I noticed differences.

2.     Once they (and you) know how to take their pulse, ask them to count the beats over a minute.

3.     Do three runs of 6-6-4 breathing (breath in for 6, out for 6 through the nose and hold for four seconds).

4.     Count the pulse again. What’s different?

5.     See what happens. Whatever goes on in a highly aroused autonomic system and the states of mind associated with it – including, for example, cognitive effects relating to the experience of time – will be open to your joint investigations. What does a pulse feel like when someone feels this or that way? Explore these things yourself. That kind of curiosity overcomes a certain cut-offness which some call objectivity, which is the nemesis of all psychotherapy.