This is why the X-card, specifically, is so beneficial, though.
You don't have to "shape" stuff beforehand and try and anticipate every possible situation. And it's less disruptive to the game than you having to leave. It also makes people feel less bad.
I had things more like checklists in mind but the X Card is also something I am not really that sold on. In the times this happened, I don't feel an X Card would have made much of a difference for me. In one occasion I particularly remember, I won't get into the details here, but in this case it started with food, completely unrelated to the game, then some thoughts. I was also running the game so it wasn't about content. I only mentioned this to provide some context to my views on this (so people understand I know what it feels like to have a panic attack).
Obviously some people might use it and find some benefit. I realized for me, taking a break and dealing with the underlying problems was more important to me, and doing my best to keep whatever I was going through from disrupting the table was also important.
I also don't think an X Card would have helped me get better (in my case at least, I can't speak for other people). One initial problem for me when I first started having symptoms was I effectively used an X Card on the television (which is why I mentioned that). It became very clear though this was not healthy for me, was frustrating for people around me, and deepening my symptoms.
I think a lot of people "skeptical" of it just don't really understand it, or are put off by what they misperceive as "woke" language or the like. I mean, you can get more detailed descriptions, but the principle is simple.
for me it isn't so much about the woke language as I just don't think it is the healthiest approach. If people find it works for them, I have always said, they should use these tools. I also think because game designers and writers are not psychologists or pyschiatrists (at least most of them aren't), providing tools like this, when we don't really know anything about treating different forms of mental illness, may not be the best idea. Maybe these tools are useful. I am not saying people shouldn't have them available. But I worry that we've accepted it as a fact that this is the way to go, and I know in my case at least, it would have only caused more damage and taken me longer to recover if I had embraced a concept like safety tools to game while I was experiencing symptoms (again I am only speaking for myself here, I realize each case is its own).
1. There's a card with an X on it on the table.
2. If you're upset by what's going on, you tap the card.
3. At this point, you can explain if you want, and most people do, but you're not required - it's usually best to indicate the topic/incident causing it at least though, if it's anything but obvious.
4. The DM works out what to do - usually with some discussion with the player who tapped it - if it's a situation, that in-fiction is occurring, maybe you skip to past it. If it's a description of something, you stop the description, and so on.
I understand how X Cards work (I believe). I think I have two issues with the process. The first is I think it is unfair to have the group miss out on the things the X Card gets triggered by. People might not express it, but I do think if someone is upset every time green goblins show up, and it effectively results in those not being present in the game, then some players are going to feel like a pretty standard expectation of play is being taken away. The same could happen if you are simply skipping over scenes or descriptions. I also think if there is something a particular player can't handle in play, I'd rather that be a conversation before play begins or between sessions, so it can be decided the best way to deal with it (some groups might want to accommodate it, some might feel it is a request that can't be accommodated, etc). This is obviously stuff people have debated a lot. If groups want to use these tools, I have no objection. But I personally prefer not using this kind of method for dealing with problems related to a player's mental health (I will work with a player going through mental health issues, but I am also not a psychologist so there is only so much energy I am going to be able to expend accommodating someone if they are really going through something bad----and if it is that bad, and it is being set off by playing the game, I am not sure the game is going to be the best thing).
The second thing is I feel like having this button, at least in my case, could have really prolonged my symptoms (as I said in my prior paragraph). And I believe there would even be temptation to use it when it isn't necessary.
Again if it works for you and others, by all means, you should use it as a tool. I simply object to it becoming an expectation for all groups, or for all games to have safety tools (especially when I don't think designers are in much of a position to evaluate the efficacy of the safety tools----I believe you the player can certainly evaluate them for yourself, I just think it could be misleading for companies to offer safety tools when they don't really know what effect they are going to have on a person's mental health (i.e. if someone needs something like this to play an RPG, a much better approach in my opinion is for them to speak with their therapist, and through that conversation decide what procedures might be helpful---and then speak with their group about incorporating them). I get that isn't a conversation everyone wants to have. But having done therapy and seen the results, and also seen how important a therapists input is, I really think if someone is suffering from something as severe as PTSD, we are way better off as a community encouraging more openness about that and about the fact that some of us are in therapy, than using safety tools that could potentially be causing more harm than good for some people.
Some of this may also be cultural and regional as well. I think where I game and the types of people I tend to game with, an X card or other safety tool would feel very uncomfortable for all of us.