distraction techniques

OK. It is roughly 11:30 Friday night. I am having a severe panic attack. The Zyprexa is not working. I'm in this weird limbo state between completely dissociated and knowing exactly where I am and what's going on.

Yet, I'm (for about another minute, I think) coherent enough to ask what people do in these situations. All the grounding techniques I know involve wiggling your toes, or moving around in your chair, or something physical to remind yourself where you are and that it's now, not then.

Thing is, it's my body that was assaulted, and that's the last thing I want to touch or feel right now. I'd rather not have anything to do with it. I also don't want to disturb my neighbors at this hour.

I'm going to go take another Zyprexa and try to get some sleep, but if anybody has any helpful hints here, I'm takin' em. Thanks.

Candy

There used to be a real me, but I had it surgically removed. -- Peter Sellers

Grounding Tecniques

Sensory Awareness Grounding Skills

Keep your eyes open, look around the room, notice your surroundings, notice details.

Hold a pillow, stuffed animal or a bell.

Place a cool cloth on your face, or hold something cool such as a can of soda.

Listen to soothing music.

Put your feet firmly on the ground.

FOCUS on someone's voice or a neutral conversation.

Cognitive Grounding Skills

Reorient yourself in place and time by asking yourself some or all of these questions:

Where am I?
What is today?
What is the date?
What is the month?
What is the year?
How old am I?
What season is it?
Who is the President?
List as many Grounding skills as you can.

Practice several grounding skills every day.

Construct a list of those which are most helpful and effective.

Goals When Using Grounding Techniques

To keep myself safe and free from injury.
To reorient myself to reality and the here and now.
To identify what I attempted to do to prevent the dissociative experience.
To identify skills that I can use in the future to help myself remain grounded.
Goals Prior To Using Grounding Techniques

Learn as much as I can about dissociation, grounding techniques and triggers.
(What are the triggers that usually signal that I am about to dissociate?)
Practice, practice, practice, my grounding skills when I am in a stable, comfortable space so that I am prepared when I need them.
Make a list of the grounding techniques that work best for me and put it where I can easily refer to it when necessary.
Women's Treatment Network, McLean Hospital
M. Brody, L. Frey, psyD, Edelson 1994
An important part of effectively learning, practicing and utilizing grounding techniques successfully is learning to master the intrusive symptoms.

Mastering Intrusive Symptoms

Flashbacks and other intrusive symptoms are automatic reactions in which a survivor temporarily associates some trigger in the present with an aspect of their past abuse.

This results in dissociation from the comfort and security of the present and a re-experiencing of the past abuse.

The automatic reactions may be thoughts, feelings, or somatic sensations that disrupt current functioning.

Automatic reactions are extremely common, insidious and often operate below conscious awareness, making the survivor feel confused, upset and out of control.

Common emotional reactions are: fear, panic, terror, anger, sadness, shame, disgust, paranoia, anxiety, confusion, suspicion and emotional numbness.
Common physical sensations are: nausea, pain, headache, tight stomach, rapid heart beat, chest pain, adrenaline rush, sweat, chills, cold, genital pain, flushed, euphoric, inappropriate sexual excitement, spontaneous orgasm, sleepy, faint, or physical numbness.

Common intrusive thoughts include: abusive sexual fantasies, thinking partner is an offender, thinking the past is the present, thinking you are a child, thinking you are bad, thinking you are inadequate, thinking you are unworthy of being loved for yourself, wishing you were someplace else.

Some automatic reactions last for seconds, some for hours. Automatic reactions usually occur in a series, linked up so that one triggers another. A chain of automatic reactions can trigger compulsive sexual behavior.

Your triggers may be known to you, dormant for years or difficult to identify. Identifying and analyzing your triggers gives you power. The triggers lose their secrecy and mysteriousness once you understand them.

Reducing the number of triggers in your life may make it easier to deal with your automatic reactions. Also, eliminating stimulants may help. Counseling and support groups are essential.

Questions to ask yourself in discovering your triggers:

Where were you at the time of the abuse?
What were you like at the time?
What was the offender like?
What was your relationship to the offender like?
What touch and sexual experiences did you have during the abuse?
What was happening inside your body?
What were your emotional experiences?
Other sensations, feelings or thoughts you experienced at the time of the abuse.

The key to handling automatic reactions is to bring them into your awareness, understand them, and find ways to cope.

The following steps provide a format for you to analyze and master your intrusive symptoms:

Stop and become aware: Acknowledge what's happening. Say to yourself, "I'm having an automatic reaction." Assume you have hit a trigger.
Calm yourself: Tune into your body. What are you feeling? Tell yourself something reassuring. "I'm safe, no one can hurt me." Take slow, deep breaths. Relax your muscles. Go to your "safe place".
Identify past situation: When have you felt this way before? What situation were you in the last time you felt this way? Try to identify the trigger.
Identify similarities: In what ways are this current situation and your past situation similar? For example, is the setting, time of year, or the sights, sounds, sensations in anyway similar to the past situation when you felt this way? If there is a person involved, how is she or he similar to a person from the past who elicited similar feelings?
Affirm your current reality: How is your current situation different from the situation in the past in which you felt similar feelings? What is different about you, your sensory experience, you current life circumstances and personal resources? What is different about the setting? If another person or persons is involved, how are they different from the person(s) in the past situation? Affirm your rights: "The abuse was then. This is now."
Choose a new response: What action, if any, do you want to take to feel better in the present? For example, a flashback may indicate that a person is once again in a situation that is in some way unsafe. If this is the case, self-protective actions should be taken to alter the current situation. On the other hand, a flashback may simply mean that an old memory has been triggered by an inconsequential resemblance to the past such as a certain color or smell. In such cases, corrective messages of reassurance and comfort need to be given to the self to counteract the old traumatic memories.

<A target="_blank" HREF=http://www.dreamstalker.org/wings/ptsd001.htm>http://www.dreamstalker.org/wings/ptsd001.htm</A>

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<font color=blue>"Never react emotionally to criticism. Analyze yourself to determine whether it is justified. If it is, correct yourself. Otherwise, go on about your business."</font color=blue>

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(((Candybear))) I really understand what you're going through. Sundance covered all the ideas I had. The only other thing I thought of is that sometimes when I'm feeling panicked I feel worse if I take a medicine that makes it hard for me to focus because I feel out of control even more. Do you have a crisis line near you?
I really hope you're feeling better and got some rest. All my best to you! Annie

Thanks you guys.

Sundance, that was an incredibly useful list. I'm going to print it out for my T so he can use it for other folks too. Where'd you get it?

I wound up taking an extra Risperdal (Zyprexa is as-needed, Risperdal is daily) and going to bed. Anything over the 2 mg I normally take puts me out like a light. The only problem today is the nasty "hangover," but at least I got some sleep. Daylight helps, too -- I associate bad things with darkness.

Thanks again

Candy

There used to be a real me, but I had it surgically removed. -- Peter Sellers