Grounding techniques - Staying present during therapy - Disassociation

What grounding techniques do you use?

I struggle to stay present in therapy and wondered what grounding techniques you use and what work for you. I'm willing to try almost anything.

T helps a lot with me. These are some things we do....

I have to look around, I can't focus on one specific thing.
Keep both feet on the ground.
Feel the couch, blanket, hands, etc.
Tell T when I first notice I'm starting to 'drift' - could be something talked about that was a trigger, etc. It's helpful for her to know where I am and what caused different things. So talking, touching items, breathing and keeping T informed is what helps me.

I've been trying putting both feet on the floor (I usually sit with crossed legs) and my T asks me to look around the room but that's where I struggle to lift my gaze from the floor. Looking up feels more shameful than difficult. I don't know why I find it hard to look up, my T does everything to accommodate me, I just don't think I want her looking at me if I have to stop hiding my face...

There's blurred lines between my panic and disassociation. Sometimes there's very little time to react and become aware of what's happening. I'm definitely going to talk to T when I feel myself slipping. Accept the help instead of hiding from it. Here's to being brave.

I used to instantly dissociate. There was no warning, no break, no signs, nothing. Gradually over time we've been able to seperate the panic and dissociation a little more. You don't have to look up to look around. Your shoes, her shoes, the rug, bottom of chair, bottom of desk, books on bottom shelf of bookcase, etc. I understand not being able to look up because of shame. I never had long when when I started telling her so we used a word or a hand movement she could watch for so I didn't have to think about it too much and that way she was aware even though I didn't have much time. You are brave!

That's what happens to me now, it's instant and I don't hear a lot of what's going on. Hopefully in time I'll be able to separate the panic and disassociation. Thank you EllahMea

My therapist has puzzles, toys, and other objects on her desk which she encourages me to touch or play with - whether I am having a difficult or flighty moment. If I feel I'm drifting off I will grab one too.

This happens to me too! I've shared before that my hands and feel start tingling on the way to my session. I was sitting in the waiting area and when my counselor walked in, the minute he said hello, it's like an electric shock hit the bottom of my feet. I feel myself drifting but at the same time I'm still there. I tell him what's going on and I feel ok, just not ALL there. After I get home, I don't remember a lot of what we talked about. There are topics but not a lot of content about the topics.

Does anyone else experience this? I would love to try and get a handle on it.

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I don't get the same feelings but by the time I get home I've basically forgotten or pushed the whole session out of my mind. I remember sentences rather than the conversation. I get really nervous and panicky before my session, I can't say anything works for me yet but that's why I started this thread - I'm going to try a couple of Ellahmea's techniques at home and therapy and hopefully in time it'll get easier.

Good luck and if anything works for you please let me know

This is totally me! I haven't found anything that works --- but to be fair, I haven't really tried anything to make it stop. I just kind of accepted that crapping myself before every session and not remembering anything when I got home was just how it was.

I've drifted off in sessions - its instantaneous, so no warning. I wouldn't even know its happened usually, but a couple of times my T has said 'where were you just then?' - I've found that really helpful, as it makes me realise it has happened and sometimes I get a fleeting glimpse of where I went.

Thank you for sharing these!

We've tried these also. Sometimes I can feel myself kind of settle other times they don't help. Don't know why that is.

I have tried walking around his office. That kind of helped but I was so off balance, it felt really weird.

Mine has no warning either. It just kind of sneaks in.

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Thank you for starting the thread!

Maybe someone has found something that works we haven't tried!



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My T asks the same things but I wear my hair down in my sessions and tend to hide behind my hair when it falls over my face so it's difficult for her to see when I've checked out.

I think the more aware I become of it the more I'll be able to get to grips with it. My T says understanding physical changes will help me to understand what signs I can notice in myself before I disassociate.
I assume in time I'll be able to notice the signs and apply grounding techniques before I slip out the room.

My therapist notices before I do...in fact, I never even realised that I dissociate before seeing her. She says there's a certain direction my eyes go to. She encourages me to try and make eye contact or hands me something to hold on to. If I need more than that, she might get me to stand up or ask me questions about something in the room but what really helps is this exercise:

Naming 5 things I can see
4 things I can touch (and touch them)
3 things I can hear
2 things I can smell
1 thing I can taste

I find that one good to use at home as well. Ice packs can be great too, to hold onto when you need to or place over your face to quell the anxiety/panic a bit

Trailrunner ... yes this is the same for me! I feel like I am half there in the sessions and by the time it is all over and I have left the building I have forgotten most of what was talked about. It all feels very surreal to me. I need to get a handle on it too.

That used to happen to me all the time. I tried to stay present and do most of the things you mentioned, but nothing really worked. So I gave up and just drifted when I drifted and came back when I came back. What worked for me is not forcing it. Over time I learned to control it, but it took A LOT of time. Now I can feel when I start to check out and I actually decide if I want to stay or to go away for a bit. And yes, sometimes I decide to check out because I just feel like it. I guess that freedom took away the pressure, and that helped too. Therapy is for me, and if some part of my brain wants to check out and not say a word for half of hour, maybe it needs that, what do I know... But I'm lucky, both me ant T are in favour of the "no pressure, no strict rules" attitude and I have basically unlimitted time to be in therapy, no insurance or whatever stuff.

In the UK most people including myself use the NHS, (private is too expensive on a weekly basis for me at least anyway). The building I go to is a mental health centre, and the room used to talk has one or two paintings and a desk. It's so impersonal, there's nothing that belongs to my T on the desk or anywhere because her next client won't be in that room.

I wish the room was more comforting, so I had something to hold on to. I could always hug the box of tissues lol. In all seriousness, I wear jewellery like a necklace or ring I can fiddle with but I think I need to really notice what I'm touching rather than it being a nervous thing. I'm taking away the importance of it by playing with the jewellery constantly. I hope that makes sense.

I try and focus on things around the room. I try to look at my T so I can stay focused on the fact that I am there with her. I look at details about her that I normally don't notice, like her hair or what she is wearing or her facial expressions. I have a hard time with eye contact so this is useful for me. If we are holding hands while processing something difficult I will hold onto her hands really tightly and sometimes squeeze them to remind myself that I am in the present with her. I told her I do this as a way of "staying present" so she holds my hands just as tight and squeezes me back. It really helps.

I can't imagine holding my T's hand. It's not conceivable to me. I think I'd slip out the room faster. :/

Me too!! I wish I could though!

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For me.. Sometimes I feel like I'm not completely there and this pressure starts to make it STOP. Somehow, that seems to make me feel like I've done something wrong that I have to fix. That sends me even further away. Vicious circle!! Relaxing into it may be a very good thing for me to try!

Thank you for sharing that!!

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My t has me do breathing exercises if I notice I'm starting to dissociate. But if I don't catch it and she does, she has me do progressive relaxation, which is where I start by tightening my muscles in my feet and work my way up to my shoulders, and then I release from top to bottom, all while breathing regularly. I pretty much hate doing that more than anything else, but it works. She used to make me do the 4,3,2,1 thing that another poster posted about, but I shut that down after only a few times lol

I get really bashful? Shameful? Somewhere in the middle of that with a bit of panic. I don't think I'd fair well with that exercise either. I feel like her attention on me apmlifies and I can't stand it. I feel silly? I think that sums it up actually.

I can totally relate to that! If all his attention is on me, I feel like I have to do it perfectly and can't relax. So it's really counterproductive.

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She offers to look away, but that feels sillier still. I don't know, sometimes I think we just have to take a leap of faith with these things and work it out as we go. I think that's basically what I've learnt here so far, if you don't try the things your T does to help, you're not going to help yourself.

It's actually doing it, that's where I'll be tested.

It was hard and awkward at first. Now holding her hand is a great comfort and helps keep me from dissociating. Its not for everyone.