grounding techniques

WHAT ARE GROUNDING SKILLS?

Grounding Skills are interventions that assist in keeping a person in the present. They help to reorient a person to reality and the immediate here-and-now. Grounding skills are useful in many ways. They are particularly helpful with symptoms of dissociation. They can help a person prevent dissociating. However, they can be used to help re-orient oneself when experiencing intense and overwhelming feelings and intense anxiety. They help to regain one's mental focus.

These skills usually occur within two specific modalities:
1.) Sensory Awareness
2.) Cognitive Awareness

SENSORY AWARENESS GROUNDING SKILLS

Keep your eyes open, look around the room, notice your surroundings, notice details.
Hold a pillow, stuffed animal or a ball.
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:
1.) Where am I?
2.) What is today?
3.) What is the date?
4.) What is the month?
5.) What is the year?
6.) How old am I?
7.) What season is it?
8.) 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

1.) To keep myself safe and free from injury
2.) To reorient myself to reality and the here and now.
3.) To identify what I attempted to do to prevent the dissociative experience.
4.) To identify skills that I can use in the future to help myself remain grounded.

GOALS PRIOR TO USING GROUNDING TECHNIQUES

1.) 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?)
2.) PRACTICE, PRACTICE, PRACTICE, my grounding skills when I am in a stable, comfortable space so that I am prepared when I need them.
3.) 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

1.) 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.
2.) This results in dissociation from the comfort and security of the present and a re-experiencing of the past abuse.
3.) The automatic reactions may be thoughts, feelings, or somatic sensations that disrupt current functioning.
4.) Automatic reactions are extremely common, insidious and often operate below conscious awareness, making the survivor feel confused, upset and out of control.
5.) 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.
6.) 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.
7.) 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.
8.) 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.
9.) Questions to ask yourself in discovering your triggers:
a) Where were you at the time of the abuse?
b) What were you like at the time?
c) What was the offender like?
d) What was your relationship to the offender like?
e) What touch and sexual experiences did you have during the abuse?
f) What was happening inside your body?
g) What were your emotional experiences?
h) Other sensations, feelings or thoughts you experienced at the time of the abuse.
10.) The key to handling automatic reactions is to bring them into your awareness, understand them, and find ways to cope.
11.) The following steps provide a format for you to analyze and master your intrusive symptoms:
A) Stop and become aware: Acknowledge what's happening. Say to yourself, "I'm having an automatic reaction." Assume you have hit a trigger.
B) 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".
C) 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.
D) 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?
E) 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."
F) 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.
Adapted from "Resolving Traumatic Memories" (p. 107) by Y.M. Dolan, 1991, New York: W.W. Norton and from Wendy Maltz's "The Sexual Healing Journey", Harper Collins Publishers, 1991, Chapter 5. Copyright Michael J. Sturm 5/95

"Safe Place" Visualization for Containment and Grounding

Like other techniques for containment and grounding, "safe scene" visualization enables an individual to nurture and soothe him or herself and to practice effective control over their feelings and thoughts.

"Safe scene" work utilizes an individual's natural talent for dissociation. When doing "safe scene" work and individual chooses to experience internal stimuli which is safe, soothing and nurturing over internal stimuli which is unsafe, traumatic and re-victimizing. With practice an individual can soothe him or herself at will and exercise control over the spontaneous dissociation and flashbacks that survivors of trauma often experience.

To create an effective safe scene, it is important to incorporate all of the senses. The more senses involved, the more functional the scene will be.

Examples include:

Visual - seeing colors, distances, details, features of the safe place.
Hearing - soothing sounds with varying volumes.
Smell - a variety of pleasant scents.
Touch - a variety of safe and pleasant textures.
Kinesthetic - standing, walking, sitting, lying down.

Focusing inwards and internally visualizing a safe scene can help an individual to quickly relax. There are no limits to the creativity or imagination an individual may employ in the safe scene work. A safe place can be an actual place, an imaginary place, or a combination of the two. Safe scenes can be inside or outside, on this planet or another, and include beaches, islands, meadows, forests, or any other setting that an individual would find safe and soothing.

Safe scenes include items within which can contribute to an even greater feeling of safety and security, such as walls, moats, containment images, and safe animals. It is best to not include other real people in an individual's safe scene image because the security and soothing derived from the safe scene should not be dependent on others and should not reinforce a dependency for safety and soothing on others. Rather, safe scene work reinforces an individual's ability to take responsibility for their own soothing.

Once an individual has developed a safe scene, there are many things he or she can do to reinforce their safe scene and increase its effectiveness. The first step in this process is to write out a detailed description of the safe place, including the experience of all of the senses in the safe place as described earlier. This should then be shared and processed with others (i.e., therapist, or group therapy) in order to receive feedback, comments and suggestions. Then it is often helpful to make a picture which represents in some way the safe place. This, of course, is not to be an artist's rendering of the safe scene, but rather a representation of it through colors, images, etc. Most importantly, the safe scene should be practiced at least three times daily, when a person is in a calm and relaxed state. Safe scenes increase in their effectiveness the more they are practiced.

Here are just some Ideas To Facilitate Grounding:

1.) Visualize internal safe place.
2.) Visualize setting aside overwhelming /memory/emotion/experience
3.) Change sensory experience/input: Sight: allow yourself to see through your eyes, look at a picture, read a book
Touch: allow yourself to feel the chair you are sitting on, touch ice, hold a smooth stone Sound: talk to someone, listen to music, TV Taste: eat something Smell: perfume, favorite scent
4.) Concentrate, become absorbed in activity.
5.) Express something verbally -- go to an empty room and yell, if necessary
6.) Write in your journal.
7.) Do safe anger work with you therapist.
8.) Breathing exercises.
9.) Relaxation exercises.
10.) Self-hypnosis
11.) Connect with internal support/resources
12.) Visualize a "STOP" sign
13.) Use positive affirmations.
14.) Connect with the here and now
15.) Look into a mirror and talk to yourself
16.) Transfer your feeling/memory into a safe "container" either through visualization or by creating an actual box where you can write the feeling/memory on a piece of paper and slip it into the box leaving it to be dealt with together with your therapist.
17.) Monitor self-talk, change negative to positive.
18.) Identify cognitive distortions and replace with counter statements
19.) Dance
20.) Repeat a grounding phrase: "I'm here right now."
21.) Give yourself permission to address one thing at a time ("Rome wasn't built in a day.")
22.) Identify (in writing) all problems you're facing. Then divide them into two groups:
a.) Those you have control over, and
b.) Those you cannot control Concentrate on only one of those issues that CAN be controlled.
23.) Decide what is important and what is not.
24.) Keep It Simple
25.) Hold a safe object (smooth stone, stuffed animal, watch, ring, cup or mug, etc.)
26.) Pray (e.g. Serenity Prayer)
27.) Exercise
28.) Draw
29.) Find a safe person
30.) Listen to a tape of your therapist
31.) Listen to a tape of self-affirmations
32.) Most importantly... Identify the Trigger

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