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Grounding Techniques
What Is Grounding?
Goal: To use simple strategies to calm yourself from negative feelings (for example, drug-craving, self-harm impulse, anger, sadness, anxiety).
- Distraction works by focusing outward on the external world -- rather than inward toward the self. You can also think of it as "distraction," "centering," "a safe place," "slowing down," "looking outward," or "healthy detachment."
"Grounding" means focusing on the outside world rather than on your inner feelings. - "impulse control,"
- "grounding,"
- "gaining control,"
- "centering,"
- "a safe place,"
- "slowing down,"
- "looking outward,"
- "detachment."
Use grounding whenever you are faced with a trigger. Grounding creates a healthy distance between you and the trigger. Most women with PTSD and substance abuse either feel too much (overwhelming emotions, flooding of memories) or feel too little (numbing, dissociation).
In grounding, you attain the desirable balance between the two: you are conscious and in touch with reality, but also able to manage and tolerate it. As long as you are grounding, you cannot possibly use drugs or hurt yourself.
Remember to rate your mood before and after grounding, to test whether it is working. Before you ground, identify how upset you feel (0-10, where 0 means "not upset at all" and 10 means "extremely upset"). Then rerate your mood afterwards. Has it gone down?
As with anything, if a particular technique makes you uncomfortable, don't try it; only you know what will work best for you.
Try to ground yourself by trying any one of the techniques listed below. Once you have found techniques that work for you type them up and print them out and keep them handy to ensure you'll use them when you need them:
MENTAL TECHNIQUES
Pull up the daily newspaper on your browser, like
The Washington Post
Call a friend and ask them to talk with you about something you have recently done together.
Mentally remind yourself that the memory was then, and it is over. Give yourself permission to not think about it right now.
Realize that no matter how small you feel, you are an adult. If you have kids think about them now.
Speak out loud. Say your name, or your childs name or significant others name.
Visualize a bright red STOP sign to help you stop the flashback and/or memory
During a non-crisis time make a list of things that are in your house and what room they are in. Give this list to friends that you can call during a flashback so they can help remind you what is around you.
During a non-crisis time make a list of positive affirmations. Print them out and keep them handy for when you are having a flashback. During a flashback read the list out loud.
Listen to familiar music and sing along to it. Dance to it.
Make a list of known triggers and give it to your therapist. Ask them if they can help you find a way to desensitize those triggers so they aren't quite so powerful.
Write in your journal. Pay attention to yourself holding the pencil. Write about what you are remembering and visualize the memory traveling out of you into the pencil and onto the paper. Tear the paper up or seal it in an envelope. Give it to your therapist for safekeeping.
Go online and talk with an online friend. Write an email.
Imagine yourself in a safe place. Feel the safety and know it.
Watch a favorite t.v. program or video. Play a video game.
Meditate if you are comfortable with it.
Say a "safety statement": "My name is _____;
I am safe right now. I am in the present, not in the past. I am located in ________; the date is ________.
I am clean from drugs."
Remember the names and faces of people who are important to you (if possible, carry photographs of them to look at).
Say a coping statement: "I can handle this,"
"One step at a time,"
"This feeling will pass."
Use humor: think of something funny to jolt yourself out of your mood.
Count to ten or say the alphabet, s...l...o....w....l...y.
Repeat a favorite saying to yourself, over and over, like a mantra.
PHYSICAL TECHNIQUES
Name 5 things you can feel, see, hear, smell and can taste. Then list 4 of each , the 3 of each, 2 of each, then 1 of each.
Stomp your feet to remind yourself where you are. Press your feet firmly into the ground.
Run cool or warm water over your hands, or hold a frozen orange -- feel it's texture, smell it's fragrance; when it is thawed out you can peel it.
Carry a "grounding object" in your pocket, that is, a small object (such as a small rock, clay, ring, piece of cloth or yarn) that you touch whenever you feel triggered.
Try to notice where you are, your surroundings including the people, the sounds like the t.v. or radio.
Spray some perfume or cologne that is a safe smell, reassuring, on a tissue and smell it.
Concentrate on your breathing. Take a deep cleansing breath from your diaphragm. Count the breaths as you exhale. Make sure you breath slowly so you don't hyperventilate.
Cross your legs and arms. Feel the sensations of you controlling your body.
Take a warm relaxing bubble bath or a warm shower. Feel the water touching your body.
Keep a rubberband on your wrist and pluck it -- feel the slight sting as it touches your skin.
Find your pulse on your wrist and count the beats per minute. Concentrate on feeling the blood pulse throughout your body.
Go outside and sit against a tree. Feel the bark pressing against your body. Smell the outside aromas like the grass and the leaves. Run your fingers through the grass.
If you are sitting, stand. If you are standing sit. Pay attention to the movement change. Reminding yourself -- you are in control.
Rub your palms, clap your hands. Listen to the sounds. Feel the sensation.
Hold something that you find comforting, for some it may be a stuffed animal or a blanket. Notice how it feels in your hands. Is it hard or soft?
Eat something. How does it taste, sweet or sour? Is it warm or cold?
If you have a pet (a dog, cat, hamster, gerbil) use that moment to touch them. Feel their fur and speak the animals name out loud.
Go to a mirror and make yourself smile. Watch your reflection as the expression changes. How does it make you feel.
Step outside. If it's warm, feel the sun shining down on your face. If it's cold, feel the breeze. How does it make your body feel?
Take a walk outside and notice your neighborhood. Pay attention to houses and count them.
If you have a garden, work in it. Feel your hands running through the dirt.
Wash dishes or clean your house.
Exercise. Ride a bike, stationary or otherwise. Lift weights. Do jumping jacks.
Get up and walk.(2)
Grounding works! But, like any other skill, you need to practice to make it as powerful as possible. Below are some advanced methods to make grounding work for you.
Practice longer: it may take anywhere from five to thirty minutes for grounding to work
Practice as often as possible.
Be sure to keep your eyes open, scan the room, and turn the lights on.
Try to notice whether you do better with "physical" grounding methods or "mental" grounding.
Create your own methods of grounding. Any method you make up may be worth much more than those you read here because it is YOURS.
Start grounding as early as possible. Start before you succumb to the trigger: for example, when the drug craving has just started, or when you begin to dissociate -- Start distraction as early as possible in a negative mood cycle. Start when the craving just starts or when you have just noticed a drug trigger. Start when you begin to feel yourself "spacing out" (dissociating). Start before the anger gets out of control. Make up an index card on which you list your best distraction methods and how long to use them.
Have others assist you in grounding. Teach a friend or family member how grounding works so that she or he can help guide you in if you become overwhelmed.
Prepare in advance. Locate a place at home, in your car, and at work where you have materials and reminders for grounding.
Make up an index card on which you list your best grounding methods and how to use them.
Don't give up!!
Try grounding for a loooooooonnnnngggggg time (30 minutes). And, repeat, repeat, repeat it.
Create an audiotape of a grounding message to yourself that you can play when needed. Also, you can record on it the voice of someone important to you.
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
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Cass' System!
