What do therapists mean when they talk about grounding?
Grounding is about learning to stay present (or for some get present in the first place) in your body in the here and now. Basically it consists of a set of skills/tools to help you manage dissociation and the overwhelming trauma-related emotions that lead to it. Processing done from a very dissociated state is not useful in trauma work. Neither is the goal to be so overwhelmed by feelings that you feel re-traumatised. Once you are present, you also need to learn other means of managing the feelings and thoughts associated with traumatic memories.
Every one is different. Different grounding techniques will work for different people. The following are some general categories and ideas. Exploring the pros and cons of various approaches with your therapist can be useful.
Grounding often takes the form of focusing on the present by tuning into it via all your senses. For example, one technique could involve focusing on a sound you hear right now, a physical sensation (what is the texture of the chair you are sitting on, for example?) and/or something you see. Describe each in as much detail as possible.
Diaphragmatic or deep breathing: Trauma survivors often hold their breath or breathe very shallowly. This in turn deprives you of oxygen which can make anxiety more intense. Stopping and focusing on deepening and slowing your breathing can bring you back to the moment.
Relaxation, guided imagery or hypnotherapy techniques- folks with dissociative disorders are engaging in a form of self-hypnosis much of the time. The trouble is, it is out of your control! Some trauma therapists are also trained in hypnosis and can help teach you how to use dissociation in a way that works for you. For example: you can develop a safe container for traumatic material between sessions, create a safe or comfortable place (“safe” may not be a concept some survivors can relate to or may be triggering to some) or learn ways to turn down the “volume” of painful feelings and memories.
Grounding and emotion management skills can help you proceed with the work of trauma therapy in a manner that feels empowering instead of re-traumatising.
Finding a Safe Place or Activity
A safe place is a form of anchor to reduce the stress of working with traumatic
memories. "Anchors" can be used as ‘braking’ tools when the going gets rough.
A suitable anchor is one that gives relief (in body and emotion) and a sense of well-being.
It is preferable that an anchor is chosen from real life experience, so that positive memories
in both body and mind can be accessed. It is useful to work with your counsellor
to establish in advance an anchor that can be used when needed in trauma work.
A safe place or activity is a current or remembered experience of protection.
It should have associations of calmness and safety (as opposed to ‘relaxing’ -
which can feel unsafe for people who have experienced trauma, or ‘pleasurable’ - which can
be over- stimulating). It is preferable for the safe place/activity to be something real that is
known from life. This is because there will be somatic resonance in the memory - sights, sounds, smells, etc. which will be recorded as sensory memory traces and be highly accessible.
It is helpful to imagine the safe place/activity during times of stress and anxiety, or it can
be used as an anchor, to reduce hyper-arousal during a therapy session.
Thank you for your helpful well-written advice. It is much appreciated.
ReplyDeleteI so appreciate your writing about this, all the year's of therapy, didn't help.I know why I do what I do
ReplyDeleteAs a counsellor who works with survivors, I couldn't agree more about the importance and usefulness of grounding techniques. Not just for in the counselling room (but vital for safety in that context) but also for coping day to day with trauma symptoms like flashbacks, nightmares, intrusive memories etc. Thank you for such a clear, helpful article
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