Grounding Techniques

Image: "RHS Chelsea Flower Show 2014" by Karen Roe

CC BY-2.0

Grounding techniques are techniques that are used to prevent, dull, or distract from dissociation, flashbacks, switching, panic attacks, self harm, addiction cravings, or other negative emotions, internal experiences, or impulses. They work by engaging the senses and occupying the mind in a non-destructive fashion. Many grounding techniques are subtle and can be done anywhere without other people noticing, though some rely on specific sensory experiences or are made available through specific apps for phones or ipads. Grounding techniques are not the same as processing techniques and do not involve getting in touch with one's emotions or struggles. Instead, they help to orient one in the present and to achieve a healthy medium between being cut off from or overwhelmed by emotions.

Some people find that some grounding techniques work better for them than do others, and some grounding techniques may be more helpful in some situations than in others (such as a technique being more useful for dissociation than for panic attacks). Some techniques may become more effective with practice. As well, grounding techniques may be easier to use when an individual first begins noticing the signs that grounding might be necessary. If someone is experiencing an intense flashback, it can be harder for them to realize what grounding techniques are available to them and which are likely to be effective, to carry out a grounding technique, or to even understand that grounding is an option.

Knowing what situations are likely to trigger a negative emotional response, dissociation, or flashbacks and having grounding techniques prepared can help to prevent being too overwhelmed in the moment. Having easy access to tools that one often uses to ground can also help, as can having phone apps that walk one through the process of grounding. In some cases, one's friends, partners, medical professionals, or other caring individuals can help, especially if the individual worked out a plan with them beforehand. Finally, keep in mind that sometimes grounding may need to be combined with temporarily removing oneself from an unnecessarily stressful or overwhelming situation, choosing a different topic of conversation, removing some sources of sensory overload or environmental triggers, or taking a nap or going to sleep for the night if one is stretched too thin to ground in the moment on their own. There's no shame in sometimes needing to change one's circumstances instead of trying to cope with everything as it is. Learning when to ground and when to look for other ways to feel and stay safe is an important skill. More can be addressed by grounding alone through practice and with time.

Mental Distraction Techniques

• Pick a category of objects and try to think of as many objects as possible that fit within that category (e.g., types of dogs, cities, types of trees, crayon colors, sports)
• Pick a letter and think of emotionally positive or neutral words that begin with that letter
• Pick a color and look for things of that color. Notice differences in their exact shades
• Say or think the alphabet backwards or alternate letters and numbers (A1, B2, C3, D4, etc)
• Count backwards from 100 by 3s, 6s, or 7s or count up by prime numbers or perfect squares
• Play "fizz-buzz" with yourself. Begin counting to 100 (or over!), but replace any number that contains the number 5 or is a multiple of 5 with the word "fizz" and any number that contains the number 7 or is a multiple of 7 with the word "buzz." For example, 1-15 would be "1, 2, 3, 4, fizz, 6, buzz, 8, 9, fizz, 11, 12, 13, buzz, fizz." When you mess up, compliment yourself and start over
• Think of the words to your favorite song or poem or think of facts related to a specific theme
• Pick a word or your name and see how many other words you can make from the letters in it
• Describe an every day event or process in great detail, listing all of the steps in order and as thoroughly as possible (e.g., how to cook a meal, how to get from your house to your place of work or school, how to do your favorite dance)
• Read something technical or meant for children or read words backwards to focus on the process of reading and not the words
• Watch a children's television show or movie or watch cute or funny videos on Youtube; it might help to have a playlist already prepared for this
• Look at a current news article that is not likely to be upsetting or distressing
• Distract yourself with Tetris, Solitaire, Sudoku, word searches, or other puzzle games

Reorientation Techniques

• Say or think to yourself: "My name is _________. I am safe right now. I am _____ years old. I am currently at _____________. The date is _____________. If I need help, I am with ________/can call _________. Everything is going to be alright."
• List reaffirming statements ("I am fine. Everything is going to be okay. I am strong. I can handle this.")
• Ask yourself where you are, what day of the week it is, what day of the month it is, what month it is, what year it is, what season it is, how old you are, and other present-focused questions
• Notice things in your surroundings that indicate to you that you're safe or that you're in the present (e.g., locks on your door, electronics that didn't exist when you were younger, the presence of trusted people, a phone so that you can call for help if you need it)
• Describe your surroundings in detail, including sights (objects, textures, shapes, colors), sounds, smells, and temperature
• Name five things that you see, four that you feel, three that you hear, and two that you smell or taste, and then name one good thing that you like about yourself
• Pick four or five brightly colored objects that are easily visible and move your focus between them. Be sure to vary the order of your gaze and concentrate briefly on each one before moving to the next
• Think about a fun time that you recently had with a friend or call that friend and ask them to talk about it with you

Sensory-Based Grounding Techniques

• Run cool or warm (but not too cold or hot) water over your hands or take a cool or wam bath or shower
• Spritz your face (with eyes closed), neck, arms, and hands with a fine water mist
• Spray yourself with your favorite perfume and focus on the scent
• Feel the weight of your body in your chair or on the floor and the weight of your clothing on your skin
• Touch and hold objects around you. Compare the feel, weight, temperature, textures, colors, and materials
• Keep a small object with you to touch or play with when you get triggered. Good examples include a smooth stone, a fidget toy, jewelry, or a tiny plushy
• Bite into a lemon, orange, or lime, suck on a sour or minty candy or an ice cube, chew cinnamon-flavored gum, or put a few drops of Tabasco sauce on your tongue. Notice the flavor, scent, and texture
• Eat something or drink warm tea, coffee, or hot chocolate, and describe to yourself the taste and texture in great detail
• Place a cool wash cloth on your face or hold something cold like a can of soda
• Listen to soothing or familiar music. If possible, dance to it
• Hum, sing, recite poetry, or make up a silly poem or story as you go
• Pick up a book and read the first paragraph out loud
• Hug another person (if interpersonal touch isn't a trigger). Pay attention to your own pressure and the physical sensations of doing so
• Hug a tree! Register the smells of being outside, the wind, and the sights around you

Movement-Based Grounding Techniques

• Breathe deeply and slowly and count your breaths
• Grab tightly onto your chair or press your feet against the ground as firmly as you can
• Rub your palms and clap your hands or wiggle your toes within your socks. Pay attention to the physical sensation of doing so
• Stretch out your arms or legs, roll your head on your neck, or clench and unclench your fists
• Stomp your feet, walk around, run, jump, ride a bike, do jumping jacks, or do yoga
• While walking, notice each footstep and say to yourself "right" and "left" to correspond with the foot currently moving
• Squeeze a pillow, stuffed animal, or ball
• If you have a soft pet (dog or cat), brush its fur and stroke it. If you don't, brush your own hair slowly and without pulling too much
• Color in an adult coloring book, finger paint, or draw anything that comes to mind without worrying about quality
• Write whatever comes to mind even if it's nonsense. Try not to write about whatever is upsetting you until you're more capable of doing so without increasing the upset
• Write a list of things that make you happy or look for cheerful pictures to make into a collage
• Pop bubble wrap or blow and pop actual bubbles
• Dig in the dirt or garden, jump on a pile of leaves, or splash around in puddles or mud
• Rip up paper or stomp on aluminum cans to crush them

Imagery Techniques

• Picture yourself breathing in relaxation, calm, positive feelings, or strength. Picture yourself breathing out whatever is upsetting you. It may help to pair this with imagery of breathing in soothing colors (usually blue, purple, or green) and out more intense colors (usually red or black)
• If you need to relax, envision a soothing white or golden light slowly moving up your body, warming and relaxing every part of you that it touches. You can also think of it as protecting you from negativity or from harm
• If the problem is intense or uncomfortable emotions, physical sensations, or memories, picture them being surrounded and neutralized by a bright and healing light, temporarily placed in a mental box to be stored for later, or dialed back by an internal controller of intensity
• If you have a clear mental picture of what's upsetting you, mentally change it to something silly or harmless. If you're a fan of Harry Potter, cast a mental "riddikulus" to banish the negativity
• Picture yourself calm, focused, and able to tackle whatever problems you're facing. Focus on how that would feel in the moment. What would your expression and posture be like? Make whatever changes you need to in order to make your reality reflect your goal

How to Make a Grounding Box

• Get a box or basket
• Personalize and decorate it with construction paper, wrapping paper, ribbon, stickers, drawings, paint, photographs, glitter, sequins, or anything else that you like
• Keep within it:
• A list of grounding techniques that you know work for you

A list of positive affirmations and happy memories

• A list of the contact information of trusted friends or family who are willing to help and support you
• Small sensory objects such as: scented candles, perfumes, or lotions; hard candies or gum; soft fabrics, a stress ball, a stuffed animal, or a fidget toy; happy pictures of you with friends; a CD with relaxing music or meditation tracks. Try to cover all of the senses
• A list of possible distractions such as books to read or movies to watch
• Small portable distractions such as a pack of playing cards, a small game, or a joke book
• A list of comforting things to do such as taking a bubble bath, snuggling up in bed, or meditating
• A small journal or notebook

In the Case of a Flashback

• Tell yourself that you are having a flashback and are safe now
• Remind yourself that the worst is over, and you survived it. What you're feeling now is just a reminder of that trauma and does not fit the present moment
• Remind yourself of when and where you are, who you're currently with, and who you can contact if you need help (use the reorientation-focused grounding techniques)
• Breathe deeply and slowly. Count your breathes and make sure that you're getting enough air
• Use other mental, sensory, movement, and imagery techniques in order to distract yourself, calm yourself, and reorient yourself within the present
• If possible or necessary, go somewhere where you can be alone or with a close friend, where you will feel safe, or where you feel protected or shielded
• If there is anyone who you can trust or who will support you, reach out to them, let them know what happened, and let them know what you need, what would be best for you, or what they could do to help
• Be gentle with yourself and take the time to really recover. If what helps you to recover is to color, take a bubble bath, hug a stuffed animal, or watch a children's movie and if it would not be disruptive to do such things at that point in time, embrace those options whole-heartedly
• If possible, note or write down what triggered the flashback, what techniques you tried to use to disrupt the flashback, and what techniques helped
• Remember that you're a survivor. You're strong, and you can make it through this, though it might take some time. Be patient with yourself throughout the process of healing

Resources

https://www.e-tmf.org/downloads/Grounding_Techniques.pdf

http://www.incaresurvivors.org.uk/resources/ICSSS-Anxiety-Flashbacks-and-Grounding-techniques.pdf

http://joyproject.org/overcoming-eating-disorder/automatic-reactions-and-grounding-skills/

http://ptsdconfessions.tumblr.com/post/58024358090

http://www.sac.ualberta.ca/en/~/media/sac/Documents/Flashbacks_2009.pdf

http://mental-health-matters.com/coping-with-flashbacks-goals-and-techniques-for-handling-the-memories/?start=1

Grounding and Mindfulness Apps

http://www.makeuseof.com/tag/practice-mindfulness-help-iphone-apps/

http://www.miassisttech.org/mdrcat/index.php/panic-attack-theres-an-app-for-that/

http://www.livingwell.org.au/get-support/living-well-app/

https://itunes.apple.com/us/app/ptsd-free/id658644270?mt=8

https://itunes.apple.com/us/app/virtual-hope-box/id825099621?mt=8

https://www.headspace.com/

http://stopbreathethink.org/

http://smilingmind.com.au/

Distraction Apps

http://thisissand.com/

https://itunes.apple.com/us/app/magic-fingers!/id483980400?mt=8

https://itunes.apple.com/us/app/musyc/id489836689?mt=8