Grounding Skills

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 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

1.)  Keep your eyes open, look around the room, notice your surroundings, notice the details of your surroundings.

2.)  Hold a pillow, stuffed animal or a bell

3.)  Place a cool cloth on your face, or hold something cool such as a can of soda.

4.)  Listen to soothing music.

5.)  Put your feet firmly on the ground.  ( help to have your shoes off so you can feel the ground and feel the detail of the floor)

6.)  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 question.

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 Skill every day.

GOALS WHEN USING GROUNDING TECHNIQUES

1.)  To keep myself safe and free from injury and harm.

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 the 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 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

SAFE PLACE "VISUALIZATION FOR CONTAINMENT AND GROUNDING"

Like other techniques for containment grounding, "Safe scene" visualization enables in individual to nurture and soothe him/herself and to practice effective control over their feeling and thoughts.

"Safe scene" work utilizes and individual's natural talent for dissociation.  When doing "safe scene" work and individual choose 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/herself at will and exercise control over the spontaneous dissociation and flashbacks that survivors of trauma often experience.

To create and effective safe scene, it is important to incorporate all of the senses. The more senses involved, that 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 inward and internally visualizing a safe scene can help an individual to quickly relax.  There are no limits t 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 walls, moats, containments images, and safe animals.  It is best to not include other people in an individual's safe scene image because the security and soothing derived from the safe scenes should not reinforce a dependency  for safety and soothing on others.  Rather, safe scene work reinforces and individual's ability to take responsibility for their own soothing.  Once an individual has developed a safe scene, there are many things he/she can do to reinforce their safe scene and increase its effectiveness.  The first step in the 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 through your eyes, look at a picture , read a book.

Touch:  Allow yourself to feel the chair you are sitting in, 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 your therapist

8.)    Breathing exercises

9.)    Relaxation exercises

10.)  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 and 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 as a time.

22.)     Identify ( in writing all problems you're facing.  Then divide them into two groups.

a.)  Those you have control over.

b.)  Those you cannot control.

Concentrate on only one of these 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.