What we call “grounding” is a method of dealing with strong emotions that seem very overwhelming, such as fear, sadness or flashbacks when a memory takes over and is experienced in the present.
The reactions after being exposed to one or more traumatizing events can be frightening for most people. Many people experience major changes in their own behaviour which in themselves are disturbing. Shock, irritability, sleeplessness, flashbacks, nightmares and remoteness can be experienced as being changed; not fully recognising oneself. Some triggers seem incomprehensible and unpredictable but can trigger strong reactions. The trauma reactions lead to a feeling of lack of control over oneself and some fear of having gone mad.
To deal with trauma therapeutically, gradual exposure will almost always be decisive. But just as important as exposure is helping to gain control over the traumas, to learn to cope with them and to have the tools to master them. You get some tools to deal with your symptoms and get some distance from the evil that happened. By feeling safe in the present, you gain more perceived control over thoughts, feelings and bodily sensations.
We have previously described the “tolerance window”, what it means to be overactive or underactive. After traumatic experiences, the “tolerance window” is narrower; it takes little to become hyperarousal or hypoarousal. One needs both to widen the “window”, i.e., widen the tolerance for negative affect, and methods to return to a level of activation where one can reflect, learn and respond in a rational way. Below are some exercises that can be used to return to the “window”.
Always remember to invite the survivor to participate in a grounding exercise. Let it be an open invitation. If he does not feel ready to participate in an exercise, respect his wish. Remember that some survivors might be triggered by certain types of grounding exercises that suggest closing one’s eyes or concentrating on certain senses.
You can find more grounding exercises on our training manual for Women page.
1. Safe place
This exercise can help survivors to calm down, subdue overactivation, and find a more balanced emotional state.
While doing this exercise, you can choose to keep your eyes open or closed.
(1) Think of a place that makes you feel calm and safe. It may be a place you’ve been to, or a place you’ve seen in a film, or heard of. It can be at home with yourself or with someone you know, or a place in nature. You can also create a place in your imagination.
(2) The place must suit you and your needs. You can constantly adapt it. No two people are alike: this is your place.
(3) It is a private place that no one else knows about or can find without your permission. You choose it and you decide whether you want to share it with others or not. The place should shut out all the stimuli of the present that are overwhelming and should be comfortable and richly equipped for all your needs. Everything is here that you require to be comfortable.
Important note: some helpers prefer to change the name of this exercise from “safe place” to “calm place“. When people live in unsafe contexts, such as war and conflict zones, the very mention of the concept of safety might be difficult, even triggering.
(4) Visualise this place in your imagination, and imagine that you are there. Take time to imagine it in detail: its colours, shapes, smells, sounds. Imagine the sunshine, feel the wind and the temperature. Notice what it is like to stand, sit or lie there; feel how your body is in contact with it. Feel what it’s like when everyone is safe, everything is fine. In your safe place you can see, hear, feel, smell and feel exactly what you need to feel safe.
(5) You can go to this place whenever you want and as often as you want, and just by thinking about it you will feel safer and calmer.
(6) You might want or need more than one place. Work on this step by step. Notice what each memory or emotion needs.
Note. Some male survivors might find it more useful to imagine an activity they like that comforts them to think about, instead of a place; for example, playing a game of football or walking their favourite hiking path.
2. Distinguish past from present
This exercise can help survivors to calm down and deal with overactivation.
- Recall a mildly unpleasant incident, when you were a little anxious, restless or ashamed. What do you notice in your body? What happens in the muscles? What happens in the stomach? How does your breathing change? Does your heart rate accelerate or decelerate? Do you become hotter or colder? If there are changes in temperature, do they occur everywhere or in specific parts of your body?
- Now turn your attention back to the room you are in. Notice the colour of the wall. Notice details of decoration. What is the temperature? What do you smell?
- Does your breathing change when your attention changes?
- Now try to pay attention to your current surroundings while remembering the mildly unpleasant event. Can you keep your attention on where you are physically now, while remembering the event?
- End this exercise with your attention focused on your current surroundings.
3. Handle flashbacks by being attentive
This exercise can help survivors to calm themselves and deal with overactivation.
[Example]
Right now I feel _________ (Insert the name of the feeling you have, often fear).
My sensations are that I am _______________________________ (Name three bodily sensations.)
I remember _____________________ (Give one source of trauma, give no details.)
At the same time I look around at where I am now: in _________ (Write the current year).
In __________________ (Write your location now).
I can see___________________________ (Describe things you see now, in the place you are in).
Therefore I know that _______________ (name the trauma again) is not happening now.
4. Attentive presence
This exercise can help survivors to calm down and anchor themselves in the here and now.
- Sit in a comfortable position. Sit with your back straight and let your shoulders relax.
- Choose whether you want your eyes open or closed. If you have your eyes open, try to let your gaze focus approximately half a metre in front of you.
- Notice how the body feels against the surface: feet on the floor, thighs against the seat, etc.
- Notice your breathing. Feel your breath enter and leave your lungs. Choose whether you want to focus on the air in your nostrils or the air in your lungs. Breathe in; breathe out.
- Keep your attention on your breath and follow it in and out.
- Notice what thoughts are flowing through your head. What feelings do you have? Acknowledge the feelings. What are your bodily sensations right now? Feel for any tension or discomfort.
- Every time you notice something else entering your consciousness, notice it (“greet it”), and kindly but firmly bring your attention back to your breath.
Try as well as you can to see your thoughts as mental events, perhaps by naming them. Accept all thoughts, images and feelings that arise. Try not to push any thoughts away or become involved
in them. Leave them alone and concentrate on your breathing. If your attention is distracted one hundred times, your only task is still to return to your breathing. If you have thoughts like “I can’t do this very well” or “this was weird”, notice them and return your attention to your breathing. If you need the help of a picture, imagine that your consciousness is the sky and that thoughts, feelings and sensations are clouds moving across it. For some, it will be difficult to focus on breathing. It is possible to choose another focus, such as looking at an object, listening to a sound, or repeating a specific movement (for example, walking).
5. Noticing and reducing anger using “the window of tolerance”
The anger and frustration of survivors is often caused by real and inescapable problems. Not all anger is misplaced; often it is a healthy, natural response to difficulties. In many instances, the most helpful thing to do is not to focus on finding a solution to these, but on how to manage the problem.
Here, the “window of tolerance” can be useful (see this page). All people have an area or window where they are in balance, where their state of mind allows them to be present, concentrate, and learn new things. If the person is above the window of tolerance, we say he is overactivated. This means that he cannot cope.
What helps a person to control his anger and return within the window varies from one individual to another. If a survivor tends to become angry, work with him on visualising the “window of tolerance”. Plan with him what he can do to get back into the window.
For example, he can:
- Remove himself from the situation and go for a walk or a run, to change his mental and physical state.
- Slowly count backwards from 10 and focus on his breathing.
- Do a grounding exercise (for example exercise 4, Attentive presence, or Progressive muscle relaxation).
- Have a squeeze ball ready to channel his negative energy.
6. Worry time
When a survivor has spoken about frightening experiences, he may feel worried and anxious afterwards. To a survivor in this position, you can give the following advice:
It is not always possible to forget all worries, but you can schedule a worry-time – for instance between 5.45 and 6 pm. Whenever a worrying thought arrives, notice it and say to it: “Hello, I know you are there, I will attend to you, but you have to wait until 5.45”. Alternatively, seat each of the worrying thoughts and feelings you have around a table. In turn, invite each one to express its concern. When you have listened to what they have to say, you review what they have said. You decide what you can dismiss and what might be useful. Then you end the meeting and go on with your day.
7. The river. Create a coherent narrative.
Rivers can be a good metaphor for time and the course of life. A river flows in one direction, from its source to the sea, from cradle to grave, birth to death. Our thoughts and attention are like birds above the river, flying back and forth. We remember good and terrifying things, sorrows but also happy events. Our thoughts also fly into the future, to our worries, what we fear, what we look forward to and long for.
Together, the helper and survivor visualise the river. On one bank of the river, draw symbols or write keywords that represent the survivor’s good memories, the good things of the present, and what he hopes the future will bring.
On the other bank, draw symbols or write keywords that represent sad or frightening things the survivor has experienced in the past, what is stressful in the present, what makes him anxious or worried about the future.
Make sure he draws and writes some things that he longs and hopes for in the future. Encourage him to notice where his thoughts tend to travel.
This exercise can help a survivor see his life as a whole. This may in turn help him to feel that his traumatic experiences do not dominate altogether but can become just one part of his experience, alongside many other memories.