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Present Moment Grounding Techniques

Present moment grounding techniques can help to anchor you to the present and help you find solid ground.

Situate yourself. Repeat to yourself today’s date, the day of the week, month, year, time of day, and where you are currently. Remind yourself that you are safe in the moment, not in the past, and right now you are safe. Notice the season it is outside, and what the sky looks like. Name the street you are on and the postal code/zip code.

Now and plans for the day. Remind yourself of who you are now. Your name, age, occupation. Where you are. What you did today and what you are going to do next and later today.

What is going on? Remind yourself where you are and today’s date. Acknowledge that you are feeling the emotions, thoughts, or body sensations from the trauma coming into the present.

Distraction Techniques

Distraction techniques are best used for tolerating and surviving a crisis situation that you cannot deal with at the moment. It is about moving you away from the extreme feelings, body sensations, and thoughts of the moment. It is important that you do not over-rely on distraction techniques as they take you out of the present moment, and can lead to problems with dissociation.

Math & Counting

Count backwards from 100 by 7.

Count colours in a painting.

Run through a times table in your head.

Pick and number and try to come up with as many equations that will get you to that number (addition, subtraction, multiplication, division, etc.)

Count your breaths.

Categories

List as many items you can think of in a category (dogs, cities, fruits, etc.). Make sure you are able to list at least 10 or switch to a different category.

Pay attention to your surrounding and make lists of items in your surrounding that fit into different categories.

Go down the alphabet and for each letter list girls’ names and then boys’ names. You also can do the alphabet strategy for other categories like countries and fruits.

Reading

Read something backwards, letter-by-letter. Practice for at least a few minutes.

Recite a poem, story, or song.

Spell the weather, such as rain R-A-I-N.

Guessing /Memory Games

Look at people around you and guess their occupation.

Look at a photograph or picture for 5-10 seconds. Turn over the picture and recreate it in your mind or mentally list all the things you remember in the picture.

Emotions (Try to get in touch with a different emotion – the goal is to get out of the current emotion that you are feeling)

Listen to emotional music that evokes a different emotion.

Watch emotional movies, shows, films, or documentaries that evoke a different emotion.

Read emotional books/stories.

Comparisons

Think of a time when you felt differently and compare it to how you feel now.

Watch reality TV shows about others’ troubles or watch documentaries about disasters.

Activities

Focus on a task, movie/show, video/computer/mobile game, or surf the internet

Read a newspaper, magazine, or book.

Do a puzzle, colour in a colouring book, or doodle.

Visualization

Visualise yourself putting the problem on a shelf for you to come back to later.

Visualize a daily/common task that you enjoy and go through all the steps mentally that it takes to complete the task.

What is Sensorimotor Psychotherapy?

Sensorimotor Psychotherapy was developed by Pat Odgen and is a body-centred approach that focuses on the somatic symptoms of trauma. It holds that unresolved traumatic experiences end up trapped within the body. It is a combination of somatic therapies, attachment theory, neuroscience, cognitive techniques, and other techniques.

The focus of Sensorimotor Psychotherapy is to use a person’s physical, mental, and emotional states to manage and relieve the physical sensation that are connected to the trauma. Details of the trauma do not necessarily need to be recalled for the treatment to be effective.

Sensorimotor Psychotherapy can be beneficial for:

  • PTSD
  • Substance dependency
  • Abuse
  • Anger
  • Relationship issues
  • Depression
  • Anxiety
  • Development issues
  • Issues with emotion regulation
  • Chronic pain

Further Reading

Sensorimotor Psychotherapy https://sensorimotorpsychotherapy.org

This is the official website for Sensorimotor Psychotherapy. It is more for therapists desiring trainings, but it does have some information on Sensorimotor Psychotherapy and it has a Therapist Directory in which you can look up officially trained therapists.

What is Somatic Experiencing (SE)?

Somatic Experiencing (SE) was developed by Peter Levine and focuses on addressing the effects of trauma. It focuses on releasing people from where they may have been stuck in a traumatic event. For example, someone may develop chronic pain in a body part that was hit in a motor vehicle accident. The reason for that pain may not be physical but may be due to not going through certain processes that release the traumatic energy and therefore the energy stays in the body and creates tensions and pain.

The purpose of Somatic Experiencing is to help the body release the traumatic energy and to enable it to self-regulate.

The focus of Somatic Experiencing is to help the client find places of safety so that the client can experience sensations relating to traumatic events in a safe way and be able to process the trauma.

Somatic Experiencing can be very helpful for trauma and other conditions that involve a dysfunctioning nervous system from trauma.

Further Reading

Trauma Healing https://traumahealing.org

This is the official website for Somatic Experiencing. It has resources, information on trainings, and a place to look up therapists who have passed their official trainings.

Official Youtube Channel https://traumahealing.org/c/SomaticExperiencingInternational

Recommended Books

Healing Trauma – Peter Levine

This book is a simple little book that is a 12 phase Healing Trauma program. It provides the necessary information that is important to trauma healing but not all the science behind it (if you want the scientific background read Waking the Tiger or In an Unspoken Voice for that information). It includes a CD with 12 guided Somatic Experiencing exercises. There are a variety of exercises or modifications that you can use for each of the 12 phases.

In an Unspoken Voice – Peter Levine

This book summarizes Peter Levine’s work in trauma. It explains the science behind the strategies of Somatic Experiencing, why some people develop PTSD and others don’t, what you can do to lessen the chances of developing PTSD after a traumatic event, and what you can do to release the trauma that has become trapped in the body after a traumatic event.

What is Internal Family Systems (IFS)?

Internal Family Systems (IFS) Therapy was developed by Richard Schwartz in the 1990s after he began hearing clients speak about inner parts within themselves. He looks at these parts as an internal family in the mind, where some parts have certain goals while other parts have other goals. Each part has its own likes, dislikes, burdens, and history and is thought to play a role in achieving self-preservation. Parts have healthy, productive or extreme roles and those with extreme roles may benefit from therapy.

There is a Self that is the seat of consciousness at the core of each person. The Self is often hidden by the different parts, especially the extreme or wounded parts which are trying to protect it. The goal is to unburden those parts and create a trusted, healthy, harmonious internal system that is coordinated by the Self.

Internal Family Systems is an evidence-based practice and has been found to be effective for the improvement of general and mental well-being. It can be used to treat:

  • Trauma
  • Physical, emotional, or sexual abuse
  • Compulsive behaviours
  • Depression
  • Bipolar
  • Body Image issues
  • Anxiety
  • Phobias
  • Substance dependency
  • Chronic pain

Internal Family Systems can be used to understand why certain behaviours keep happening and for more extreme behaviours (substance dependency, self-harm) figure out if those behaviours are still needed and what could be done instead. Some of the parts may be living in the past when the circumstances were different and Internal Family Systems can be used to bring those parts into the present where those extreme behaviours are not needed anymore. Internal Family Systems can be a powerful tool to work with trauma, especially developmental trauma.

Further Reading

IFS Institute https://ifs-institute.com

This website is the official website for the practice of Internal Family Systems. It has resources, ways to find a formally trained IFS therapist, training and learning options, information about the theory, and research about IFS.

No Bad Parts – Richard Schwartz

This is a book written by the founder of Internal Family Systems, Richard Schwartz, for the general public. It explains the IFS theory and why it works for trauma and other struggles. It also includes techniques and exercises.

What is Cognitive-Behaviour Therapy (CBT)?

Cognitive-Behavioural Therapy (CBT) is a short-term form of behavioural therapy. It focuses on the relationship between beliefs, thoughts, feelings and behaviours. The assumption behind CBT is that by changing one corner of the triangle, you can change the other corners of the CBT triangle (see image below). For example, by changing the thought you have in a situation you also can change the emotion and behaviour you have in that situation. In cognitive behaviour therapy, there is awareness brought to the pattern of thoughts or emotions and then there is an effort to change that pattern. This is done with short manageable goals.

CBT can be used to better manage and cope with chronic conditions such as Chronic Pain, Chronic Fatigue Syndrome, Diabetes, and Irritable Bowel Syndrome.

CBT has been found to be effective for:

  • Depression
  • Anxiety
  • Mood Issues
  • Post-traumatic stress
  • Obsessions and compulsions
  • Chronic fatigue syndrome (CFS)
  • Irritable bowel syndrome (IBS)
  • Chronic Pain
  • Sleep Issues
  • Phobias
  • Disordered eating
  • Substance dependency
  • Sexual issues
  • Anger management

It can be very effective to lessen the suffering of people who have negative thought patterns or are prone to anxiety. It complements other modalities as well.

Further Reading

Beck Institute https://beckinstitute.org

This is the website of the institute of one of the biggest influencers of Cognitive Behaviour Therapy. This website has a lot of information about CBT, possible trainings, and other resources.

Mind Over Mood – Christine A. Padesky & Dennis Greenberger

This is a great book on how to use CBT to improve the quality of your life by changing your thoughts and emotions. It has worksheets included with the book and has step-by-step plans that you can use.

What is Emotional Neglect?

Emotional Neglect is not about what happened to you but what did not happen. It is about your parents or caregivers not adequately responding to your emotional needs. This can happen from a parent having unrealistically high expectations and not listening attentively to invalidating a child’s emotional experiences to the point she/he feels self-doubt. Most of the time, it is not intentional. There are a lot of parents who do not adequately respond to their children’s emotional needs because their parents did not respond to their needs, trauma got in the way of their emotional development, or they got too busy or exhausted to be able to respond adequately to their children’s emotional needs.

In emotional neglect, children learn that their feelings are not important. With childhood emotional neglect the Amygdala (part of the brain that has a primary role in memory processing, decision making, and emotional responses) becomes bigger and more reactive. Emotional neglectful families often look normal, but members of the family may not receive the aspects of family that allow children to develop properly, this can result in:

  • Depression
  • Anxiety
  • Insecure-avoidant or disorganized attachment patterns
  • Failure to thrive; poor academic performance
  • Aggression
  • Low self-esteem, low self-compassion
  • Apathy
  • Hyperactivity; disruptive & impulsive behaviour
  • Developmental delays
  • Substance misuse and risky behaviour; suicide attempts
  • Withdrawing from friends and family; anger towards parent; negativity during parent-child interactions
  • Appearing uncaring or indifferent
  • Shunning emotional closeness or intimacy; poor peer relationships and the avoidance of interaction with other children; significantly less positive social interaction
  • Self-blame, shame, humiliation, feelings of worthlessness
  • Less emotional knowledge; difficulty recognizing angry faces

Some effects of childhood neglect in adulthood include:

  • Post-traumatic stress disorder (PTSD)
  • Emotional unavailability, numbing out, or being cut off from one’s feelings; difficulty identifying or expressing feelings
  • Shunning intimacy
  • Depression
  • Feeling empty or hollow inside
  • Poor self-discipline
  • Anger and aggressive behaviours towards self or others
  • Difficulty trusting others or relying upon anyone else; trouble asking for help or support
  • Feeling deeply, personally flawed; hiding behind a mask; disconnected from self
  • Guilt and shame; easily embarrassed
  • Feeling like there’s something missing, but not sure what it is
  • Easily overwhelmed or discouraged; frequent feelings of worry, excessive fears, and dissatisfaction
  • Perfectionism with acute sensitivity to feelings of failure
  • Pronounced sensitivity to rejection
  • Lack of clarity regarding others’ expectations and your own expectations for yourself
  • Feel the need to people please
  • Lack of ability to empathize
  • Blame, judgmental, and critical towards self or others

Please note that the effects of emotional neglect can range from mild to severe and you might only have some of the previously noted effects and symptoms.

What can you do to recover from Emotional Neglect?

  1. Work on emotional intelligence
    • Become aware of your emotions as you are experiencing them
    • Listen to music or watch TV shows/films that expose you to more emotions and become aware of how you feel watching/listening to the music/TV show/film
  2. Identify your needs and take steps to meet them.
  3. Check the Facts on any beliefs that you are not good enough, you don’t deserve to have your needs met, and/or you can’t trust anyone.
  4. Be gentle with yourself. Know that the patterns took years to establish so it will take time to change them.
  5. Know that you are a unique, beautiful person but you just cannot feel it because you have either not learned to connect with that part of you or you have not had that belief instilled in you.

Further Reading or Activities

Dr. Jonice Webb – Running on Empty

Running on Empty is a good book for describing how emotional neglect happens and what it is like. It can be a very validating book for people who have been emotionally neglected in childhood.

References

Summers, D. (2016). How to recognize and overcome childhood emotional neglect. https://westsidedbt.com/how-to-recognize-and-overcome-childhood-emotional-neglect/

Webb, J. (2012). Running on empty: Overcome your childhood emotional neglect. Morgan James Publishing.

https://www.allrelationshipmatters.com.au/insights-healthy-relationships/emotional-neglect

What is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) therapy was developed by Francine Shapiro and is a body-mind integrated therapy that has been proven to be highly effective for people who have experienced trauma. It was founded on the basis that trauma interferes with the brain’s processing and that during trauma, our brain processes and stores memories incorrectly. This incorrect storage makes it so that past events seem to be in the present. These memories can be triggered by emotions, negative cognitions, and physical sensations.

EMDR uses bilateral stimulation (eye movements, tones, or taps) to access memory networks in order to move them from a place of emotional activation to a more rational, logical place.

EMDR is an effective, evidence-based form of treatment for Post-Traumatic Stress Disorder (PTSD) and is recognized for its effectiveness by the American Psychiatric Association, the Department of Defense and Department of Veterans Affairs (US), and the World Health Organization. With EMDR, it is not necessary to discuss the details of a traumatic experience.

EMDR can be used for more than just PTSD, it can be used for:

  • Anxiety
  • Panic attacks and phobias
  • Depression
  • Chronic Pain
  • Substance Dependency
  • Various kinds of trauma (intergenerational, developmental, etc.)
  • Abuse and Assault (Physical, Emotional, and Sexual)
  • Grief and loss
  • Eating Disorders

Further Reading

EMDRIA https://www.emdria.org

EMDRIA is the international association for EMDR. It has guidelines for official trainings, reports on EMDR research, explanations of EMDR, as well as a place to look up EMDR trained therapists.

Getting Past Your Past – Francine Shapiro

This is a great book for people who aren’t mental health professionals. It has good explanations about trauma, EMDR, and techniques to use for trauma.

What is Dialectical Behaviour Therapy (DBT)?

Dialectical Behaviour Therapy (DBT) was developed by Marsha Linehan at the University of Washington while trying to find an effective treatment for suicidal and borderline personality disorder patients. She started with Cognitive Behaviour Therapy but found that it was lacking in certain areas, so she added aspects to the treatment and made changes to improve treatment results. This resulted in what is now known as DBT. Some of the changes she made were a balancing act between acceptance and change, adding validation, mindfulness, and interpersonal skills.

The focus of DBT is to “build a life worth living” and it is a collaborative type of therapy where the therapist and the client work together to enable the client to build a better life through collaboratively decided goals, therapy techniques, and skill-building.

Behind the DBT is biosocial theory, which believes that invalidating environments are at the root of emotional dysregulation. Emotion dysregulation involves being emotionally sensitive and emotionally reactive and having a slower return to baseline. There are several reasons for emotion dysregulation, such as biological disposition, attachment problems, loss, trauma, and invalidation. When people have frequent prolonged intense emotional reactions, they tend to create neural pathways that are sensitized to these types of reactions. These reactions can become more automatic as time goes on. The emotional reactions can become more and more intolerable as time goes on it can become more difficult to cope with them and choose effective behaviours to deal with them. DBT can help point clients in the right direction of choosing better behaviours to deal with intense emotions and learn how to tolerate them.

DBT works by moving back and forth between acceptance and change. It validates your past experiences yet encourages you to move forward. It offers skills that you can learn to deal better with the world around you and better manage your emotions. These are often skills that people who grew up in supportive environments learned, but people who grew up in less supportive environments did not learn or have deficiencies in their skills.

The skill-building in DBT can really help people to be able to better cope with their emotions, tolerate distress, improve their relationships, and better understand how they can improve how they feel about life. I find this modality really works well with people who have had emotional neglect or developmental trauma because it focuses on the skills that were neglected in their childhood. There are other modalities that work well with the actual inner wounds from childhood, so this form of therapy works well complementing those.

What is Trauma?

Trauma is what happens when the nervous system gets overwhelmed. When the nervous system is overwhelmed, things (emotions, thoughts, self-beliefs, etc.) do not get stored in the brain properly, and everyday things trigger them to manifest like they are happening in the present when the emotion, physical sensation, and/or perception is actually coming from the past.

Traumatic memories are “less likely to be recalled in a clear, coherent narrative” and more likely to be “remembered in the form of sensory elements without words, ” such as emotions, changes in breathing or heart rate, body sensations, tensing, or feelings overwhelmed (Fisher, 2021).

What are some of the symptoms of Trauma?

  • Numbing
  • Decreased concentration
  • Anxiety, panic attacks
  • Depression
  • Irritability
  • Headaches, chronic pain
  • Loss of sense of “who I am”
  • Emotional overwhelm, mood swings, emotion dysregulation
  • Insomnia
  • Shame, guilt, self-blame and worthlessness
  • Nightmares, flashbacks
  • Substance abuse, eating disorders, self-destructive behaviour
  • Feeling unreal, out of body
  • Hypervigilance, mistrust
  • Denial, disbelief, shock
  • Few or no memories
  • Loss of a sense of the future, hopelessness
  • Loss of interest in things you used to enjoy
  • Isolation, withdrawing from others

What works best for Trauma?

Trauma can be very individual and unique. So what works for one person may not work for another. It should involve both top-down (thinking/brain-based strategies) and bottom-up (somatic/body-based) strategies. There are some strategies like EMDR that involve both top-down and bottom-up strategies that have evidence to work for different types of trauma.

The problem with top-down approaches (CBT, some DBT skills) is that they don’t work when someone is hyperaroused or hypoaroused because when you are in those states, you cannot think properly. If someone is hyperaroused or hypoaroused they need to come back to a place where they can think clearly before using these skills. These skills can be useful to people who have been traumatized but they need to be used at the right times and be complemented with bottom-up strategies.

Recommended Reading

Peter A. Levine – Healing Trauma

This book has a good summary of trauma plus it comes with a CD that has 12 Guided Somatic Experiencing exercises.

Bessel Van der Kolk – The Body Keeps the Score

This is an incredible book that describes the experience of trauma, how trauma affects the brain, and different treatments for trauma that have been successful. Bessel Van der Kolk is one of the top experts in trauma. This book has been an NYT bestseller and can probably be borrowed from your local library.

Transforming the Living Legacy of Trauma – Janina Fisher

This is an incredible workbook that has the essential psychoeducation about trauma as well as step-by-step strategies to start to heal the trauma and cope better with triggers. Janina Fisher is one of the top experts on trauma.