Tag: Trauma Resources

Window of Tolerance

The Window of Tolerance was first coined by Dan Seigel to describe the “optimal zone of arousal for a person to function in everyday life.” This window is the state where a person can effectively manage and cope with their emotions, and readily receive, process, and integrate information. When in this window, a person can adapt and respond in a way that fits the situation.

When you leave the Window of Tolerance, the reactions take over. They are instincts built within your body from evolution (they are instincts that helped out ancestors to survive and were passed down to us) and past experiences. They are about what was helpful then, but they may not be helpful now. For trauma survivors, these reactions are the story of their survival. They are reactions that were not integrated into the system, so when something similar happens in the present they come back feeling like they are in the present moment, but they are tied to the past.

When you are outside your “Window of Tolerance,” you are not able to think properly and that is because your prefrontal cortex (the thinking/reasoning part of the brain) in the brain has shut down to allow the survival part of the brain to take over. Before you can think about the situation, you need to get back to your “Window of Tolerance.” There are various techniques to achieve that, including grounding skills.

Hyperarousal is a heightened state of activation/energy and is often referred to as the “Fight, flight, or freeze response.” The person’s nervous system is on high alert and primed to respond to danger. This may appear as:

  • Angry outbursts
  • Panic
  • Hypervigilance
  • Fear
  • Tight muscles
  • Anxiety
  • “Deer in the headlight” freeze

When you experience chronic hyperarousal, you may experience:

  • Emotional overwhelm
  • Impulsivity
  • Hypervigilance
  • Reactive
  • Racing thoughts
  • Angry
  • Feeling unsafe
  • Defensiveness
  • Panic

Hyperarousal can be helped through deep breathing, orientation grounding techniques, and self-soothing techniques.

Hypoarousal is a “shutdown” or “collapse” response. It can either come directly from leaving the Window of Tolerance or come after going through a Hyperarousal state after leaving the Window of Tolerance. It comes from too little arousal and an overloaded parasympathetic nervous system. Hypoarousal can appear as:

  • Depression
  • Blank stare
  • Inability to speak
  • Numbness
  • Dissociation
  • Emptiness
  • Flaccid body/paralysis without obvious cause (trauma)

When you experience Chronic Hypoarousal, you may experience:

  • Numb
  • No feelings
  • Ashamed
  • “Dead”
  • No energy
  • Disconnected
  • Not present
  • Passive
  • Unable to think
  • Shut down
  • Unable to say “no”

Hypoarousal can be helped through movement, reminders of the present moment and location, focus on one of the 5 senses, and re-regulating the breath.

While stress and trauma can shrink your window of tolerance there are strategies that you can use to expand your Window of Tolerance. Grounding and mindfulness skills can be used to return to the window of tolerance. Processing trauma through specific modalities such as EMDR, Internal Family Systems, Somatic Experiencing, and Sensorimotor Psychotherapy can help to widen a person’s window of tolerance.

The National Institute for the clinical application of Behavioural Medicine has a useful infographic on their website as well as good information about the Window of Tolerance. https://www.nicabm.com/trauma-how-to-help-your-clients-understand-their-window-of-tolerance/

A book that describes well how the Window of Tolerance works with people who have been traumatized is Janina Fisher’s book “Transforming the Living Legacy of Trauma.”

What are Grounding Techniques?

Grounding Techniques are strategies that can bring an overactive nervous system down. They are different ways of calming a nervous system.

There are different types of grounding techniques. Not all of these work for everyone. You may need to try a number to figure out what works or combine a few of them to help to calm your nervous system down. There are some techniques that fit into more than one of these categories.

You may need to pick out some that work for different situations. When you are dealing with trauma from childhood experiences it may be more effective to match the grounding technique to the age you were when the trauma first happened or the needs that were neglected during the trauma (such as love, safety, stability, comfort, validation, and acceptance). For example, if you have a trauma trigger that is connected to your 7 year old self, a grounding technique that would be comforting to a 7 year old may be more effective than something that an adult is more likely to do (wrapping yourself in a blanket may be better than exercising indoors).

Grounding techniques can be used to bring someone from a hyperarousal state back into their window of tolerance. Some may work for people in a hypoarousal state. They are an essential resource for trauma recovery. It can be good to have a card with the grounding techniques that work best for you in different situations, so you can reference it when you are not able to think straight and enable yourself to get back on track.

I have a separate blog post with examples of the different types of grounding techniques.

Observation Techniques are grounding techniques that help to calm the nervous system by focusing on identifying and describing objects in the environment. For example, you may pick an object in the room or outside the window and start to describe it in different ways until your system starts to calm down.

Somatic Techniques are grounding techniques that help to calm the nervous system by focusing on sensations and/or movements in the body. For example, you may focus on the feeling of your feet pressing onto the floor.

Breathing Techniques are grounding techniques that help to calm the nervous system by focusing on the breath, control of the breath, and/or sensation of breathing. For example, you may focus on prolonging (slowing) the exhale as you are breathing.

Distraction Techniques are grounding techniques that help to calm the nervous system by distracting yourself from what is causing the nervous system to be overactivated. For example, you may watch funny Youtube videos.

5 Senses Techniques are grounding techniques that help to calm the nervous system by using your senses to calm the nervous system. For example, you may focus on the taste of a candy or the scent of a particular scent.

Self-Soothe Techniques are grounding techniques that help to calm the nervous system by soothing the nervous system through activities that are comforting to your system. For example, you wrap yourself in a soft blanket and focus on how soft the blanket feels around you.

Present Moment Techniques are grounding techniques that help to calm the nervous system by alerting it to the present moment during trauma triggers. When you are triggered by trauma the past comes back and feels like the present, so reminding yourself what the present moment is can calm the nervous system. For example, you may name today’s date and location.

5 Senses Grounding Techniques

Using your senses to regain control of your body can help you when you are hyperaroused or hypoaroused. They can be good to help to ground you in the present moment.

Scent – the olfactory bulb (scent organ) has direct access (other senses have indirect access) to the parts of the brain where emotions, mood, memory, and creativity are processed, so you can have faster effects for calming the nervous system.

Put on a scented perfume/aftershave/cologne/lotion and focus on the scent and how it makes you feel.

Inhale a scent (essential oil through a diffuser, burning incense, or scent from a scented candle). Focus on the scent and how it makes you feel.

Go for a walk in a wooded area and breathe in the smells of nature.

Sniff a strong mint. Focus on the scent and how you are feeling and any changes within your body after inhaling the scent.

Make some baked goods and focus on the scent of them baking.

Smell some flowers.

Taste

Make a favourite meal. Focus on the taste. Focus on the emotions and memories associated with that meal.

Treat yourself to a dessert or baked good.

Have a piece of candy and focus on the taste, texture, and sensations coming from the candy.

Take a raisin, nut, or some seeds. Focus on how it looks, feels, and smells. Put it in your mouth notice how it feels before chewing it slowly, and notice how it feels to swallow it.

Mindfully taste the food you eat.

Sound

Listen to a favourite song. Focus on the melody and how it makes you feel.

Stop and listen. Notice and name the sounds you can hear nearby. Starting with the closest and loudest sounds. Gradually have your awareness move outward, so you are focusing on sounds further and further away.

Put on a piece of instrumental music. Give it all of your attention. Maybe follow a single melody line, notice how the music makes you feel, or notice the changes in rhythm.

Sit in nature and notice the sounds around you.

Play a sound on an instrument you play (piano, guitar, etc.) or sing a song.

Hum a soothing tune.

Listen to loud music.

Make a playlist of music to get you through tough times. Listen to it.

Touch

Put on a favourite item of clothing, wrap yourself in a blanket, or hug a pillow. Notice the texture, colour, and the way it smells.

Splash some water on your face. Notice how it feels. Now how the towel feels as you dry. Use words in your mind to describe the sensations.

Hold a cool beverage glass, can, or bottle in your hands. Feel the coldness and wetness on the outside. Drink slowly taking the time to notice the taste and texture of the drink.

Hold your breath and put your face in a bowl of cold water (above 50 degrees) or hold a cold pack on your eyes and cheeks. Hold for 30 seconds (This is especially for reducing extreme emotion).

Wrap yourself in a blanket. Give yourself a bear hug.

Pay attention to the clothes on your body, what is covered, and the sensation of your clothes as you move in them. Notice how your feet feel.

Wear an elastic band on your wrist and flick it gently, so that you feel it spring back on your wrist.

Feel something that has an interesting texture. Describe it in your mind in detail as if you were trying to describe it to someone who has never felt it.

Cuddle or pet a cat or dog.

Hold an ice cube and let it melt in your hand. Noticing the temperature and how it feels. Notice the wetness on your hand as it melts.

Take a long bath or shower.

Have a massage. Soak your feet. Focus on the body sensations.

Put a cold press on your head.

Sight

Look at a picture of a loved one, a place with a good/neutral memory, or an object that reminds you of a loved one. Notice how it makes you feel. If any memories come up, notice how you feel when you revisit those memories.

Look and take an inventory of what is around you. Name and notice the qualities of large objects before moving to smaller objects.

Pick an object in your vision and trace the outline with your eyes like you were drawing it.

Do some kind of puzzle (crossword, sudoku, word search, etc.).

Read a book, magazine, or article.

Walk in a beautiful place noticing the sights around you.

Look at the stars at night.

Look at beautiful pictures.

Light a candle and watch the flame.

Go people-watching or window shopping.

Watch a beautiful sunrise or sunset.

A number of these techniques are from:

Linehan, Marsha M. (2015). DBT Skills Training Manual, Second Edition. Guildford Press.

Observation Grounding Techniques

Observation grounding techniques use what is in your environment to help ground you. They are beneficial grounding techniques because you can use them pretty much anywhere and there is nothing that you need to have with you to be able to do them.

5-4-3-2-1

What are 5 things you can see?

What are 4 things you can feel?

What are 3 things you can hear?

What are 2 things you can smell?

What is 1 thing you can taste?

Pick an object and describe it in as much detail as possible. Make sure you describe it in different ways: colour, texture, shape, etc.

Describe the room you are in.

If you are in a place with other people, take notice of their appearance and describe as many details as possible.

If you can, step outside and notice the temperature of the air and how it is different from where you came from. You can also notice if there is any scents in the air.

Somatic Grounding Techniques

Somatic Grounding Techniques use your body to help ground you in the present moment. They can be useful for both hyperarousal and hypoarousal.

Press your feet onto the floor and notice the sensation. Focus on the connection that your feet have to the floor.

Body scan. https://www.healthline.com/health/body-scan-meditation#beginner-tips

Wiggle your toes or fingers and notice the sensation as you move each one.

Rhythm. Tap your feet or fingers in a particular rhythm and repeat it. Stay focused on the beginning and end of each sound.

Do an activity that involves using your hands: gardening, knitting, playing with sand/silly putty, folding laundry, washing dishes, etc. Pay attention to the sensation or body movements.

Clench your hands into fists, then release the tension. Repeat this 10 times.

Press your palms together briskly. Notice the sound and the feeling of warmth.

Reach your hands over your head like you’re trying to reach the sky. Stretch like this for 5 seconds. Bring your arms down and let them relax at your sides.

Stretch and focus on your breath and the physical sensations.

Go for a walk and notice your surroundings, the sensations of walking.

Notice the pressure points on your body on the floor, chair, or whatever you are laying on if lying down.

Do a quick bout of intense exercise in which you use out the body’s stored physical energy (running, jumping, lifting weights, etc.)

Squeeze a rubber ball very hard and notice the sensations in your body as you are squeezing and releasing the tension.

Hold ice in your hands and notice the temperature and the wetness as the ice melts.

Breathing Grounding Techniques

Deep breathing quiets the sympathetic (fight or slight; stress response) part of the autonomic nervous system, which triggers the relaxation response of the parasympathetic nervous system. Deep breathing needs practice and you want to practice deep breathing when you don’t have high anxiety (if you always do deep breathing when stressed or in pain, your body may associate deep breathing with those states and it won’t be as effective).

The extension of the duration of exhalation can calm a person because the exhalation connects with the vagus nerve that calms us. So if you are not able to focus on an entire breathing pattern, just focusing on extending your exhale can help to calm the nervous system.

https://hbr.org/2020/09/research-why-breathing-is-so-effective-at-reducing-stress

Belly or Diaphragmatic Breathing. Place one hand on your stomach, and the other on your chest. Breathe slowly and deeply into your belly. Try to keep your chest still.

4-7-8. Breathe in (inhale) slowly for 4 seconds. Then, hold your breath for 7 seconds. Finally, breathe out (exhale) slowly and softly, for 8 seconds. Repeat as many times as feels comfortable.

Paced Breathing. Slowly and deeply breathe into your belly. Try to average 5 or 6 breaths per minute. Exhale slower than you breathe in.

Paired Muscle Relaxation. This is a muscle relaxation technique that is paired with breathing. While doing belly breathing, tense your body muscle. Notice the tension in your body. Say the word “relax” as you exhale and release the tension. Notice the difference in your body.

Heart Breathing. While breathing slowly and deeply, imagine that you could breathe through the centre of your chest. Imagine breathing in around the heart space and breathing out through the heart space.

Boxed Breathing. Inhale for 4 seconds, hold your breath for 4 seconds, and exhale for 4 seconds. (You can increase the length of time for the sections as long as you stay at an equal length to each other, such as 5-5-5, 6-6-6, etc.)

Pairing Stretching with Breathing. Stretch while you are slowly and deeply inhaling and exhaling.

Pair the Breath with Body Movements. This can be done by doing one body movement on the inhale and another on the exhale. For example, you can start with your arms at the sides with the inhale raise your arms over your head and lower your arms to the starting position on the exhale.

Pair the Breath with Intention. Pair a word or phrase that you want to bring in with the inhale and let your body relax on the exhale. Some examples of words/phrases are strength, calm, peace, I am loved, etc.

Self-Soothe Grounding Techniques

Self-Soothe grounding techniques are about taking care of yourself. With self-soothe grounding techniques, you are grounding yourself in things that are comforting to you. One important thing with self-soothe techniques is to listen to your body and do what is comforting to you and not what is effective for others. Each of us is unique and has unique experiences that influence what is comforting to us, and it is important to respect that. When you do activities or imagine things that are comforting to you, it signals to the brain that you are in a good place and that calms the system down.

Take a shower or bath. Notice the sensation of the water hitting your skin

Make a cup of tea or coffee. Focus on the taste. Notice the warmth of the mug.

Wrap yourself in a soft blanket. Focus on the softness of the blanket and how it makes you feel.

Sip a cool drink of water, iced tea, or juice. Notice the difference in temperature and how it makes you feel.

Imagine very relaxing scenes.

Engage in spiritual practices, such as prayer to God/higher power or something else.

Imagine hurtful emotions draining out of you like water out of a tap or sand slipping through your fingers.

Remember a happy time and imagine yourself in it again.

Find purpose or meaning in a painful situation. If you have trouble finding meaning in your current circumstance, try to remember a time you found meaning in a painful situation.

Imagine everything turning out okay.

Focus on the positive aspects of a difficult situation.

Do some self-massage.

Practice yoga or some other stretching.

Get into bed and pull the covers over your head.

Remind yourself of another time when you felt similarly, and things turned out okay.

Encourage yourself:

  • “I will make it out of this.”
  • “This will soon pass.”
  • “I’m doing the best I can.”
  • “I will be okay.”

Imagine yourself leaving the painful feelings behind. This can be walking, swimming, or running away from the feelings. Writing the feelings on a piece of paper and burning it.

Visualize your favourite place. Think about the sounds and scents there as well.

List and visualize 4 or 5 things that bring you joy.

Some of these techniques are from Marsha Linehan’s DBT Skills Training Manual, 2nd Edition.

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 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.