Monday, September 26, 2011

On Being Grounded

DSC_0407

A few weeks ago I was telling my therapist about this thing I do when I get anxious or upset, or when I'm just sitting around not really thinking of anything in particular. 

It's weird to describe the feeling, but basically my eyes unfocus, my head physically numbs over and I kind of "shut down" for lack of a better term.  I usually start picking my lips (a habit since childhood) when I'm in this state.  When I was a child my mother used to have a joke that "there is a movie going on in Caitlin's head that no one else can see."  For the longest time (well, until a few weeks ago) I always thought that this was what everyone called daydreaming.

My therapist gave me a book about PTSD and trauma and in it I read descriptions of exactly that state that my brain slips into so easily in times of distress.  I mentioned it in a session and she told me that this unfocused, numb state was actually called depersonalization.  I'm sure you don't care to hear me explain it so click that to get the Wikipedia article on it.

We talked about it and agreed that the depersonalized state isn't a good or healthy way for me to deal with stress.  When I zone out, I feel like Rob and I are on two different planets.  I can touch him and talk to him and joke with him, but it's as if a thin transparent wall is sitting between us.

The "treatment" for this state when you're in the thick of it is to engage in a process called grounding.  Essentially grounding refocuses your thinking to the here and now, rather than not thinking at all or only focusing on the source of your emotional pain.  I wanted to share some of these "grounding" techniques because they've already been extremely helpful to me.  I run through some of these when I'm in the throes of an early-morning panic attack or when zoning out has become easier than actually dealing with my feelings, and I thought someone else might be able to find some inspiration.

Quick note: I am not a mental health professional and I'm not saying that these will work for everyone, only that they have helped me when I am feeling extremely depressed or anxious. If you suffer from depression I highly recommend you see a therapist - I'm constantly surprised by how much it's helped me. Everything below came from a handout called Detaching from Emotional Pain (Grounding), from Seeking Safety by Lisa M. Najavits (2002).

Guidelines:

1. Grounding can be done any time, any place, anywhere.
2. Use grounding when you are faced with a trigger, enraged, disassociating, having a substance craving, or when your emotional pain goes above 6 (on a 0-10 scale).  Grounding puts healthy distance between you and these negative feelings.
3. Keep your eyes open scan the room, and turn the light on to stay in touch with the present.
4. Rate your mood before and after grounding, to test whether it worked.  Before grounding, rate your level of emotional pain (0-10).  Then rerate it afterward.
5. No talking about negative feelings or journal writing--you want to distract away from negative feelings, not get in touch with them.
6. Stay neutral: avoid judgements of "good" and "bad." For example, instead of "The walls are blue; I dislike blue because it reminds me of depression," simply say "The walls are blue," and move on.
7. Focus on the present, not the past or future.
8. Note that grounding is not the same of relaxation training.  Grounding is much more active, focuses on distraction strategies, and is intended to help extreme negative feelings.  It is believed to be more effective than relaxation training for PTSD.

Ways of Grounding:

Three major ways of grounding are described below--mental, physical, and soothing.  "Mental" means focusing your mind, "physical" means focusing on your senses, and "soothing" means talking to yourself in a very kind way.  You may find that one type works better for you, or all types may be helpful.

Mental Grounding:

1. Describe your environment in detail, using all of your senses. Describe objects, sounds, textures, colors, smells, shapes, numbers, and temperature.
2. Play a "categories" games with yourself. Think of "types of dogs," "jazz musicians," "states that begin with 'A'," "cars," etc.
3. Do an age progression - If you hve regressed to a younger age, you can slowly work your way back up until your current age.
4. Describe an every day activity in great detail, for example, a meal you cook (First peel the potatoes and cut them into quarters, etc.)
5. Imagine - use an image; glide along on skates away from your pain, change the tv channel to a better show, think of a wall as a buffer between you and your pain.
6. Say a safety statement - my name is ___, I am safe right now. I'm in the present, not the past. I am located in __, the date is __
7. Read something, saying each word to yourself, or read each letter backward so you focus on the letters and not the word.
8. Use humor, think of something funny to jolt yourself out of your mood.
9. Count to 10 or say the alphabet very slowly.

Physical Grounding:

1. Run cool or warm water over your hands
2. Grab tightly onto your chair as hard as you can
3. Touch various objects around you: a pen, keys, clothing, the table, the walls. Notice textures, colors, materials, weight, temperature. Compare objects you touch. Is one colder? lighter?
4. Dig your heels into the floor, literally "grounding" them. Notice the tension centered in your heels as you do this. Remind yourself that you are connected to the ground.
5. Carry a grounding object in your pocket - a small object that you can touch when you feel triggered
6. Jump up and down
7. Notice your body: the weight of your body in the chair, wiggling your toes in your socks, the feel of your back against the chair. You are connected to the world.
8. Stretch - extend your fingers, arms, or legs as far as you can, roll your head around.
9. Clench and release your fists
10. Walk slowly, noticing each footstep, saying 'left' or 'right with each step
11. Eat something, describing the flavors in detail to yourself
12. Focus on your breathing, noticing each inhale and exhale. Repeat a pleasant word to yourself on each inhale, such as a favorite color or a soothing word

Soothing Grounding:

1. Say kind statements, as if you were talking to a small child. For example, "You are a good person going through a hard time. You'll get through this."
2. Think of favorites. Think of your favorite color, animal, season, food, time of day, TV show
3. Picture people you care about (e.g. your children) and look at photographs of them
4. Remember the words to an inspiring song, quotation, or poem that makes you feel better (e.g. the AA Serenity Prayer)
5. Remember a safe place. Describe a place that you find very soothing (the beach or mountains, or favorite room); focus on everything about that places, the sounds, colors, shapes, textures, objects
6. Say a coping statement: I can handle this, this feeling will pass
7. Plan a safe treat for yourself, such as a piece of candy, a nice dinner, or warm bath
8. Think of things you are looking forward to in the next week, perhaps time with a friend, going to a movie, or going on a hike.

What are some of your strategies for dealing with stress?

15 comments:

  1. Holy crap. I didn't really realize that I have some of the same experiences at times. And I totally do the "kind statements" thing to calm me down, especially when I am having a panic attack right before bed. I think of all kinds of happy things, and basically talk to myself (either out loud or in my head) and tell myself all the good things in my life.

    I also sometimes go through worst case scenarios in my head, and explain to myself why none of them would really be that bad. Totally works. Not only am I taking the fear and mystery out of them, but I am preparing myself (at least mentally) for every possible situation.

    ReplyDelete
  2. I do the same thing right down to picking my lips & really thought I'd freakishly combined a bunch of anxious behaviors.. or lack thereof, and was all alone in my lip-picking. Wow. Caitlin this really is a hugely helpful post. Thank you.

    ReplyDelete
  3. i do this too, and until i read this post, i had no idea what it was called or that anyone would even understand it! my trigger is food, and i usually try to talk about what i'm feeling with my boyfriend...but after reading this i'm realizing that maybe i should stay more neutral, like guidelines 5 & 6 say. thank you for sharing this caitlin, and also for your honesty as usual. i'm definitely going to try some of these tips next time i'm feeling anxious.

    ReplyDelete
  4. I can't figure out if I do THIS or if I really daydream. I'll have to look more into it... Thanks for sharing though & I'm glad to hear that these techniques are working for you!!

    ReplyDelete
  5. It's so brave and amazing for you to share this to help others that might have similar problems :) Keep up the good work with the therapist! I saw one for years and little by little it helped me regain control of my life after some fairly traumatic experiences.

    On side note: tried your gorgonzola tomatos tonight and they really are to die for! My 100% carnivore boyfriend even admitted to loving them!


    A Sweet Release

    ReplyDelete
  6. My wife and I both have various mental illnesses. Jen, my wife, has BiPolar Depression, anxiety, social anxiety and separation anxiety from me. I have severe OCD, mild depression, anxiety and severe separation anxiety from Jen.

    When I'm having a severe OCD panic attack (which could range from something horrible happening, albeit unrealistically, such as someone shooting through our bedroom wall (for no reason... and we're in a safe neighborhood) to a sink hole opening up...) I try and do what our care manager taught us. Mentally I say "I do not acknowledge this thought." Silly, maybe, but it's helped.

    I also try to focus on something else. I plan a redesign for our bedroom, work on a story within my mind, etc.

    I love the lists you've posted and I think they will help both Jen and I.

    Lately, I've been getting panic attacks which are so bad I feel as if I'm going to pass out. These have happened while I was walking around the neighborhood and while I've been in the shower, mostly. I'm not sure why. When I was walking, I just had to power through and get home. When I was in the shower, I got out and laid on the bathroom floor with a cool rag on my face. I breathed in the cool air and let the temperature change calm me.

    I also often get hives for no real reason, though I think it's linked with stress... I don't know.

    Again - though - thank you for this!

    ReplyDelete
  7. I did this for a period of about a year after my daughter was born still in July 2004. I could hear others talking to me but I could not look at them or respond. I used to call it 'getting stuck'. It would last for several seconds at a time. I didn't really do anything to remedy it, it eventually went away on its own.

    I agree that you are incredibly helpful to put this out there! I wish I'd known back then what was going on, this could really help someone out!

    ReplyDelete
  8. At least you know how to respond now! Thank goodness for that.

    ReplyDelete
  9. i don't go into that state when i'm stressed out, but my mind is known to go numb when i have a free second just to myself. so maybe that is my body trying to just de-stress itself? either way, i'm glad that you got some answers!

    ReplyDelete
  10. This was truly an interesting read! I am quite fascinated by the mind and how it copes with issues such as stress... I've also always been fascinated by better techniques of arguing, but that's another story.

    I love this guide for engaging with the situation, and I hope they continue helping you in yours! Also... I pick my lips too, lol :(

    Aya ♥ Strawberry Koi

    ReplyDelete
  11. thanks for sharing this! being brave enough to share these things about yourself in order to help someone else is an amazing thing. these grounding techniques are great reminders!

    ReplyDelete
  12. Very interesting and helpful post. I love that you share these parts of yourself with the internet world. It's very brave and helpful to others. xoxo

    ReplyDelete
  13. It takes a lot of strength and will to help yourself get better mentally - I know this from experience. These are great techniques - thanks for sharing!

    xo
    cortnie

    ReplyDelete
  14. Gaaaaaaaaah, my internet keeps going in & out on me and I just lost my comment. It pretty much said this:

    I just stumbled upon your blog & I'm so glad that I did. It's so nice to know that other people go through these things & it's awesome to see how they deal with it. When I'm having a panic attack it's soooooooo tough to bring myself back down to earth. Dealing with depersonalization and derealization is SO scary.

    These tips that you shared will definitely help me. Thanks!

    ReplyDelete

Go ahead and leave a comment! You know you want to.