When someone is in the grips of a flashback or panic attack as a result of Post-traumatic Stress Disorder (PTSD), learning how to return to the reality of the present moment and restore calm by using grounding techniques can be a powerful tool; reinstating serenity and feelings of safety.
Studies have shown that “There is a shortage of suitably qualified therapists able to deliver evidence-based treatment for Post-traumatic Stress Disorder (PTSD), precluding timely access to intervention.” [1] While this continues to improve, it is crucial that sufferers learn some helpful techniques they can employ at any time, in conjunction with a Guided Self-Help (GSH) programme of psychological treatment, developed by mental health professionals with expertise in the fields of GSH or PTSD.
Flashbacks or intrusive memories are a key feature of PTSD which cause the subject to lose touch with reality.[2] They return the sufferer to the source of trauma, dissociating them from their current reality and can be triggered by anything from sounds to smells to changes in light or by people or places. Grounding techniques use the senses to divert attention back to the present and can be perceptual (such as smells or textures) or cognitive in the form of grounding statements or mental challenges, which serve to reassure an individual that they are safe and the trauma has passed. This is also referred to as earthing as it helps sufferers reconnect to their surroundings or get their feet back on the ground. Being able to feel safe is a key element in the recovery process for PTSD sufferers. While it might be hard to imagine something as innocuous as sniffing a lemon or rubbing ice on your arm could be of material benefit, the practice is so effective that it is used in the first stage of specialist treatment for PTSD.
Senses Working Overtime
When it comes to grounding techniques for PTSD, a person’s senses (sight, sound, smell, touch, and taste) can be their best asset.
Here are some examples which can help to reconnect with the present and, most importantly, safety.
Sight
In the spirit of those eye spy or numberplate games played on long and tedious car journeys as a child, the idea is to scan the environment and choose something, then see how many other examples can be found. It could be someone in a blue coat or a red car etc. Spotting something intricate and describing it in detail is another option. This is often a skill we lose as adults anyway, so it can also help with creativity and recall. Similarly, completing puzzles can also be of help.
Sound
It can often be a sound that has caused your flashback into trauma in the first place, and sound is equally powerful at pulling you back out. Speak to someone you’re close to on the phone or in person, put on your favourite music (especially calming music), listen to the wind in the trees or birdsong. If you’re in a very urban area, it is possible to get birdsong on CD or download so you can have some feathered friends on hand at all times.
Smell
The most powerful of all the human senses, smells have the ability (for better or worse) to transport us in time and evoke powerful memories, with one of the most well-known examples of this being Proust’s Madeleine.[3] Reaching for something with a robust and zingy scent such as citrus fruit or even a ripe soft cheese, especially if you are partial to the taste and smell, can be highly comforting, and if all else fails, you can always take a bite! Scented candles can provide comforting smells for more extended periods, but it’s important not to go overboard as you could become immune to the fragrance.
Touch
Something like ice can be highly effective but is not always at hand. Carrying around a stress ball to squeeze, especially if it is textured like the spikey ones that are available, can be really helpful in offsetting anxiety. They don’t call ‘em stress balls for nothing! Popping bubble wrap is not just the preserve of children and can also serve the same purpose as a stress ball, though this might not be ideal for people who have suffered violent trauma in the form of terrorism or warzones. For others, it can be both satisfying and useful. If you have nothing to hand, clenching a fist as tightly as possible to crush the negative feelings before opening your hand and casting them away can also be very powerful symbolically as well as in the sensation of the clenching, along with wiggling your fingers and toes.
Taste
While biting into the lemon you were smelling might be a bridge too far for some people, sharp or sour tastes can jettison you into the present moment, along with strong peppermints, cough drops etc. If you have a sweet tooth, let some chocolate melt in your mouth or suck on one of those fruit drops your grandmother used to buy in tins (which can make having one to hand very convenient as long as you save them for when they’re needed!).
Another slightly more involved method is mindfulness meditation, either guided by someone or done alone. Studies have shown these to reduce both mental and physical symptoms of PTSD and help build resilience in sufferers.[4]
To try this technique:
- Place your feet firmly on the ground, slightly apart (say, at hip width).
- Say the time and date clearly and out loud.
- Take three slow, deep breaths filling your abdomen with air, not just your chest.
- Look around and say out loud what you can see in the current setting.
- Tell yourself you are in a safe place right here and right now.
- Describe in detail and out loud items in the room or environment.
- Try using visualisation techniques like closing the door on past trauma.
- Sing something, recite a poem, rap, or even say your times tables to bring yourself into the present.
- Visualise a safe place or somewhere you’d like to go, like a tropical island or focus on things you need to do or future plans that you’re looking forward to.
A combination of techniques will be most helpful, so experiment and work out what is most beneficial for you or go with what you have to hand when necessary. These techniques are very powerful and form the first line of treatment when working with a mental health professional. Still, it may be necessary to get regular support from a trained PTSD specialist to decide on an appropriate treatment plan for your specific issues, which could include guilt or shame, as these go hand-in-hand with PTSD.
Sticking to a routine, socialising, and working are all important for helping sufferers achieve a sense of normality and build supportive relationships. Connecting with people and the environment can facilitate a disconnection from the past and the distressing emotions and memories that go with it and help balance mental, emotional, and physical energies for a happier reality.
If you have a client or know of someone struggling to heal from psychological trauma, reach out to us at Khiron Clinics. We believe that we can improve therapeutic outcomes and avoid misdiagnosis by providing an effective residential program and outpatient therapies addressing underlying psychological trauma. Allow us to help you find the path to realistic, long-lasting recovery. For more information, call us today. UK: 020 3811 2575 (24 hours). USA: (866) 801 6184 (24 hours).
Sources:
[1] Lewis, Catrin et al. “DEVELOPMENT OF A GUIDED SELF-HELP (GSH) PROGRAM FOR THE TREATMENT OF MILD-TO-MODERATE POSTTRAUMATIC STRESS DISORDER (PTSD)”. Depression And Anxiety, vol 30, no. 11, 2013, pp. 1121-1128. Wiley, doi:10.1002/da.22128. Accessed 2 Aug 2021.
[2] Jones, Edgar et al. “Flashbacks And Post-Traumatic Stress Disorder: The Genesis Of A 20Th-Century Diagnosis”. British Journal Of Psychiatry, vol 182, no. 2, 2003, pp. 158-163. Royal College Of Psychiatrists, doi:10.1192/bjp.182.2.158. Accessed 2 Aug 2021.
[3] Troscianko, Emily T. “Cognitive Realism And Memory In Proust’S Madeleine Episode”. Memory Studies, vol 6, no. 4, 2013, pp. 437-456. SAGE Publications, doi:10.1177/1750698012468000. Accessed 2 Aug 2021.
[4] Smith, Bruce W. et al. “Mindfulness Is Associated With Fewer PTSD Symptoms, Depressive Symptoms, Physical Symptoms, And Alcohol Problems In Urban Firefighters.”. Journal Of Consulting And Clinical Psychology, vol 79, no. 5, 2011, pp. 613-617. American Psychological Association (APA), doi:10.1037/a0025189. Accessed 2 Aug 2021.