In-between Session tracking
This worksheet will help us track and assist with anxiety, panic & flashbacks. When we have these experiences the response can get stuck and can heighten anxiety, dissociation and agitation in your body. The whole purpose of bringing down big emotions is to work with them in a way that feels safe, manageable and more regulated.
It is best to try practicing grounding when you aren't experiencing distress, not just when things have become unmanageable. It will then take less effort to use them in the moment. Engaging in these activities can be challenging at first, but purposefully stick with them for at least 20-40 mins for good effect.
Stuation and Trigger
Negative thoughts/beliefs
Emotions
Body Sensations
Disturbance 1-10
First, Ground yourself
In times of high distress, grounding helps bring focus back to your body and surroundings. It brings us into the here and now and away from the ruminating thoughts and panicked sensations that accompany any big surge of emotion. Remember, this is temporary and will pass.
Grounding Exercises
Activities that involve focus and concentration can help reset. These can be anything from;
1. Counting backwards from 100 by 7’s
2. Play the alphabet game from A-Z (pick a category such as fruits and veggies or capital cities).
3. Observe and describe a picture on the wall, as if you want someone else to draw it but can’t say what it is.
4. A shift in body position like standing up, running on the spot or transferring weight back and forth
5. Remind yourself of your body in the here and now by touching your body boundary and remind yourself you are here. Look around the room and describe what you see.
6. Go around the room and orient yourself, touch the furniture and say what you are touching as you go around. Secure your space and make sure you feel safe as you re-regulate your system
7. Do simple math. This will take you out of your alert brain and right into the frontal cortex.
Engage the Dive Reflex
Intense emotions activate our sympathetic nervous system and can cause us to move into the panic modes of fight, flight, or freeze. This is a common trauma response. All mammals have a dive reflex, which is triggered by diving into cold water. Our heart rate is slowed, our brain begins to refocus, and our parasympathetic nervous system is engaged to help us settle down the heightened arousal. We can engage our own dive reflex by putting our faces in a big bowl of cold water with a few ice cubes. Research says to repeat four times, for about 15 -30 seconds total. This exercise is not suppose to be harmful, do only if you feel safe and do not go past
Emote
Cry, express anger, growl, and complete instincts of the body. Move through the state by expelling emotions rather than containing them. Feel an impulse to kick your leg up…DO IT. Feel like a good scream or weep. Complete the stress response and release what wants to come out.
Involve the Senses
Sensory awareness helps soothe our active nervous system. When we’re emotionally flooded, our focus is narrow and the information we take in is limited. Engaging our senses helps open up our awareness and expands our perception beyond the emotion.
You can attend to your senses with an activity like naming;
five things you see,
five things you hear,
five things you sense or feel,
and then proceeding to five things you can taste.
Scribble It Out (from EMDR)
Fold a paper into 4 parts. Draw out the distressing image in the top left and scribble it out with energy. Draw the image again in the top right, notice if any part of it has changed and scribble that out. Continue on other quadrants. Notice if any energy of the moment is dispelled.
Recalling a Kindness
Remembering a kindness can settle our nervous system by activating the adaptive side of our brain. Remember now a time when someone showed you kindness. Try and remember everything you can about the words, touch, feelings, eye contact that they used to soothe you or just showed up for you and listened. As you recall what the kind person did, notice what you see, hear, feel on your skin, etc. – as if it is happening now. Connect with your breathing by putting a hand on your heart or stomach. Notice everything about your experience. If you feel happy, teary, connected. If a negative feeling arises, return to the sensory aspects of the kind memory. Put the negative thoughts or feelings in a container and allow yourself the pleasure of feeling this kindness. Notice what you’re feeling in your body now and your overall experience.
Positive Interaction with Affection
Just as above, recall if you can, a time when you had a positive interaction with physical affection. Follow the steps as above.
Creative Expression
Do you paint, draw, make music, sing, dance? If any of these are part of your life, engage in these activities. These forms of expression can take you out of the alert centre of your brain.
Engage in Exercise
Getting our heart rate up when emotions are high is another great way to help us move out the stress inducing hormones that are released when we are in a state of intense distress. Most people know that regular exercise is helpful for our mental well-being and state of balance. A spontaneous burst of jumping jacks, sit-ups, running the stairs at work, or whatever exercise you can do for approximately 20 minutes will also help manage an emotional surge.
Breathing
A deep belly breath works wonders and is a portable skill you can always access. When we inhale deeply and elongate the out breath, you engage the diaphragm and also engage the parasympathetic nervous system to calm us down.
If you cannot start with deep breathes due to anxiety, box breathing (in for 2-4 seconds, hold for 2-4 seconds, out for 2-4 seconds, hold for 2-4 seconds, etc.) can help you work up to breathing more deeply. If this feels like too much, just notice your breath, focus on only it and don’t try and change it.
If breathing is hard, try saying a long sentence without breathing in the middle. See how long you can get that out breath and how many words you can fit in.
Make yourself laugh
Find a funny clip on YouTube or Netflix of something you know you find funny. This is moving your experience out of the alert brain and into the frontal cortex.
Try an Anchoring Phrase
This might be something like, “I’m Full Name. I’m X years old. I live in City, Province, country. Today is Friday, June 3. It’s 10:04 in the morning. I’m sitting at my desk at work. There’s no one else in the room.”
You can expand on the phrase by adding details until you feel calm, such as, “It’s raining lightly, but I can still see the sun. It’s my break time. I’m thirsty, so I’m going to make a cup of tea.”
Progressive Muscle Relaxation
A person cannot be both tensed and relaxed at the same time. This exercise involves tensing and holding isolated muscle groups for approximately five seconds and letting go quickly. This allows our brains to focus on the sensation of tension, then the release. This exercise is a great practice to do outside of a triggered incident and helps your body know it can release when needed. Click here for instructions.
Container
If you have practiced this with me, float any left over disturbing or ruminating thoughts and just say ‘not now’ it isn't for now. You get to decide when you think these thoughts. You aren’t ignoring them, but they aren't useful to you now. If they float back, know this is normal, put them back as many times as needed.
Safe/relaxing space
If you have built this in our work, use it now to float to a place and dial down your nervous system. Remember the sights, sounds, smells, temperature and sensations. Do what you need in this space, sit, leap or lay. Take deep breaths here.
Engage in Socratic questioning
Really dig into some targeted questions about what is at the core of any triggered response. Identifying hot thoughts after an event can help with further learning about what are triggers for you. From this helpful core work can be done with EMDR. Get this sheet here
Journal
Get is out, don’t just contain it. Write out how it felt, whether you are angry or sad. Notice any patterns, does this link to something you have felt before. Ask, what is at the core of this? What are you noticing?