Unable to deploy grounding/coping strategies.

[Bert]

Hi everybody,

I wanted to raise a Q here with regards to coping.

To put it bluntly, I can't seem to self-regulate myself whatsoever really. I've been struggling with virtually all of the cptsd symptoms over the past few months to a level that is affecting most departments of my life quite severely.

I have a lot of respect and rapport with my therapist, and when I reveal how much I'm struggling day-to-day at the moment and ask her how can I get by and cope better, she runs me through a variety of grounding and coping exercises. Most notably; naming things you can see, smell, hear, feel, taste; breathing techniques; and mindfulness.

However, when experiencing EF's and various other debilitating symptoms (almost all day everyday), I cannot seem to find any comfort or soothing in any strategy other than frantically needing to call a certain person or two for reassurance + distraction.

Sadly, any of the things I would usually gladly do to distract myself such as playing sport, videogames and spending time with a select few people, I'm unable to do as I am swamped with feelings of shame. I find myself in a pit of despair and depression.


It just seems that the primary advice for dealing with chronic stress is to just breathe, meditate or ground. But I can't seem to deploy any strategy to just relax. My mind is just permanently switched on and fearful.

[Ghost]

Hi Bert,
This was totally my life a few years ago. It was like fight or flight was at the max 24/7. The good moments were when I was dissociating.

My therapist also gave me the 5 senses thing, I remember her talking about that all the time and telling her how hard it was. I think this is the hardest part of all of the therapy I ever did, was learning to ground.

At that point, the brain doesn't have a pathway to get from "extreme distress" to "take a breath and look around" so you have to make one by practicing.

I carried a little keychain squishmellow with me at all times. So when the panic would hit I would squeeze it, feel the different textures, and focus on the stitching. I would say the "I am safe" stuff outloud and after that, I could look around, sometimes I listed two things I could see, no smells, three things I could touch, just anything to keep my mind in that process of creating that pathway. 

Maybe you could find a little something that you can carry with you all the time. Maybe it could make noise and jingle to remind you it's there. Or maybe it's like a bracelet. I needed something soft because I squeeze things when I'm triggered.

I really hope this is helpful.

[NarcKiddo]

I don't know what to suggest for something acute like this. So I am just throwing out some thoughts in case they help. But I have always found those grounding techniques to be of limited value when I have tried to do them. Well, not the naming things as I have never done that and I can see the theory of how it might bring you into the present. I find breathing techniques helpful but not for any length of time and anything like meditation is hopeless as my mind skitters off everywhere.

What I have found to be helpful is repetitive activity. Swimming lengths has always been good for me. Counting the lengths (or even the strokes if it is a pretty long pool) gives my mind something to concentrate on and the physical movement, support of the water etc is helpful. The treadmill at the gym is helpful although mostly because it allows me time to think while striding along, so it probably would not be all that good for me in a crisis moment. Although listening to decent music can get me into a fairly calm zone.

I have recently found adult colouring to be very, very helpful. I like very complicated patterns so I have to concentrate on doing it nicely but different people like different approaches. The thing I most like about that is that the activity is repetitive and easy enough not to be taxing, but requires enough concentration that I can get fully immersed in it. Things like knitting would have a similar effect, I guess. Or model making. Something creative, anyway.

I would have thought video games might help - but maybe you are playing familiar games? If you are trying to better a score or something then maybe that would not be ideal right now. Something totally new, and simple in the early levels, and a bit different to what you might usually play could help, maybe? I'm thinking of fairly old school stuff here, like Tetris or Angry Birds.

Do you like animals? Does anyone have a dog you could borrow to take for a walk?

It strikes me that the activities you usually turn to involve other people. Well, maybe not the video games, as that depends on what you play, but sports and calling people and hanging out with people certainly do. It feels to me like you maybe need to find out how to feel safe with yourself.

[Bert]

Ghost - I relate to the good moments being when in a dissociative state. My therapist explained that that occurs when at a 9-10/10 on the anxiety and fear meter. And then when dipping back down to the 7-8/10 range that's when your body allows the experience of the anxiety all over again. With that in mind, I can understand why the constant yo-yo'ing. I will make an effort to keep something particularly intriguing by me to practise grounding in the fashion you've described. I understand now that it is something to be developed - not so immediately attained.

Narc - Thank you as always for leaving a response and helping. I love being in water, but a trip to the local swimming pool would be quite difficult to achieve at the moment. I like the sound of the colouring. I can see why that'd be the perfect way to occupy the brain without it being too strenuous. I do have a dog (funnily enough he is called Bertie - hence my pseudonym) which I find a great deal of comfort in.

I hope you are both well

[Blueberry]

I have a lot of respect and rapport with my therapist, and when I reveal how much I'm struggling day-to-day at the moment and ask her how can I get by and cope better, she runs me through a variety of grounding and coping exercises. Most notably; naming things you can see, smell, hear, feel, taste; breathing techniques; and mindfulness.

However, when experiencing EF's and various other debilitating symptoms (almost all day everyday), I cannot seem to find any comfort or soothing in any strategy other than frantically needing to call a certain person or two for reassurance + distraction.

Sadly, any of the things I would usually gladly do to distract myself such as playing sport, videogames and spending time with a select few people, I'm unable to do as I am swamped with feelings of shame. I find myself in a pit of despair and depression.


It just seems that the primary advice for dealing with chronic stress is to just breathe, meditate or ground. But I can't seem to deploy any strategy to just relax. My mind is just permanently switched on and fearful.

I was recently inpatient in a trauma program, not for the first time I might add. One thing they said there about grounding techniques is you need to find the one that works for you. Some of them are going to be great for somebody else but either don't work for you or make you feel worse. So a bit trial and error.

Of course, I'd love to have my symptoms disappear 100% while doing a grounding technique but that's probably not going to happen, so it's good to note how bad you feel before you start on a scale of 1-10 or even percentage-wise and see if there's been any change when you finish the exercise, even if just a brief, minor change. It's also helpful to practise grounding techniques when you're not triggered or less triggered so that you find them more easily when you're badly triggered. Relaxing might be too much to hope for? When I relax, memories tend to come up (same with breathing, non-active meditation), so why would my body want to relax? Just putting that out there, idk how it is for you.

Naming things I can see, smell, hear, feel, taste is something I did quite a lot inpatient, not so much at home   but it does help me because I tend to get lost inside myself somewhere. Another similar grounding technique is to take some object in your hand that you don't often carry, close your eyes (or look the other way) and describe what you feel (hard/soft, pointy...), if possible out loud. You can even have a bag or box of tactile-interesting objects and pull one out at random to describe. Or count/list specific whatevers you can see in the room or out the window: e.g. red leaves OR tree trunks OR car tires. If possible out loud because that engages your ears and your voice as well.

'Active' meditation e.g. adult colouring in that NK mentioned is good for me, as I mentioned more passive 'normal' types are not, things come up. Sometimes word puzzles and sudoku are good for me - they engage my brain. Brain is switched on, but channeled into one specific activity and away from traumatic memories. 

I was able to reduce my shame by doing EFT / Tapping, with sentences like "Although I'm ashamed of..., I accept myself." Or "Although I'm feeling fearful, I accept myself." Or even "Although I don't want to do this stupid exercise, I accept myself." Even better if you can replace "I accept myself" with "I like myself" or even "I love myself" but that took a long time in my case. An inner voice tells me what fits a particular situation. There are videos on Youtube on how to tap and you don't have to keep going for 15 minutes or whatever some of the gurus suggest! I did need to do it regularly for a good while though, not daily necessarily, but just off and on for weeks till it became a habit.

What I also learnt ages ago as a quick fix: pushing off walls/ pushing walls 'away', stamping (not as anger release, but just to physically feel more) and right-left movements which can include walking on the spot or of course stamping. This time in inpatient treatment, they said not to push off walls etc if it causes pain/muscle tension, so I'd say the same applies to stamping. Way, way back I found that saying some version of "I'm about to dissociate" and taking a few steps would actually stop me dissociating. I discovered that in therapy.

There were times in the past when I got most help by phoning someone, partially because way way back in inpatient therapy, that was one of the go-to methods. It's good to develop other methods. Like petting Bertie the dog. Pets are super company. I assume you don't feel so much shame when you're hanging out with Bertie   A little pocket stuffie might work for you too, for times when Bertie can't be with you. Probably not as effective as Bertie, but 5% reduction in anxiety is better than 10% increase. Or maybe imagining Bertie? Or imagining yourself with Bertie? That's helped me in the past, imagining the dog we had when I was a child, or imagining the little Furbabies I no longer have. I was able to imagine stroking them or talking nonsense to my little Furbabies - any kind of day-to-day activity with furbabies - also a possibility when Bertie can't be with you. 

I hope something in here is helpful for you some way. Ignore if not.