Sunday, December 11, 2005

grounding exercises for ptsd symptoms

Today I'll go over a grounding exercise I learned that was very helpful in managing ptsd symptoms. Its not a cure. At best, it makes the unbearable manageable. Sometimes when things were really bad it did not work well at all, but I did it anyway. The goal is to bring the ptsd sufferer back to the present by way of the senses, out of a flashback or intrusive memory. Anytime the symptoms of ptsd come on, whatever they are for you, is a good time to practice this exercise.

First look around and see five things present where you are, naming them -- out loud if possible (the naming out loud is supposed to help, but sometimes I would cheat and do it under my breath, too). Anyway, name specific things, in detail, as you see them. For example, I see a picture of my old dog with a wet nose; I see a black computer speaker; and so on. Then name five things you can hear, like the humming of a fan, cars passing by, the dishwasher running, and so forth. Then name five things you can feel. I had a hard time with this first, because I thought it refered to emotions, feelings, but that's not what I was supposed to be after. Its the sense of touch, so I feel jeans against the skin of my left thigh; I feel the soles of my feet on the floor, and so on. If you get stumped, its ok to repeat things, just concentrate on actually sensing them in the present. Then repeat the whole process for sight, hearing and touch four times, then three, then two, then one. You get extra bonus points if you become so wrapped up in your senses that you lose count. Generally, this would bring me back a little. I would still be miserable most of the time and in pain, but the memory part would subside and sometimes the worst symptoms of a flashback would recede.

[n.b.: updated 12/8/08 to replace broken links with new ones]
This isn't the only way to do it, just a very simple and easy to learn one that worked for me if you need it. has some simple suggestions. The Mental Health Matters web site breaks it into three options: accept it and go through with it, learn to control it, or escape it. It is not always a matter of choice though. Their methods of coping are the same for whichever option you choose (or which chooese you!), including one that I tried during the worst of the flashbacks at the behest of counselors in the PTSD treatment center I was in. They had me hold two liter bottles of frozen water (ummm, I think they call it ice :), one in each hand to bring me back. I melted the ice in both and still didn't come back...they were about to send me off to the hospital, but I managed to get a handle on things after about a four hour flashback. Possibly the worst few hours of my life. Cold, the site explains, activates some reflexes that slow down the heart and exert a calming influence. Finally, you can read a more academic but still enlightening and useful treatment of coping techniques in the book Rebuilding Shattered Lives by James Chu.


reallynotimportant said...

I feel jeans against the skin of my left thigh; I feel the soles of my feet on the floor, and so on. If you get stumped, its ok to repeat things, just concentrate on actually sensing them in the present.

This is all a good introduction into grounding. The practice I used is based on a simpler variation still!!! It is simply called "Following the Breath". The short form is that you focus on the sensation of the breath going into and out of your nose and just that. Not changing it in any way just watching it. A variation is to count each breath from 1-10 and then restart. There are several more variations but I don't think they are ideal for a PTSD scenario.

Once you can focus on your breathing you can expand your focus into the rest of your body and all the feelings that might be going on there.

One thing I have found quite useful (if a little odd) is to go barefoot.

The key thing to all of this stuff is that it brings you into your physical body in this immediate place and start to stop the mind thinking lots of stupid things.

I would say that grounding in one form or another is the KEY way to deal with panic attacks and other types of triggers where the mind just runs away out of control.

Oh yeah, and if you do it a lot you mellow out :-)

Creating Health said...

Good stuff, pstd guy. I'll have to come back when I have more time and read through the sections on betrayal.

Anonymous said...

hey PTSDguy,

I have/do experience ptsd and I was just reflecting on how it has changed my thinking (the fog and the fear) and what to do about it.

I googled `how to concentrate and focus your ptsd mind` your blog is the third result of 66,700, but the first I connected with due to accuracy of your observations and the effectiveness of the grounding technique.

Sincerely THANK YOU.

One more positive step on the road.

GettingBetter said...

Great...glad it helps!

Anonymous said...

Thankyou, although i am having counselling i have not been given tools for dealing with these horrible 'living' flashbacks. I have been finding a quiet place like a public toilet and waiting for the 'meltdown' to stop. I have filed away the FIVE THINGS for next time I will tell you how it worked for me

GettingBetter said...

I hope it works for you. Like I said it was not a cure, but it did help manage the symptoms most of the time. Do please let us know if it works for you, or if you find any other ways to ground yourself that help you.

Anonymous said...

I found this helpful too but just wondering has anyone tried Eye Movement Desensitization and Reprocessing techniques - I have heard it mentioned before in relation to PTSD.

Anonymous said...

Great Techniques. I have read many methods but observing surroundings with sound, feel and vision was amazing. Thanks you for sharing.

GettingBetter said...

Glad it helped!

dubyajay said...

"Cold, the site explains, activates some reflexes that slow down the heart and exert a calming influence. "

I wonder if this is why I get so cold during an episode. It can be 90 deg. and I'll be shivering like it's the middle of winter. Maybe my body is making itself cold in an attempt calm itself. It could just be a shock response too. I suppose the next obvious question is: are those two things really the same thing?

More generally regarding your site: Excellent. Just excellent. I've been going through it and I don't have the words to express how much your words have helped me. Simply knowing that I'm not the only one in this boat is a great grounding tool in addition to these sensory reminders you suggest.

Anonymous said...

I'm going to see if this helps.

PTSD Sufferer said...

Thank you for this post. It has helped. I'm going to try ice and a strong smell next time (the site suggest peppermint). A four-hour spell sounds horrendous. :(