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The Clinic on Dupont Toronto

10 Grounding Strategies to Cope with Post-Traumatic Stress

post traumatic stress clinic on dupont blog

When faced with danger, our bodies kick into survival mode, reacting to protect us through the fight, flight, collapse and freeze responses. Reactivating neurological pathways that lead to these responses may sensitize individuals who have experienced trauma to use the same coping strategy every time they anticipate danger in their environment. This functions as a way for the body and mind to try to protect themselves long after the trauma has ended. Thus, even when the individual perceives a benign threat, their body may still respond in a similar way by association, which may cause hyper-vigilance, dissociation, suppressed appetite and deficits in language, learning and memory.

The Neuroscience of Traumatic Response

The polyvagal theory explains that when we are faced with trauma, we go through different stages of responses: Initially, our fight/flight response will be activated, which increases the stress hormone cortisol and activates the amygdala and sympathetic nervous system, stimulating mobilization through a fight/flight response. If this stage fails (the threat can’t be outrun or fought off) then the dissociative stage will be activated, and the prior hyper-arousal will turn into a collapsed, frozen, and numbed state of hypo-arousal.

In a fight/flight response, the amygdala (the emotional center of the brain) increases in activation, hijacking other brain regions including the pre-frontal cortex (responsible for executive functioning), hippocampus (coordinates learning and memory) and the language centers, as well as the digestive tract. This may cause an individual to go mute, have reduced appetite, attention, and concentration, and be affected by impaired learning and memory.

One possible coping strategy that can emerge through a collapse/freeze response is for the left and right hemispheres of the brain to creatively disconnect. This may cause an individual to not remember the event or for gaps to form in their memory, even as the event is remembered at an unconscious level. Other forms of dissociation, including flashbacks (re-experiencing the event), out of body experiences, and time dissociation (losing track of time) are also possible.

Strategies to Cope with Hyper-Arousal and Hypo-Arousal

If you’ve experienced a traumatic event, working with a qualified clinician to help you cope with your post-traumatic stress is crucial. Practicing the following grounding activities can also help to mitigate hyper-arousal by activating your parasympathetic nervous system and can bring you back to the here and now if you are in a dissociative state.

  1.  5-4-3-2-1: Look around the room and name 5 things you can see, 4 things you can touch, 3 things you can hear, 2 things you can smell and 1 thing you can taste.
  2. Box breathing: Take a deep breath in for 4 seconds, hold your breath for 4 seconds, breath out for 4 seconds, and hold for 4 seconds. Repeat.
  3.  Mindful eating: Take a raisin or other piece of food. Examine it. What does it look like? How does it smell? How does it feel? Slowly begin to chew it. How does it taste?
  4.  Counting backward: Count backward by 7 starting from 100.
  5. Ice cube technique: Take an ice cube and move it along your arm. Notice the temperature, if it melts, how it feels, and what it looks like- again, tap into the 5 senses.
  6.  Teddy bear technique (for children): Lie on your back and place a teddy on your belly. As you take deep breaths in and out, watch the teddy bear move up and down with each inhale and exhale.
  7. Progressive muscle relaxation: Start with your right hand in a relaxed state. Slowly begin to clench your hand. Notice the tension as you begin to do this, as you transition your hand from a relaxed state into a fist. Next, slowly begin unclenching your hand back into a relaxed state, again noticing the difference in tension. Repeat these steps with your left hand and then move along to other body parts such as the foot and leg.
  8. Naming colors: Name everything in the room that is blue. Now name everything in the room that is red. Now everything in the room that is yellow, etc.
  9. Mindful walking: As you walk, notice the weight of each foot on the ground and how your weight changes as you take each step. If you are outside, notice if it is sunny, hot, cold or rainy. If it’s sunny, notice how the sun feels on your skin. Notice if you can hear cars passing or birds chirping.
  10. Monitoring your heartbeat: Place your fingertips together from both of your hands. Notice your pulse in your fingertips and pay attention to the rhythm of your heartbeat.

theclinicondupont-lisa-zemanovichLisa Zemanovich, MSW, RSW

Lisa is a Registered Social Worker, Psychotherapist who specializes in the treatment of trauma/PTSD, somatization and mood disorders. She received her Master’s degree from the University of Toronto and utilizes an eclectic approach, drawing from evidence-based practices when working with clients.

Posted September 25, 2018