See also the page on stress management. Information on this page taken from various handouts I got during Skills group in a partial hospitalization program for eating disorders. I have, however, found that they are excellent strategies for dealing with flashbacks and urges to self-injure as well.
Dealing with triggers
Current experiences can be contaminated by thoughts, feelings, and actions. Triggers can flood a person so that the past seems present. Triggers can be people, places, or things. People need a PLAN to manage those triggers that they are aware of and contingency plans for those that come up without warning.
Responses to triggers may include...
- Cognitive responses; i.e. intrusive thoughts. ("I can't do anything." "This will always happen." "I'm just worthless.")
- Emotional responses (fear, anger, sadness, terror)
- Physical reactions (rapid heart beat, muscular pain, stomach ache, panic attack)
- Behavioral responses (drinking, not eating, isolating, purging, self-injuring)
To manage your responses, you must first recognize them. Become aware that you are beginning to be triggered. Acknowledge what is going on. Identify your feelings. Stop the automatic process and think of your plan. Calm yourself in healthy ways; tune into your body, breathe slowly from your diaphragm, tell yourself reassuring thoughts, and concentrate on relaxing tensed muscles. Use grounding skills (see below) to keep yourself in the "here and now." And don't be afraid to ask for help if you need it.
Grounding skills
Grounding skills can be helpful when a person is anxious, having flashbacks, or having difficulty staying in the present. Grounding skills are used to help a person stay focused, using all five senses: sight, hearing, taste, smell, and touch.
Sit in a relaxed position, with your eyes open and feet flat on the floor
Consciously become aware of everything you see around you, and take inventory of each item, naming what you see aloud or quietly in your mind.
Notice every sound around you and identify what you hear.
Describe what you taste. Sometimes chewing gum or sucking on hard candy can help you focus on your sense of taste.
Identify what you smell and describe it
Describe what you are touching with your hands and your body, being aware of the details of texture, hardness, temperature, and shape of what you are touching.
Stamp your feet on the ground so that you remember that you have feet and can get away now if you need to. (As a child, you couldn't get away. Now you can.)
Practice this exercise several times a day, so that it becomes very familiar to you. Make use of grounding whenever you feel anxious or have difficulty staying in the present.
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