Blogroll Please!
Tuesday, May 12, 2009 at 04:36PM So here is my blogroll, straight from my google reader :-) If you have visited any of these wonderful people, I highly recommend it!
Thoughts and Musings of a Girl Interrupted
Safe Place Imagery
Saturday, May 9, 2009 at 01:41PM Back in my Containment 101 post I suggested using imagery to help self-soothe. Creating a safe space for yourself is not just something for people with trauma disorders. How many people do you know have pleasent pictures of beaches, forests, oceans, etc on their walls in their offices and homes. Everyone enjoys looking at peaceful images and thinking about how nice it would be to be there.
For people with trauma in their histories it can be very difficult to imagine safe spaces. A lot of normal things can bring up memories from the past. However, those who experience flashbacks have a great ability to retain sensory information, albeit generally negative and frightening, the ability to do this can be helpful if used in the right way.
In my treatment, I have been taught how to self soothe parts of me by helping to construct internal safe places to visit in our head when things become difficult. All of my parts have unique safe place imagery to call upon when they need to. In the beginning I found it help to create safe place collages to have right in front of me to help me focus on safe things. It's fun to make them and a lot of my parts enjoy collaging. So I post this to reccommend collaging your safe place. They can be images, words, music lyrics...anything that is comforting. I have some specific to help me with certain feelings or times of the year. Have fun with it!
Grounding 101
Saturday, May 9, 2009 at 01:28PM Everyone dissociates to some degree, some just do it at a more intense level that can interfere with their daily functioning. Grounding is the foundation to managing your level of dissociation, my hopes with this post are to educate those who suffer from intrusive levels of dissociation on how to manage it .
Above is the dissociative continuum. Hello crash course. We start out in the normal range which everyone experiences. At the normal level you may experience driving somewhere and become so lost in thought or in the music playing in your car that you may forget having driven a couple of miles. People experience this also when they do repetitive work, because their movements are so repetitive they can become lost in thought and not remember doing several tasks, like those who work on lines in factories. The second on the continuum is a single dissociative episode. This can happen in those moments of deja-vu where things feel very similar and unreal. It doesn't occur on a regular basis or interfere with daily functioning. Third is a dissociative disorder such as dissociative amnesia which can be described as not being able to recall important information due to high stress. The general public describes this as "blocking something out". Fourth is PTSD, in which people experience loss of touch with reality when immersed in a flashback or body memory. In those experiences people are unaware of time and surroundings because they are so lost in their flashbacks. Fifth is the atypical dissociative disorder like frequent and severe sleep walking...some people report actually leaving their homes and performing tasks completely unaware they are doing them. Finally, dissociative identity disorder is the dissociative extreme in which two or more states of being are present in an individual.
For individuals experiencing the more extreme forms of dissociation it can be a love/hate relationship. Dissociation can feel extremely helpful in difficult situations, just zoning out to not have to deal with uncomfortable feelings is a great escape and as a child it was VERY helpful. The downside to this is that at some point the dissociation becomes so natural that we often miss out on pleasant feelings and can end up in dangerous situations. Our brains and bodies react to stress with dissociation and situations that are dangerous we become more vulnerable and unable to make quick decisions or act if necessary to protect ourselves.
We we do not stay in touch with reality we become more vulnerable to flashbacks, body memories and intrusive thoughts and impulses. Below are a list of tools and strategies that can help you re-train your brain to manage dissociation to lower symptoms and gain more control over your dissociation.
What exactly does grounding mean?
It means the here and now. It's the process of being connected to the present moment. It's simply awareness and connectedness.
Techniques
Use your 5 Senses
This technique makes you pay attention to your senses and what it is experiencing in the present moment. If you are extremely triggered by one of your senses (I am over-reactive to the smell sense) it may not be a good idea to focus to much on that particular sense.
What exactly is audible in the present moment? Can you hear a clock ticking? The sound of the air conditioner, static? Is your TV or radio on? Can you hear street noise or a dog barking from a neighbors yard?
Come up with a list of sounds you find soothing and use one of them.
-music, -nature sounds, -familiar sounds, -white noise machine
What can you see in the present? Are their shadows on the wall made by sunlight? Find one object for each color in the rainbow. How many circles/squares/triangles are in the room?
Make a collage of visually pleasing images and photographs that you can keep folded up in your purse/backpack, etc. You can use your current photo ID to ground you to your present appearance and age. Keep photos of safe people or animals around you.
Touch is very powerful. This particular sense can get you completely aware of your body if you start from your feet and go all the way up to your head, telling yourself what each of your body parts are touching. For example, my feet can feel the floor below me, the backs of my legs are touching the chair, I can feel my spine on the chair, I can feel the hair on my head pulled into a pony-tail.
Since touch can be so soothing, keep a favorite lotion on hand and use it to feel your hands and arms (if it's scented it'll work for that sense as well). Find a small smooth stone you can use to feel temperature and texture. Ice cubes are so cold that it's easy to feel them, put an ice cube in your hand.
Taste. Using strongly flavored candies can help you get your grips on the taste sensation. Altiods, lemon, cinnamon, ALL very strong tastes. Find a candy that is not connected to your childhood and keep it on hand for a quick taste check.
Smell. For me, this sense can be a little overwhelming and I struggle to find scents that are not connected to my past. Some solutions I have found for my room include carpet fresheners that I never had in my home as a kid. I sprinkle a little on my air cleaner and BOOM, present day. You can also use scented candles, soaps and lotions.
Something that helped me plan this out in advance was to come up with a list of situations in which I know I often become ungrounded in. For example, I know that near the end of the workday when my brain is overloaded and I have a mandatory meeting to attend that I typically zone out. So I made a plan for myself to get grounded before the meeting and made the items I need to do this available to myself. If you know those situations it's less likely you'll be caught off-guard. I then made a quick note-card for myself that had my grounding techniques on it and kept it in my purse so that I'd have it available if I began to panic.
In the beginning of learning all of this I found it really helpful to do a grounding worksheet each day. Basically I have a chart with all the hours of the day and at the top of each hour I would check in with myself and rate from 1-10 on how grounded I felt. I had a separate list of what I would do corresponding with each number on ways to help myself become more grounded.
You can make your own in Word or Excel, specific to you. Or if you'd like the one I have, leave a comment or e-mail me privately with your e-mail and I will forward it to you.
I learned all this at Sheppard Pratt Hospital's Trauma Disorders Unit. My treatment has cost nearly one million dollars. I hope everything I learned for massive amounts of money can be distributed to the general public in a helpful way. If you have any questions or concerns, please let me know and I will do my best to help you.
Containment 101
Saturday, May 9, 2009 at 12:03PM Oh the joys of containment! I am not sure how many are familiar with this symptom management technique, so I decided to put it out there for those that are not. Containment summed up is a way to teach your brain a more helpful way of storing traumatic material, a less intrusive way and one that grants the sufferer more control over these intrusive thoughts, feelings and behaviors.
DISCLAIMER: I ask you to forgive me now, I am not a PhD, and some of my terms may not be exactly the best clinical way of describing them. I hope that my layman speak will actually be easier to understand. For all intent and purpose, this description is best applied to those that have a trauma history and not the general population.
Ok, the below chart is a description of how people with trauma typically store information related to their abuse in a way that can lead to flashbacks, body memories, feelings that don't match to the present day and acting out behaviors not directly related to a current stressful event.
The conscious is where we keep all current information like date and time, or where we
are. We are aware of this knowledge but it is not something we necessarily acknowledge. But it's always available. The preconscious is where we store information like our birthdate, our address, phone number or things like our first car, our first job. This information is something we can recall when we put some effort into it and doesn't really have any trauma attached to it. The unconscious is a deep dark place that you really cannot access, even with considerable effort. Trauma survivors store all their blocked out memories and feelings in this place, hoping for it to never come back again.
We break our memories up into behaviors, affect, sensations and knowledge...or BASK. The chart also demonstrates what happens with that stored information. Sometimes a trigger occurs, other times for no reason at all, one of those pieces of information shoots up in the conscious and reeks havoc on your conscious. Flashbacks and body memories abounding. Then, we tend to shove it right back down into the unconscious where it looms until the cycle begins all over again. It can be torturous and definitely effect your ability to function in your daily life!
So really, what is a person supposed to do? How can you end the cycle? How can you start a process that allows YOU control over this?
This is where containment comes into play. Containment is a set of strategies that re-train your brain to take those BASK pieces and store them appropriately in your preconscious where YOU have the control to access them or not to. This is not to be confused with stuffing, or keeping quiet. This won't stop the information from invading, it won't stop the flashbacks all together, however the more you use this...the less there is to store in your unconscious and the less there will be to come out invasively.
So how do you do this you ask?
Well, first you need to figure out how you learn best. Are you a concrete thinking that requires something tangible, something more hands on? Or do you better with imagery and closing your eyes and just thinking something through? (and eventually you can do both)
For the concrete thinkers out there, the best practice for this is finding yourself a small box, preferably one you can lock or by using your journal. When you experience the intrusive symptoms quickly write down on a piece of paper or in your journal three or four simple describing words that will help you to recall the information you experienced. Try to be gentle with the memory trigger words, not too graphic. Seal this information up in the box and lock it or in your journal. Spend the next 15 minutes or so using pleasant imagery, go to your safe place in your head and take care of yourself. Remember, you store that information for later...you don't need to deal with it right now. Once you've successfully done that, congratulate yourself. You just did containment. Sometimes you have to go through this process SEVERAL times before you get relief. It's a learned skill and it takes practice.
Now, with this 'stored' information you can take it to your therapist and add it to the list of things to process. You have the memory triggers there and you can recall it in a safe environment with support.
For people that prefer a more imagery based approach (which is a little more difficult in my opinion) the possibilities are endless for your containment devices. Some people can just make a box in your head, and others I listened to have constructed some VERY intense ways to store it. Some examples include:
-A Hot air balloon -a treasure chest with multiple locks at the bottom of a lake -a remote control car with a box locked to it -a treetrunk with a revolving keypad entry door
One of the most important things to remember about imagery and containment is that with whatever you decide to use, the object must be attached to something that you can imagine yourself using to pull the object back. For example, with the hot air balloon you could have a tether tied to the ground. Or with the treasure chest, and rope attached to a dock or boat. Now that you have your object of storage you can place all the intrusive symptoms in that object and send it to where it is supposed to go and then pull it back while you are in therapy.
Like I said before, the imagery way of doing it can be very complicated and I recommend trying the tangible way first.
Some pointers? -Test your ability to use this skill with begnin information. Something I used was a commercial I saw on TV. I saw it, wrote a few words on a piece of paper and locked it up. I wrote a note on my computer reminding myself to recall that information later in the day. I tried to remember the commercial without my box, but no such luck. When I opened the piece of paper it was easily recalled. I've also done it with trying to remember important meetings and dates nd it worked. Get comfortable with that before trying to tackle th big stuff. -DON'T GIVE UP. Sometimes it works, other times your brain just might not be ready and it's something you HAVE to practice. -Be creative, find something that works for you and ONLY you. -If you have DID you may need multiple forms of containment, and some parts might want to contruct their own object for their information. It's a wonderful tool. -Remember, this is a tool to give you control...not silence you.
