Telehealth sessions only
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A Holistic Approach to Psychotherapy
COPING SKILLS
FLASHBACKS
Below are two very useful strategies you can use when triggered or emotionally overwhelmed. One page is for what to do when you having a flashback or get triggered. The other page is for after and can help you identify your triggers. As we know, sometimes we find ourselves triggered and don’t have any idea what set us off. This information comes from a book by Yvonne Dolan - “Resolving Sexual Abuse” (which is really more a book for therapists) and she says in the book it is fine to share these techniques. Yvonne has many other helpful books for survivors you might want to check out.
Some people think flashbacks are when you all of a sudden experience being in a different time and orplace. That is one kind of flashback. There are emotional flashbacks where you all of a sudden find yourself completely overwhelmed and melting down, and you are not always sure of why. That is an emotional flashback. Both can be helped with these techniques.
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Triggered states and/or dissociated states: There are two great free apps that can help. "The Tapping Solution" (also you will find videos on you tube of how to do this - look for the ones by Nick or Julia Ortner.) The other free app is Insight Timer. It has thousands of meditations and guided imagerys which you can listen to and they will help you control your anxiety, and may help you come back from a trigger, a flashback or out of a dissociated state. Of course sometimes when we are too dissociated we may not have presence of mind (or we may be in another part (DID)) that knows to go to the resources for help. I recommend to my clients writing on an index card (or several) and post them around your home. Big letters. Tapping Solution. Insight Timer. Use ice to ground yourself.
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STRATEGIES FOR DEALING WITH FLASHBACKS
from publications by Yvonne Dolan
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Use this method to stop a flashback when you are having one.
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STOP what you are experiencing (if possible). For example, stop playing the music, stop the car, stop reading, etc. What is happening?
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CALM yourself so that you can experience grounding and a sense of boundaries, e.g. talk to yourself, take a drink, go to another room)
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AFFIRM and reorient yourself to the present through the five senses. What do you feel, see, touch, hear or smell in the present? (e.g. I am with my partner in my home. I am an adult. This is the year 2013 and I am 42 years old. )
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TAKE ACTION. How do you interact or not interact with this experience (trigger) in order to feel safe? (e.g. talk to your partner, call a friend, speak to a counselor, focus on being in the safety and security of the room, take time to write in a journal, etc.)
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TECHNIQUES OF EMPOWERMENT FOR FLASHBACKS
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Use this method to gather information about what triggered the flashback.
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Have you felt this way in the past? What circumstances or situations did you encounter the last time you felt this way?
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How are the present situation and your past situation similar? For example, are there particular colors, sounds, objects, locations, seasons of the year, times of day, or sensations that are in some way similar to a past experience when you felt this way? If there is one or more persons involved, how is this situation similar to the past situation?
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How is your present situation different from the situation in the past that you are reminded about? In what ways are your sensory experience, current life context, and personal resources different from the past? In what ways is the setting different? If another person or persons are involved, what is different from the person(s) in the past situation?
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What steps, if any, do you want to consider in order to help yourself feel better in the present? For example, a flashback may indicate that a person is once again in a situation that is in some way frightening. If this is the case, steps toward self-protection and personal security should be taken to change the current situation. On the other hand, a flashback may simply mean that a past memory has been triggered by a connection made to the past such as certain colors or odors. In such cases, messages of reassurance and comfort need to be given to the self to lessen the negative impact of past memories of trauma.
In addition, it is often helpful to identify practical and concrete ways to deal with the situation. Write these ideas down as resources that you can access.
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GROUNDING
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One of the most essential coping skills is being able to group yourself when you become emotionally overwhelmed, triggered or dissociated. There are several good techniques you can use.
The 5 senses: orient yourself to time and place by using your five senses. Find something in your surroundings that you can SEE that tells you where you are and what year it is. Calendars are good. Or it could be something that is comforting to you. Find something you can SMELL that indicates the here and now. Do the same with each sense: HEAR, TOUCH and TASTE. Take a drink of water or something liquid. That will often put you back into your body.
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Ice: Try holding ice, or sticking your hands or face into a sink or bowl full of ice.
Feet on floor: Put both feel firmly on the floor. Put your attention on how they connect to the floor or earth. Feel the toes, heels, etc. Step up and down, alternating feet.
Touch: Hold something that is textured; many clients have worry stones, or an object with a lot of texture that grounds them when they rub it.
Tapping: Try using one of the meditations from The Tapping Solution. Install the free app on your phone so it will be readily available when you need it.
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BREATHWORK
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Doing counted breathes are very effective at reducing anxiety and stress and feeling overwhelmed. Take a deep breath in through your nose..for a count of 4 or 5. Hold for a count of 4 or 5. Exhale through an open mouth, like a sigh of relief, for a count of 5 to 7. Pause and repeat. It is most effective to practice this daily to condition it By practicing it every day, your body will condition to relaxing when you start to do it, with that first breath. I’ve done it so many years now that when I take that first breath in, I get “noodle body”, an almost immediate relaxation. Did you know you cannot have stress in a relaxed body? As soon as you experience stress, your body will start to tense up. Relax the boy and the stress/tension will go away. It will still work if you don’t do the conditioning part, but not nearly as well.
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MEDITATION AND MINDFULNESS
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I cannot stress enough how important these are to recovering from trauma, attaining peace, stress reduction, and managing anxiety. There are many free videos on you tube that can teach you how to do mindfulness meditation and teach you about mindfulness. DBT is based on mindfulness. Also a type of therapy called ACT: Acceptance and Commitment Therapy is also based in mindfulness. There are probably hundreds of videos on you tube. Look around until you find one that resonates with you. Here is one I like.
https://www.youtube.com/watch?v=yMz_UagXkFk
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I want to emphasize you don’t have to sit cross legged or perfect. Sit in a chair and do what you need to do to be comfortable. It will still be very helpful.
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To enhance your meditation experience, you might want to try incorporating tapping. You can go to The Tapping Solution website and learn more about this.
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Some trauma survivors have a lot of trouble doing meditation. This is often due to the hyper-vigilance of PTSD. It’s too scary to be that still and it feels too vulnerable. The good news is there are LOTS of different kinds of meditation. Walking meditation is sometimes better, or something like Tai Chi. I found a book called “Meditation for dummies” (which I laughed at when I saw the title but upon looking through it found it VERY useful. The book comes with a CD also.) There are many different kinds of meditation in that book. Also sometimes being unable to meditate is associated with limited or no emotional regulation control, which I suspect many of you trauma survivors know about. When there is early trauma and/or neglect, brains form differently, and the parts of the brain that enable other people to self soothe and control their overwhelming emotions do not develop normally. (See Bessel van Der Kolk’s book - The Body Keeps the Score). If that is the case, your therapist will need to work with you for awhile...sometimes quite a long while...so your brain can rewire itself and you can build emotional control.
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SPIRITUALITY
People often ask me how I healed from my own trauma. I tell them it was a combination of good therapy and regaining a spiritual connection to the divine. Many trauma survivors become disconnected from their religions or their God, due to any number of reasons. You don’t have to believe in an particular religion or spiritual path, but work to find your connection to whatever spirit is for you. Consider reading some of the Buddhist books. I am not a Buddhist but I believe following their philosophies have also been responsible for my healing. I highly recommend materials by Thich Nhat Hahn or Pema Chodron.
Try to read something spiritual to start your day. You don’t have to read the whole book....just some little bit often helps. I use facebook to keep me connected. I follow many spiritual leaders and throughout the day some helpful phrase or teaching will pop up and when I log onto facebook it’s so very nice to read that. Whatever your path, make an effort to find others who have that path or similar interests. Spiritual community can be a lifesaver. I started a Women’s Spirituality Group years ago with some like-minded women. We meed once a month..now on Zoom...and it’s phenomenal. If you are disconnected, try lots of different things until you find something that resonates with you. Ever day I post uplifting, inspirational, and/or spiritual quotes, pictures and memes on my facebook page, Lotus Counseling; you can just click on that to see it.
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BOOKS AND READING - go to the book recommendations page.
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MUSIC
Music can be a lifesaver. It can change your mood, settle you down, lift you up, mellow you out, or make you productive. I have a few different playlists I can go to for mood management. I will recommend a couple here that are tremendously helpful for me. Shaina Noll’s “Songs for your Inner Child” is amazing. There was a time in my recovery that I listened to it every single day, sometimes more than once. I hold a feminine image of God and she has a song on the album, “You can relax now”. You may wish to imagine a Divine Mother God singing this song to you. Another artist I just love is Karen Drucker. She sings/writes mostly spiritual songs and some of them seem to have been written for survivors. I have 4 of her CD’s, all of “Songs of the Spirit” ....I, II, III and IV. I wonder if I can put in a link to one of her songs here. Let’s see: So Many Angels: https://www.youtube.com/watch?v=A4RPfuTwE-E or you can find it on youtube.
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OTHER USEFUL SITES AND RESOURCES
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This technique can help you in so many ways. It is also free, which is amazing. It helps to resolve negative emotional states and balance/restore your body's energy. You can install the free app on your phone.
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This site has thousands of guided meditations and meditations. It's also free. You can also take classes on this site in meditation and other topics. You can install the free app on your phone.
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This is another free APP for stress reduction, relaxation, insomnia, music and meditation.
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DBT (Dialectic Behavioral Training) is an essential tool for regulating and managing emotional states. The website is very useful and you could learn to use DBT just by going to the website. However, if you are very emotionally unregulated, you would probably want to attend a DBT training class and work with a DBT therapist. There are many DBT apps you can download on your phone. You can find some free ones, but many of them do have a fee.
The companion app for the DBT self help website is quite affordable; I believe is is 99 cents per month.
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This site is a wonderful place to find inexpensive courses in everything from spirituality, relationships, personal growth, recovery, meditation and so many more. They offer a "pay what you can" sliding scale starting at $15 per course. I have taken many of their courses and loved every one.
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Stay tuned....more coping skills to come
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