One of the most frustrating things about the process of recovery is that the thoughts and symptoms feel so automatic. By the time you realize you’ve been triggered, you’re already stuck in a chain of negative thinking and unhealthy behaviors, and the rational part of your brain that might be able to intervene has already shut itself off. It’s auto-pilot from there.
So, is there anything we can do?
The short answer is: YES! In fact, these situations are actually great opportunities to increase our awareness of our deeper emotional experience and to learn to live in the moment again.
Grounding Skills are tools that can help us to stay focused on the moment. They can help us to re-connect with the reality around us when our mind has jumped to thinking about the past, our biggest fears, the size of our thighs, or planning our next binge/purge session. Once the mind starts down that path, it can be incredibly difficult to get back on track. That’s where Grounding Skills come in. The good news is: the more you practice grounding skills, the easier it will be to bring your mind back to a healthy place once it’s been triggered.
Automatic thoughts, flashbacks, impulsive behaviors, and other symptoms can happen when something we’ve just seen, thought, or felt is associated in some way with our deeper emotional pain—the stuff we don’t want to think about. Chances are, it will happen so quickly that we won’t realize that our mind has completely shifted gears. Some automatic reactions last for a few seconds, some for hours or days. We might go blank for a few seconds before jumping back into a conversation. Or, we might decide that the outside world is just too overwhelming, and we choose instead to stay within ourselves and ‘zone out’ for the next day or two. Often, one trigger causes a particular symptom that tends to trigger another symptom, and before we know it, we’ve engaged in a whole chain of unhealthy automatic behaviors. When we look back on the events of the day, we might feel like we weren’t even there!
First step: Awareness
When you notice that your thoughts have drifted away from what’s going on in the moment, STOP. When you find yourself analyzing whether you ate too much or whether you’re a worthwhile human being, recognize that you’ve lost touch with what’s happening around you. Remind yourself that you are in the present. Take an inventory of exactly what is going on around you. Take deep breaths and try to relax your muscles.
Second Step: Identify the Feeling
This is a step that tends to frustrate any person with an eating disorder. After all, we’re either “fine” or “not fine”, right? For this reason, some people find it helpful to use a list of feeling words. (Go to http://www.joyproject.org/Documents/emotionslist.pdf for a list you can use). Identify any words that seem to “fit” with what you’re currently feeling.
Third Step: What does this remind me of?
Ask yourself what comes to mind when you think of past situations where you might have felt similar feelings. Don’t think too deeply about those situations for now—just make a note of what pops into your head (either a mental note, or a written note). What sounds, sights, sensations, people, subjects, or thoughts are you experiencing now that were similar back then?
You can reflect on those situations more at your next therapy session, or when you’re in a good place to really focus on dealing with those feelings. For now, the goal is to get your mind back in the present moment so you can continue what you were doing before you were triggered.
If some aspect of your current situation is alerting you to a danger that you’ve faced in the past, then begin planning to take action to protect yourself. Don’t ignore your instincts.
However, if the current situation is NOT dangerous, and you’re simply finding yourself ruminating about internal fears or past hurts, focus on reminding yourself that the current moment is safe, and that those fears don’t need to block out what’s happening now.
Fourth Step: Re-Ground your thoughts to the current moment
The following is a list of ideas that can help to bring your mind back into awareness of the present.
PHYSICAL OR SENSORY GROUNDING SKILLS
Reorient yourself in place and time by asking yourself some or all of these questions:
1.) Where am I?
2.) What is today?
3.) What is the date?
4.) What is the month?
5.) What is the year?
6.) How old am I?
7.) What season is it?
8.) Who is the President?
Focus on your surroundings. What items are near you? Notice details. Describe these items in your head (i.e. “The couch is green, the table is smooth, the book is on the shelf”)
Hold something with a unique texture and focus on how it feels against your skin.
FOCUS on someone's voice, the sound of the refrigerator running, or the sounds of the birds outside your window.
Hold a safe object, such as a favorite stuffed animal, a picture of someone you trust, a smooth rock, a stress ball, a special piece of jewelry, etc.
Listen to a tape of self-affirmations
Take your shoes off and rub your feet on the ground.
Move parts of your body. Focus on what you’re feeling in each arm, finger, kneecap, or your toes.
Stomp your feet
Stomp on aluminum cans to crush them.
Suck on an Altoid, or a super-sour piece of candy.
Put a few drops of Tabasco sauce on your tongue, focusing on the intense flavor.
Spray yourself with favorite perfume. Breathe deeply as you smell it.
Draw on yourself with a marker.
Focus on your breathing. Breathe in and out slowly.
Place a cool cloth on your face, or hold something cool such as a can of soda.
Chew on ice.
Rub ice over the body.
Stick your hand or face in ice water.
Place a loose rubber band around the wrist and snap it hard enough to feel it but not to do any damage.
Jump into either a hot shower or a cold shower. Do this fully clothed for a different sensory experience.
Listen to music that fits the emotion you’re experiencing.
Listen to music that portrays the emotion opposite from what you’re experiencing.
Sing out loud.
Put a small pebble in your shoe and walk around.
Dig your nails slightly into your palms just enough to cause dent marks, but not enough to cause damage.
Brush your hair slowly, concentrating on each stroke.
Pop bubble wrap.
Pet a cat- pay attention to the softness of the fur, the sound of purring, the cat’s warmth.
Take a bath. Add scents to the water for a stronger sensory experience.
Go for a walk, paying close attention to the warmth of the sun, the feel of the wind, or the smells around you.
Dig in the dirt in your garden.
Turn on as many lights as you can.
Say something out loud. Yell, if you’d like.
Talk to yourself in a mirror. Pay attention to the facial expressions and
body language of the person looking back at you.
Write in your journal.
Imagine a STOP sign in your head.
Visualize putting your thoughts into a safe container. Mentally throw the negative thoughts into the trash.
Write your thoughts on paper and throw the paper away or put it in a box to take out later.
Try to change any negative thought into a positive—even if you don’t really believe the positive. For example: if your picnic was rained out, tell yourself you are relieved you won’t have to deal with mosquitos and ants today.
Identify cognitive distortions, i.e.: Do I KNOW that I’m a loser, or is that just a fear of mine?
See how many things you can think of that begin with the letter “J”.
Think of a place or time when you felt very safe.
Say a prayer.
Repeat a comforting phrase, such as: "this is now, not then."
Count nice things.
Count backwards from 100 to 1, skipping every third number.
Create a list of something: books, CDs, favorite movies, states you’ve been to, etc.
Finally: Reflect on this situation at a later time, and ask yourself how you can use this information to identify ways to minimize your vulnerability to triggers in the future. Are these triggers something you could easily avoid? If they are not avoidable, are there things you can do to make you less vulnerable when those moments arise? If you made some attempt to deal with a trigger, and it didn’t work, ask yourself what went wrong. Do you need a different strategy next time? Do you need additional help to overcome this trigger in the future?