Grounding and stabilization are essential forms of care for individuals experiencing acute reactions. These techniques help bring the person back to the present moment and can help to reduce distress. This is especially important when the individual cannot function or respond to questions due to the intensity of their response.
The First Steps
- Focus on being calm yourself—intentionally slow down your actions and speech
- Use a soft, even voice
- Allow the person to dictate the distance between you
- Introduce yourself
- Keep questions simple and explain why you are asking. Avoid questions with an investigative tone.
- Ask without judgment or criticism
- Avoid pushing for additional information
- Give the person time to think through requests
- Normalize and validate statements made
- Normalize—the experience is normal
- Validate—the experience is important
- Provide reassurances without making promises.
People will naturally mirror each other. If you can calm yourself by slowing your breathing, quieting your voice, and relaxing tense muscles, others will respond similarly. For example, think of how the intonation of an airline pilot’s voice can affect the state and response of passengers on a flight.
Be the non-anxious person in an anxious situation!
Grounding Techniques:
Grounding techniques are practical tools that focus attention on the senses (seeing, hearing, tasting, smelling, touch) to slow the body’s fight/flight/freeze response and stabilize distress. These techniques are intended to “ground” someone in the present moment by intentionally engaging with their senses and what they are experiencing right here, right now.
Note: Grounding techniques are beneficial for varied levels of distress response (always keeping personal safety in mind). These techniques allow the body to re-regulate to functional physical, emotional, psychological, and spiritual levels.
- Intentional breathing exercises: Help slow the heart rate and calm the nervous system. Ex: Breathe in for a count of 4, hold for 4, breathe out for 5, repeat
- Sensory-focused activities: Identify and focus on what can be heard, felt, seen, and tasted in the present environment. (See sensory-focused examples below).
- Muscle relaxation: Try tensing and releasing each muscle group, starting from the feet and moving to the head. This exercise intentionally releases tension trapped in muscles. (see Intentional Muscle Relaxation exercise p. 48)
- Mindfulness: Pay attention to the present moment without judgment while focusing on breathing. This can help calm the mind and reduce rumination on distressing thoughts.
- Imagery: Use the imagination to create a calm and safe place in the mind. This can help to provide a sense of comfort and escape from distress.
- Cognitive Distractors: Can help people regain control of their cognitive function and compartmentalize some of the stimulation they are experiencing.
Ideas for cognitive distractors:
- Counting backwards
- Looking at pictures of animals/pets
- Images of nature
- Tapping fingertips in a rhythm together
- Puzzles or brain games
- Music or podcasts
- Crafts
- Exercise
Safety Note: Highly distressed or agitated individuals may act in ways that compromise yours or others’ safety.
They may:
- Challenge or question authority
- Refuse to follow directions
- Lose control and become verbally agitated
- Become threatening
DO NOT HESITATE TO SEEK ASSISTANCE IF AN INDIVIDUAL DOES NOT RESPOND TO YOUR ATTEMPTS AT STABILIZATION.
Ideas for sensory stabilization:
Visual:
- Play “I Spy”
- “How would you describe the color of the sky today?”
- “What is the brightest color in the room today?”
Smell:
- “Do you smell that?”
- “I wonder what is cooking?”
- Hand someone a scented flower.
Taste:
- Carry peppermint or sour hard candy or a piece of gum
- Give someone a snack and ask them if it tastes good
- Provide a flavored hot or cold drink- coffee, tea, hot chocolate, flavored water (sparkling or still), or juice.
Hearing:
- “Do you hear that?”
- “Is that a bird?”
- “Traffic is deafening today.”
Touch:
- “Can you wiggle your toes?”
- “That shirt looks comfortable and soft.”
- “What does the fabric on that chair feel like?”
- Place your hand on their shoulder ***ASK FIRST
These tools help a stressed person re-engage with the here and now. They can help a survivor get out of ruminating on past thoughts or experiences and repetitious speculation of the future.
When grounding techniques are employed, there should be an observable effect of calming regulation. If there is no observable effect, or the survivor becomes more agitated or irritated, seek help from others.
If something does not seem helpful, do something else.
Remember: stabilization restores dignity and value to an individual by restoring cognitive function and the agency of choice.
Further Resources:
