Monday, March 30, 2020

Flashbacks

COPING WITH FLASHBACKS


Tell yourself you are having a flashback and that this is okay and very normal in people who 
have experienced trauma. 

 Remind yourself that the worst is over – it happened in the past, but it is 
not happening now. “That was then, and this is now”. The „child‟ or 
traumatised person inside you is giving you these memories to use in 
your healing and, however terrible you feel, you survived the awfulness 
then, which means you can survive and get through what you are remembering now. 

 Call on the „adult‟ or stronger part of you to tell your child or victim part, that she/he is not alone, not in any danger now, and that you will help her/him to get through this. Let your child or victim self know that it‟s okay to remember and to feel what she/he feel and that this will help her/him in their healing from what happened to them. However hard it is for you, she/he is communicating in the only way she/he can. 

 Try some of these ways of „grounding‟ yourself, and becoming more aware of the present: 
 Stand up, stamp your feet, jump up and down, dance about, clap your hands, remind 
yourself where you are now. 
 Look around the room, notice the colours, the people, the shapes of things. Make it 
more real. 
 Listen to and really notice the sounds around you: the traffic, voices, washing 
machine, music etc. 
 Notice the sensations in your body, the boundary of your skin, your clothes, the chair 
or floor supporting you. 
 Pinch yourself or ping an elastic band on your wrist - that feeling is in the now, the things you are re-experiencing were in the past. 

 Take care of your breathing: breathe deeply down to your diaphragm; put your hand there (just above your navel) and breathe so that your hand gets pushed up and down. Imagine 
you have a balloon in your tummy, inflating it as you breathe in, and 
deflating as you breathe out. When we get scared, we breathe too 
quickly and shallowly and our body begins to panic because we‟re not 
getting enough oxygen. This causes dizziness, shakiness and more 
panic. Breathing slower and deeper will stop the panic. 

 If you have lost a sense of where you end and the rest of the world 
begins, rub your arms and legs so you can feel the edges of your body, the boundary of you. Wrap yourself in a blanket, feel it around you. 

 Get support if you would like it. Let people close to you know about flashbacks so they can help if you want them to. That might mean holding you, talking to you, helping you to reconnect with the present, to remember you are safe and cared for now. 


 Flashbacks are powerful experiences which drain your energy. 
Take time to look after yourself when you have had a flashback. 
You could have a warm, relaxing bath or a sleep, a warm drink, 
play some soothing music, or just take some quiet time for 
yourself. Your „child‟ or „victim‟ and you deserve being taken care 
of, given all you‟ve been through. 

 When you feel ready, write down all you can remember about the flashback, and how you got through it. This will help you to remember information for your healing, and to remind you that you did get through it (and can again). 

 Remember you are not crazy – flashbacks are normal and you are healing. 
Adapted from Bristol Crisis Service for Women.

GROUNDING TECHNIQUES for Coping with Flashbacks & Distress 

Grounding techniques can be very useful when we feel really distressed, particularly when the distress makes us feel very unreal or detached, or it feels like we are in a different situation to where we really are.
A flashback is part of the brain's way of working to process the trauma so that the experience can be filed away as a past memory (rather than a current threat).  This will enable your healing. We can help this process by allowing the flashbacks to happen, rather than fighting or avoiding them. We can cope with them by getting our heads out of the past (trauma) and into the present (safety), by using grounding techniques. 
Anxiety often makes us feel very detached, dissociated, or unreal.  Grounding techniques help to bring us back to the here and now, with an awareness of our own bodies.  They are strategies that help us to be in the present moment, in reality, rather than in the traumatic experience of the past or current distress.
Practise them, and learn what works best for you - whether it's a mental strategy like telling yourself you're safe now, or maybe doing something more physical.  The aim is to turn your focus of attention away from the past or current distress, and into the here and now of reality and safety.


Tell yourself you are having a flashback or anxiety attack and that this is okay and normal.
The worst is over - it happened in the past, but it is not happening now.
Tell yourself:  That was then, and this is now.  However terrible you feel right now, you survived the awfulness then, which means you can survive and get through what you are remembering now.
Open your eyes and put a light on (if it's dark).
Look around the room, notice the colours, the people, the shapes of things. Make it more real.

Listen to and really notice the sounds around you: the traffic, voices, washing machine, music etc.
Notice your body, the boundary of your skin, how your clothes feel on your skin, movement in your hair as you move your head, really feel the chair or floor supporting you - how that feels in your feet, your legs, your body.
Pinch yourself - that feeling is in the now, the things you are re-experiencing happened in the past.  That was then, and this is now.
Stand up and put your feet firmly on the ground
Move about: stretch, stamp your feet, jump up and down, dance, run on the spot, rub your arms and legs, clap your hands, walk, remind yourself where you are right now.
Use 5,4,3,2,1:  Think about 5 things you can see, 4 things you can hear, 3 things you can touch (and touch them), 2 things  you can smell or like the smell of, and 1 slow, deep breath.
Notice what is right now - and notice how different it is to the distressing memory.
Breathe mindfully: breathe deeply down to your belly; put your hand there (just above y
our navel) and breathe so that your hand gets pushed up and down. Imagine you have a balloon in your tummy, inflating it as you breathe in, and deflating as you breathe out. When we get scared, we breathe too quickly and shallowly and our body begins to panic because we're not getting enough oxygen. This causes dizziness, shakiness and more panic. Breathing slower and deeper will stop the panic.
Rub your arms and legs.  If you have lost a sense of your body, rub your arms and legs so you can feel where your body starts and ends, the boundary of you. Wrap yourself in a blanket and feel it around you.
Walk, and really think about walking - mindfully.  Notice the way your body moves, how your feet move and feel as you walk, notice  your leg muscles, and the way your arms feel as they swing. Notice the movement in your hair, and the sensation of moving air on your skin.  Notice the sensations of breathing as you walk.
Describe (and say out loud if appropriate) what you are doing right now, in great detail.  Or describe doing a routine activity.
Try to think about different things, almost like playing mental games, for example:  count backwards in 7s from 100, think of 10 different animals, 10 blue things, one animal or country for each letter of the alphabet, say the alphabet slowly, say the alphabet backwards etc.
Carry a grounding object with you.  Some people carry a stone or other small object, perhaps which has personal meaning, to comfort and touch when you need to.

Get support if you would like it. Let people close to you know about flashbacks or how anxiety attacks affect you, so they can help if you want them to. That might mean holding you, talking to you, helping you to reconnect with the present, to remember you are safe and cared for now.  If there is no-one, use a helpline.

Self Care:  flashbacks and anxiety are powerful experiences which drain your energy. Take time to look after yourself afterwards. You could have a warm, relaxing bath or a sleep, a warm drink, play some soothing music, or just take some quiet time for yourself. Be kind to yourself.
Ask yourself questions in order to bring yourself into the present. Write down your own questions, for example: 
  • Where am I, right now?
  • What day is it?
  • What year is it?
  • How old am I?
  • Where do I live?
Use Positive Coping Statements.  You might prepare a coping statement, for example:  "I am (name), I am safe right now, this is just a memory - that was then and this is now.  I am in (place) and the date is (date). This flashback will pass".
Make an emergency or soothe box you can use another time, and fill it with meaningful and helpful objects or reminders.
Download an mp3 onto your phone such as First Aid for Panic, or use another from here:
Remember you are not crazy -  flashbacks are normal and they are helping you to heal.
When you feel ready, you might want to write down about the flashback or anxiety attack, and how you got through it. This will help to remind you that you did get through it, and can again.

Flashbacks


If you can’t get your mind from remembering traumatic events or feel like you are in a flashback, try changing perspectives.

  • Write about your situation as if you were another person or a piece of furniture or a pet looking at it from a distance.
  • Write letters to people who you’d like to say something to. Be bold. Don’t hold back. Then rip it up or dissolve it in water. Journal about your experience.
  • Find an old photo of yourself and make up a completely new fictional story about what is happening in the picture. Write a story where the subject is empowered.
  • Write your life story as if you had the happiest, most unique life in the world. It doesn’t have to be fiction, use real examples but pretend you see it from a different point of view. Leave out all the bad stuff. The more trauma you leave out, the funnier the story starts to seem.
  • In your mind, play out your life worries as cartoon characters. Make the characters ridiculous and give them silly voices.
  • Read a children’s story or any other story that’s not too complex out loud as if you were a storyteller.
  • Color in a coloring book.
  • Draw pictures with heavy crayons or oil pastels that allow you to distort and mesh the picture by smudging it with your fingers.

Thursday, January 9, 2020

APPENDIX

APPENDIX 1: EMOTIONAL FREEDOM TECHNIQUES (TAPPING)

 APPENDIX 2: HANDS FOR HEALING

 APPENDIX 3: PHYSICAL EXERCISES
 Set 1: Grounding
 Set 2: Quieting and Flow
 Set 3: Breath of Life
 Set 4: Relaxation

 APPENDIX 4: CHAIR YOGA

 APPENDIX 5: YIN YOGA

 APPENDIX 6: NEUROVASCULAR HOLD

 APPENDIX 7: FEAR MELTERS

 APPENDIX 8: CALENDAR

Saturday, October 19, 2019

Radically Open DBT

"Radically Open Dialectical Behavior Therapy (RO DBT) is a new evidence based treatment targeting a spectrum of disorders characterized by excessive self control, often referred to as overcontrol (OC)It is supported by 20 years of clinical experience and translational research that parallels established guidelines for treatment development (e.g., UK Medical Council, 2008; Rounsville & Carroll, 2001; 2006). You can read more about RO-DBT on the ABCT website: RO DBT Fact Sheet."

"Maladaptive overcontrol is characterized by four core deficits:


  • Low receptivity and openness: manifested by low openness to novel, unexpected, or disconfirming feedback, avoidance of uncertainty or unplanned risks, suspiciousness, hyper-vigilance for potential threat, and marked tendencies to discount or dismiss critical feedback.
  • Low flexible-control: manifested by compulsive needs for structure and order, hyper-perfectionism, high social obligation and dutifulness, compulsive rehearsal, premeditation, and planning, compulsive fixing and approach coping, rigid rule-governed behavior, and high moral certitude (e.g., there is only one right way of doing something).
  • Pervasive inhibited emotional expression and low emotional awareness: manifested by context inappropriate inhibition of emotional expression (e.g., exhibiting a flat-face when complimented) and/or insincere or incongruent expressions of emotion (e.g., smiling when distressed, showing concern when not feeling it), consistent under-reporting of distress, and low awareness of body sensations.
  • Low social connectedness and intimacy with others: manifested by aloof and distant relationships, feeling different from other people, frequent social comparisons, high envy and bitterness, and reduced empathy."




Undercontrolled (UC)
Emotionally Dysregulated and Impulsive

  • Borderline PD Borderline Personality Disorder is characterized by emotional instability, intense interpersonal relationships, and impulsive behaviors.
  • Antisocial PD Antisocial Personality Disorder tends to show up in childhood, unlike most other personality disorders that don't appear until adolescence or young adulthood. Symptoms include a disregard for rules and social norms and a lack of empathy for other people.
  • Narcissistic PD Narcissistic Personality Disorder is associated with self-centeredness, exaggerated self-image, and lack of empathy for others.
  • Histrionic PD Histrionic Personality Disorder features a need to always be the center of attention that often leads to socially inappropriate behavior in order to get attention. People with this disorder may have frequent mood swings as well.
  • Binge-Purging Eating Disorders
  • Conduct Disorders
  • Bipolar Disorder
  • Externalizing Disorders


Overcontrolled (OC)
Emotionally Constricted and Risk-Averse

  • Obsessive Compulsive PD Obsessive-Compulsive Personality Disorder is characterized by a preoccupation with orderliness, perfection, and control of relationships. It's not the same as obsessive-compulsive disorder (OCD).
  • Paranoid PD Paranoid Personality Disorder affects between 1 percent and 2 percent of adults in the U.S. Symptoms include chronic, pervasive distrust of other people; suspicion of being deceived or exploited by others, including friends, family, and partners; angry outbursts in response to deception; and cold, secretive, or jealous behavior.
  • Avoidant PD Avoidant Personality Disorder can show up during childhood. It's characterized by a disregard for rules and lack of empathy and remorse.
  • Schizoid PD Schizoid Personality Disorder is characterized by social isolation and indifference toward other people. It affects more men than women. People with this relatively rare disorder often are described as cold or withdrawn, rarely have close relationships with other people and may be preoccupied with introspection and fantasy.
  • Anorexia Nervosa
  • Chronic Depression
  • Austism Spectrum Disorders
  • Treatment Resistant Anxiety-OCD
  • Internalizing Disorders