Following on from yesterday’s post, Grounding Techniques, developing a grounding kit is the next step where you pull together all the information you’re learning. What’s important about this? One of the big issues with dissociation is being able to retain information. The point at which you’ll really need your grounding techniques is also the point at which you’re least likely to be able to remember any of them, or even the concept. So, the idea of a grounding kit is to find a way to pull together all your effective grounding techniques and have some way of being able to remember them. Some people literally put together a box of things, a bit like the example kit I took into the TheMHS to explain this idea:

I probably wouldn’t recommend keeping the plant in there though…

People dealing with other issues use a kit like this too, I’ve heard of people who experience depression keeping a kit that has a good book, a block of chocolate, birthday cards with uplifting messages in them, that kind of thing.

But, it doesn’t have to be a literal kit, a list of ideas that you keep somewhere safe can be just as helpful. Many voice hearers who come to Sound Minds love this list of strategies and carry them with them so they can refer to it during stressful times. It’s easy to have a bit of a play about with grounding techniques while you’re not feeling so bad, forget about them, and not have anything to draw upon during a difficult episode. So, a grounding kit is the stage 2 of this process that actually makes sure you have something helpful you can do for yourself the next time your dissociation is bad. This is where self awareness becomes self care – learning what you need, and then actually doing it!

There are two key concepts that help make your grounding kit really effective. The first one is that it must be individualised! That means, specially tailored to you. I tried various techniques for years, like the breathing exercises, really frustrated that other people seemed to find them helpful but they didn’t work at all for me! But, I get given them by doctors, recommended them by ACIS, they’re all around. Now, I think a lot more broadly than that, and I’ve been able to share techniques that do work for me with the people who support me. This means that when they’re trying to be helpful at least now they’re recommending things that have a chance of helping me. The more your kit has been specially tailored to you, the better it will work.

No single technique always works every time. This is kind of frustrating, but it’s important to be aware of. The whole point of working out a bunch of techniques is so that you have lots of helpful options to pick from. Don’t give up on a technique the first time it doesn’t work for you. I find, for example, that some techniques work for me with mild to moderate dissociation, but aren’t strong enough to help with severe dissociation. Many of my techniques aren’t something I only do during the bad weeks, they’re things I do regularly because they prevent chronic dissociation from happening in the first place.

Which brings me to the second key concept that makes grounding kits effective. In order to set up a grounding kit, you have to overcome the denial that you have a problem with dissociation in the first place. The middle of an acute dissociative episode is not the ideal time to be reading up on strategies and trying things out. Ideally, you use the times when you are well to set yourself up for the best care possible when you are struggling. Of course, some of us are dealing with chronic issues and don’t really get weeks or months free of symptoms, but the basic premise still applies. Crisis isn’t the ideal time to be trying to work out your grounding techniques! This means that when you are going along doing pretty well, you should put some time into trying different grounding techniques and seeing how they work on mild symptoms. And, as you collect your grounding kit, you can start to share this information with anyone else in your world who could then better support you through rough patches. Trust me, its a lot easier to explain these ideas to someone else when you’re not in the middle of a panic attack, flashback, or acute dissociation!

You can also have a look at what was going on in your life when you are well, and when you are really unwell to work out what your key grounding strategies may be. So, in my instance, I did no art at all during the years of my most severe dissociative symptoms. Now that was partly the result of how much loss of function the dissociation was causing me. But in my case I’ve also discovered that without regular creative activities, I’m much more vulnerable to dissociation. So these days art/writing is much more a priority for me, because I know now that it’s one of the things that keeps me well. I don’t wait until major dissociation kicks in before I pick up a paintbrush or pen. I build these techniques into my everyday life, and as a result I’ve drastically reduced the degree of dissociation I experience.

When I kick into the denial and get blasé about how important these techniques are for my health, I quickly find my stress level and symptom level stepping up. And I’m learning to pay attention to those early warning signs instead of putting my head in the sand until I’m a complete wreck. But it’s hard work in some ways to keep your worst days in mind when you’re feeling good! It’s tempting to stop looking after yourself, to even feel like a bit of a fraud, as if your bad days couldn’t really be that bad, and maybe if you’d just tried a bit harder you could have pulled yourself through without all the fuss. This is pretty common.

It’s part of the nature of mental illness that it’s episodic. For some of us that means months or years where we travel well, for others the ups and downs are more hour by hour. But all of us feel tempted to put the bad days behind us and dash off into the sunset. There’s nothing wrong with that impulse! It’s great to make the most of those good days, and we all need time off from anxiety about our situation and thinking about our mental health! But, making ourselves spend a bit of time putting in some safety nets just on the off chance we have another bad day – that’s often the key difference between people who live well with even severe mental illness, and those who are always being surprised by it, caught unaware and unprepared. And if it turns out you never need it, that your bad days really are gone forever, that’s awesome, no harm done. But, having a safety net in the form of a grounding kit can make the difference between having another bad day and total catastrophe.

Are ways people manage all kinds of mental health issues. I’ve come across the idea of grounding and being grounded in all kinds of mental health literature, recovering from trauma, handling addictions, managing anxiety, and dealing with self harm issues. It’s an idea that is especially appropriate for people struggling with dissociation of any kind. In this context, a grounding technique is anything you do that helps to reduce your dissociative symptoms. In my experience, anyone who’s been dealing with dissociation for awhile has come up with a few strategies that help them to manage it. They might not always work, or be discrete enough to use in public, and sometimes they can be self-destructive, but if they reduce dissociation for us, we’ll give them a go. It can be really useful to spend some time thinking about what you already use when your dissociation is bad. Do you find mindfulness helpful? Do you look to spend some time with a friend? Do you find regular exercise helps keep you on track?

Everyone is different and people react completely differently to grounding techniques. What is helpful for one person may not work for another, or may even make their dissociation worse! Learning more about yourself and what works for you can make a huge difference in being able to manage your condition and improve your quality of life. This can be a bit of a trial and error process, and at times frustrating especially if you’re trying things other people find helpful that aren’t working for you. So, putting some thought into what you already do that helps can give you a bit of a foundation to work from.

Grounding techniques fall into one or more of a number of categories, and these can make it easier to work out what approaches you tend to respond most to.

1. Calming – you can find a lot of these techniques in literature about managing anxiety and recovering from trauma. Calming techniques are things like going on a gentle walk, listening to soothing music, doing breathing exercises or yoga, giving your cat a cuddle. Dissociation is often a reaction to feeling stressed and unsafe. Calming techniques work by settling you down so that your stress level goes down, and with it the degree of dissociation.
2. Intense – some of the self help literature about managing self harm issues have some great suggestions about intense grounding techniques. Intense techniques include things like strong tastes, holding onto ice cubes or taking cold showers, a hard workout at the gym, screaming into a pillow, listening to loud music. Intense techniques work by reaching through the dissociation to reconnect you to your body, feelings, and environment.
3. Physical – some techniques are about affecting your physical body, a warm soothing bath, the texture of your dog’s soft fur under your hand, grass on the soles of your feet, guitar strings under your fingers. They help to anchor you back in your body and connect you to the environment around you. They can be either calming or intense.
4. Emotional – these techniques work on an emotional level, they can also be calming or intense. Hugging a stuffed toy that calms you, holding onto a bracelet that your grandma gave you, writing in a journal, watching a film that really moves you, painting your nightmares.
5. Intellectual – these techniques engage your mind to access information that helps to orient you in the here and now. Examples are asking yourself and answering questions such as “Where am I right now? Who is here in this space with me? What year is it? What can I see, hear, feel, smell around me?” These can be really helpful if you are having trouble with flashbacks or that spacey kind of disorientation where you get confused about what’s happening now and what are memories.

Many grounding techniques work on more than one of these levels – like playing with your dog – it’s physically and emotionally engaging, and if you run around the park and then collapse for a rest it’s both intense and then calming. Sometimes it’s these kind of techniques that affect us on many different levels that are the most powerful. There’s nothing in my world quite as grounding as a lap full of kittens!

So, to give you some examples of what I find helpful, I rarely use intellectual grounding for myself. I do find it useful when waking up sometimes from long complex dreams where I can get disoriented about where reality left off and dreams began. Apart from that, it almost never appears in my repertoire. I’ve found that intense techniques are where I tend to gravitate. Some of the calming techniques, like breathing exercises, actually make my dissociation worse. Whereas I’ve used freezing cold showers to snap out of really bad dissociative episodes quite effectively. Creativity is also really critical for me, I keep journals and basically talk to myself in them. I use them to connect to my feelings and express thoughts and fears that otherwise just knot up inside me. This emotional connection with myself helps a lot to reduce my dissociation. It’s basically a way of telling myself that I’m listening and I care – which is pretty important to make time to do when often you’re getting through your day by ignoring, denying, suppressing, and downplaying your symptoms and feelings. 

Some techniques are much easier to use in public than others, and it’s a good idea to experiment until you find a bunch that are helpful. For example, I use strong tastes a lot. I’ll often order a bitter flavoured drink, something carbonated, or a meal with a vinegar salad or salty olives. Obviously, it helps that I actually like most of these things! But the bitter drinks I didn’t used to like much at all, I just found that the intense flavour helped keep me grounded. Now, they’ve grown on me. 

Another discrete one for me is wearing perfume. I get bothered by strange smells, and at times I hallucinate strange smells simply as a response to feeling really stressed. So, being able to lift my wrist to my face and smell something that is familiar and soothing can be really helpful. 

When sitting down, you can deliberately push your feet into the floor to feel the ground beneath them. When I’m wearing flats, I’ll often slip them off under the table or desk, and rub my soles along the carpet, the sensation is grounding. 

I mentioned self-destructive grounding techniques before – some of us discover by accident that pain can be very grounding, and if we’re prone to dissociation, we may turn to self harm to try and manage it. Obviously, there are many other reasons people self harm, different needs and beliefs that can drive that behaviour. But, this can be one of them, and if it’s that way for you, I’d suggest that you consider some other techniques and see if you can finding something not harmful that also works for you. Sometimes other intense, physical techniques can replace self harming as a way of grounding.

As overwhelming and totally out of your control as it can feel to experience chronic severe dissociation, you can learn to manage it sufficiently to keep safe, feel alive, and get to do things you love. At the outset you may feel totally in the dark, nothing makes sense, your symptoms appear and subside without warning and you are always fighting just to be here. Take a breath. Accept what is going on, and start to investigate it. Knowledge is power, self awareness will give you the keys to better predict, manage and cope with dissociation. You will in time learn what triggers your dissociation, and what your key grounding techniques are that keep your feet on the ground. It may take time, but you will make sense of it and put together your own personal grounding kit, and that puts you back in the driver’s seat.