Keeping Me Well - Cardiff and Vale University Hospital

Introduction to trauma

It is very common for people to feel anxious, withdrawn and hyperalert following a difficult experience. It often makes sense to ask ‘what has happened to you?’ rather than ‘what is wrong with you?’. 

After having COVID-19 you may find you are more alert to danger or experience heightened anxiety, you may be more withdrawn or find it difficult to move past what has happened to you. This is a normal response to a difficult or traumatic experience. 

Many people may have not named the difficulties they experience as a ‘trauma’. However, any experience that leaves you feeling overwhelmed, scared or alone can be traumatic, even if it doesn’t involve physical harm. When we have experienced difficult events, we may find that we are distrusting of others, can feel overwhelmed easily or have reoccurring thoughts of difficult times. These are normal experiences to abnormal situations. Our minds and bodies are made to protect us from harm, for example, avoiding situations that may be dangerous. Sometimes, these reactions get stuck and we carry on as if the difficult situation or trauma is happening now. 

Trauma is very individual and symptoms can vary from person to person, what traumatises one person may not affect another person. Trauma can affect how we think, feel and behave. However, it doesn’t have to last forever. You can learn effective strategies and skills to help manage how we are feeling. 

Grounding is a technique that can help pull you away from difficult thoughts, feeling and emotions. Grounding can help you distract you from what your experiencing and refocus on the present and what is happening in the here and now. 

Physical Techniques:

  • Put your hands in water

Focus on the physical feeling of the water (temperature and how it feels on different parts of your hand). Try this with cold and warm water.

  • Pick up and touch items near you

Notice the textures, weight, feel, smell, look and sound of items around you. Try and describe the items to someone (you can do this in your head) paying attention to every detail.

  •  Take a short walk

Notice each step you take, the sound and rhythm.

  • Hold a piece of Ice 

What does it feel like before it melts and after it melts. Notice the change in temperature and the change in sensation on your hands. Does it feel rough or smooth?

  • Move your body
    What does it feel like in each part of your body. Move slowly and more quickly. Notice the feeling in each part of your body and how it feels. Can you feel your body moving through the air? Can you feel pressure on your skin?
  • Try the 54321 method 

Working backwards from 5, use your senses to notice things around you. Try to make an  effort to notice the things you may not always pay attention to. 

Mental Techniques:

  • Play a memory game

Look at a detailed picture of photograph for 20-30 seconds and turn it over. Try to recreate the picture of photograph in your mind paying attention to all of the details. 

  • Think in categories

Think of a category of information such a musical instruments or countries. Try and name as many items as you can within the category. You could try and think of an item for each letter of the alphabet. 

  • Use maths and numbers

Go through a times table in your head or try to work out a maths problem. Count backwards from 100. 

  •  Spell your name backwards.

 You can also spell names of those around you backwards. 

Soothing Strategies:

  • Picture the face or voice of someone you love

Imagine the person speaking to you or spending time with the person. 

  • Visualise your favourite place

Picture yourself in this place and describe your surroundings in details.

  • Listen to music that makes you feel good or your favourite music. 

If your struggling with nightmares or disruptive images it can help to keep something ‘grounding’ or comforting by the side of your bed or on your person (e.g. a picture or small teddy or keyring). If you wake in a state of distress this can help bring you back in to the here and now quickly. It can also help to develop your own soothing statements. These are statements that you have decided upon and that will help you to feel calmer and bring you in to the present time. Statement examples include ‘I’m safe, I am in X room sitting by the window’, ‘My name is X and I am X years old’, ‘I am feeling frightened but this will pass as the trauma is not happening now, I am safe, ‘I can see my cat, my sofa and the TV’. 

When people have trauma memories or feel overwhelmed and frightened, they often feel unsafe. Something that may help is either making a place in the house where you feel safe, or creating an image of a safe place in your mind.

A safe place in your home

Some people find it helpful to create a safe space within their home that they can go to should they feel unsafe. Your safe place might be on the sofa with a warm blanket around you, listening to your favourite music, or sipping a hot drink. Or it might be a corner of a room with your favourite photos on the wall or a peaceful view from your window. Wherever it is, try to make it as calm and comforting as you can.

A safe place in your mind

Another way of creating a safe place is to build up a picture in your mind. This might be a real place where you have felt happy and secure, such as a beach or a wood, or it might be somewhere imaginary. Use all your senses to make this as real as possible to you; for example, imagine a gentle breeze, the feel of the sun, the sound of the waves and so on.

These are only suggestions and yours might be different. Allow your body to relax, as you enter your own special unique safe place. 

When feelings of distress become overwhelming, it is not always possible to change the situation to make it better. In these situations we need to find ways of tolerating this. One way to do this is by distraction. Distraction can distract your mind.

There are many ways of distracting yourself such as:

Activities that take up your attention, such as cleaning the house; tidying up; having a phone conversation with a friend; knitting or sewing; jigsaws; cooking; walking, gardening and other types of exercise. The choice of activity doesn’t really matter as long as it fits you and your lifestyle and is enough to hold your attention. 

Occupying your thoughts by online games; reading; watching funny and feel good videos/movies; concentration exercises like counting back from 100 in 7’s, counting your breaths,  or looking through photographs of happy memories. 

Using sensations such as splashing your face with cold water; drinking something cold; using an ice cube on your skin; using an elastic band around the wrist and flicking it; having a hot shower; smelling flowers; perfume or candles. 

Releasing feelings by letting yourself cry; writing or painting; dancing to loud music.

Tips for distraction

  • Choose something you enjoy doing if you can. 
  • It may be helpful to choose a distraction that creates the opposite emotion to what you are feeling. For example, if you are angry and frustrated, you could try a relaxing activity. If you are very anxious, you could try something which helps you to feel safe and soothed. Reading or watching television work for some people but are too passive for others. In such cases, activities such as exercise, walking and tidying might work better. 
  • It is a good idea to do the distraction activities as mindfully as possible, which means giving them your full attention, focusing on the present moment, and doing only one thing at a time. Our minds will naturally wander away from the task, but when you notice this you can gently bring your attention back to what you are doing. 
Keeping Me Well - Cardiff and Vale University Hospital

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