Image credit: Adobe Stock

Introduction

Grounding is a type of coping strategy that “grounds” people in the present moment and is a form of mindfulness. 

When you become overwhelmed by flashbacks or dissociation, it is as if the brain forgets where you are, and you become transported to past times when you felt unsafe.  Grounding strategies help the brain refocus on the present.

There are two main types of grounding strategies: 

1. Sensory, e.g. Using strong sensory input to bring one back to reality and the present moment (e.g. listening to loud music, biting a lemon, holding a piece of ice)
2. Cognitive, e.g. Doing an activity requiring one’s focused attention.

What Can Grounding Techniques be Used For?

Grounding strategies can be helpful in many different situations:

• For people hearing voices, or having paranoid thoughts
• For people having flashbacks, i.e. re-experiencing a stressful or traumatic, like a unwanted movie playing in one’s head
• For people experiencing a dissociative episode, i.e. spacing out or losing track of time
• Anxiety disorders, or any situation where one might become overwhelmed

Sensory Grounding Strategies

5-4-3-2-1 Exercise

This is a 5-4-3-2-1 exercise that you can do:

1. Describe 5 things that I can see

• E.g. What furniture do I see?

2. Describe 4 things that I can touch and feel, 

• E.g. the floor beneath your feet

3. Describe 3 things that I am hearing right now,

• E.g. the sounds in the room

4. Describe 2 things that I can smell

5. Describe 1 thing that I am grateful for.

If doing the exercise indoors doesn’t work, try practicing the exercise outdoors. Nature has much more soothing sensory experiences.

5-4-3-2-1 Exercise - Information for Carers and Loved Ones

If your loved one is upset, here are some things you can say to ground them:

• Orient your loved one if s/he is disoriented
  • You: “Jennifer… It's me, your mom… I’m here… It’s Saturday… We’re at home….”
    
• 5-4-3-2-1 exercise
  • You: “Tell me 5 things that you can see…”
    E.g. other people, things in the room or outside
  • You: “Tell me 4 things you can touch and feel…”
    E.g. stomp the ground, rub or clap your hands together, feel your pulse
  • You: “Tell me 3 things you can hear…”
    E.g. sing a song, talk to yourself, turn on the radio, the sound of the wind or birds (i.e. turn on music, sing out loud etc.)”
  • You: “Tell me 2 things you can smell (put lotion on your hands etc.)”
    E.g. lotion on your hands, lip balm, chewing gum, perfume or aftershave
  • You: “Tell me 1 thing that you are grateful for….” / “Or one thing positive…”

Cognitive Grounding Strategies

Make a "Safety Sack"

• Gather a few things that help you feel safe. Feeling "unsafe" is often connected to experiences in the past, thus you can help yourself feel safer or “ground” oneself by having things to remind you of the present such as:
  • Pictures of you in the present
  • Pictures of your loved ones in the present, e.g. partner, children, etc.
  • Your work ID badge / student card / bus pass card
  • Your driver’s license
  • Special mementos, jewelry, soothing smooth stones
• Put these things into a small sack that you can carry around with you. If you become overwhelmed and are unable to feel safe, you can see and touch the sack to help you feel safer and grounded.

Create a Safe Place in Your Mind

• Imagine a place where you can feel safe.
  • Where is it?
  • What does it look like?
  • What sounds, sights and colors are in your safe spot?
• Whenever you are feeling overwhelmed, you can close your eyes and go to your safe spot in your mind.

Create a Safe Spot in the Real World

• Find a room or part of a room that can be your safe spot. You can also decorate this place, or have objects that you can touch to make you feel safer.
• Whenever you are feeling unsafe or overwhelmed,, you can go to your safe spot and do deep breathing until you are feeling calmer.

Write Out a Card with Safety Statements

• On an index card, write down some words or sentences that you think might help you feel safer whenever you are feeling anxious and overwhelmed.
• For example:
  • "I am safe and there is nothing around me that is going to cause me any harm."
  • "I have power and control over what happens to me.”

• Consider keeping the card with you at all times, so that you can can read it aloud or to yourself whenever you need it. Or you can have someone you trust read it to you. Or you can have a trusted loved one (or a health professional) repeat the statement into a recording, so that you can play it back and listen to it whenever you are feeling unsafe. Or the phone number of a close family member or friend that you can call when needed.

Imagine a "Force Field" around you:

• Imagine a powerful force field of colour, like white or pink around you that protects you from danger, and keeps you safe

Make a "Safety Collage"

• Make a collage with pictures or images that mean safety to you. For example, you might have pictures of people and places that make you feel loved and safe.
• Once you have made your collage, hang it up somewhere and look at it to help when needed. The collage can also be things that you can touch as well as see. The more you use your other senses together the easier it is to ground yourself.

After Being Grounded, Continue with Soothing, Calming Strategies

After you are feeling grounded, you can do calming, soothing, self-caring activities to continue to help yourself calm down.

Sensory ideas:

• Visual
  • Looking at favorite personal photos, or a photography book
• Hearing
  • Listening to music or someone read to you
• Smell
  • Smell a perfume canister or a freshly cut fruit like an orange
• Taste / oral
  • Suck on strong mints
  • Chew large amount of gum
  • Suck on a popsicle, chew ice chips
• Touch
  • Stamp or tap feet rhythmically or clap hands hard
  • Take a cool shower
  • Snap a rubber band on wrist
  • Choose a smooth stone that you can rub and manipulate in your hand
• Movement
  • Manipulate an object (hand fidget)
  • Do vigorous exercise
  • Do heavy work (using large muscles)
  • Go for a walk.
  • Dance to some favourite music

Mental and social activities:

• Meditate or be mindful
• Consider a mindfulness app such as Calm.com
• Special Place or Quiet Lake from MindMasters (or another guided imagery)
• Do a crossword or word search puzzle
• Do a detailed jigsaw puzzle
• Play Sudoku, solitaire
• Phone a friend
• Read something
• Drawing, doodling
• Juggle
• Yoga
• Chess
• Begin a journal or diary (hand written or computer generated)

For More Information

Sensory calming and alerting strategies

https://www.ementalhealth.ca/index.php?m=article&ID=62537

Deep breathing

https://www.ementalhealth.ca/index.php?m=article&ID=62559

About this Document

Written by the mental health professionals at CHEO (Children's Hospital of Eastern Ontario) in Ottawa, Ontario, Canada. Special thanks to Michel Poirier, social worker; Cynthia Dawson, mental health intake and system navigator; Michael Cheng, psychiatrist; Melodie Dupuis, Peer Support Network. No competing interests to declare.  Image Credits: www.freepik.com for flat icons used in this article; Adobe Stock.

Disclaimer

Information in this pamphlet is offered ‘as is' and is meant only to provide general information that supplements, but does not replace the information from your health provider. Always contact a qualified health professional for further information in your specific situation or circumstance.

Creative Commons License

You are free to copy and distribute this material in its entirety as long as 1) this material is not used in any way that suggests we endorse you or your use of the material, 2) this material is not used for commercial purposes (non-commercial), 3) this material is not altered in any way (no derivative works). View full license at http://creativecommons.org/licenses/by-nc-nd/2.5/ca/

My Grounding Strategies: Worksheet

Here are the things that I am grateful for in my life, and the things that give me purpose, hope, belonging and meaning…

Here are some of my triggers

When I get triggered, I can do these things to ground myself

• 5-4-3-2-1
  • 5 things I can see
  • 4 things I can touch
  • 3 things I can hear
  • 2 things I can smell
  • 1 thing that I am grateful for

Other things that I can do to ground myself and calm down

5-4-3-2-1 Exercise

	What are 5 things that I can see?
	What are 4 things that I can touch and feel?
	What are 3 things that I am hearing right now?
	What are 2 things that I can smell?
	What is 1 thing that I am grateful for?