Understanding Coping and Healing From Abuse and Trauma Workbook
Understanding Coping and Healing From Abuse and Trauma Workbook
Coping
&
Healing
from
Abuse & Trauma
©2020 Gary Rukin
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Table of Contents:
1. What is Trauma………………………………………………………….....………page 1
Shock Trauma
Developmental Trauma
2. Symptoms of Trauma………………………………………..….…..…..….……..page 2
Re-experiencing Symptoms
Avoidance Symptoms
Hyper-Arousal Symptoms
3. Distressing Reactions to Trauma……………………………..……..…….……….page 4
Strong Negative Emotions
Relationship Difficulties
Substance Abuse
Re-traumatization
4. The Triune Brain………………………………………………..……..….…...…...page 8
Brain Stem or Reptilian Brain
Limbic System or Mammalian Brain
Neocortex or Human Brain
The Triune Brain under Trauma
5. How the Brain Processes Trauma (Why you are stuck)………..…….…..….….page 11
6. Begin with a Breath (Mindful Interventions for Trauma)………………….......page 12
7. Grounding Exercises…………………………………………….………………….page 14
8. Visualization & Mindfulness……………………………………………………….page 16
Learn to Relax using Visualization
Create Your Own Environment using Visualization
Learning to put those Anxious Feelings on Hold
Mindfulness
9. Somatic Healing (Begin with your Body)……………………………………,….page 24
Relaxed Vision
Sun Rays
Know Your Resources
10. Activities to Promote Healing……………..…………………..……..…….,.…...page 28
Forced Smile
Superhero Stance
The Road Less Traveled
Keeping Track to Stay on Track
11. Journaling for Healing from Trauma……………………………………….……..page 33
12. Vision Board…………………………………………………………………………page 36
13. Learning to re-program your brain………………………………………………..page 40
14. When Self-Help isn’t Enough………………………………….…………………...page 42
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What is Trauma?
Shock Trauma:
Shock trauma is the result of a single event or series of events experienced as life threatening which
overwhelms our capacity to respond effectively. Shock trauma was first identified with soldiers in
combat situations, but can be related to a vehicle accident, an assault, a sudden illness or the death of
someone close. The current Diagnostic and Statistical Manual of Mental Disorders, the DSM 5, defines
shock trauma as being exposed to: death, threatened death, actual or threatened serious injury, or
actual or threatened sexual violence, either with direct exposure or witnessing the event.
Shock is a reaction to a threat of life based in the physiological and/or nervous system.
Shock Trauma is literally that, a shock to our systems. Shock Trauma is not
processed in the thinking portion of our brain, but in the more primitive
and instinctual parts of our brains. It is also stored in our bodies.
Shock can occur in lesser forms of threat, including surgery, witnessing a car accident or falling off a
bicycle. People, especially children, may be overwhelmed by what some perceive as common, events.
A series of so-called minor mishaps can have the same damaging effects as major traumatic events, such
as war or rape. To a child, their parents divorcing will be traumatic.
Developmental Trauma:
Developmental Trauma occurs when a child does not receive the nurturing or the proper attachment
they need for their nervous system to develop properly. A child naturally knows how to “wind up”
into distress, but has to learn to self-soothe, to regulate emotions as
well as tolerate distress. Developmental Trauma can be the result
of early physical, sexual or emotional abuse as well as neglect.
Adults who have experienced early trauma are engaged in a lifelong struggle to manage high levels of
arousal. They struggle with dissociative responses that disconnect them from their body, with the
vulnerability of ruptured boundaries, and dysregulation that accompanies such struggles. Individuals
with less obvious symptoms may not consciously realize that they experience a diminished capacity for
joy, growth, and intimate relationships. If they are aware of their difficulties, they usually do not
understand the source.
The result of early developmental trauma is chronic dysregulation of the stress-response system.
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Symptoms of Trauma
For some of us, reactions to a traumatic event are temporary, where others have prolonged reactions
that move from acute symptoms to more severe, prolonged, or enduring mental health consequences
and medical problems. We may not meet criteria for post-traumatic stress or other disorders but
encounter significant trauma-related symptoms or culturally expressed symptoms of trauma. Depending
on the culture in which we grew up, this may be expressed more physically than emotionally. Even if
we do not meet diagnostic criteria for trauma-related disorders, it is important to recognize that trauma
may still affect our lives in significant ways. Following are some common symptoms of Post-traumatic
Stress Disorder.
Re-experiencing Symptoms:
A common way that we re-experience traumatic
events is by having unwanted memories, images
or pictures of parts of the traumatic experiences
pop into our minds. Sometimes a memory is so
vivid that it feels as if this memory is happening
again. This is called a flashback. These memories
may be triggered by external actions – a
television show, movie, sound or scent – or by
internal events – a thought or a feeling. They
may also include nightmares or night terrors, or upsetting memories as well as feelings of distress, or
intense physical reactions when we are reminded of the traumatic event(s) as indicated by sweating,
racing or pounding heart, nausea or shaking. When these experiences happen, we often feel as if we
have no control over what we are feeling, thinking and experiencing. Post-traumatic Stress Disorder is
not about what happened in the past, but what is happening in the present.
Avoidance Symptoms:
We often avoid other people, places and things, as well as distressing thoughts and feelings, which
remind us of our traumatic events. This is quite natural, as they can be
upsetting. Avoidance, however, is only partially successful. It is difficult to
avoid every possible reminder of trauma, and we often find that the more we
try to avoid these reminders, the more intrusive they become. We begin to
avoid activities, places or thoughts that remind us of the trauma. Often we are
unable to recall important aspects of the event or events. We begin to detach
from others and find ourselves emotionally numb, and can lose interest in
activities and aspects of our lives we used to find meaningful. We may have
difficulty imagining our future, and even begin to believe that we have no future.
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Hyper-arousal Symptoms:
These include difficulty falling asleep or staying asleep, irritability, outbursts of anger, difficulty
concentrating, feeling jumpy and easily startled, and hyper-vigilance – being on constant “red alert.”
These changes in our minds and our bodies are the result of fear. When people or animals are
threatened, they react by fleeing or fighting – a normal reaction. This response requires a burst of
adrenaline to mobilize the body and help it respond to the danger. When we have experienced
traumatic events, we come to think of the world as hostile and want to be ready for it. Our bodies
may respond by being in a constant state of preparedness and arousal, so that they are ready to react
to the danger. This response means that we are always on-guard, always vigilant, and can affect many
areas of our lives, both physically and mentally.
Cognition and mood symptoms can begin or worsen after the traumatic event, but are not due to
injury or substance use. Individuals may feel alienated or detached from friends or family members.
We may have difficulty imagining the future and seeing ourselves progressing.
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Distressing Reactions to Trauma
In addition to the major symptoms of trauma, many of us experience distressing reactions to trauma.
These influence our self-image, coping strategies, and our approach to, and experience with
relationships. They also affect our view of, and place within the world. Trauma drastically changes the
way in which our brains experience and react to events around us. In doing so, relationships become
more difficult: relationships with ourselves as well as others. Trauma overwhelms and disconnects us
from the world and our feelings. Trauma informs a vision of the world as unsafe, causing distress. We
put coping strategies in place to deal with this distress, some more successful than others. Many of the
common coping strategies we put in place end up creating, rather than relieving, distress, and
exacerbate symptoms related to trauma and abuse.
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Relationship Difficulties:
Traumatic stress often causes problems with relationships. We may have complications as a result of
strong feelings of depression, anxiety, irritability or anger. These cause difficulties in getting along with
others. When we have been victimized, it is difficult to trust others, even others who are close to us.
That very closeness itself can be frightening. Situations that involve intimacy may stir up distressing
emotions and memories. We may shut down and avoid spending time with others. Traumatic
experiences can lead to difficulties in intimate relationships and bring out feelings of guilt and shame.
Substance Abuse:
Our minds and bodies seek to escape the sensations that we feel as a result of abuse and trauma. One
way to escape those sensations is through drugs and alcohol. This may temporarily allow us to avoid
thinking about the trauma, feeling the unpleasant things we feel, and help us to sleep. Eventually, the
same substances that initially provided relief then add to our distress. The same symptoms we are
seeking to avoid simply double their
efforts to make us aware of their
presence. Sleep gained through drugs and
alcohol is often disrupted. Often we will
wake up in the middle of the night. In
the sleep we do manage, we often
experience disturbing dreams, thoughts
and sensations. Recovery from trauma
requires controlling substance abuse issues
in order to begin processing the trauma
therapeutically.
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Re-traumatization:
Flashbacks and disturbing nightmares are the way our minds and bodies attempt to re-experience our
trauma(s) in a safe manner, when we are not under stress, in order to begin processing this
information.
Post-traumatic Stress Disorder is a condition in which the replaying of the traumatic event or events not
only fails to process the trauma, but in which the trauma virtually occurs repeatedly – our minds and
bodies constantly re-experiencing these events as if they were happening over and over again.
Some of us will act out the events of the trauma without realizing this is happening, and this often leads
to re-traumatization. Same behaviors – same results. Others are guided to retell our trauma stories
repeatedly until they goes away.
This may be effective if you are able to process the trauma, otherwise this simply burns the trauma
deeper into our fabric, and again we are re-traumatized. Later in this manual, we will list evidence-
based treatments designed to help with Post-traumatic Stress Disorder. Please hold out hope. We
humans are capable of astounding feats of recovery and healing!
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The Triune Brain
Human Brain
Mammalian Brain
Reptilian Brain:
The oldest and most primitive part of the brain – the brain stem.
Controls breathing, sexual arousal, balance, sleep, appetite, and body
temperature.
The primary function of the Reptilian Brain is to enable survival by
identifying dangerous situations and responding accordingly.
It acts by Instinct.
The primary mechanism in control of the freeze, fight or flight response
Mammalian Brain:
Biologically known as the limbic system.
Controls emotional expression, the body’s physical response to danger, and
short term memory processing.
The Mammalian Brain lives in the present with no sense of time.
Activates the freeze, fight or flight reaction.
Makes decisions based on input from the reptilian brain.
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The Triune Brain under Trauma
The Triune Brain is actually three brains in one. That’s right. We have access to not one, not two, but
three separate brains. Access is key here, because we don’t always have access to all three at once. They
are the primitive or reptilian brain, the limbic system or mammalian brain, and the pre-frontal cortex,
or the human brain. Let’s start by understanding our three brains. Don’t worry – we’ve got the brains
to do it!
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Freeze, Flight or Fight
Recall that the freeze, fight, or flight response occurs as a biological reaction to danger in the reptilian
and mammalian brains, and not in the human brain.
Not only does this response feel as if it is out of our conscious control, it actually is out of our conscious
control. When we experience a traumatic event or series of events, the mammalian brain is likely to
pair intense sensations with the trauma: sensations of fear, disgust, rage, and helplessness.
As a result of trauma and abuse, the limbic system will become overwhelmed, and we become
overwhelmed. When we are overwhelmed and fearful, older and more primitive portions of our
brains activate. In order to provide them with the resources they require, the human brain is put on
hold. When trauma occurs, we are captivated by the activity in the brain stem and limbic brain and our
access to executive function is severely limited.
Trauma prompts our braina to focus on survival, not peripheral details. The more fear or stress
generated, the more significant the filtering becomes, especially during experiences that threaten our
survival. The brain locks in on the central aspects of the experience while many of the peripheral details
are lost.
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How the Brain Processes Trauma: Why we are stuck
Trauma plays havoc with our entire nervous systems. Traumatic memories stay "stuck" in the brain's
nonverbal, unconscious regions – inaccessible to the human brain. Post-traumatic Stress Disorder is
marked by an inability to construct a coherent story of the traumatic event or
events, which occurred. Our memories become disorganized and incoherent, and
attempting to recall those memories causes us to become emotionally distraught,
often with highly charged flashbacks, nightmares, distressing sensations and/or
night terrors. These re-experiencing symptoms not only disrupt our lives and
interfere with functioning, they serve to reinforce the trauma, and increase the
symptoms of avoidance and hyper-arousal.
When we re-live traumatic experiences, the frontal lobes become impaired and have difficulty thinking
or speaking, just as they did during the original trauma. The human brain shuts down, and replays the
sensations, the pictures, smells, and body sensations that occurred during the original trauma. The more
primitive parts of the brain react to the stored sensory input, and the trauma recurs. Coherent
narratives about the past require both left and right hemispheres of the brain to be fully online. The
right side holds the images, themes and sense of time, while the left side holds the ability to make
logical meaning and put words to feelings and perceptions.
The first effect of trauma is shock and dissociation. Dissociation is a separation from the elements of the
traumatic experience, which initially reduces the impact of that experience. As traumatized people, we
are used to dissociation, not feeling our bodies. The memories cause us to shut down, go numb, blank
and frozen in order to avoid feelings.
When our brains function well, we function well. Trauma is a wounding of mind, body and spirit. It
overwhelms our ordinary adaptations to life, and interferes with brain function and the body’s reaction
to stress, as well as the integration of emotional and cognitive functions. Trauma creates chaos in our
brains by separating thoughts, emotions and sensations. We may have vivid graphic thoughts about
what happened but no emotion, or intense emotions without thought or coherent memories. Often
we experience conflicting impulses, to confront the source of the trauma at some times, and to avoid
them at all costs at others, as we become unable to discern between real and perceived threats.
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Often we have been told that the symptoms we experience are “only in our heads,” however intense
stress or trauma, and the re-experiencing of those events, is accompanied by the
release of triggering hormones, causing the heart to beat faster and prime our
bodies for emergencies. This flood of hormones produces the "fight-flight"
response in most people, and a freeze response in others, or at other times. These
events are stored in our bodies as well as our brains. They permeate every cell in
our bodies, and change the way our minds and bodies, react to stress.
With exposure to traumatic events it is normal for your body to react in physical ways including
headaches, upset stomach, muscle tension and fatigue. Trauma and the resulting stress causes harm
through physiological changes to body and brain, and these harms can persist through life. Those of us
who have experienced trauma may have stronger and more frequent surges of adrenaline, causing
wear and tear on our bodies — just as they would in a car where the engine was constantly racing. Our
bodies produce more adrenaline, our hearts race, and our bodies prime themselves to react.
There are however ways to calm our minds and our bodies that do not involve drugs or alcohol or
self-harming activities. The remainder of this manual will offer tools to help us regain that calm in our
minds as well as our bodies.
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Begin with a Breath
Healing Mind, Body & Spirit
Begin by choosing a word you find relaxing. This word can be “peace,” or “calm,” or “ease,” or any
word you associate with relaxation. Try to use a single syllable word. Write it down below.
My words is ____________________________________________.
Next, sitting upright, and breathing in through your nose, take a normal breath.
As you breathe in, notice the flow and temperature of the air coming in through your nostrils and into
your lungs.
At the end of your breath, pause for just a moment, and as you exhale through your mouth, speak
your relaxing word, either to yourself, or aloud. Notice the flow and temperature of the air as it leaves
your lips.
It will feel a bit awkward at first, especially if you are choosing to say the word aloud. Try it again, this
time taking a bit longer to exhale. You will want to exhale for a short time longer than you took to
inhale.
You will notice a feeling of peace and tranquility begin to appear following each breath.
Try repeating this pattern of breaths for a set of ten breaths, inhaling normally through your nose,
taking a brief pause before the exhale, and then exhaling slowly through your mouth, repeating your
relaxing word either to yourself or aloud.
Choose a time and a place to practice this technique, for ten sets of breaths, twice a day. We will
practice this technique twice a day, at the same time and in the same location each day. We will
practice at a time when we are calm, to learn to become proficient in this technique.
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My 1st daily practice session will be at ________________ in _______________________________.
time location
The more we practice, the more proficient we become in this technique. It will be one of several tools
we can use to help tolerate distress. When we are overwhelmed, we can use these tools to de-escalate
our emotions and reduce distress.
Practice one more set of breaths, now, before proceeding in this workbook.
Inhale through your nose, observing the flow and temperature of the air coming in through
your nostrils and into your lungs.
Pause briefly.
Exhale through your mouth, for slightly longer than your inhalation, while saying your relaxing
word, either aloud or to yourself.
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Grounding Exercises
From time to time, we all become overwhelmed. When this happens, grounding exercises may help.
These are not obvious to outside observers, and many can be performed in public, even in crowded
rooms, without anyone noticing.
Grounding ourselves involves becoming oriented to the present moment. When not grounded, we
may feel disconnected, confused, anxious or emotionally unstable. The following are some exercises we
can do to counteract these, and bring us into a calm, clear-minded state.
Using the The 5~4~3~2~1 Skill we purposely pay attention to the sensations that surround us using
our five senses. Sight, touch, sound, smell and taste.
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Oak Tree Exercise
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Learn to Relax
Using Guided Relaxation
For many of us who have experienced trauma, relaxation is a word without meaning. Even the word
relax often creates tension. We may have learned that to relax is to open ourselves up to harm or that
relaxation is something other people do – it has nothing to do with us.
Find a comfortable place to sit or lie down. If you have access to the Internet, you can listen to the
Guided Muscle Relaxation recording at http://www.garyrukin.wixsite.com/guidedhealing. If not, simply
follow the steps outlined below:
Begin by relaxing your forehead. Let the muscles in your forehead relax so that you can feel the
wrinkles smooth and the muscles behind your eyebrows loosen. As you proceed, where you notice
tension, simply contract and then release the muscles, allowing the tension to dissipate.
Let the small muscles around your eyes relax, feeling the pressure behind your eyes letting go.
Allow the muscles around your nose, and in your cheeks to relax.
Now relax the muscles in your jaw, allowing for a small opening between your lips, and feel the
tension drain out of your face.
Feel the muscles in your neck relax, rotating your head back and forth in small circles a few times.
Allow the muscles in your shoulders to relax, rotating them forward, and then back, allowing your
arms to hang easily from your shoulders.
Now relax the muscles in your chest. Again, where you notice tension, simply contract and then release
the muscles, allowing the tension to dissipate.
Feel the muscles in your abdomen let go, paying careful attention to your breath, and feeling your
diaphragm rise and fall with each breath. At this time, pay attention to your breathing. Notice the
temperature of each breath as you inhale, and again as you exhale.
Allow the muscles in your hips and in your buttocks to relax.
Feel the relaxation flowing through your thighs, through your knees and into your calves.
Now feel the relaxation flowing through your ankles and into your feet. Feel the relaxation flow from
the top of your head down through your toes.
Once more, scan your entire body, and where you notice tension,
contract and then release the muscles, allowing the tension to
dissipate. Know that each time you practice this exercise, your body
will relax more and more.
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Create Your Own Environment
Using Guided Imagery
Guided imagery is one of the most powerful and simple self-awareness tools we can use.
Guided imagery uses words and images to help move our attention away from worry, stress and pain
to help us find our own inner strength and creativity, while promoting healing.
Guided imagery has many health-related physical and emotional benefits. It helps us feel calm, reduce
pain and even achieve a goal such as an athletic or academic achievement. Athletes use guided imagery
to imagine themselves performing at their best, and research indicates this helps performance.
Our minds are very powerful tools, which have a tremendous effect on the body. Our bodies react the
same whether we are actually experiencing something or just imagining that experience. If you think
about lying on the beach in Hawaii, your body responds as if you are actually lying on the beach in
Hawaii. No airfare, no security lines, no high priced hotels. Simply the power of our minds.
Guided Imagery has a positive effect on our heart rates, blood pressure, breathing, temperature, and
hormone balance. Guided imagery can help relieve symptoms caused or made worse by stress including
chest pain, high blood pressure, high blood glucose, headaches and digestive problems.
Are you ready to get started on your next vacation? Close your eyes. Imagine where you would like to
be. It can be any place you imagine. Hawaii, Fiji, your childhood home, a scene from a movie you
once saw, or someplace you have never been, someplace that never existed in the real world,
someplace that is yours and yours alone. This is a place where you will be spending time; somewhere
with you always, so spend some time creating it.
After you have created this retreat, you can also
make changes, much as you would remodel a
home at times, moving furniture around, and
even adding walls, rooms, landscaping and
repainting as needs and tastes change. Let your
imagination soar!
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Describe the place where you feel most safe and peaceful (real or imagined):
Is there anything you would like with you? (e.g. stuffed animal, jewelry, favorite object, etc)
What is the ideal weather for the place you feel most safe and peaceful?
What do you feel? (e.g. a warm gentle wind; warmth from a fire; a cool breeze, etc.)
What do you see around you (or out the window) in your safe and peaceful place?
What do you taste? (e.ge. A drink that you have with you, a meal you just ate, etc.)
Briefly describe what you are doing in your most safe and peaceful place:
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Now that we have created our safe and peaceful retreat, it is important to name this place. Giving it a
name allows it to hold a place in our minds, and provides a link to our retreats.
Name: ______________________________________________________________________________
Once you have named your retreat, close your eyes and go there.
First, conduct a Guided Relaxation to relax your muscles. Relaxing your muscles also relaxes your mind,
and makes the Guided Images that you are about to create more vivid and real.
Memorize each aspect of your retreat, the sights, smells, sounds, tastes and textures of your retreat. Are
you alone or do you have people, pets or objects with you? What are you wearing? What is the
temperature? As these details become set in your mind, you will be able to create this in your mind
more easily.
Now, being certain you are in a truly safe location, close your eyes and imagine your retreat. Say the
name you have given to this place. Do not fret if you are unable to bring it to your mind immediately.
Even if you are unable to see your retreat in your mind’s eye, you will still enjoy its benefits. Even if it
is only a thought, that thought will help you to relax and
heal. Do not worry if you are performing this exercise
properly. Simply close your eyes and enjoy this brief
respite. If you can spend one minute in your retreat, enjoy
that minute. See if you can work your way up to fifteen
or twenty minutes each day.
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During these exercises, Guided Relaxation and Guided Imagery, uncomfortable feelings may arise.
Sitting in a quiet space and closing our eyes may create tension, bodily sensations and anxiety as
remnants of our trauma. While these are normal, and not a cause for alarm, they may interfere with
the practice of Guided Relaxation and Guided Imagery, as feelings of anxiety and distressing body
sensations arise.
Using your imagination, picture a safe place in which you can store the feelings of anxiety and
distressing body sensations. We don’t wish to dispel them altogether, as these feelings, in certain
situations, can be warnings of real danger. But we do need a place to store them temporarily, in order
to feel comfortable in situations which we know are safe.
Some examples of a place to store these feelings and sensations are a safe, a file cabinet, a storage
warehouse with a padlock, or any container which is large enough and which can be secured by a lock
of some type.
When these feelings and sensations arise, note the size, shape, colors and textures of these feelings.
Imagine placing these feelings and sensations inside the storage container that you have chosen, and
locking them away.
If you are using a combination lock to secure these feelings and sensations, note the combination so
that you will be able to retrieve them when you are done with your retreat. Take care not to use a
number that may trigger your traumatic memories.
If you are using a key lock to secure these feelings and sensations, note the location of the key so that
you will be able to retrieve it when you are done with your retreat.
If you wish to simplify the locking and unlocking process, you can use a “fingerprint lock” as your
fingerprint is something you always have with you.
Notice the relief as you store away these feelings of anxiety and distressing body sensations. If helpful,
you may wish to repeat the process two or three times until all, or most of the distressing sensations are
gone.
Once all or most of the distressing sensations are gone, you can proceed with your Guided Relaxation
and Guided Imagery Exercises!
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Use Mindfulness to Create Awareness of the World Around You
Eat Mindfully
We often eat mindlessly; in front of the television or while engaged in other activities.
Mindful eating is simple, enjoyable, and may have a profound effect on your lifestyle!
3. Start with a food you can truly enjoy. For many of us, chocolate is a perfect choice.
7. Notice what the food feels like in your hand or with a utensil.
8. Place the food in your mouth. Notice the weight, texture, & sensations of the food in your
mouth.
11. Continue to eat the rest of your food by paying close attention to all of these experiences
and sensations.
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Walk Mindfully
Walking is a great way to integrate mindfulness into your everyday life, if you are able.
1. As you begin to walk, notice how your body feels. Does it feel heavy or light, stiff or relaxed?
Take a few seconds to become aware of your posture & how you carry yourself.
2. Without trying to change the way you walk, observe how it feels.
3. Be aware of what is going on around you. Take care to notice cars, other people, road signals
and your environment as you walk.
4. Notice what you see going on around you. Notice the colors and shapes, the movement and
perhaps the stillness too.
5. Turn your attention to sounds – what can you hear? Take a moment to be aware of the sounds
you hear as they come and go.
6. Turn your attention to smells. Some may be pleasant and others unpleasant. Notice if each of
the smells reminds you of somewhere, something or someone.
7. Finally, make a point of noticing any physical sensations or feelings. Perhaps a feeling of warm
sunshine, cool rain or a cold breeze. Perhaps a sensation of the soles of your feet touching the
ground with each step, or the weight of your arms swinging at your side.
8. As you continue to walk, do not try to prevent any thoughts or feelings from your awareness –
simply notice as they come and go, how one thought or feeling is constantly replaced by the
next.
9. Gently shift your attention to the sensation of movement in your body. Notice how the weight
shifts from your right side to your left side and back again. Notice the rhythm.
Use the rhythm of the walking and the physical sensation of the soles of your feet touching the ground,
as your base of awareness. Concentrate your awareness on these sensations. Let them be a place you
can come back to mentally when your mind wanders off.
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Meditation
There is a common belief that Meditation is about emptying our minds until we
think no thoughts, feel no sensations, hear no sounds and are devoid of emotion.
Meditation, on the other hand, is a state of awareness. Awareness of our thoughts. Awareness of
sensation. Awareness of sounds. Awareness of emotions.
Meditation is the art of being aware of our sensations, both internally and externally, without reacting
to those sensations. When we have been exposed to trauma, we tend to not only react to those
sensations, but to overreact. If you have practiced the Guided Imagery exercises, the Mindful Eating
exercise or the Mindful Walking exercise, you have practiced forms of meditation.
Remember that breathing exercise we learned before. You can use your breath as a form of meditation.
In fact, you can breathe using the technique you learned as the Relaxing Breath, and if you use that for
a period of time: five, ten or fifteen minutes, you will gain much of the benefit of meditation.
During your practice, as you exhale using your “relaxing word,” remember to focus on your breath.
Focus on the temperature of your breath as you inhale, and the change in the temperature of your
breath as you exhale.
Notice the sounds you hear. Sounds external to you, and the sounds of your breathing.
Notice the temperature of the room, or the air if you are outside.
Notice the feeling of the air on your skin, and the way your clothing sits on your body.
You may gaze at the flame of a candle, or at a fixed point, or you may close your eyes and engulf
yourself in the darkness.
Notice any odors in the air, or the taste left in your mouth by the last thing you ate or drank.
Notice any feelings of contentment, anger, joy, shame, guilt, love or compassion.
Focus on the temperature of your breath as you inhale, and the change in the temperature of your
breath as you exhale.
As you breathe, exhaling with your “relaxing word,” remember to focus on your breath.
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Cognitive Diffusion
In your mind’s eye, let the sky fill your vision, so that all that you see is a field of blue.
Notice from time to time, a cloud will drift across the sky.
While you are performing this exercise, thoughts will come to mind, and feelings arise.
Your thoughts, feelings, and clouds will come and go at their own pace. There is no need to rush
them or to slow them down.
If your thoughts and feelings stop momentarily, continue to watch the clouds in the sky.
Eventually, they will start up again.
From time to time, you may think that this exercise is silly, or that you are not doing it correctly.
Place these thoughts and feelings on a cloud and watch them drift away.
If a cloud does not move, allow it to remain in the sky until it is ready to float by. If the thought or
feeling reappears, place it on another cloud and watch it drift by again.
If a difficult or painful feeling arises, simply acknowledge it. Say to yourself, “I notice myself having
a feeling of boredom or impatience or frustration.” Place those thoughts and feelings on clouds
and allow them to drift away.
From time to time, your thoughts may hook you and distract you from being fully present in this
exercise. This is normal. As soon as you realize that they have sidetracked you, gently bring your
attention back to this visualization exercise.
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Somatic Healing
Allowing Your Body to Heal Your Mind
Have you ever watched a rabbit being chased, and witnessed the rabbit after it is successful in eluding
its hunter? The rabbit will continuously shake in order to rid itself of excess adrenaline.
Many of us experience involuntary shaking after a severe fright or when nervous. These tremors are
our body’s way of discharging excessive tension through rapid muscle contraction and relaxation. This
calms our bodies down from an over-excited adrenal state. A rabbit, or fallen horse, goes through the
same process to soothe itself.
In our culture, these tremors are often mistaken for weakness or vulnerability, and we may suppress
them rather than allowing them to organically restore our bodies to balance. When this occurs, the
body stores the trauma in the body, and the adrenaline builds. This can feel as if your mind and body
are racing at a hundred miles an hour. Allowing the tremors is like a massage from the inside out, and is
actually enjoyable when we let it release tension from our bodies.
Movement can help release tension from the body. Trauma often results in chronic pain and
inflammation, which impede movement, and any mild exercise is likely to help. Walking, running, and
especially stretching exercises such as yoga, which release tension from the body,
can improve chronic pain and inflammation as well as anxiety symptoms.
A simple way to start is to stand with your feet about two feet apart and to hold
your arms out at the sides so that you are forming a “T.” Then raise one arm up
while lowering the other, return to the “T-form” and then continuing the
exercise, switching sides. Hold each of your extreme positions for a few seconds
or more.
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Relaxed Vision
Trauma affects all aspects of our lives, including our senses. We may be hyper-focused on our senses of
touch, taste, smell, hearing and sight. This exercise helps us relax by relaxing our vision. By training our
eyes to de-focus and relax, we can change our perception. We can shift the way we view the world.
26
Sun Rays to Warm Your Body & Soul
In the winter, the frigid temperatures increase the tension in our bodies, as a reaction to the cold. In
the summer, the warmer temperatures and healing rays of the sun help relieve some of this tension,
and may allow us to relax a bit. Even when it is cold outside, you can create this feeling using your
imagination.
Imagine a safe place in nature. Perhaps you are laying on the warm sand of a tropical beach, on the
smooth rock of a mountaintop, or on the flat ground of a redwood forest.
Place your hand on your stomach, directly above your belly button.
Breathe slowly into your belly underneath your hand, feeling your stomach rise and fall with each
breath.
Now imagine the sun’s rays radiating into your belly and diffusing throughout the rest of your
body.
Continue to breathe slowly into your belly, feeling the sun’s rays warm your breath as they flow
into you and through you.
Close your eyes, and enjoy the warmth, breathing slowly and regularly into your belly.
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Nutrition
Trauma increases inflammation in our bodies. In addition to exercise and good sleep, food can
affect the levels of inflammation in our bodies.
Nutrition is important in dealing with psychological trauma. Eating a healthy diet can reduce
the negative effects of stress on your body. A healthy diet builds a solid, more enduring
foundation for your body by reducing oxidation and inflammation and by helping to reduce
weight gain.
Recommendations:
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Healing Touch
As human beings, we need the power of touch in our lives. For those of us who have
experienced abuse and trauma, this may be as frightening as the potential it has for healing.
A healing touch, such as massage, has been shown to be especially effective when paired
with guided imagery to soothe the mind and body together.
If however, this seems too big of a step to take at this time, you can either
Find a friend or loved one, and ask if you can hold their hand
Identify an inanimate object with a pleasant texture, and hold that object
o A soft cloth
o A stuffed animal
o A river rock
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Know Your Resources
We all have internal and external resources. Many of us are fortunate enough to have relationship
resources: Friends and family. Our resources allow us to survive the trauma we have experienced, and
help us to navigate life’s challenges.
Resources can be any person, place, thing or belief that allows you to feel safe, connected and
grounded, to help you cope with life.
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Activities to Promote Healing
Two common effects of abuse and trauma are depression and anxiety. These conditions are often
debilitating and tend to be self-perpetuating.
With anxiety, we feel a desire to avoid all triggers. Usually, this results in further isolation in order to
avoid triggers, other people, any stressful situation, and any type of pressure.
These conditions of depression and anxiety inform our behaviors. They create conditions under which,
in order to deal with these symptoms, we often do nothing, or as little as possible. What happens
based on our response to these symptoms? The symptoms increase!
Why?
In short
our thoughts create feelings
feelings create behavior
behavior reinforces thoughts
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Forced Smile
When we avoid all triggers, anything that increases our anxiety, we acclimate ourselves to a lower
stress level, which increases the effects those triggers create when we encounter them. When we choose
not to leave our home, or only leave as necessary, we increase the simple trigger of leaving our home,
especially when forced to leave on our own.
So what is the solution when we are too tired to do anything? When nothing seems worthwhile? When
self-doubt consumes us? When self-esteem and self-confidence are gone? When the act of getting out of
bed to go to the washroom requires extraordinary effort?
Let’s try an experiment to demonstrate a point. Don’t worry! You won’t even have to get out of bed.
All you need is a pencil and a piece of paper.
Pick a number to describe your mood right now, where 1 is the lowest you have ever felt and 100 is
the best you have ever felt. Write that number down on a piece of paper.
Now comes the hard part. Force yourself to smile. Not a thin, slight smile. A big
wide smile. As wide as possible. I know it’s hard. I know you don’t feel like it. I
know it feels forced. Keep that smile on your face for as long as possible anyway.
Remember: behaviors reinforces thoughts. When you change your behaviors,
you change your feelings!
Now, take a long, slow breath in, and exhale until you feel your lungs empty. Keep breathing!
Again, pick a number to describe your mood, where 1 is the lowest you have ever felt and 100 is the
best you have ever felt. I’m guessing your mood has changed for the better, but only you know the
answer to that. If it has, you have just demonstrated to yourself that:
and
But if a smile can change your mood, what other steps could you take to
improve mood, increase self-esteem and confidence, and accomplish goals
you haven’t yet dared to attempt!
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Superhero Stance
Superheroes are quite different from the rest of us. They are strong and confident. They have special
powers. They star in movies, television shows, graphic novels and video games. They save the world
on a regular basis. They always prevail. And, they have their own stance!
It is a stance that creates power, self-confidence and self-esteem. Sounds farfetched, doesn’t it?
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The Road Less Traveled (Opposite to Emotion)
I took the one less traveled by,
And that has made all the difference. ~Robert Frost
Often when we are depressed, our depression tells us to isolate, stay in bed, reduce motion and avoid
engaging in activities we used to like. These actions are likely to increase depression.
When anxious, anxiety tells us to avoid situations that make us anxious, and increases anxiety.
The Road Less Traveled allows us to engage in activities that, though difficult, are likely to change that
emotion, rather than continue the emotion in which we are currently trapped.
______________________________________________________________________
______________________________________________________________
3. Thoughts, actions, and behaviors that bring the opposite emotion into my awareness:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________
4. Ways I can engage in these thoughts, actions, and behaviors on any given day, in any given
situation:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
__________________________________________________
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Keeping Track to Stay on Track
How do you know what will help when you are in distress? Often in distress, those of us who have
been subject to abuse and trauma overlook our coping skills. We can easily lose track of what has
worked in the past.
In using this manual we have already learned coping skills and strategies including:
Relaxation Breathing
Guided Relaxation
Create Your Own Environment using Guided Imagery
Learning to put those Anxious Feelings on Hold
Mindfulness
Eat Mindfully
Walk Mindfully
Meditation
Cognitive Diffusion
Relaxed Vision
Sun Rays
Know Your Resources
Forced Smile
Superhero Stance
The Road Less Traveled
So let’s keep track of how these skills we’ve learned affect us. Every day, practice one skill, recording
how you feel before your practice, what skill you are using, and how you feel afterwards. That way
you’ll know what skills are most effective for you!
There’s a table in the back that you can use when you fill this one up!
Initial New
Level Initial Initial Level New Level New Level
Initial of Level of Level of New of of of
Feeling Anxiety Depression Confidence Skill Used Feeling Anxiety Depression Confidence
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Journaling to Heal from Trauma
When we experience a traumatic event, our minds struggle to process and understand what has
happened. Often we only recall bits of information, and creating a story from these small bits of
information seems beyond our grasp.
Translating these experiences into language allows us to create a story from a set of feelings, images
and sensations. Creating a story allows us to make sense of what happened. This is especially true if we
feel unable or unwilling to share the experience with others.
When you begin to journal, take care to be in a safe place. If possible, find a location where support is
available, should you need it. Write for short periods of time. Ten or fifteen minutes to begin. If you
are able to tolerate this without overwhelming distress, you can try for longer.
Some health benefits of journaling include improved cognitive function, reduced stress, and
strengthened immune function. Expressive writing helps us cope more effectively with symptoms of
depression, fear, confusion, irritability and anxiety. Journaling can even reduce body tension and
restore focus.
Journaling can take many forms, including a paper and pen journal, a computer with a word
processing program, a sketchpad with drawing and/or writing, even a collage. It doesn’t matter what
tools you use to journal, what is important is putting your thoughts, feelings and ideas down on paper.
Writing will help you identify triggers for your
symptoms. It will point out patterns in your life
you continue to repeat. It will help you find
solutions to problems. Journaling is a method of
self-therapy where you will discover just how
truly gifted you are as a therapist!
Take care of yourself before, during and after you
journal. Putting these thoughts and images down
on paper may be upsetting, and can trigger you.
Please be certain to have needed supports in
place, whether another person, a pet, or a special
object. If you need to stop or take a break, please do so! Self-care is self-love.
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So now to begin:
Begin with now.
Find a pen or pencil
Find a piece of paper
Find somewhere comfortable to write, draw or scribble.
Begin with a breath:
Sit up straight
Take in a breath.
Let it fill you with peace & compassion.
Exhale, and as you exhale, feel the muscles in your forehead, face & shoulders relax.
Continue to breathe. As you exhale feel the muscles in your abdomen relax.
Continue to breathe. As you exhale feel the muscles in your hips relax.
Continue to breathe. As you exhale feel the muscles in your legs and feet relax.
Now write, draw, or scribble whatever comes to mind. It does not have to make sense or be filled
with deep meaning. Write, draw, or scribble for ten minutes. Set a timer, and stop at the end of ten
minutes. Do not forget to breathe.
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Journaling as a Practice
Journaling is a habit, and just as with any other habit, repetition is the key to success.
Journaling as a one-time event has some benefits.
Journaling as a habit has enormous benefits.
The Huffington Post reported 10 Surprising Benefits You’ll Get From Keeping a Journal including:
1. Stretching Your IQ
2. Evoking Mindfulness
3. Achieving Goals
4. Increasing Emotional Intelligence
5. Boosting Memory and Comprehension
6. Strengthening Self-Discipline
7. Improving Communication Skills
8. Healing
9. Sparking Your Creativity
10. Increasing Self-Confidence
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Vision Board
Create Your Own Future
One false lessons of trauma is that life is only what happens to us.
This takes away the truth that we are able, to some extent, to create
ourselves in our own image, and to reimagine our lives and our futures.
Creating a vision board generates a sacred space to bring our desires into our world in
concrete form. Creating a vision board is visualizing the future. Visualization, as shown
previously, is one of the most powerful exercises available.
A Vision Board is a graphic representation of how we want to feel, how we wish our lives to
progress, who we aspire to become and what we desire to bring into our lives. It as a sacred
space on which to create the lives we yearn to live. It is a form of visualization creating
thoughts and feelings which encourage our dreams to come true. It provides concrete goals
so that we can observe our aspirations on a daily basis.
Pictures, words – anything we can write, draw or glue onto a piece of poster board. Anything
that motivates. Reminders of our goals. Consider relationships, career, finances, home, travel
spirituality, recreation, education, health & personal growth. Set an intention for desires, and
focus on feelings and items that bring out those feelings.
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What you will need:
An idea of changes you desire and how you would like to progress. What you wish to
manifest in your life. A word of warning:
We often wish to change others. Be the change you wish to see in the world.
And then choose some or all of:
Any kind of board: a poster board, a corkboard or a canvas.
Scissors, tape, pins and a glue stick to put your board together.
Markers, stickers, colored pencils, stencils, paint or pens.
Magazines from which to cut images and quotes.
Photos, quotes, sayings, images of places you wish to go, reminders of events, places or
people.
Anything that will inspire you
Time
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Learning to Re-program your Brain: from Victim to Survivor
The good news – the great news, is that we are well on our way to re-programing our brains. We are
moving from victims to survivors. You may have already completed this transition!
The skills we have learned to this point will help us on the journey toward healing. Especially if we
practice. The more we practice, the further we move from victim to survivor. With each of the steps
we take in this manual, we are reprogramming our brains.
There are other skills that will help us. First & Foremost: Remember to MOVE!!!!
Movement is, at the very least, part of the antidote to trauma. Even if we are unable to perform major
movements, whatever movements we can create will be helpful.
Yoga or Tai-Chi are especially helpful.
Expressing ourselves is also extremely helpful, whether through writing, dance, art or theater.
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When You Are Lost at Sea, Set an Anchor
We all have emotional reactions to events in our lives that may derail us. As waves on an ocean, they
rise and fall. They can be unpredictable, unstoppable and unsettling. They have a tendency to throw us
off course. It is easy to become beaten and battered.
In our lives, it is helpful to set a course, and when we are awash with chaos, intense emotions and
strong reactions to what surrounds us, it is even more urgent.
We determine the course we set by our values.
Our ability to maintain a set course is dependent on a commitment to our values
& navigation skills.
We can do this by:
Identifying our values, and using them as a compass in our daily lives.
Learning to accept our situations and ourselves as they truly exist.
Being mindful in the present moment.
Observing our thoughts without becoming overwhelmed by them.
There is a force in the universe, almost unstoppable, with the power to overcome obstacles, to win
hearts and minds, and move mountains. This ability turns boulders into sand and small streams into
Grand Canyons. It is the power of persistence.
Calvin Coolidge said, "Nothing in the world can take the place of Persistence. Talent will not… Genius
will not… Education will not...Persistence and determination alone are omnipotent. The slogan 'Press
On' has solved and always will solve the problems of the human race.”
Committed Action, in accordance with your values, will help you to overcome the obstacles you have
been waiting to subside. The wait is over. The time is now!
However, that does take commitment. Commitment first to your own values, and to your dreams. Ask
yourself, What would you do with your life if all of the obstacles you face disappeared, all resources
were available, and if you truly believed in yourself?
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Some Values to Identify
Sometimes it is easy to identify our values, but not always. It may help to have a list. Choose a few. If
we choose too many it becomes difficult to focus on what is important. Choosing one is not dismissing
the others. It allows you to concentrate on what it important in your life.
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When Self-Help is not Enough
This workbook may be enough, and it may not. I hope the journey we have shared has brought you to
a place of healing. If you wish to continue this journey, there are several types of therapy that you may
find useful.
Eye Movement Desensitization and Reprocessing (EMDR) is a psychotherapy treatment which allows
for rapid access to memories and images from the past. It pairs bi-lateral stimulation of the brain with a
focus on traumatic memories and associated negative beliefs. EMDR has the most positive outcomes for
those who developed PTSD as an adult. It is much less successful for developmental trauma. You can
find qualified therapists through EMDRIA at www.emdria.org
Cognitive Behavioral Therapy (CBT) focuses on the relationships among thoughts, feelings and
behaviors; targets current problems and symptoms; and focuses on changing patterns of behaviors,
thoughts and feelings that lead to difficulties in functioning.
Cognitive Processing Therapy (CPT) is a specific type of cognitive behavioral therapy that helps people
learn how to modify and challenge unhelpful beliefs related to the trauma.
Prolonged Exposure is a specific type of cognitive behavioral therapy that teaches individuals to
approach trauma-related memories, feelings and situations gradually. By facing what has been avoided,
a person learns that the trauma-related memories and cues are not dangerous and do not need to be
avoided.
The relationship between a therapist and client is as important, if not more so, than the type of therapy
we choose. We may decide to interview a few therapists before finding someone we can work with. It
is important to feel comfortable with a therapist, and to believe they have faith in our ability to heal.
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The Journey
Please know that the journey we are on is a lifelong journey, that there will be healing, there will
be pain, there will by joy, there will be chaos and there will be peace. These feelings and
sensations that we experience will change us in ways we may not imagine. We will continue to
experience astonishing growth and gains, which will serve us well over the years.
Many journeys have a specific destination. This is not one of those journeys. Still, having a
destination in mind will help us in finding our path.
Let us choose a path that honors our values, our progress, our talents, our interests and our
dreams. Let us design a path to nourish our hearts, souls and spirits.
We may feel too wounded to heal properly. We may feel we do not have enough time to heal
properly. We know we will never forget. We may fear that we will not be able to find it in our
hearts to forgive.
If nothing else, we can forgive ourselves. For our vulnerabilities. For whatever
part we feel we have played in our trauma history. For whatever part we did
play. For not being strong or brave enough.
We have the strength to survive our trauma. We have the strength to wake up
every morning and greet the day. We have demonstrated the strength to
confront our fears.
We are strong enough. We are brave enough. We may not be to blame for
our history, but we are strong and brave and determined enough to forgive ourselves and forge a
meaningful life path. We are strong enough to live our lives.
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Skills Acquired
Relaxation Breathing
Guided Relaxation
Create Your Own Environment using Guided Imagery
Learning to put those Anxious Feelings on Hold
Mindfulness
Eat Mindfully
Walk Mindfully
Meditation
Cognitive Diffusion
Relaxed Vision
Sun Rays
Know Your Resources
Forced Smile
Superhero Stance
The Road Less Traveled
Journaling
Vision Boards
The 5~4~3~2~1 Skill
Oak Tree Exercise
Physical Awareness Grounding Exercises
Mental Grounding Exercises
Soothing Grounding Exercises
Language & Affirmations
Set an Anchor (Living by your values)
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Initial New
Level Initial Initial Level New Level New Level
Initial of Level of Level of New of of of
Feeling Anxiety Depression Confidence Skill Used Feeling Anxiety Depression Confidence
47