Emotional regulation – we all have feelings; those feelings are fleeting, and they ARE valid – no one can question your individual emotional experience – it might be helpful to remind people about this; validate all their emotions, educate them about how emotions are made; model connecting with and expressing a wide range of feelings but also choices around them – we can struggle, subconsciously shut down to stay safe and that’s OK.
xperiences of triggers and build our awareness of how we can cope with them when they occur; so it can be helpful to provide some psycho-education (explain what triggers are, normalise strong reactions); explore past coping mechanisms and make flexible plans for new triggers; build a safety net/tribe – people who are available to help; practice actually accessing, asking for help (people might not know how to do that).
Boundaries – traumatised people may have challenges with saying no and not even realise how they put themselves at risk, so it may help if they learn to discriminate, judge and regain the sense of their agency, map out their circle of safety; talking about self-care might be a good starting point to setting boundaries (“What do YOU need?”)
The window of tolerance (a zone of emotional arousal in which we can function most effectively and safely) – it’s that margin of emotional temperature where you feel emotionally ok, low or high but not out of control; this window of tolerance can be smaller after a traumatic experience but it can be expanded in therapy; outside of the window of tolerance clients can present hyperaroused (on edge, angry, anxious) or hypoaroused (numb, not present, disconnected). So it helps to accept those emotional boundaries, connect with the person, listen carefully, make time to co-regulate with the client (pay attention to your feelings, ground yourself, your body will support this attunement).
Pacing – slow down, pace the conversation, monitor the intensity of emotions (imagine a thermometer of emotions and check with the person where they are on it and what they can do to keep that emotional temperature lower a bit); apply brakes and check-in (you can ask: “if you share this now, how will you feel later? is this too much to share right now?”)
Safety – check for safety – what does the person need to feel and keep themselves safe; you can use Maslov’s model of needs (from the top: self-actualisation, self-esteem, belongingness and love, safety and security, physiological needs), but please note that this model is fluid and people have all those needs so check in for physical safety, access to food and shelter but also for safe, validating, protective, reliable relationships – your interaction could be that first experience of safe and caring, validating interaction too
Flashbacks – involuntary recurrent memory that occurs primarily due to new triggers reminding a person of their past trauma, you can see they lose the sense of present time and connection with the world around them, are in distress – softly bring the person back to the present, ground them, check-in what is going on for them; you might need to ask them to gently shift their gaze to connect with you, ask simple questions about the surroundings or basic facts (their age, present year, day of the week), help them distinguish between past and present reality and remind them that right now they are safe.
Dissociation – it’s a defence mechanism, a mental process of disconnecting from one’s thoughts, feelings, memories or sense of identity – in shock, we switch off, and that is how we protect ourselves – so please respect that people might not want to connect with their emotions, they might seem cold and distant, it has nothing to do with you but with their need to survive which can sometimes move on even beyond traumatic times – what helps it to be patient, soft, respectful and to recognise it as a natural defence reaction
Calm space – the word “safe” concerning a mental space where we feel protected can be triggering, just as breathing can be triggering for some people. However, you can remind people that this is a calm space – they are safe. So do something nurturing together, talk to them softly and ask questions to switch on their cortex (part of the brain responsible for rational thinking and awareness), suggest grounding exercises to help people learn how to calm body and mind.
“How to find a good therapist?” – Friends ask me this question quite often, and I remember being quite worried about this myself: how do I even start looking for a good therapist? How do I choose one suitable for my needs? How do I know they are professional enough to keep me safe and sound?