Did You Know?: C-PTSD and DID Edition

    No matter the topic, misinformation and lack of understanding is everywhere.  When errors are made or false ideas get perpetuated, they tend to go unchecked and unchallenged usually because most of us just plainly don't know enough to even realize it needed to be corrected or looked into.  And, this is completely understandable, right?  We can't be expected to be informed on nearly every subject and struggle of humanity.  We can try our best, but there will always be things we are still woefully ignorant on.  Access to education, reliable resources, and just knowing where to even look for more information on any given topic is so hard.  We're left to take our cues from those claiming to be knowledgable, go along with the basic understanding held by the general public and our loved ones, and/or just let it be and invest our attention elsewhere.  When it comes to mental health, no doubt, all of these issues collide head on - multiple times over.  We unconsciously acquire so much misinformation about psychological disorders by the time we're only kids - and just by casually picking things up in conversations, media, and comedy, we also tend to adopt some heftily stigmatizing ideas as well.  And, if this is true even for those expressing no real interest in mental health, imagine the damage when people who do try to learn from the professionals are met with uninformed practitioners or those grossly misleading the public, their colleagues, and even their patients.  This is how Complex PTSD, and most especially Dissociative Identity Disorder, have been treated for decades.  We would like to start changing that.

   Little by little, bit by bit, we want to undo some of that damage and raise more accurate awareness for both C-PTSD and DID.  You can read more about the conditions themselves here (individual DID page coming soon!), but we also think it important to touch on what survivors with these disorders are currently going through just to obtain treatment.  After all, they wouldn't be struggling to get care so badly if those in the field had more of a vested interest in them - becoming at the very least trauma-informed, or better-equipped themselves to treat a client with complex trauma.  This will be an ongoing series no doubt - with many myths to debunk and important notes to impress!  So, to start chipping away at that iceberg, here are 8 things we should all know about Complex PTSD and Dissociative Disorders, and the survivors who have them.  

  With as vast as the United States is, this is supremely disappointing.  You can find the current list of those facilities here on our website.  Even within those 9, many keep relocating or downsizing, some have a very small number of beds or are restricted to only certain age groups, others have had all their additional programs (like PHP/IOP) cut entirely or are so underfunded they don't run smoothly.  Overall, the standard of care for trauma patients nationwide is very low.
   Finding a trauma-informed unit at all is pretty scarce, but the greater drawback is that many who claim to be able to take Complex PTSD or DID patients offer them no therapeutic tools or classes designed to address their unique needs and have them intermingled with the rest of the mental health population. This might not sound like an issue, but due to the nature of a trauma patient in crisis and their high susceptibility for flashbacks, panic attacks, switching, and self-harm, being surrounded by unpredictable and sometimes volatile patients is unreasonable and unsafe.  Staff also need to be heavily trained in what is an acceptable and safe way to engage with a severely traumatized patient - particularly if they are in flashback, a dissociated self-state, or critically unsafe.  Units remain safest (from perpetrators and potential flight-risks) when they are locked, but an understanding that this can be also be extremely distressing for other patients is something staff need to be able to empathize with and negotiate.  In short, the nuance of care required for complex trauma patients is unlike that of any other mental health condition.  And yet we have less than 10 places we can safely send individuals, and many of those 10 even have their shortcomings.  A couple even continue to produce more negative reviews than positive, and some of the leading facilities have proven time and again they are fantastic with some patients but are not equipped to handle ritual abuse patients.  Greater education, as well as funding to produce more units in existing psychiatric hospitals is a MUST.

  As a side note, there are a handful of residential facilities cropping up in various places throughout the U.S.  Residential treatment centers, while valuable and a potentially great resource (especially when there's nowhere else to turn), are typically not equipped to handle clients who need stabilization or are struggling with safety.  They are also more unregulated, therapy modalities can be harder to discern, units are not locked, insurance rarely participates, and they tend to be extremely small in bed-availability.  While they are often very beautiful and relaxed, and nothing like an inpatient setting - they can be extremely expensive, with limited staffing, and tough to guarantee quality of treatment.  And again, while they may be able to facilitate a chronically traumatized patient through a rough patch in their healing, they are often not trained or equipped to aid in crisis stabilization, and are usually far from a hospital should the need arise.

   As it turns out, averages can be tough.  Research in this field is still limited, and even where it exists, trauma patients aren't typically the most eager to participate in a study.  However, despite research on treatment length being slightly dated, and the fact we are getting more practitioners better-able to facilitate a patient through their recovery, as well as those who can at least make an informed diagnosis more quickly -- we are still grossly behind.  So, while some may want to argue this estimate is too high based only on what they see in their well-trained offices, others who have patients working well into their 15-20th year of therapy would argue it's still much too low. Regardless of the exact specificity, this is a very reasonable estimate at the moment, and is witnessed to be valid by many, many clinicians, patients, and communities of survivors fighting this battle. Now, this does not always mean 10 years of consecutive therapy - though it absolutely can and does for many.  It's quite common for patients to have to stop and re-start therapy multiple times - for myriad reasons.  Finances, inadequate treatment, personal unreadiness, a geographic move, unavailability of clinicians, and/or feeling stable at one point but needing to return as more things surface later - these are all very common factors for a more drawn out therapeutic journey.

   Ultimately, treatment of complex trauma takes a very, very long time in even the best of circumstances.  It can be extremely daunting and feel outrageously unfair to the survivor.  The average of several misdiagnoses before arriving at a proper one alone, then coupled with misguided therapy, not only adds more years to the recovery but also risks turning clients away from therapy altogether.  It's even been a traumatic experience for far too many.  We need compassion and understanding for these survivors.  To support them through this long process, no matter how many years it may take or how many times they need to stop and try again. Recovery from trauma is scary.  They need our love and support, not added obstacles.

   As mentioned earlier, inpatient care for complex trauma is extremely scarce.  It requires a specialized unit and, for many, that will be out-of-state.  Insurances rarely cover beyond their state's borders and non-participating provider agreements can be very tough to come by - let alone something we should ever expect a survivor to have to fight for themselves while in a terrible, terrible place.  Because of this, many of them have to pay tens- to even hundreds-of-thousands of dollars out of pocket for care.  Many facilities will not let you pay once you get in and settled and can think clearly.  They often require a sizable sum up-front, before you even enter the unit.  And, again, coming up with thousands and thousands of dollars that most don't have to begin with, particularly while in crisis, is a feat many just cannot accomplish.  Needless to say, most go without.

    How many people in the world do you know with red hair?  There are at least that many people with DID in the world - though, more than likely a lot more than that.  Due to fear, stigma, high rates of suicide, misdiagnoses, lack of public education, and countless other reasons, most who have DID aren't even accounted for yet.  But, the bottom line is that this is NOT a rare disorder.  It's only rarely talked about.  And, when it is, it's very rarely talked about in a positive, empathic light.  Most refuse to confront the reality of its prevalence rate, because to do that would mean having to confront causality.  And, what causes DID?  It's most always man's inhumanity to one another and the cruel callousness of the world.  No one wants to acknowledge that or accept how rampant it is, so they sweep the survivors of such under the rug (while others go so far as to actively paint them as dangerous or truly insane, especially in media).  DID is not rare.  It's not a one-in-a-million case you'll never see.  It is everywhere.  And those suffering with it just want someone to help them after years and years of abuse, pain and neglect.

   This is another fact that is just so very sad.  Complex trauma and dissociative disorders are hard enough on their own, but so are depression, anxiety, OCD, addiction, eating disorders, self-harm.  To have a collection of many of these at once just seems grossly unfair - yet that's the insidious nature of trauma.  The ever sadder part is how many of these aching, traumatized souls find themselves in eating disorder facilities or drug/alcohol rehabs (or even jail) for the more overt or destructive symptoms, but never receive trauma-informed care of any kind. Care that is specific to complex trauma or the uniqueness that DID can play in some of these more addictive or self-sabotaging behaviors is even more rare in places like these.  Additionally, when you try to "fix" an addiction or eating disorder through traditional means, without addressing the way its delicately woven and spun around the trauma, you can make them dramatically worse.  This, like all bad treatment, can turn them away from therapy (or help in general) forever - or more devastatingly, push them to lose their battle before they ever had a real fighting chance.

   It may be a broken record, but there is no place that the abundance of misinformation, redirection of resources, or ignorance of childhood trauma doesn't touch.  PTSD in any form is brutal and terrible and all-consuming.  But it's sad that in 2017, the first group of people that comes to mind for most whenever you mention trauma or PTSD, is still veterans.  If our "war flashbacks" and "triggered" memes online are any indication, people really do not understand the severity of the condition at all, nor do they even attribute it to the population struggling with it the most.  There is absolutely a way to keep the very real and VERY valid suffering of war veterans and those who've served in the military very present in our minds, hearts, and resource initiatives, while ALSO lifting up childhood trauma survivors and victims of sex crimes considerably higher than they currently are.  They need our attention and visibility.  And fast. 

    I bet if you call to mind any trauma survivor you know, they've also got at least one chronic (or "mystery") illness - maybe even several.  In fact, it's probably several if they've survived prolonged trauma.  Migraines, fibromyalgia, asthma, autoimmune disorders, rheumatoid arthritis, severe allergies, eczema, dysautonomia, POTS, EDS, neurologic disorders, chronic fatigue, or possibly even the highly insulting [and inaccurate] label of "conversion disorder".  These are all seen to coexist alongside trauma in abundance.  This list is by no means exhaustive, and - just like diagnoses for C-PTSD and dissociative disorders - many are still trying to just figure OUT what is wrong. They know they have a chronic illness, they just don't know which one, and every avenue they explore seems to point toward a dead end.
    We may have a helpful answer to you.  In reality, trauma affects absolutely every part of the body - especially the autonomic nervous system (which then affects everything else).  This can cause all sorts of havoc and in ways we are only just beginning to more fully understand.  It's been well-observed for awhile that trauma and physical illness go hand-in-hand, but it's only more recent that we've been able to see how, why, and where more specifically.  Because of this, and the fact it's a very lengthy topic, we cannot recommend the book The Body Keeps the Score by Bessel van der Kolk enough.  Or, at the very least, if you aren't interested in reading, maybe peruse some of his work online.  It'll be something you definitely won't regret, and supplies a well-studied introduction to all the ails, aches and pains, and mysterious illnesses you or a loved one have been suffering with for what seems like forever.

    Finally, in the same vein as so many of these facts but on a slightly different wavelength - traumatized children are seeing some of the most ludicrous misdiagnoses we've seen in quite some time.  The lack of understanding of what children who are being actively hurt (or just recently were) are "supposed to look like" in terms of their symptoms, is staggering.  Instead of traditional PTSD symptoms that we observe in adults, most kids are demonstrating all of the behavior one might expect from a child presently terrified, scared, shut down to numb, avoidant or afraid to attach, feeling under threat, trying to seek control and a voice, and who doesn't know what to do with all that adrenaline and nervous energy coursing through their tiny, terrorized little bodies. Sure, traumatized children can present in a variety of extremes, and that can be tough to distinguish at face value - but it's not too difficult to learn. And it's not acceptable to take the response of "No, no one's hurt me." as gospel in a child who's still in danger and never pursue it further - especially when all their symptoms are telling you otherwise.
   Jumping to the opposition-defiant, mood-dysregulated, ADHD, autistic, etc labels/misdiagnoses can be so harmful and even lead to more abuse at home.  Not to mention, they can follow them around forever, reshaping who they think they are or believe to be "wrong" with them.  It can make them feel broken or defective - particularly when the treatment for these suggested conditions can make them so much worse.  In reality, they are just traumatized children who did nothing wrong, but are being wronged by all the caregiving adults in their lives.  They're trying to communicate their suffering to you in any way they know how, but most of those "listening" are all too eager to villainize, label, or neglect them instead.  That is not helping them.  We need to do better.

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  There are so many, many more things we all need to know and recognize about Complex PTSD, dissociative disorders, and the survivors who have them.  We will absolutely be continuing this list and adding more to the conversation.  What are some of YOUR greatest misconceptions about trauma disorders, or details you really wish people knew about the process of healing from them?  Please share them below!

MORE RESOURCE POSTS YOU MAY FIND HELPFUL:

  -  Grounding 101: 101 Grounding Techniques
  -  Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
  -  Imagery 101: Healing Pool and Healing Light
  -  Coping with Toxic/Abusive Families During the Holidays

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Imagery 101: Healing Pool and Healing Light

Whether you are struggling with physical pain, body memories, illness, headaches, or any of the other distressing symptoms that can come with being a trauma survivor (or someone with a chronic illness) - there are imagery techniques out there that can help alleviate your suffering!  As I'm sure you're well aware, medications do little to nothing to relieve your body of pain it’s reliving from the past.  Conditions like fibromyalgia and other autonomic/nervous system disorders are also highly prevalent amongst trauma survivors, and they, too, show some of the greatest resistance to medications and other external approaches to treatment.  While there are several therapies that can help release your mind and nervous system of these specific types of pain, one solid tool you can use anywhere and anytime, no matter what shape your body is in, is imagery.  More specifically, Healing Pool or Healing Light imagery.

We'll walk you through both of these techniques, but to make sure you have the greatest chance at success, we want to be sure you understand the concept of imagery and how it's used first. (If you're already familiar, you can skip this part and head straight to the exercise!)

Imagery is a coping skill that allows you to picture things in your mind's eye - very vividly and in exquisite detail - to bring yourself and your body to a calmer state. It may be used to relieve pain, put away upsetting memories or intrusive thoughts, contain distressing emotions, retreat to a safer or quieter place, get some desperately needed rest, or just about anything your mind can create.  This is a skill that, like all tools for combatting trauma symptoms, does take practice and is one to experiment with when you don't "need" it. This way, when you're flustered, overwhelmed and unable to think clearly, it's second-nature instead of "some dumb thing that's probably useless anyway".  (Yes, we're very familiar with that rhetoric and guilty of it ourselves when distressed.)  Imagery is a technique constructed around being as detailed, descriptive, multi-sensory, and personalized as possible. Imagining yourself in a place or scenario that holds absolutely zero interest to you, that you have a hard time visualizing, or is even upsetting to you, is NOT going to be helpful.  Commanding the full use of your mind and its senses will engage so many more neurons and ask them to get off the upsetting or painful feedback loops they’re currently on - which is good not only mentally but for your physical health.  So, more detail, more customization toward my preferences and interest, got it!  What else?

Have patience with yourself.  Sometimes your mind is going to wander, that's okay. Sometimes the environment just isn’t going to work well, and you might feel frustrated, but that's also okay.  It's not your fault, or an inability to "do it right", or "never going to work".  Your body may be under a lot more distress than can be managed at that moment or it’s a visualization that just isn’t tailor-made for these symptoms. If for any reason it's making things worse, perhaps there's something triggering about the scene you chose that you hadn't even considered.  Or, particularly for those with DID, maybe there's a part of your mind who has misgivings about allowing you to feel comfort or make the pain "go away".  (Even if you don't have DID, some aspect of your mind may still feel this way.)  This happens sometimes.  It doesn't mean all is lost, that you'll never be able to use this skill, or that your mind is sabotaging you.  You just need to work with that stumbling block and either talk through it or at least find a compromise.

And, finally?  The more you truly believe these skills are working for you - drawing out the pain from your physical body, sealing up those memories nice and tight, slowing not only the intense emotions but your heart rate and tense body too - the better it will work.  If you just go through the pictures in your mind and don't try to connect them to what your body and mind are truly experiencing (whether that’s because you were sure it couldn't possibly touch the level of pain you’re in, were just doing it to tell your therapist you did, think coping skills are worthless, yadda yadda), welp, then, you're right, it's not going to work.  The mind is sooo powerful, and highly susceptible to the input YOU give it.  If you tell your mind you're now feeling differently or that parts of your body are starting to feel numbed or relaxed, it's likely going to believe it at least a little (if not much more) and start to follow suit. (And not just in a hocus-pocus, frou frou kind of way, but instead a well-researched, biological way - based on the new neural connections you helped your body make.)  Trust in it; the more you do, the more success you'll have.  And truly, if you're in distress and just need the madness to pause, or the pain to stop, what do have to lose by committing your whole self to the exercise?  You've probably tried everything else, possibly even things with serious side effects.  This has zero, so why not give it your all?

Now for the fun part!

HEALING POOL

Healing pool is just what it sounds like.  It's imagery that relies on a body of water with personalized healing properties to target and alleviate your pain from head to tippy toe.

To start, choose a location that feels the most calming and soothing to you based on the type of pain you’re experiencing and the environment that appeals to your senses.  Nothing is off limits!  It can be a real place you’d like to visit or one you’ve already been and love. Or, you can create a magical, mystical wonderland that’s the perfect fantasy destination for healing. Try to paint the scene as vividly as you possibly can. Is it a tropical oasis?  ..on a beach with crystal clear waters, sand, and an ocean breeze?  Is it in a mythical forest?  ..with a hidden spring, ancient stone fountains, and tall woodland trees all around you?  Is it in a rainforest or Hawaiian escape?  ..with tall, cascading waterfalls emptying into a warm, quaint natural pool?  (Hey, it can be magic, remember? That pool doesn't need to empty out somewhere else just because there's a waterfall leading in!)  Or, do you prefer something in a colder climate? A northern, mountainous retreat with perhaps a hot spring bubbling up, or a cooler lake to calm the aching? If none of these known environments are pleasing to you, you can even leave this world behind and be on your own planet, in a futuristic world, or high atop the clouds in a land with its own prodigious body of water. Creativity in imagery knows no earthly bounds!

Once you've chosen a general landscape and water source that is perfect for you, go deeper still into that world.  What do you hear?  Are there birds or other animal/nature sounds? What kind? Are they quiet and sporadic or filling your ears like music? Does the water itself make a trickling sound, have crashing waves hitting the shore, or does it bubble as it waits for you to enter? What do you feel? Is the air warm? The hot and muggy kind? Sunny but breezy? That still and "just right" feeling? Or, is it instead cold, clear, crisp and refreshing? Now, what about the time of day? This may change each time you return, but is your healing hideaway in the invigorating daylight, amidst the beautiful colors of a sunset, or is this a moonlit dip in the water?  (You can try all the above in future visits!) Now, return your focus to the water.  This is your healing water - not just any old water. Does it have a special color? Does is glisten or sparkle? Does it have any billowing mist coming off of it? Perhaps it's not even earthly water, and instead a mystical, dry ice-like fog?  Or, maybe it's more like a warm liquid gold? Maybe crystal blue ocean water with iridescent ribbons of light eager to heal your pain speaks to you? The possibilities are endless!

❧ ❧ ❧

Now it's time to get in.  We know when you’re in terrible pain and agony, the urge to just jump right in and submerge yourself immediately can be so intense - anything to stop the pain immediately. But, this technique actually works much better, and for longer, if you can gradually go through each part of your body, one at a time - really feeling it take effect not only in your mind, but in your skin, muscles and bones. Some may even witness the coloring in their skin shift through different techniques as their body responds as though this were entirely real. So, go slow and commit yourself to experiencing the variety of sensations; relief will find you much more completely.

Go ahead and stick your toes in. What happens? Does the water change color? Make a sound? Begin to draw the pain out of your body, dissolving it as it hits the water? Is it cold on your toes - almost making you shiver or giving you goosebumps? Or is it so warm and inviting - everything you ever hoped to be - stirring an audible sigh of relief at first touch?
Now, go ahead and let it cover your ankles.  Wiggle your toes around and paddle your feet, remembering that this is YOUR healing water, no one else's. It knows just what you need.
Move further still, putting your calves in. Notice them relax, surprising you at just how much tension they were holding while you were totally unawares. Give your legs another kick, pushing and pulling against the weight of the water, feeling it whisk between your legs as they pass each other. 
Scoot further in now and let it cover your knees.  Spend some extra time here and let it fully soothe your tired legs and aching joints. Notice how incredibly weightless they feel. It's quite possibly the best feeling you've ever had.
Slide in now and feel the water come up over your thighs and up to your hips. It's not too hot or too cool, it's exactly what your body craves, almost as if it was pulling you in. Notice your legs just completely melt, almost wishing to release a sigh of their own. It's as if not only the healing properties but the water itself goes straight through your skin into every tissue, cell and fiber of your body, drawing out every ounce of hurt or exhaustion in your poor, tired legs. They feel almost euphoric in the release.
Go in up over your tummy and up to your ribs now.  As a wave of relief washes over you, even the coloring in your face changes and the tension held in your pained expression relaxes. All the nausea and cramping and pain - any body memories or low back pain - it's all just drawn out of you and replenished with a level of comfort you didn't even know was possible. Cooling, numbing, calming every inch, while warming and softening other aching muscles.
Go ahead and let your arms start to fall in now.  After your fingers dip in, it's only natural to want to play with the water. You've never been in anything like it! What does it feel like? Does it swirl? Can you pick it up, does it change when you hold it in your hands?
Now sway your wrists and hands through the water, pushing and spreading it out. See how cramped and pained your hands were? You maybe didn't even notice in all the rest of your body's aching. Or, maybe they were swollen and rigid and tense and this was exactly what you wanted. Spend extra time on them. Now you can open and close a fist without pain, wiggle your fingers loosely, and dance in the water without pressure or restriction. They feel FREE!
Drop your arms until the water covers your elbows - now able to stand completely comfortably, your shoulders more relaxed. Take a nice deep breath. Do you want to keep walking around in it now - free to twirl in a circle - or, would you rather sit on an underwater stone or rocky ledge and just take it easy?
Either way, dip yourself slowly lower until the water is up to your collarbone.  Feel your chest cavity expand and the fresh oxygen rush into your lungs.  You'd been holding your breath for so long in the pain and you're now invigorated with such clean, healing air. You didn't know your lungs could open so far! Notice your heart rate slow and steady. And the PAIN held in your heart and chest, the spaces between your ribs - all of that weight from such emotional anguish and hurt - it just dissolves.  ...almost as if the healing water swirled around inside of you and gave your heart a warm, loving hug. Stay here as long as you need. This is so important.
When you're ready, cover your shoulders - possibly relaxing back against a cozy ledge.  Goodness, it's like your whole body has become jello now. Some of those last bits of tension are melting away and releasing the hold on you they'd had for so long. Take another deep, deep breath. Close your eyes if you want to.  And, now it's up to you if you want to take your head under or just splash some on your face instead. If you have a headache or migraine, I'm sure you almost can't wait. If you don't want to go under, that's okay, too. Just being close, or rinsing your face can be more than helpful.
If you decided to dip yourself under, go ahead.  Good news is that in this healing pool, you don't have to worry about holding your breath. Just let the water relax your jaw, smooth away the creases from your brows and forehead once contorted from pain. Feel it draw out all of the throbbing, aching, pounding, or sharp pains in any and every part of your head. Your thoughts calm and slow, and the worries, memories or awareness of pain just disappear. Everything goes quiet, and feels still. You could almost sleep in the absolute serenity. You're only right here, right now, and it's all you could ever hope to feel. Breathe deep. Spend all the time on you and your body that you need before lifting your head out of the water.

You can decide if you want to stay here and swim, take a nap in this place, or just relax for a few more moments - making sure you truly experience deep, deep healing in even the most stubborn parts of your body. When you're ready to leave you can slowly bring your awareness back into the present, but don't worry, the healing doesn't just disappear. You take at LEAST a piece of it with you for the most sore parts of you, and even more elsewhere. It wants to gift it to you and you’ve already changed a great deal of how your neurology while you were here. It won’t just undo. Over time, if it wears off or symptoms return, you can return. You can come back to this at any time and change any part of it that you need - customizing it for any future aches and pains, headaches, overstress or body memories.  

You may need to take a couple extra moments for grounding after coming out of such a calming oasis. If you're heading to bed or doing this before sleep, you're a-okay.  But if you need to return to the regular world, you may need to shake the fog from your eyes and fully connect with your surroundings before re-engaging with life again. So, be sure to orient yourself fully. (If you aren't sure what to do for grounding, good thing we've got 101 Techniques for that!)  But, even though reconnecting with the real world can be undesirable, that doesn't mean the calm, peace, and pain relief found there just goes away! You're more refreshed than you've been in...maybe ever.  Just be sure to fully re-orient, even if that haze seems more inviting.  ;)

Healing Light

Healing Light works in a very similar way to Healing Pool, but it's especially great for anyone who has any kind of uneasiness around water, needs more of a localized "spot treatment", or has a harder time creating more scenic imagery in their mind.  

Just like Healing Pool, this skill is much more effective when you make it as descriptive and detailed as possible - only this time you will mostly need to focus on detailing the light and less so your surroundings. The light can even reach you right where you are sitting or laying right now if you'd like. But, if you want to visit a more soothing environment as you practice this, you are more than welcome to include one and detail it just as we did earlier! It’s all about your comfort and what will maximize the benefits you’ll receive.

So! When it comes to light, the possibilities here are endless. Is it a sun ray that bursts through the clouds and finds you? Is it more like a secret weapon, a thin, pain-zapping laser? Is it more like a glowing orb of light, personalized just for you? Or, perhaps it’s more conical like a flashlight, being emitted from some other precious source that you can turn on and off? Maybe it's no beam of light at all, but more like a dancing, ribbon-y, spritely kind of light flitting through the air. Is there a trail of shimmer or glistening particles that follow it in its magical nature? Is it warming and softening, or cold and tightening? Possibly something more gaseous, or like pressurized ice that can flash-freeze and numb ANY type of pain, seems more satisfying for your needs?
Does it make a twinkling sound, the whirring of a pulsating orb of light, or is it more of a buzzing or zap of a machine as it obliterates the pain? Does the light come in one color or many? Maybe you have different colors for different areas of the body, or a variety of colors and styles dependent on the type of remedy you need for it to give.  Perhaps you have one light that heats and relaxes the skin, another that freezes your pain dead in its tracks, a third that envelopes and "holds" the pain until the throbbing stops, a more aggressive light that shatters the pain into a million pieces and then individually dissolves each one, another that injects coolness through the area like a gel and feels like an internal ice pack, a highly unique one that simply erases the aching entirely as if it were never there, and a super satisfying light that draws the pain out from your body like a magnet or vacuum. You can even have one that incorporates more of a spiritual element, or the energy and care of someone you love, who can offer a special kind of comfort that no one else can. So many options!

Like the slow entry into the water in Healing Pool, it is oftentimes more effective to start with an area of the body that's unaffected - gradually approaching your "target" area so that your mind and body have an opportunity to fully connect this imagery exercise with your actual pain. If you're a fan of those that obliterate and destroy the pain with like dry ice blocks, etc, you miiiight want to give the light a "seeking" function that just cools and nurtures the healthy areas as you begin the process, then let it 'scan for' the most painful section you want it to destroy.  We don't need you feeling like your forearm just got pulverized or flash frozen when it was your shoulder that was waiting for the relief, ya dig? ;)

Okay, so, first!

Visualize in your mind's eye where the light source is coming from. You might even start to feel building anticipation of the relief you’re about to receive. Picture this light source, notice its glow, feel the warmth or coolness it’s emitting, listen to its unique sound.
If it's your head that is throbbing, perhaps allow the light to first hit your spine - releasing and soothing each individual vertebrae as it climbs your back to your neck and head. Allow the healing particles to weave throughout your jaw and mouth, completely relaxing them along with your brows, forehead, and eyes. Then send it to your pounding skull. Let it do there what you’ve desperately been needing it to. Let your mind subconsciously direct it. If your abdomen or low back are aching, maybe show some love to your toes, feet and legs before reaching the pain of your midsection. If it's your shoulders or neck, let the light graze your fingertips and creep up your forearms, triceps and deltoids before tackling your upper body pain and releasing that suffering.

This light is so detailed and meticulous, so specified to you and your needs. It reaches through every capillary, tissue, cell wall, vein and nerve fibre. It knows what you need without your instruction.

Visualize what's happening beneath the surface as it finds your pain. The way it coats, cools, and soothes your pulsating nerves. See the light pierce through all parts of you to find your toughest tissues and muscles, melting them into the greatest relaxation you've ever felt. Imagine how your light sprinkles your skull with tingling, healing properties - how they then trickle through all the wrinkles and spaces and curves of your brain, quieting and soothing not only the aching but all your frenetic thoughts, too. Picture its warming, swirling path to all the cramping and twitching muscles that are remembering something from the past. See it drawing out the inflammation and "darkness" that can feel so heavy when it gathers in your joints, or even in your lungs or heart. It's gone now. You can breathe. You can feel that relief. It may have even felt so good that now you need that light to go everywhere else. That's perfectly okay! Practice that self-care and bathe in that light if that feels right to you. This is your light. No one else's. It's made just for you, for your pain. No one can change it, tamper with it, or even know about it if you don't want them to! This is YOUR healing light.

When you've decided that you are finished, you can watch the light slowly leave your body - taking any last stubborn remnants of pain with it. Take a deep breath knowing that as it leaves, the pain will not just immediately return; it's been healed. Your mind and nervous system have chosen a different path and sent wellness to that area. You aren't just "imagining" relief, you've neurologically and chemically given your body some different instructions. And when life is being a jerk again, you can call on your healing light any time to give your body that relief once more. It is so precious.
 

These techniques are but a few in a sea of treating ailments and managing distressing trauma symptoms through imagery. There are countless others, like those involving the use of colored “pain water” that fills up the body but is slowly drained out from the heels. Another semi-silly one that is taught in some trauma units is called "flick the pea". In this one, you imagine your pain as a very large sphere (like a basketball or even larger if it feels more massive). You then move that ball away from that area causing you so much distress, toward your arms, shrinking it down in size as it travels, until it's so small (the size of a pea) that once it reaches your fingertips, you can flick it away with a very, very satisfying flick. There's another that is specific for numbing that just involves sticking your finger in an ice cold water and mentally carrying that frozen feeling up your arm and through your body until it meets the pain you’re suffering with. This is one you can often see the color change occur in the skin as your mind registers the chill taking over you.

We have also made a post on Color Breathing, which not only helps with emotions and panic, but pain as well. There is also an introduction to imagery techniques that use dials to help modulate pain, intense feelings, and memories which you can find here.  If you would like us to share any of these in more detail, we can certainly do that. We are planning to make many more articles on imagery - particularly containment skills (for memories, emotions, intrusive thoughts, self-harm urges, etc), but we wanted to be certain to tackle those that help with physical pain first!

We truly hope these skills help! Feel free to expound upon any of them, make them your own, or - if you're just learning - even let your phone or computer read them out to you so that you can just close your eyes and follow along, visualizing as it guides you through! These can also work for anyone, not just trauma survivors! So don't hesitate to share them with friends and loved ones, particularly if they have chronic pain or any chronic illness!  Good luck, and if you have any questions, please ask below or message us!

 

More Resource Posts You May Find Helpful:

✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Flashbacks 101: 4 Tools to Cope with Flashbacks
  ✧  Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
  ✧  Coping with Toxic/Abusive Families During the Holidays

  ❖  Article Index  ❖

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Nighttime 201: Small Sleep Strategies that Make a Big Difference

Welcome to Part Two!

If you're coming from our Nighttime 101 Guide (and if you're not, why don't ya start there first!), it may seem the techniques offered there are a bit more on the advanced side as they'll compare to what's about to be presented. So, why would we have picked that as the starting point if these are more simplistic, quicker fixes?

While those ‘foundational four’ skills - a nighttime routine, journaling, internal communication, and medication - do require more in-depth understanding and greater effort overall, we really feel that for survivors with Complex PTSD and dissociative disorders, that approach to sleep is truly your first line of defense. It is your ground level to build on. If you cannot successfully apply some of those tools, your sleep could remain interrupted and fitful even if you completed every single item on this list. The tips and tricks here are more like icing on the cake; things to add to your already-reliable baseline that will improve the quality of the rest you may finally be getting.

It's possible some of these may become a part of your own foundation, particularly if they tackle a critical issue that's been keeping you up, but for the most part, none of these alone will be the key that unlocks decades of restlessness for you. We hope they instead improve what you've already been working on - tying up loose ends, and settling any of the hiccups that continue to cause you grief. With trauma, sometimes the simplest of steps can still make the largest differences, particularly in this complicated fight for good rest.

So, let's go some sleep! Here is a list of several additional things you can try that may create a safer, more comfortable, restorative, and peaceful rest.

• Make your room, and your bed, an inviting place to be.  If your room is full of clutter, food, or your school or work items, or is comprised of drab colors, lifeless pillows, and only the bare bones necessary to call it a bedroom, how is your poor mind ever supposed to want to be there for several hours? How is it going to feel calm, secure, and nurtured? Warm things up! Make it a place that welcomes you, pulls you in, is a place you want to be.

  Even if you possess very little or have minimal means to change things, there are small ways to make your room your own and tell your mind ‘at least I care about me'. Keep it decluttered, refreshing, and not too busy. Try not to bring things into it that wind you up or stress you out - like work, school, or therapy projects. Create a sea of fluffy pillows, cozy blankets, soft colors. Maybe add a few nice pictures or go real wild and buy some new drapery that makes it look like you really know what you're doing in there. ;)

  Try out a simple DIY project that makes you proud of yourself and what you've done with the space. (And hey, not crafty at all? All the more reason to create something just for you! Because not only will you be even more proud of what you were able to make, you'll always be reminded of the fact you believed you were worth that effort! Because you are!) Even with the smallest of budgets, it's possible to take a space you've sorely neglected and transform it into your perfect, personalized little oasis. And, this seemingly insignificant change to where you rest your head can actually do wonders for your mind and body - which leads to more Zzz's.

• Use signs or pictures near your bed to help with grounding.  Put notes and personalized reminders right where you can see them from your space on the bed - especially if you should awake with a start from a nightmare. Create a pretty sign for the wall, put a notecard or photo in a frame that stays on your nightstand, decorate the ceiling if you have to! Make something that has the current year in bold lettering, along with with other grounding or reassuring statements.
  Perhaps you need to elaborate further on where you are, how old you are, that you are safe now, or a mantra that settles or re-centers you — anything that you know you'll need to see the moment you open your eyes struggling. Whether you wake from a nightmare, re-open your eyes as you're drifting, or wrestle away flashbacks during the night, having those reminders right where you can see them - without having to work too hard to find them when you're already disoriented - can really be the thing that helps you right then until you're in a better place to help yourself more broadly.

• Turn all the clocks in the room around. As long as you have a trusty alarm set, no one needs to see those glowing numbers taunt them with how much time you do or don’t have left to sleep. Is it 12:16 or 4:52? Who knows?! Who cares! I got time and can’t wait to use all of it on sleep!

• Make a music playlist just for sleep.  The options here are limitless. Some folks like calming versions of songs they enjoy during the daytime, while others go for ambient music, music made for sleep, classical sonatas, or even kids' lullaby music. If you have child parts inside, sometimes an album full of kids' music (or just sprinkling a song or six into your otherwise adult playlist) can be great for all of you as a unit. Whether you like a Fisher Price or Baby Mozart album made with newborns and young children in mind, pretty Helen Jane Long albums, any of (ironically named) Sleeping At Last's instrumental tracks, or songs from your favorite film score, there is such a wide range of music that can help you strike a balance between adult you and music for a child-oriented mind.  ..no matter which end of that spectrum you'd like to fall on. And, even if you don't have parts inside, you'd be amazed how much lullaby-esque songs can soothe even the toughest of adults - sending them peacefully off to dreamland.

  Some individuals prefer there be lyrics, so as to keep their mind engaged and less likely to drift into dark places, while others need zero lyrics because they keep them awake or cause them sing along ;) Whatever you need is just right and definitely out there with a little bit of effort! Change it up weekly if you need, or keep it exactly the same so that your body always knows it's time to rest when you hear it. And? If you sleep with a partner who's anti-tunes, the lightest little bit of quiet music from beneath your pillow can still be more than enough to reach you. Headphones/earbuds are also an option, but we'll hit on those later!

• Discover podcasts, Spotify playlists, or white noise apps that really appeal to you.  The internet and smartphones/iPads/etc have changed the game in helping people get some sleep - particularly if they cannot staaaaand silence, yet outside noise keeps them up. Entire Spotify playlists exist just for sleep. There are apps upon apps upon apps that contain soothing sounds or "white noise" options specifically designed to help you rest easier.

  If music isn't your thing but a flashing TV is too much, podcasts may be your solution. Find one you love, one that bores you to tears, or is a happy medium between fascinating and something you aren't too invested in. That way you can stop listening and fall asleep without being sad you missed something important. Podcasts without massive highs and lows in volume or content that could be stressful are most recommended. Some of us find that the podcast A Way With Words fits that bill nicely for most survivors :) But there are tons out there for you to discover.

• Consider buying some darkening curtains/blinds. If you are super light-sensitive or find you're only able to sleep during the day, a set of darkening curtains/blinds can be a lifesaver. And the good news is, inexpensive stores like Walmart and Target even have some great options now. We're sure other outlets or discount fabric stores would have even more impressive prices, but you don't have to completely break the bank for darkening curtains anymore.

• Conversely, buy lighter blinds if you have a hard time waking up or like to sleep all day as an escape.  We all want our blinds closed at night so no one can see in, but if you're prone to sleeping in all day or struggle with depression to the point it keeps you returning to that bed in the daytime - some lighter blinds may be what you need. A bright, sunny room is harder for many to sleep in, but it also helps keep your internal clock more aware of the time of day - willing you to stay awake even if you want to come back. Staying on a proper sleep|wake schedule during the day can make resting at night a much better experience.

• Consider going to bed with a full tummy.  We know traditional sleep guides (and whack diet advise columns) insist on not eating an hour or more before bed. Whether they claim it gives you bad dreams or makes you gain weight, little to no science agrees. And when it comes to Complex PTSD and dissociative disorders specifically, for many survivors, an empty stomach can be upsetting for a number of reasons. Some grew up rather poor and had to go to bed hungry each night. Others were plainly denied food as punishment or as part of their abuse. Many survivors have struggled severely with eating disorders, and may still be struggling today. Some simply just could not eat after trauma when they were young, or wouldn't do so before bed if they thought trauma was imminent because it made them sick.

  All of these reasons and countless others can be terrible reminders of trauma, pain, and sickness — the simple growl of your stomach as you try to go to sleep can signal to your mind and body that you aren't okay. Something as simple as heading to bed with a moderately satisfied, or even full, tummy can lead many to feel more secure, and thusly safe enough to disengage for rest. And, eating a bit before bed can even lead some to just naturally get sleepier, solely because their body is no longer trying to get their attention to tell them they're hungry. Imagine that!

• Try not to drink too much right before bed.  Conversely to above, drinking too much before you head to bed can not only make you feel a little sloshy when you lay down, but it frequently leads to that midnight bathroom run. Sometimes just KNOWING you'll need to go to the bathroom in the middle of the night can keep you restless and unable to fall asleep as easily just because you're on alert - anticipating when it's time to "go".  And, above all, once you've had to get up to make that pit stop, it can sometimes be nearly impossible for sooo many of you to get back to sleep. We don't want that for you.

• Make sure to listen to what YOU need, not just what someone else tells you is good or bad to do before bed - including us!  There are countless guides out there telling you what to do and not to do at night. Whether it's the ones that say don't eat before bed, to never sleep with a TV on, not to drink ANY caffeine 12 hours (or whatever arbitrary number) before bed, to never exercise or be active at night (or the reverse!), or any other seemingly sound instruction, no rule is gospel. That includes ours!

  Some can drink coffee RIGHT up until the second they lay down without the slightest disturbance. Others require a TV on. Someone else may not be able to even tolerate laying down without having a huge mug of their favorite beverage first. Listen to your needs and know that your body may be more or less sensitive to certain things than others'. No matter what someone else insists the root of your sleep problems is, they might not be right. Only you can know that.

  We provide suggestions based on what we've seen in so very many survivors, ourselves included, but wholly recognize that it won't apply to each and every one of you. Feel free to pass on those that don't! You know you better than we (or anyone else out there) ever could. Try out new things - as you may be surprised by their effectiveness or your ability to adjust to something you thought you'd hate but turned into real help - but, ultimately, do what your body needs.

• Invest in nicer pillows, throw blankets, or comfort items.  Not only do some of these items make your room LOOK nicer and more inviting, they are actually comforting to your physical body and mind together. They make you eager to lay down in your now very-gorgeous, soothing bed. The sense of being able to flop down on pure comfort, or cozy up in the softest, snuggliest of blankets, just automatically makes your body want to relax and let its guard down for the night.

  Don't have much money? Sometimes something as simple as buying some extra stuffing for 3 bucks on Amazon (especially if you have, or want to buy, pillows that zip close) that you can use to fluff your pillows up to your own desired squishiness can make a dramatic difference in the coziness of your bed. Sure beats a flat and sad pillow. ;) Or, just choosing to go in on one velvety soft blanket that all but swallows you up, and is only yours, can bring so much gentle peace.

• Pajamas. In the same spirit, maybe get yourself some nice pajamas or underclothes for sleep -- something you can't wait to get into and that immediately makes you feel ready for bed. Ragged T-shirts and basic cotton bottoms with paint on them can get the job done, but if you're really struggling to sleep, sometimes just taking a little more interest in you and what you wear can be a game-changer. It's also about self-care. Not only do you just feel snuggly in your nice, new PJs, you also feel taken care of.  ...reminded that you are worth the rest you are about to get.

  You are worth more than just that disheveled tee and holey pants you've been wearing for years once they were no longer presentable in public. If you have an impossible time feeling motivated to lay down, a nice new set of PJs can make you a bit more eager to get started just so you can be in those comfy clothes sooner. (As an aside, they don't even have to be ~fancy~ pajamas by any stretch. Sometimes just getting something new is enough. It feels fresh. It feels different. It feels special. Too many of us have been in the same haggard jammies for yeeears. The lifetimes we’ve lived in them can bring reminders of the past, too. A simple item or two can spruce things up a lot and remind you that you deserve to be comfortable. You are worthy of good sleep.)

• Linen sprays or fragrance/oils. If you aren't a fancy schmancy homemaker, you might not have known there even is such a thing as linen sprays! But, boy, are they a thing! There are so many fragrances you can put on your linens that just call to you - inviting you to breathe them in deeply and melt in deeper as you exhale. Isn't that what we all want to feel when we hit the bed for the first time after a long day?

  Find a fragrance that does that for you. The same is true for essential oils or other items that produce fragrance. Whether you believe in the calming properties of various essential oils or not isn’t important, the fragrances alone can just take you to a nice, relaxed state that speaks directly to you and your needs. …while also being a grounding presence that keeps you in the here and now.

• Light a candle a bit before bed that will leave your room with a pleasant aroma.  We don't want you to leave candles lit while you sleep, but sometimes lighting a candle for an hour or so before bed and blowing it out still leaves the room billowing with a fragrance you love. This is not only calming, pleasant, and/or inviting (just like above), it can be really grounding as a strong scent that lingers should you re-wake.

• Consider purchasing a tiny child's stuffed animal or baby blanket - even as an adult.  It may seem silly, but sometimes that younger you who feels so afraid of sleep can feel at ease by these little gestures. You're never too old, too cool, too tough, or too anything for a stuffed animal or small blanket. And, if you have internal parts, this simple "gift" can bring such wonderful comfort to you all.

• Try color breathing before bed or once you lay down.  This is a wonderful way to calm down. Additional breathing techniques, especially those combined with visual imagery, may be equally as helpful if you have one you really like. You can also create your own technique! Yes, you are completely allowed to just make something up. Not every breathing technique has to come from a manual, guide, doctor, or study. Sometimes you just know what settles you best.

• Progressive muscle relaxation. Here is one example, but there are many - some even come with audio recordings to lead you through.

• Healing light/healing pool imagery - especially for pain.  Healing light and healing pool, along with some other similar imagery-based techniques, can be critical skills in relieving physical pain that could be the root of what's keeping you up. You can read about those here. They can also be so satisfying and relaxing for mental distress, upsetting emotions, or just the natural tension we all carry.  

• Consider asking your therapist to make you a voice recording. They aren't hard to do anymore, as just about every smartphone has a record feature that can be easily sent through email (or even text if it's short enough). The recording could be a guided imagery, various grounding statements, or just generalized comforting thoughts to lead you to sleep. Hearing them from your therapist (or a loved one) can offer an added layer of security and calm that many of us can benefit from as we try to rest our eyes.

• Positive reinforcements and gratitudes.  We mentioned something similar in our Nighttime 101 Guide, but that was a bit more specific to journaling practices before bed. This is something you can do in your mind alone. If you are particularly restless, in an anxious or upset place, or just can't stop the recursive self-shaming your mind wants to do as you rethink the day - consider redirecting your thoughts to name 5 positive things about the day. They don't have to be groundbreaking, but they're there. You'll find them even on the worst of days.

  Similarly, you can try thinking of 5 or 10 things you're thankful for - in general or just for that day. Others may want to pick 3-5 things you like about yourself or that you did right/well that day. Challenging other cognitive distortions may be an area someone else needs to focus on today. Whatever you need most, just be sure to flip the script on that rough tone of thought that was finding you and you'll be grateful for how much calmer and sleepier you feel. It may even improve your dream quality.

• Do some light stretching before bed.  Tension is a jerk. It causes pain, increases anxiety, steepens depressive feelings, and just plainly makes us miserable. Some slow stretching can get the day’s excess energy that’s still zinging through your nervous system out — while soothing and calming your body down for the night. It can loosen stiff muscles, un-pinch painful spots, and send fresh blood throughout your whole system so that your body can more effectively heal and repair itself during your period of rest.

• Temperature, pets, and outside influences.  There are so many things outside of our own selves that keep us up but that we also can’t control. So, anything we can do to tend to those things before laying down is a great step. Double-check that the temperature will still be comfortable as night falls, your pets are where they need to be (with you or closed away in their sleeping areas), family members are aware you're trying to turn down, your phone's notifications are silenced, any TV timers are set, you have any extra blankets or socks you may need ready and in reach, your contacts are out, mouthguard is washed, makeup is off, meds are taken, teeth are brushed, etc, etc.

  Double-check all the things that could make you have to get up after you've already snuggled in (or worse, already fallen asleep). No one likes having to get up after they've already experienced that first wonderful sigh climbing into bed. The second time around is never nearly as satisfying, and if you were already asleep, getting back to sleep can be a nightmare on its own. Let’s try to prevent that!

• Wash your sheets frequently.  Simple, simple. Little is more inviting than fresh sheets to make your body feel peaceful and happy when you lay down. Crumbs, dirt, or "stale" sheets aren't exactly the most welcoming invitation for your dreams and sleep. Wash 'em. You'll be glad you did.

• Consider buying a therapeutic pillow or (if you have the finances for it) a new mattress. This is certainly not in the realm of possibilities for everyone - and it's something most of us have all heard plenty of times.  ...but sometimes the solution to poor sleep really does lie within your physical mattress and pillow. Given that so many survivors with complex trauma are also sufferers of chronic pain, a proper mattress and pillow that supports your head and neck sufficiently may be what you truly need.

• Invest in some soft and pliable earbuds or earplugs. For many, any outside noise at all will wake them up, startle them into symptoms, or keep them from sleeping at all. Earplugs can be either a savior or deeply unsettling (if all you hear is yourself breathing in your ears, or your pulse, it’s not exactly helpful for the anxious). But, many headphones aren't comfortable to sleep in. There are a few companies that make super soft and flimsy earbuds that have little-to-no hard plastic or metal inside your ear. Some even have fairly soft connecting pieces, that way when you lay on your side, it doesn’t hurt your ears.

  We know that Samsung makes a few, but there are most assuredly other companies out there, too. This would not only allow you to listen to music/podcasts/recordings/white noise without bothering anyone else (particularly if you have a partner or have to sleep in a more public area for any reason) - but for those really sensitive to outside noise, earbuds ensure that you hear nothing else. The sounds you want to hear just get injected into your ears, filling your whole head with goodness, while the outside worlds gets effectively shut out - leaving you free to get the sleep you need. We know some don't mind sleeping on even the hard earbuds or earplugs (and we recommend giving both a go if you don't mind them!) - but if you can't take the discomfort, spending a little extra money for the softer earbuds might let you sleep through the night, both pain- and distraction-free.

• Look into information regarding blue light or the effect electronics can have on your sleep cycle.  There is now a ton of literature on the way the 'blue light' from our electronics can affect brain activity, but more importantly, how it can alter the cadence of our sleep cycle. There are various ways to turn this off in our devices. If this is something that concerns you, is something you want to learn more about, or is something you just want to learn how to turn off in your personal gadgets, you shouldn't have to google too far before finding what you need. It could make a difference - particularly if you're someone who is more sensitive to it than you knew!

• Get browser extensions, or use the installed features, on your personal devices that disallow using certain apps/websites at certain times.  Ha, yes, they exist out there! Some even come on the device itself now. And there are plenty of them - for both computer and mobile - that are designed to meet your specific needs. These can be extremely helpful in getting you off youtube/social media/gaming websites if you just can't resist or are using them as a distraction to keep you from sleeping.

  Many allow you to set the times you need it run, like an "every day at this time" function, while others require you to turn it on when you need/want it in use - setting a timer for how long until you’re allowed back. Some are even created to ensure that even if you un- and re-install it, the timer will still be in effect until it runs out.  ...so you can't cheat by just getting rid of it! If you find yourself glued to your phone or computer when you should be sleeping (or working!), you may need to look into these extensions and apps that exist to help you out here.

• Better waking up.  If you can wake up easier and more smoothly, you are much more likely to be ready for sleep when bedtime rolls around. If you have trouble with sleeping TOO long, ignoring your alarms, or returning to bed during the day, that will inevitably disrupt your sleep rhythm and leave you wide awake come nighttime. So, to target better waking:

  Set alarms that have music that MAKE you want to get up - invigorating fun music. Something that makes you happy. We don't like the idea of obnoxious, annoying alarms because that just puts you in a bad mood the very moment you open your eyes.  ...or rather, before you've even had a chance to open them yet! That doesn't make anyone want to be awake. Start your day off right with something that makes you happy. Change it often so that happy-fun-new-alarm-you-love doesn't turn into one you hate! No one likes when a good song gets ruined! ;)

  Put your phone across the room so you have to get up to turn it off. Or, incentivize. If you get up and stay up, you get to have x treat. Remind yourself that if you're truly that exhausted by late afternoon, you are allowed take a short nap then.  ...but not until you've given the day your best shot for a good while. You'll be surprised how ready to get up you actually were!

• Just. Get. Started.  The hardest part of any task - absolutely any task whatsoever, including something as seemingly simple as heading to bed - is just getting started. Once you get up and begin your nighttime routine before bed, you'll be baffled by just how ready for sleep you really were. ...no matter how sure you were that you were totally wired and sleep was nowhere in your near future.  Just. get. started.  Once you mentally "turn off" and start heading for the pillow, you'll be consistently impressed almost every time at just how much your body was craving the collapse. ...even though it was only mere seconds ago you were convinced otherwise.

• Give it a shot anyway.  Sufferers of chronic sleep disturbances are no stranger to the losing game of just not being able to sleep, no matter how hard they try. You can do everything right, but still be awake for ages after you lay down. After experiencing this so much over time, we can convince ourselves so confidently each night that "it's just not gonna happen tonight" - because for so much of our lives it really hasn't.

  But this kneejerk response to how we THINK sleep will go can lead that to become our reality as we stay up far longer than necessary and refuse to even entertain the idea of settling down. ...all because "we just know". But our confirmation bias - looking for only the signs that prove we were right - can actually influence what our body believes, and lead it to respond accordingly. We can become the reason we're still up, because we just decided how our body was feeling and it followed suit. And, sad to say, we're often wrong. Had we just given it a shot anyway, we would've actually been fast asleep by now.

  So, what's the worst that happens if you do give it a shot? You get nice and ready for bed and it's a no-go. Oh well. So you get up or do something in bed and try again later. But at least you're now cozier in your PJs and physically ready for bed. Then, the moment you are sleepy, you can just turn down right away instead of having to "wake yourself up" just to go get ready for bed — additionally running the risk of missing that window of opportunity we all know exists. But hey, the other possibility is: you might actually crash. You've been trained your whole life to ignore your body. You'd be amazed (and impressed) by how exhausted and ready for sleep it can actually be without you realizing it. You are very rarely going to regret trying, but you almost always regret waiting too long. ..especially the once you wake the next morning, utterly dragging yourself across the floor!

• Finally, we can't forget about things like journaling, internal communication, grounding, medication, and more (each discussed in our first post)!  The suggestions here may be a bit easier to apply, but the skills there will be relevant and useful throughout your entire life - no matter the home you live in or the path life has taken you. Give those a look-see and don't forget their importance either :)

Some thoughts for those with DID/OSDD systems specifically:

• Put the kiddos to bed first. For survivors with young child parts, the nighttime is often the most difficult. But, they’re also very young. They may be used to going to sleep before the adults, want a bedtime story first, or would benefit from a corrective, safe, and comforting tuck-in. You can try doing this internally with older caretaker parts on the job, in your mind yourself (either earlier in the night or once you lay down), or out in the body through the actions you take just for them. Maybe that’s reading a real children’s book to them first, putting on lullaby music or a movie just for them, or even using soothing items for tiny children just before laying down (like cuddling baby blankets, using a sucker/paci, or snuggling a stuffed animal). Just be sure your most adult self is forward before you truly drift off to sleep! We want to be sure your body and mind stay their safest after giving those kiddos what they need.

• Change the time of internal clocks. For some survivors, there is a specific time of night they routinely find themselves waking up in distress - or, perhaps they just can’t fall asleep at all a certain time has passed. In survivors with histories of organized abuse, they may even have parts with strict rules that tell them to wake up, switch, or perform a task at specific times of the night. If that sounds possible for you, you can always alter the internal clocks instead.

  You can try pushing them ahead or behind an hour. Or, have it slow to a crawl just before that critical time - long enough to allow you a few hours’ rest - and then have it zoom forward to the correct time when it’s time to wake. There will likely be some part inside who is capable of managing this task and they may even feel really important for getting to do so. Get creative! The clock itself hasn’t done anything to you, so it no longer gets to have power over you and your lives. You can control it now :)

• Temporarily reverse day|night shifts. Similarly, for survivors of organized abuse (and even some whose trauma was not systematic), there may be a harsh division between parts who are active during Day versus Night hours. If your system was conditioned to be active or perform jobs in the evening, sleep may feel all but impossible now on a traditional work schedule.

  Internally, there may be dials, levers or other controls that mandate or signify when the switch from Day to Night is to occur. So, it may be possible for someone inside to temporarily switch things to “Day” and let you just “take a nap”. It’s just, y’know, an 8-hour nap ;) Then, when you wake for the day, you can either choose to switch it back to Night and utilize the most wakeful and energized members of your system, or leave it as the real daytime that it is because you’ve found that still works for you all. All you have to know is that you all are in control of the levers today. If doing so will help you rest, that’s the most loving and healthy thing you can do for yourselves.

• Simply say goodnight! You’d be surprised how much a simple acknowledgment and kind gesture of saying ‘goodnight’ to internal parts inside can do! Create a little role call in your mind, add a little g’night message to it, and take that time as you close your eyes for sleep. You may even choose to pop inside, peek your head in their respective rooms, and say it that way quickly, too. But, sometimes a little telegraph in words through the mind is enough! Some validation to feel seen, a little “I didn’t forget about you!”, can make parts feel good—helping them close their eyes, too!

Now it's your turn!

Because so many of these are much simpler options, we’re certain many of you have countless ideas just like 'em! Tell us, and all the other survivors reading, what you do to get some sleep!  What's the one thing you can't get to sleep without, or has made the biggest difference for you in your journey for better rest?

MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101: 101 Self-Care Techniques
  ✧  Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
✧ Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101: Healing Pool and Healing Light
  ✧  DID Myths: Dispelling Common Misconceptions about Dissociative Identity Disorder
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
  ❖  Article Index  ❖

FIND US ON SOCIAL MEDIA:

  ✦  Facebook
  ✦  Instagram
  ✦  Twitter

Nighttime 101: Sleep, Nightmares, Insomnia and More

 

Getting Some Rest as a Complex Trauma Survivor

It’s no secret survivors of trauma often have an incredibly difficult time with sleep. Whether that's due to terrible nightmares, night terrors, or sleep paralysis, having a racing mind that won’t turn off, only feeling safe to sleep during the daytime, or wrestling with any of the other complications that can surround bedtime, we know the time of day most really look forward to can be the one to fill many survivors with dread. We have accumulated, utilized, and witnessed the success of a wide variety of sleep strategies over the years - tools specifically designed to help trauma survivors not only get to sleep, but do so safely and stay asleep more peacefully. In sharing some of them with you, we hope it may even shift your overall approach to sleep and, ultimately, lead to a much more secure, restorative rest. As an added bonus, you can fund reassurance knowing you are not alone, crazy, nor making too big a fuss out of “something so easy” or “basic". It is not easy; there are incredibly valid reasons this is so difficult. Be kind to yourself. And, hopefully, we can help get you some long overdue rest!

We'll be tackling four main areas: Nighttime Routine, Journaling (both before bed and as a tool for nightmares), Internal Parts (for those with DID/OSDD, but also still applicable to most), and Medication. Feel free to take what you need and just leave the rest. Also, be sure to add your own experiences, struggles, and suggestions below! You may find that someone else has the perfect solution for your biggest challenge, or - by sharing your own experiences - you spark a light bulb for someone else and bring clarity to their lifelong sleep battle. So, don’t be shy! Your voice is valuable.

Nighttime Routine

One staple skill for just about anyone to have in their toolbox when they're warring with sleep is: creating a nighttime routine. When you take a series of deliberate, personalized steps about 30-60 minutes before bed - and do so night after night - you send an early signal to your mind and body that you plan to disengage soon. It learns that once you've begun step one, it’s time to start slowing down, settling your heart rate, and preparing to turn off and recharge. As you likely know all too well, most (C/)PTSD minds are extremely hyperaware and vigilant for any sign of distress throughout the day, and some turn on their Expert Level mode once they suspect sleep is on the horizon. So, any early indicators you can give your mind that you plan to disconnect - while also offering reassurance that you’re both taking intentional steps to ensure it's safe to do so and that this is all in your control - can make a dramatic difference in it following suit. ..and doing so in a timely manner.

For many, this routine may start with taking nightly medications - which is a great place to start if you have any that are for sleep. Doing so 30-45 minutes before you aim to rest allows them time to take effect before your eyes are closing. Perhaps there are sitcoms or online videos you like to watch to help you unwind and shift into a lighter place. If this kind of entertainment is an important part of your evening, it’s good to add it to the routine early so that you’ve had a solid 15-30 minutes without electronics before shuteye (longer is even better, but let's start realistic!). This isn’t only a good idea because of the way digital devices keep our minds active and can affect sleep rhythms, but they are notoooorious for sucking us in and getting us to watch one more episode, scroll a little longer, or play just one more game. …or, okay, one more. ;) If you're also dissociative or just really, really avoiding sleep? I don’t think you need us to tell you that it can lead down a tech-hole that's not easy to get out of, robbing the entirety of your designated sleep hours from you. So, enjoy these treats early on, with focused intention and built-in boundaries, then continue on with the rest of your bedtime routine. Get a snack, drink some tea, or enjoy another calming treat. Feed your pets if you have them. Wash your face. Brush your teeth. Take out your contacts. Put on your PJs. Set your clothes out or gather other items that you need for the next day.  Do all the things that you need to be ready for bed while adding in any self-care items you aren’t currently doing that could be helpful to you and your sleep.

Once you’ve climbed into bed, we know this can be the hardest part. Ease into it. Go ahead and plug in your phone, set your alarms for the next day, and turn on any light music or white noise apps that you enjoy. Then, instead of just closing your eyes, you’ll want to take some extra steps that are just for your mind. This is part of the Nighttime Routine, not just what brings you to the physical bed. Whether this is done through journaling (discussed more below!) or mental imagery, do what you can to consciously put the day and alllll its stressors and triggers away. Take some time to acknowledge to yourself where you are, the year, that you are an adult, and that you are safe. Look around and do some self-talk, reminding yourself of all the ways you are secure in your home and in your room, that no one can interrupt your rest in an unsafe way now (even if you easily startle by pets, kids, or partners). If you have parts/alters inside (DID/OSDD), go ahead and take time for them; make sure their needs are met and they are ready for bed as well. (More on this below!) Then, spend a bit more time on pleasing imagery for yourself, whatever that may mean for you: safe place imagery, progressive muscle relaxation, color breathing, or just envisioning a special place you’d like to visit. Hopefully, it shouldn’t be too long before you drift.

While we know there can be other pitfalls to sleep that we’ll discuss in a moment, establishing a routine like this that you try really hard to follow in the same order each night can do wonders for your rest. Setting that rhythm and getting your mind, neurology, and whole body in sync can be the key to achieving - at the very least - a more still and restful state of being. The more you can stick with it, the better the efficacy. And hey, we know life happens. It’s okay if your routine gets interrupted or you forget a step or two. It’s less about absolute perfection and more about the intentionality of taking gradual steps away from high-alert and toward a more settled and calm you. 

Journaling

Journaling to Help with Sleep

One of the best ways to ensure a good night’s sleep is to practice a coping skill called containment - and, one of the most universal mediums for that is journaling. Containment allows you to temporarily “put away” difficult thoughts, feelings, memories, urges, and more by mindfully and consciously giving them a place to go. This way, you can continue on with your day - or in this case, your rest,l - without those things intrusively revisiting you.

Everyone has experienced sleep that was made more difficult by mild stress throughout the day. But, trauma triggers you've encountered, worries and fears you have about the upcoming day, memories you’ve been wrestling with, and all sorts of similarly challenging material can make it a million times harder. Taking a moment to briefly write some of these things down gives your mind a chance to acknowledge and validate how much these things are affecting you.

This is important because it keeps you from “stuffing” (pushing things down or pretending they don’t exist, don't faze you, or are so invalid they shouldn't be there at all). Stuffing nearly always results in those unpleasantries thrusting themselves back into your awareness when you least expect it or are most vulnerable (including in dreams). “Hey! I'm still here! Don’t forget me! Okay, you're ignoring me! No! Meet this need or I won't stop 'til you do!” Validating these things by jotting them down (and just a headline or bulletpoint will do - see below!) tells your mind “I see you, I can't forget you now, and I will come back this.” But, even more importantly, journaling gives it a place to go. The journal gets to hold on to it, and when you shut the book, the hard stuff is contained within its pages - allowing your mind the freedom to concentrate on more pleasant, calming thoughts. No more ruminating, bouncing from one trigger to the next, or ancient anxieties sprung from the grave. Thinking of it in this way and making the conscious effort to believe the difficult items are contained tight within your journal pages - until you want to revisit them (be it the next day, in therapy, or weeks from now) - means you're far less likely to be kept awake or have your dreams disturbed by their content in any form. This skill is especially important if you’ve been having an excess of nightmares/terrors, body memories, or unsettling dreams.

  “How long should I journal?”  “What should I write about?”  “Won’t thinking about all the hard stuff right before I lay down just make me feel WORSE?”  “I’m so tired before bed, I don’t have time for that, I just wanna sleep!”  “I have never journaled before and I’m not a writer.”

Fear not, we’ve got some answers! You don’t need to have ever journaled before to be able to benefit from or be “good” at this skill.  Because the cool thing is, you don’t even need to write full sentences. In fact, many avid journalers can get swept away in their storytelling and get themselves worked up and fully “in it” again. We don’t want that before bed! So, some useful tips include not only setting a time limit for yourself, but consider keeping it a short one. If you want to do longer journaling (which we highly support and recommend!), you can do so any other time of the day! Keeping it simple is as effective and doesn’t get your neurological system all revved up and firing again when we just settled it down via your routine. Try briefly writing a bit about your day, some of what recycles in your mind or is upsetting you, and at least a word or two on how it made you feel. For some, this may literally be just a bulleted list, no sentences at all. If the material is particularly triggering, writing a full sentence about it may take you right back there. An effective tool to prevent that, or if you just don't know how to explain a huge event with brevity, is to give it a headline. What would a newspaper title the full story? You'll know what it means because you were there; you know they story. For other material, it's possible to list what you did or what happened that day through timestamps or a web of emotional experiences. There are countless journaling techniques out there (we will likely even make a post about them one day!), so try to personalize it based on what you know about your mind and heart. Don’t give up if it the first few attempts didn't feel right! Listen to your brain and go where it needs you!

(Note: another common, justifiable, objection to journaling a lot of survivors have is the fear someone will read it. While we love the thought of you getting a journal that feels like a really personal, inviting place to hold all of your experiences for you — there is nothing wrong with or ‘lesser' in just writing via the Notes section of your phone. Then it is always on your person, you can lock entries so no one can find them, and you still help your mind displace some of its recursive thoughts by putting them somewhere outside of your sweet little head. There are also now good “hidden apps" for this on phones and computers you may want to explore, too. We are happy to help you brainstorm if your living situation isn't conducive to safe journaling.)

Final thoughts on this! Ultimately, the purpose of journaling right before bed is to put away the day’s worries and stressors, but some use it for a ‘next step’, too. While we highly recommend following your journaling up with pleasant imagery as you lay down, many incorporate that into their journaling.  They use their 'good thoughts' as a bookend to their writing so it doesn’t feel as if all the “yuck” was just left open-ended on the page. If this appeals to you, you can do so in various ways:
- Further describe a container you'd like to place these specific things in, like a locked chest deep in the sea, flown away on a private jet, a flood of emotions filling up an entire canyon in a remote desert, images projected on to a movie screen that you can leave in the theater, a filing cabinet or bank vault system with an elaborate system of locks, so many possibilities!
- End your entry with 5 to 10 statements that challenge current upsetting beliefs or distorted thoughts. Statements like, “I have worth.” “I am safe and can protect myself.” “Their beliefs about me do not MAKE me those things. I know who I am.” “I am not to blame; they made that decision.” “My needs are important.” “I am not too much.” “I am not responsible for other people's feelings.” .
- Close with: 3 positive things you like about yourself, several grounding statements, 5 good things in the day (no matter how small), and/or 10 things you are grateful for.  There are many positive, uplifting, affirmative, or calming things you can use. 

Choose whatever feels right to you and meets your greatest need in bringing things to a more peaceful, light place. Then, that satisfying thunk shut, locking away all the bad memories and heavy thoughts, can feel that much more successful - nothing bursting at the seams or already clawing to get out - because you pacified all its energy before even picking it up. It's such an excellent closer technique. ..literally!

Journaling to Help with Nightmares

  Journaling isn’t only a great tool to use before you go to sleep, it can also be incredibly useful after you’ve had a nightmare. Some nightmares are just too stubborn and intrusive that all the coping skills in the world beforehand can’t keep them from finding you. But, returning to sleep after one can be positively dreadful, if even possible at all.  Keeping your journal nearby may be all that lends a hand when little else does.

  Similarly to above, this can work as a kind of containment your mind really needs after all that distressing content was pulled to the forefront of your mind. Though you may be exhausted, unintelligible and handwriting illegible, scribbling down a bit of your nightmare can help you ‘get it out’ so you’re less likely to keep replaying it as you try to fall back to sleep. It also allows your journal to “hold it” for you, protect you, by keeping it far away from your mind or sleep. You don’t have to write much detail or elaborate heavily, just hitting the key components that were most distressing to you is what matters most. Just list them, give them a headline, name a few feelings, objects or people, draw something if the words are too hard—any means to get the bulk of the nightmare out of your poor head and onto something inanimate. For good measure, a lot of people like to fold that page of their journal over so they can’t even see it anymore. It gets extra-contained in its layers and thickness; unseeable. Then, you can close the book up tight, set something heavy on top of it if you please, shut it tight in a drawer, and even move to the other side of the bed if you can or feel you need to. …nothing is too silly if it helps you feel it can no longer reach you. Now you're free to think about pleasing scenery or a place you wish to be instead, knowing it is tight and secure where it belongs, and you’re in your safe place heading towards relief via rest.

  As a bonus, jotting these nightmares down can be incredibly useful to later bring to therapy. If you have a particularly recurring dream, there are strong themes in your nightmares that may be trauma-related, or you’re having actual flashbacks in your nightmares, these notes can be extremely valuable when you’re in sessions. Having them written down the moment you woke from them, as authentically and raw as they came, can help you tackle things in a much more nuanced way. This can get you through them more quickly and more accurately, which inevitably leads to better solutions for them all-around. And better sleep far sooner. Nothing could be more relieving than that!

Internal Parts (DID)

  Not all survivors with Complex PTSD have internal parts, as this is more DID-specific, but that doesn’t mean some of these ideas won’t still be helpful for all to at least consider. There are many different aspects of the whole self that can struggle with sleep, aspects of yourself that you may be unaware of or had never considered before.  For those who have DID, we know it can seem so simple or obvious that alters may be the reason your sleep is so disrupted.  But it’s also completely understandable that you might be inclined to look just about everywhere else for what may be to blame before you ever think to look inside.  "Did I have too much caffeine?" "Is this work project getting to be too much?" "Did I stay online too long?" "Maybe I shouldn’t eat that before bed anymore..?"  When there are sooo many things that can keep a person from sleeping, it never hurts to be reminded to stop and consider…hm, maybe someone inside is keeping me up.  While individual alters may be physically responsible for keeping you awake, for trauma survivors without DID, the younger aspects of yourself and traumatized parts of your mind may still need just as much attention and care.  They could very much be the source of your restlessness, too.

  For DID/OSDD systems…. Parts inside might not be intentionally trying to keep your body awake, but that is actually also a possibility, too.  Checking inside to see if someone is afraid to go to bed, has a belief that you need to be more productive or don’t deserve to sleep, or actively wants to punish you for something they feel you did wrong, are all things that could be going on beneath the surface.  Looking to see if any of these types of feelings are what’s at play may lead you to some very surprising answers.  Other possibilities may be much more innocent. Like parts making a bit of a ruckus inside, but not because they wanted to keep the body awake; it was just an accidental byproduct of their distress.  Maybe a small kiddo part really wanted a you to sleep with their favorite stuffed animal or wear your fuzzy socks. Or they needed someone inside to come tuck them in or read them a story before they could rest, which left you wide awake up front.  Other parts may be having an incredibly difficult with nightmares or triggers around bedtime that you weren’t even aware of - and their nervous energy or insomnia even on the inside may be keeping you up. Some insiders may just be ungrounded or unaware that it’s 2017, and extra grounding help before bed may be all they needed to quell their terror and lead them to sleep.  Other struggles may be more challenging to overcome, though, like a part not liking that you have to share the bed with your partner if you have one.  Issues like this may require a lot of talking and compromise before you can all get some shut-eye.  A simple nighttime snack may have been the answer for someone one night, while making sure to double-check the locks on the doors may be a absolute non-negotiable every single night for someone else.  There are countless things different parts could be having a hard time with - some that may relate to sleep and others that might not at all.  But until their needs are heard and met, you will likely be left awake. 

  The good news is that there are often solutions to many of these issues.  Some are quick fixes while others take a lot of work, time, therapy, and/or compromise. But there are usually answers somewhere, if given the proper time and attention.  If you don’t yet have good internal communication, learning what the issue even is may be the harder part for you.  But if you remain open to hearing from your mind, and let everyone know it's safe for them to express their needs or worries, you’ll likely hear (or at least pick up on) something you can work with.  Perhaps making sure all parts have gone to independent safe places before bed is what you will need to do nightly.  If they each have their own room, maybe child parts will need bedtime stories and snugs from maternal, comforting parts inside.  And, sometimes things on the outside are your answer to making parts happy - like special PJs, blankets, a fan being turned on, a favorite movie, or even something more serious like not sleeping in just undies.  The solutions may not always be comfortable to you, and this is where compromise and explaining your needs alongside theirs will be necessary.  But it’s a start.  And a start is often better than nothing if it’s been months since you’ve slept and you’ve tried EVERYTHING. If this is the first time you’ve gotten any insight to what’s keeping you up, it’s worth giving it your best effort. 

  It’s just too easy as we go about our lives to forget about parts inside or even those younger, traumatized parts of ourselves if we don’t have individual alters.  Tending to their needs, fears and worries - or just taking extra time on self-care and grounding for all of you before bed - can do wonders for your mind.  You’ve been through so very very much and your mind is going to wrestle with the idea of turning off for awhile, especially when it's the most vulnerable position you can be in all day.  It’s only natural that you may need to take some extra time, thought and attention toward your health, safety and comfort.  Yes, when you’re absolutely exhausted and just want to rest, this can feel like such a pain.  But I can promise you that it’s well worth it if it actually results in good, restorative sleep in contrast to the restless, angst-ridden wrestling and warring you’re currently doing.  Be kind to yourself, to your body, to young you and teenage you and adult you.  You each have your unique challenges, but you are all one, and that whole person in this singular body needs and deserves a great night’s rest each day of the year.  So, whenever you find yourself just having zero luck catching even a moment of decent sleep, or you're routinely waking up at the same time each night, we urge you to check inside.  See what might be going on for the rest of you that you’re often less aware of during the day.  Whether that is to each individual alter, or the traumatized and still-healing aspects of the singular you, give some thought to what you may need and ways you could tend to those worries or fears.  The worst that happens if you try and it’s not where the problem was?  Well, you just get a little extra self-care and comfort.  Shucks!   ;)

Medication

  Oh, medication — it seems it’s either the most vital necessity or the greatest enemy to complex trauma survivors.  And heck, both can even be true within the same person at different points in their life, orrr even at the same exact time!  When it comes to sleep, there are no ifs, ands, or buts about it — you absolutely must get it and you just cannot keep going if you aren’t getting a good amount.  For many of you, this will require medication at some point in your life, and that is one-hundred percent okay.  Whether the decision to try medication comes after you’ve tried everything else, or is something you jumped for at the first sign of trouble, there is never any shame in asking for, or needing, medication to help you sleep.  We fully support and recommend its assistance to you under the direction of a mental health professional (most preferably one who is familiar with complex trauma, but we know those are hard to find.  We’re working on that!).  That said, we know just as well as many of you know, that sometimes medication can just stop working one day, never really did in the first place, gave you awful side effects, left you with terrible nightmares, or is something parts inside (or even you alone) have intense misgivings about and can’t reliably take each night.  We want you to know that no matter where you fall on this spectrum of the medication journey, we empathize with you completely and are sorry that it has to be so difficult.  Sleep is so important and absolutely vital; we ache for anyone who, even after all their best efforts on their own terms, can't even rely on medication to be a sustainable resource.

  We don’t have any hard and fast answers or guidelines here, but we did want to mention its role in this battle against insomnia and nightmares.  Because, while it may not be a long-term solution, and may include some unpleasant side effects, it may still be the most welcome rescue to your desperate need for sleep. Now, just going to your personal care physician and telling them you’re having an impossible time with sleep maaay lead to them prescribing some pretty heavy duty sleeping pills.  But, we want you to know that not only are these NOT the only options out there, they aren’t always the best option for someone with your specific needs anyway. Talking with a psychiatrist tends to lead to a much more nuanced understanding of what about sleep is so difficult for you.  And this can make all the difference in getting either a medication that just physically sedates you, one that takes down your excessive anxiety so you can fall asleep organically, or even antidepressants that can regulate your body’s natural sleep cycle so that you can turn down when you want and wake when you need.

Another lesser-known but available option is a group of medications that target nightmares more specifically.  These are usually only prescribed by very knowledgable psychiatrists since they tend to affect blood pressure, and nightmares are not the medication’s primary focus.  However, in recent years, they have found that certain medications (such as MiniPress/Prazosin and Catapres/Clonidine), which typically lower blood pressure, have been affective in treating PTSD nightmares.  They do not always work and require very close monitoring of the person’s blood pressure since most who are taking it for PTSD reasons do not need their BP lowered. ...but that will still happen anyway.  However, it’s always helpful to know that some of these options exist out there and could potentially be viable for you.  You will need to talk thoroughly with your physicians to find what is right and safe for you, but just knowing there are various possibilities out there may lead you to the help you deserve.  “Sleeping pills” or the hardcore medications you’ve heard tons of awful things about are not your only option. In fact, they’re pretty rarely used for trauma patients (with exceptions of course).  Whether it’s through benzodiazepines, antidepressants, other psychiatric drugs with sedating side effects, blood pressure medications, or any other class of meds — there are so many ways to tailor your sleep regimen to your specific needs.  There is no one-size-fits-all when it comes to sleep, and that even includes within the same person.  What you needed, or did terribly with, as a teen may be the most unhelpful or perfect solution to you now.

  Of course, we know there will still be a subsection of you who have tried literally every concoction under the sun and there’s just no way to get relief through medicine.  We extend our sincerest sympathies and encourage you to look deep for internal reasons that insist you fight and override every combination of medicines thrown at you.  The mind is an incredibly powerful force and if it doesn’t want to sleep, it can beat even the most powerful of substances.  This could very much be the case for you, and really taking the time to explore why sleep is so forbidden, frightening, or “bad” could eventually unlock the mystery that’s been - quite literally - keeping you up at night.  And, if that doesn’t seem to be a fruitful exploration and you’re still desperate for some Zzz’s, it's never a bad idea to at least consider retrying medications you’ve tried once before.  The body, its chemistry, and your personal needs can change dramatically over time.  What you need now may be completely different than what you’ve been trying at this stage or in the past.  We know just how frustrating this can be and completely understand why you may've thrown your hands in the air already not wanting to try anymore.  But you deserve sleep. You NEED sleep.  We want to see your body and mind get that wonderfully restorative break.

  If you needed a nudge or for someone to tell you that it’s okay to try medication again - or for the first time - this is it.  We’re telling you it’s okay.  It doesn’t have to be forever, you don’t have to rely on them, and you can stop at any time.  But you deserve a chance at peace, comfort and rest.

---

  We truly hope that this has helped some of you in your fight against nightmares or insomnia.  If nothing else, we hope that it’s helped you think about this battle you face every night in a different way, and perhaps it will lead to some looooong, peaceful nights.  Please don’t forget to share your experiences or own personal tips an tricks with us and others below.  We have far too many possibilities to include them all here, so we know that you guys have even more!  And, nothing could be more helpful than a collection of survivors’ stories on how they beat what kept them up for so long and finally got some solid sleep!

MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101: 101 Self-Care Techniques
  ✧  Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
✧ Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101: Healing Pool and Healing Light
  ✧  DID Myths: Dispelling Common Misconceptions about Dissociative Identity Disorder
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
  ❖  Article Index  ❖

FIND US ON SOCIAL MEDIA:

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Grounding 101: Featuring 101 Grounding Techniques!

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WHAT IS GROUNDING?

 

WHY IS IT SO IMPORTANT?

     Grounding is an incredibly important skill for anyone with a posttraumatic or dissociative disorder.  Being present and in the here and now is absolutely paramount to a person's physical and mental wellbeing.  While it may not always be comfortable to be grounded, and can sometimes even be downright agonizing (particularly when one is experiencing intense or upsetting emotions, physical pain, or any unpleasant life circumstance), it is the only way to ensure basic safety as well as prevent additional psychological symptoms.  When we are ungrounded - no matter where on the spectrum of severity - we are immediately more vulnerable to flashbacks; intrusive images, thoughts and sounds; self-harm urges; switching (DID); and many other destabilizing symptoms.  Being ungrounded can also even create the illusion of safety and protection, when in reality it's when we are at our most vulnerable and unable to judge who and what is safe around us.  So, unfortunately, the very skill that protected us the most during our trauma and is what got us through becomes a maladaptive, and at times dangerous, coping mechanism in adulthood.  So, what can you do?  

     For starters, just being able to recognize your personal warning signs of dissociation, as well as where you fall on the spectrum, is a great start.  Once you've been able to label the range of your personal spectrum (maybe from just a little foggy to fully rolodex switching, or from abnormally absent-minded to completely depersonalized), identifying what things look and feel like for you at each stage in the gradient will serve you very well.  Consider making a personal 1-10 scale and describe what a 5 looks like versus a 2, a 7 or a 10.  This will help you be more self-aware when you are actively dissociating, better able to communicate what you're experiencing to others (which gives them a chance to be more helpful), and most importantly, by breaking things down in this way, you can more clearly consider what interventions will be most effective for you.  What you're able to do when things are at a 2 and you're just starting to drift may be completely out of reach when flashbacks are raining down on you and you can't even remember where you are.
     Our list of 101 Techniques here includes interventions that can work at various levels of groundedness (as well as in different locations/scenarios), but they definitely won't be useful at every stage. Additionally, many of these will be incredibly helpful to one person but could even make things worse for another.  Personalization is key when it comes to grounding.  Some activities may also be triggering for one survivor but just the ticket for someone else. (Everyone's triggers and sensitivities are different and that's perfectly okay.  There's no shame or guilt to be had if you just can't try something.  Just keep moving along until you find the next good one for you!)  Take what you can use here and leave the rest.  But also, don't be afraid to try things that don't immediately appeal to you.  You may find that what you thought would never work for you may be the most effective thing you've ever tried!  ..and vice versa!  Trial and error is another key here!

     So, here is our list of 101 Grounding Techniques.  We will likely keep adding to this and make additional new posts as we collect even more.  So, go ahead and bookmark this for when you might be scrambling and in need of some help!  It'll always be here for you. And the BEST part is that you get to add your own and share with other survivors who are in the same place as you.  Leave them a comment here and share your go-to grounding techniques.  Working together and brainstorming through the hard stuff as a collective is how we all heal more effectively, more meaningfully and much more quickly!  So, let's hear 'em!  No tool or technique is too silly or insignificant!

     Here we go!  Let's do dis.

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101 Grounding Techniques

1. Open your eyes! (Sounds simple and obvious, but you’d be amazed how instinctively you close them during symptoms, and just how much more you dissociate with them closed!)

2. Put your feet on the floor. (I know it feels safer and cozier tucked up in a ball or with your legs up on the chair, but pressing your feet firmly into the floor and opening up your body is a grounding must!)

3. Uncover your ears. (Another “duh” one, but for many in flashbacks, it’s instinctive, aaand not something most wanna let go of easily. But holding that position keeps your brain convinced that you’re in danger. Plus! You can’t hear! ;) And you’re gonna want your hearing.)

4. Name 5 things you can see.

5. Name 4 things you hear.

6. Name 3 things you can smell.

7. Touch a variety of textures and fabrics. List them to yourself as you do so. Describe them to yourself. Do you like them? Dislike them?

8. Remind yourself of the date/year. (Or look on your phone to learn it.)

9. Remind yourself of your name, how old you are, where you are, and why you’re there.

10. Take several deep deep breaths. Exhale longer than you inhale.

11. Start separating the past from the present. (Notice all the things that are different from the memories or thoughts that are being so intrusive - i.e. electronics that weren’t around back then, that you’re outside now not inside, that there are people around you that you didn’t know then, that you're an adult, that you live somewhere else, etc etc.)

12. Look at your hands and feet. Notice they’re adult hands. Orient yourself to your body as you watch your fingers move.

13. Disengage from staring off or focusing too intently on one object or area for too long.

14. Stop swaying, rocking, or other rhythmic behaviors that may be trancing you. Yes, we know just how enticing and comforting and mindless this can be, but it may be making things worse. If you’re struggling instead with feeling frozen, try rocking just mildly BUT try not to fall into any sort of “rhythm”.

15. Vocalize. Say something to yourself. Hum. Sing. ..anything to hear and feel your voice in your throat. It also reminds you that you HAVE a voice.

16. Turn on some music. (Try to keep the music current if you’re struggling with flashbacks.)

17. Splash your face with/run your hands under cold water.

18. Chew mint or cinnamon gum. Notice the intense flavor and powerful scent.

19. Suck on mints or sour candies - or anything with a really intense taste and smell. You don’t have to like it, it just needs to get your attention.

20. Repeat a calming mantra to yourself.

21. Color breathing.

22. Internal communication. Remind parts who may be triggered that you’re safe and okay, just upset or experiencing symptoms right now.

23. Name 5 things you can see that are blue.

24. Spot 5 circles you can see in the room/your line of vision.

25. Find all the diamond-shaped items you can see. (This one’s harder!)

26. Find 3 things that are orange. (...or any other rare color.)

27. Call up a friend or safe person to talk to.

28. Sing along with the radio or your iPod. (This is particularly useful in the car.)

29. If you’re driving and starting to drift, grip the steering wheel and notice all of its grooves and edges and seams. (If you’re too dissociated, immediately pull over and start re-grounding while sitting still before driving again.)

30. Crack a window (this is particularly useful in a car, but works at home, too). Feel the wind and notice the new sound by your ears.

31. Trace all the fabrics and seams of furniture or clothing articles within reach. Note to yourself the difference between the cool buttons, rougher denims, soft smooth surfaces, and jagged zippers.

32. If you are lying in bed when it begins, sit up. Laying down can make it much more difficult to ground and your other techniques may less effective.

33. Journal. Write down what’s happening - particularly if it’s upsetting. Fold the page over into the book so you can't see anything you wrote anymore. Seal up and contain the dark stuff there and shut the book tight where it can’t bother you anymore. Then reconvene with other grounding techniques once it's away.

34. Write a note to someone, or even yourself. Feel the pen or pencil graze against the paper and notice the color as it hits the page.

35. Play calming apps or games on your phone or tablet. (If they are trancing, try to play something else or turn the phone off if you can't resist.)

36. Stretch. Open up your body so wide and press your feet firmly into the ground. Orient yourself to your body from the top of your head to the tip of your toes.

37. Dance. If you have the room to do so, do a silly dance or a even a serious one. Notice as you regain your balance and coordination from when you started.

38. Try some brain puzzles like Sudoko, word searches, or game apps with puzzles that require problem-solving.

39. Send text messages or write yourself a note on your phone. Feel your fingers tapping the glass as you type and try hitting all the right letters. Notice any of the haptic feedback with each long press or short tap.

40. Pet a kitty or dog or other animal that may be around.

41. Take your dog (or cat ;) ) for a walk.

42. Change scenery. If you’re in the living room, go to the kitchen. If you’re in the bathroom, head to the dining room. If you’re in the bedroom, walk outside. If you’re outside, go somewhere new. A change of scenery can do a lot, even if you don’t know why the first place was causing you so much grief.

43. Watch some funny videos on YouTube. (Maybe even make yourself a playlist of good laughs for when you’ll need them.)

44. Put on hand lotions or antibacterial gels that have a strong fragrance. Are they cool or warm? Thin or thick? Soft or stinging?

45. Paint your nails. Notice the intense scent and vibrant color. Guys can do this too!

46. Take your current nail polish off if you have any on. Notice the pungency of the acetone. (Please don’t do this if you’re extra ungrounded. Your skin and potential furniture items will not appreciate an accident.)

47. Feed your pets if you have them.

48. Eat something - you may be very hungry. Notice all the different flavors and textures and scents. Perhaps choose something with a lot of flavor.

49. Get a cold, cold glass of water. Feel the coldness in your throat and against your hand. Notice the slippery condensation on the glass with your fingers.

50. Drink coffee - even if you don’t like it. Though, be careful about making it too hot. That can be hard to judge if you’re too ungrounded.

51. Take a bath or shower if that isn’t triggering or an OCD behavior for you. Notice the water pressure and temperature. Smell each individual product before using it. If the shower itself is what’s making you ungrounded but you must take one, narrate to yourself the steps you're taking - almost as if you were hosting a YouTube tutorial. Name the products you're using and even describe to yourself why you like/use them. (Also, bringing music that REALLY pumps you up can really help you stay grounded if you're struggling with showers.)

52. Play a guitar or piano, or other instrument (if that’s something you can do). Heck, play them even if you have no idea what you're doing! Listen to all the crazy notes you can make. Feel the strings or keys and all the various textures against your fingertips.

53. Reality-test with a friend. If you aren’t sure if something you’re feeling, seeing, hearing or thinking is real, ask a safe friend to help you decide what is fact from fiction, flashback from present, old trauma messages or your current situation.

54. Check inside to see if parts need something and/or if they are keeping you ungrounded on purpose or just to get your attention (DID-specific). Try to meet their needs if they reveal them to you and if they are reasonable. Engage in more elaborate internal communication if not.

55. Watch a cartoon or kids movie - particularly if you have younger parts inside who need the comfort. Do this even if you don’t have parts. You probably still need it, too. ;)

56. Snuggle up with a suuuuper soft and snuggly blanket or robe. Feel how incredibly warm or soft it is. Notice its threading and colors. What does it smell like?

57. If you’re outside, slip off your shoes and press your toes into the ground. Is it cool or warm? Jagged or soft? Squishy or muddy? Pavement or macadam? Grass or dirt?

58. Jump up and down or bounce on the balls of your feet. Feel your shoulders and arms flop and flounce about.

59. Change all the notification bells on your cell phone. Each time they make a new noise that you aren’t used to, you’ll be startled back to awareness.

60. Take any medications you may have missed. Use your PRN’s if necessary; take pain or anxiety medications if that is what is causing your dissociation.

61. If you are in a car (passenger or driver), adjust the seat into a different position - even one that’s just slightly uncomfortable. Stretch your legs out far and lift your head up tall. Wiggle about. If you’re a passenger, look around the inside of the car instead of out the window for a bit. Then switch. (..your gaze, not parts ;) )

62. If you are the driver, keep your eyes peeled for green cars. Notice every license plate with a B in it. If it’s a particularly long drive, play the alphabet game (but not to the point of real distraction. We want safer driving here, not less!)

63. Use your imagery techniques - particularly for pain or intense emotions. Dial them down to a manageable level. Set a 15 minute timer to check back in and observe what level they're at now. It’s okay if they're "worse". The goal is just to be aware of where they are at, not necessarily improving or changing them (unless you want to).

64. List or write down your feelings in that moment. Describe them in extreme detail. If they were a color, what would they be? If they were a weather condition, which would you see? A temperature? A texture? Loud or quiet? Animate or inanimate? Soft or sharp?

65. Make some mint or other herbal tea. Inhale the scent deep into your lungs. Sip it before putting anything in it. Is it bitter? Then fix it how you like it. What were the differences?

66. Do some jumping jacks or just a few sit-ups or push-ups. (You can also workout for longer too, but it's not necessary.) Get the blood flowing. Jog in place. Shake it off like T Swifty and feel the blood as it rushes through you and your limbs buzz as you re-awaken and re-enter your body.

67. Read a book or a magazine.

68. Listen to an audiobook or your favorite podcast. Or, find a podcast you’ve never listened to before and give it a try.

69. Watch something on Netflix or Hulu. Keep it upbeat and current. If you know the oldies-but-goodies are safe for you and won’t disorient you, relish in those re-runs!

70. Do something goofy - particularly if you are in NO mood for nonsense. Pat your head and rub your tummy. Try to say ridiculous tongue-twisters. You’ll end up cracking up (or being so annoyed!) that you’ll still be way more grounded than you were moments ago. If you're extra grumpy, use that cynicism for a "Try Not to Laugh Challenge" online. The worst that happens is you get some chuckles. Or puppies.

71. Put in your earbuds and go for a run or a long walk. Get away from where you are and notice allllll the sensory changes outside. Narrate to yourself all that you see and feel and how it's different from where you were.

72. Progressive muscle relaxation. (There are great guided imageries and how-to steps for this online. This can be really incredibly useful for many, but can be trancing for others at first. Do what works for you!)

73. Go down the alphabet and list girls’ names for each letter. Then boys’ names. Then unisex. Or try to come up with silly pet’s names for each letter instead. How creative can you get?

74. Try counting by 3’s or 7’s. Try to get to 200. Then try multiplying by them.

75. Look out a window or up at the sky. What color is it? What shade name would you call it? Are there clouds or none? Are there stars or no? Can you see the moon from where you are? What about the sun? Any planes out there?

76. Use safe place imagery if you are having no luck orienting with your present surroundings. Mentally retreat to your safe place in as explicit of detail possible. When you’re feeling calmer, slowly start orienting yourself back to your current surroundings. Start back at the beginning of this list and come back into the room, into the present, and into your body.

77. Step away from social media or scrolling on your phone. This can be incredibly trancing for some without realizing it. Sit your phone across the room and spend at least 30 minutes doing something entirely different.

78. Color in an adult coloring book or doodle. Make silly crafts or fingerpaint if you have kid parts that need some attention. Do it even if you don't have parts.

79. Go swimming if it’s an option or isn’t a triggering experience for you. Notice the water and its temperature. Notice how you can both float and sink. Recreate this in a bathtub if you don’t have a pool ;)

80. Wash your face or brush your teeth. Do a face mask or use some other self-care toiletries to freshen up. Notice all the smells and textures. Notice how they feel on your skin and how refreshed and alert you feel.

81. Tap the sides of your kneecaps. Or, cross your arms, making an X on your chest, and tap your collarbones with your fingertips. Give your body some new neural feedback and stimulation to take in. Notice how it feels both weird and rhythmically calming at the same time. Observe your level of anxiety as you do - how does it change?

82. Do yoga or tai chi if you’re familiar with either and find those to be useful to you. Make it up as you go even if you don't actually know what you're doing ;)

83. Play a sport that you enjoy (or heck, even something you’re bad at! It certainly requires more effort that way!). Shoot some hoops, pepper with a volleyball, kick around a soccer ball. Or, just make up your own new game!

84. Organize a desk drawer or closet shelf. Clean your makeup or artist brushes that you’ve probably neglected for quite awhile. Clean your sneakers or something else you’ve been needing to do but keep forgetting.

85. Vacuum a room or do the dishes. Feel the vibrations and sweeping motions of the vacuum …or the temperature of the water and scent of the soap if you’re washing dishes. (If these cleaning/organizational things will trigger OCD tendencies you may have, maybe skip these and try the OTHER hundred techniques! Or, y'know, just make everything SUPER messy instead. :) )

86. Take some ice in your hands or place it in a baggie and hold it for a little while. (Make sure you’re at least grounded enough to know if it’s too extreme of a cold. We don't want you to damage your skin.)

87. Take some pictures on your phone or with a digital camera. Play with filters or photo editing apps/software that you’d never normally pick. What cool things can you make?

88. Watch a documentary on YouTube or Netflix. Find a subject that either completely fascinates you or even one you know very little about. What new things can you learn?.

89. If you’re struggling with grounding after nightmares, scribble down the nightmare in a journal - just the surface of what it was about. Then fold the page over or up real tight into the journal (or even tear it out completely). Know that it is contained in there and it’s not coming out again. Then remind yourself of the date, where you are, how old you are, and that it was just a nightmare. Then try to do some pleasing, safe-place imagery type visualizations before laying your body back down for some rest.

90. Light some candles. Notice the glow and the flicker. What do they smell like? Can you feel the warmth coming off of them? (If you are REALLY struggling with grounding, please please please don’t do this one. We don’t ever want you to catch anything on fire. But if you’re just loosely struggling or feeling a little fuzzy, this a great option.)

91. If you’re struggling with derealism, start naming all the things you know to be inarguably true. You know what name is on your birth certificate. ..how old you are now. ..where you live. ..where you are standing. ..that it is either day or night. ..that you are either alone or in the company of people. Continue on until you feel yourself becoming more rooted in reality. Then you can start challenging the things you weren’t really quite so sure about. (You may need a friend to help you and that’s okay. If you're a Hunger Games fan, you can think of it as the Real or Not Real game with a loved one or parts inside.)

92. Squeeze or massage your muscles. If this isn’t triggering to you, deeply dig into the muscles in your shoulders and down your arms. Move your thighs and calves around until you feel all that fresh blood finding them. Notice all the new and interesting sensations you feel now that you weren’t feeling before.

93. If you are frozen still, just start with very small movements. Start with just wiggling and scrunching your toes. Then try rolling your ankles. Now wiggle your fingers or tap them on a surface. Roll your wrists. Slowly work up to bending your knees and elbows. Hips and shoulders. Roll your neck. Open your mouth and stretch your jaw. Feel all the parts of your body slowly come back to life. All it takes is a small start, don't worry about the rest until you're there.

94. Take a nap or get ready for bed. You may just be so overtired that you’ll never be fully grounded until you get some rest.

95. Fold laundry or do some other similar busywork that requires a good bit of motion but also gives you something like scent and texture to work with, too. (Who wants to be fully grounded for doing laundry anywayyyy ;) )

96. Drink a carbonated beverage. Notice all the fizzies in your nose and down your throat.

97. Disengage from anything that’s too overstimulating. You may have too MANY things going on at once. Turn down a TV or stop music that might be playing. Leave crowded or busy rooms. Keep yourself engaged with your surroundings but also disengage from too MUCH sensory input.

98. Keep a grounding stone or similar item in your pocket when you’re out and about. Run your fingers over the stone, contort a Tangle into different shapes, or notice all the notches in your car keys. Find an item like this that works well for you!

99. Keep a 3x5 card attached to your sun visor in the car, or in your wallet, that clearly and boldly states what year it is, how old you are, where you live, that you are safe now, and a mantra that you may find to be soothing. Personalize it for you and your specific triggers or points of confusion - things you know you get hung up on. That way it can remind you when you aren't able to remind yourself.

100. Do the same with bathroom mirrors, nightstands, bedroom walls or any other place that you know you commonly struggle. You can make them either discrete or super bold depending on your living situation or understanding of those around you. Referring to these can save you a ton of mental energy when you find yourself in a sudden and intense spell of dissociation and can't even remember what you're supposed to do or think or what coping skills even are.

101. LAUGH. However you can, by whatever means, try to do something that makes you laugh. It’s one of the most fail-proof ways to get more grounded (even for those whose default coping mechanism is humor and avoidance. Laughing wholly and authentically with your body can still make you more present than you were.) One fail-proof way? Try to LAUGH WITHOUT SMILING. ….you’ll soon be dying over the sound that just escaped your mouth and the ridiculous face you just made trying. You won’t be able keep from bursting into real laughter! And, if you don't believe us or are too proud to give it a try, at least enjoy this video for a laugh. Good luck! “Hurr huh hurrrrr.”

MORE POSTS YOU MAY FIND HELPFUL:

  ✧  Grounding 101: 101 Grounding Techniques
  ✧  Distraction 101: 101 Distraction Tools
  ✧  Self-Care 101: 101 Self-Care Techniques
  ✧  Nighttime 101 and Nighttime 201: Sleep Strategies for Complex PTSD
✧ Color Breathing 101: How to Calm Overwhelming Emotions and Physical Pain
  ✧  Imagery 101: Healing Pool and Healing Light
  ✧  DID Myths: Dispelling Common Misconceptions about Dissociative Identity Disorder
  ✧  Did You Know?: 8 Things We Should All Know about C-PTSD and DID
  ✧  Trauma and Attachment: 3-Part Series on Attachment Theory with Jade Miller
 
  ❖  Article Index  ❖

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