grounded to grounding

Patients often become overwhelmed in the telling of traumatic stories. The therapist’s intention to form a semblance of secure containment early in the process of transformation will support the patient’s decision to be vulnerable. When the traumatic, biochemical material surfaces and becomes conscious, it’s imperative that the therapist step in to support the patient in developing an adaptive regulatory response. First, helping the patient find their breath and bring it under control, the therapist guides them back to observing the physiological sensations and mental content associated with the emotion. Again, when it appears too distressing for the patient to clearly articulate their observations, the therapist helps them return to a grounded state by softly stating, “Place your feet flat on the ground and control your breathing.”

It’s often rushed, then covered for extended periods due to innate defenses…

Patients prone to externalizing emotion will become visibly dysregulated when accessing traumatic material. Those on the other end of the spectrum, who suffer from internalized, repressed psychological trauma, will often complain of dissociated somatic symptoms, such as “knots” in their stomach. Simply put, the grounding procedure is repeated, over and over, throughout the duration of the therapy term, whether the trauma surfaces consciously or unconsciously. It often takes many months, if not longer, to properly install this down-regulating capacity in the nervous system (Cloitre et al., 2012; Ogden et al., 2022; van der Kolk, 2014).

It’s when a state of psychic balance is achieved, and the patient is flexibly stable, adaptively attuned both sympathetically and parasympathetically, that the unprocessed traumatic material will be properly integrated and the patient will be wholly transformed (Siegel, 2012; Porges, 2011; Lane et al., 2015).