With exercises for getting out of chronic dissociation the way the exercise is done is vastly more important than the action in itself. We will first look at the position of the Engaged Explorer, explain how to do titration and revisit the trinity of regulation for a solid foundation. Only then can we approach the kind of exercise that will help to grow capacity.
The Engaged Explorer
The instructions for mindfulness usually include becoming a Distant Observer of our experiences. That makes a lot of sense for people who experience too much. When we live in chronic dissociation we are used to observing from a distance, we have taken the idea too far, into the realm of at least mild structural dissociation. We separated observing and experiencing within our system. That is why becoming mindful needs a different approach for us. We need to get closer to the feeling, reduce the desidentification and return to being our bodies.
To get there we are using the curious stance of an engaged explorer:
- Exploration: We pretend to be scientists. It means that we do experiments and then we notice what happens. We are probably getting into experiences we’ve never had before and there is a lot to explore. We will be right in the middle of it, this is not the time for distance.
- Engagement: The object of our experiments is Us. We are actively trying to cause a reaction and we intentionally engage in what comes up and stay with it the best we can until we have to disengage to avoid overwhelming ourselves. This is not the time for passivity.
- Felt Sense: we can try to describe our experiences but it is more important to actually feel them and hold that feeling in our body for a while to get more familiar with it and experience the natural flow. This is not the time for neutrality
- Reaction: We don’t just blindly do things that harm us but we can explore our impulses and intentionally follow them if they seem helpful and then stay engaged to see what happens next. This is not the time for holding still.
- Curiosity: when we are curious we are less afraid and it is easier to regulate ourselves when unexpected things happen. Curiosity protects us from getting overwhelmed. This is not the time for equanimity.
We are practicing mindfulness, just in a slightly different way. We are still using guided awareness but we focus it on experiencing as much as we can without getting overwhelmed. To support ourselves we use curious self-talk. We might tell ourselves:
- “Interesting! I don’t think I ever felt that before.“
- “Oh this is new! I wonder what will happen next“
- “I am not sure what this is but I wonder what it is trying to tell me“
- “Oh look, it changed, I wonder if it will keep changing if I keep paying attention“
- ….
Titration
Titration is the art of taking small steps. With chronic dissociation we probably had bad experiences with mindfulness in the past. We tried. The things that came up where overwhelming and we ended up in a crisis situation. Increasing awareness is not bad in itself, but the exercises we used were too big too fast, the cauldron boiled over. Baby steps keep us from getting overwhelmed.
When we do exercises for getting out of chronic dissociation we only do them for a short time, just enough to get in contact with ourselves and the present. Then we stop. We can distract ourselves and try again a couple of minutes later. The practice can take only a second at first before we disengage again. When we feel new sensations happening, we notice it and then we stop. After a while the sensations might not be so new anymore and we can stay engaged a bit longer, maybe one exhale.
We don’t even attempt to get a full-body experience here. Instead, we will focus on one area only and try to sense that. Over time we can practice sensing several areas and then connect them, but that is not where we start.
As we develop tolerance for being present we will experience our body regulating. Remember all the natural sensations regulation adds to our experience. When we stay connected to our body through this, we allow it to have the little waves of regulation that will eventually bring relaxation. We practice in tiny steps and extend our practice as the tolerance grows. We will get there. It will take a couple of months of practice though. Titration is gentle. While it can be challenging, it won’t be hell.
We are not trying to learn how to regulate here. The body will regulate automatically. We are carefully integrating an experience that we dissociated, building connections to a part of our being that we had to abandon in the past to survive.
The ‘trinity’ of regulation
Whenever we work with regulation our basics are 1) safety 2) orientation and 3) grounding.
Safety
Examine your life. If you are not in a safe situation (living with abusive people, depending on those people, abuse still occurring, extreme life situations like homelessness, extreme poverty, violence, getting forced to do things etc) you still need your chronic dissociation. It is serving you well. There is healthy dissociation that protects us from being aware of too much. In that case, find help first. Getting out of dissociation is not the priority.
When our life is relatively safe we turn to the room we are practicing in. That too should feel safe. Look around to adjust lighting, open or close the door, maybe lock it, pay attention to the sounds and if they are stressful you can find a way to drown them out, remove items that make you feel uncomfortable etc. Then add whatever you need to make it feel safer.
Orientation
Now that the room is safe we can look around and get oriented in that room, perceiving the safety. It doesn’t need special exercises that focus on details or every sense. Sometimes it is actually best to just let our gaze drift from one side to the other and back, taking in the full picture of the surrounding space. This might be supported by telling ourselves where we are. This is what we will return to whenever we had a little experience of being present with our body. It helps to regulate and not get overwhelmed. We should get really good at orienting, it is a key competence that will help us throughout our day. People who live in a chronic fog with almost no awareness of their surroundings might experience their first uncomfortable feelings here. In that case orientation needs to be titrated too and practiced before moving on to working with the body.
Grounding
For grounding we need awareness of our body and then awareness of our body being in the space where we oriented. This is what we are trying to learn. We chose to sense a small part of our body with awareness and then connect it to the space it is presently in. We are creating a tiny experience of a part of us being in a place that we have recognized as safe.This is at the core of every exercise that will help us to get out of chronic dissociation. It is actually what Ts mean when they speak of grounding.
When we practice being present we create safety and orient. Then we try grounding in a titrated way from the position of the engaged explorer, using curious self-talk. We take conscious actions and when we had enough we can consciously return to orientation to make sure that we know it is still safe. There is no pressure to perform anything. We can distract ourselves any time we need to, we just do it consciously, understanding why we need it now.
We personally try to practice for 1 minute 3x/day, engaging and disengaging as needed during that minute. It is more than enough. Doing it once a day for just a few moments would already make a difference. Not every day is good for practicing a lot. The idea is to get to know our body, that includes recognizing when it is not a good time to practice because we’ve had enough on our plate that day.
Please be aware that practicing body awareness will lead to more moments of body awareness, even when we are not practicing intentionally. It is like starting to pull a loose thread, the dissociation will come undone like a sweater. Make sure that this is the focus of your therapy and that you don’t start working on this in an unstable situation. You will lose some stability while doing this. It will be back and better than before, but this is serious work.
Exercises
Without the concepts mentioned above the exercises won’t help much. It is more important to get them right than to stick to a suggested exercise.
We start with body parts with a low potential to trigger. If reading an exercise shows you that it will be like something you experienced during TraumaTime, use a different exercise or change it as you like. It is ok to make things up. Someone made these exercises up.
Take off your shoes, then sit down and make yourself comfortable. Notice your feet on the floor. Can you feel what kind of surface it is made of? When you move your feet around a little, what does that feel like? Can you feel how solid the floor is? How does it feel when you try to push it downwards with your feet? Does the floor move? How do your feet feel when you stop putting pressure on them?
When you are able to feel your feet well without being stressed, look at the room and figure out where your feet are in the room. Try to take in the whole scene and where your feet are in relation to the room and feel it. Hold this awareness for a moment.
If this is available for you, take one foot into your hands. Explore all the parts of your foot, from the toes to the heel and back, with your fingers, gently massaging it. Try to sense what the foot feels like when you do this. If that is easier for you, use a massage ball. When you’ve had enough, put the foot down again and notice how it feels. Then try to sense your other foot and compare how that one feels. Repeat with your other foot. Then try to sense where your feet are in relation to the room.
Take a chair and place it opposite a wall or door. Sit down and lift your legs so the shins are pressing again the wall or door. Try to sense the pressure on your shins. What areas are in touch with the surface? Where are the place that don’t have any contact? What does the surface feel like? Can you feel your clothes on your shins? Then turn your attention to your back that is pressed against the chair. Try to sense the pressure there. Where on your back to you feel supported? Where does the chair end? What does the surface of the chair feel like on your back?
Now try to feel where your shins are in relation to the room. Take that awareness in for a moment. Then try to feel where your back is in relation to the room. Let that sink in for a moment.
Yoga poses like we learn them in trauma-sensitive yoga can be used in a titrated way for this too. Instead of creating a full body experience we only pay attention to single body parts or muscles groups though.
Sit on the floor and put the soles of your feet together for cobblers pose. Sit upright and try to sense one foot touching the other, and the other way round. Rub the soles of your feet together and notice what that feels like. You can take your hands and massage your feet a little, rounding through the shoulders. Notice what that feels like. Cup your feet with your hands and hold them like they are precious. Where are you touching the floor? Maybe you can notice a small stretch in your neck and upper back when you bow down. Pay attention to that for a moment.
Then try to feel the location of your hands cupping your feet within the room. Stay with this awareness for a moment.
Lay down on your back, you can rest your arms at your sides or stretch them out for Savasana. Try to feel where your back touches the floor/carpet, mat. Notice all the areas that have contact with the surface and how that feels. Then notice where your hands are, how they are placed. Try changing the position, with palms up, to the side and down. Choose what feels most comfortable today and pay attention to what that feels like.
Now shift your awareness to take in the safe room around you and notice where your back and your hands are in relation to the room. Hold that awareness for a moment.
Take one hand and use it to touch your other hand. Touch or massage every single finger and tell yourself out loud what finger that is. Notice what that feels like, first in the hand that is touched, then in the hand that is touching. Is one easier to sense than the other? Touch or massage your palm and thumb and tell yourself out loud that this is your palm and your thumb. Try to be aware of your whole hand at once. Then move to our wrist, touch it gently in a way that is comfortable for you and tell yourself that this is your wrist. See if you can feel where it is in relation to your hand. Then move to your elbow, touch it any way that feels comfortable to you, explore it with your fingers and try to feel your elbow being touched. Then notice your hand and your wrist and your elbow and where they all are in relation to each other. Massage your forearm if you struggle to make a connection between the points and notice if that makes a difference. If you are up for it, touch your shoulder, rub it, massage it and explore what it feels like. Notice how the shoulder feels being touched. Then try to be aware of your hand, your wrist, your elbow and your shoulder and where they all are in relation to each other. Hold awareness for your arm for a moment.
Then try to make out where your arm is within the room and let that sink in.
We can do the same thing with our legs. It is more common to experience discomfort or memories coming up when we re-connect with our legs. Then we return to orientation within the room to make sure that we know that we are safe now. Only go as far as you can manage without getting overwhelmed. The exercise is done properly when we stop before it gets too much, not when we finish all the steps.
Make up your own exercises. That way you can practice whenever you have time for it. You can include objects or sensory experiences to help you feel yourself. Don’t practice alone when you try to feel body parts that are potentially more triggering. Follow the basic idea of awareness for the body and then combine it with awareness for the safe space you are in. Don’t forget to swing back to orientation to give yourself a break when you need it. Consciously distract yourself when it is getting too much. Don’t rush anything, titration is key.
It is extremely valuable to just sit, feel the chair, where it supports the back and where we are sitting on it. That includes more awareness for our hips and butt. This is stuff you might want to try a little later, once you have more capacity to feel other areas of your body without problems. Sensing the breath is of similar difficulty for many and should also be tried later in the process.
Eventually we can move on to body scans and sensing our whole body in the room.
If you are in a clinic and mindfulness is part of the therapy program I would encourage you to take part but only tune in for a few moments during the exercise, then move to orientation, then engage for another moment, and so forth. There is no need to skip the class altogether if you can titrate the experience for yourself. Ts should invite patients who struggle with chronic dissociation to do just that.
Creating awareness for our body also creates awareness for the body sensations of regulation and emotion and tension or pain. From there we will start to feel needs again. It is a process, but reconnecting with the body brings those dissociated areas of us back online. It can also increase awareness for our inner experience of having dissociated parts and gives us the opportunity to help these parts to get oriented in time and space.
Being alive doesn’t always feel good. Some of it does, but some of it doesn’t. We can’t have one without the other and we can learn to manage the negative feelings. We probably can’t process trauma unless we are connected to ourselves though. That is why this is important and should not be skipped.
I hope this gives you an idea how to approach getting out of chronic dissociation. Be careful and work with a T if you can. This is serious business, even if it sounds so simple. Becoming present is a huge step.
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