A lot of Mental Health Crisis management has a strong focus on moving, seeing, and hearing etc. Which is excellent. It means people have acknowledged that telling someone to “calm down” is not an adequate intervention when someone is so dissociated that “down” and “up” are irrelevant. Navigating disability at the same time is an extremely difficult task. Few resources advise on how specifically to gain the benefits of grounding when you have a disability. We need something that reassures us that we can engage fully in Grounding techniques without added stress or discomfort. To put it bluntly, what use is finding FIVE things you see around you, FOUR things you can touch, THREE things you hear, TWO things you can smell, ONE thing you can taste if you cannot readily access those senses or the environment that would provide the opportunity. In this blog, we outline some specific techniques which can provide grounding and stability when feelings of stress and overwhelm threaten to consume us—all while keeping disability in mind!
Plant Your Self
When you're rapidly dissociating, it is important to find that centre of personal psychological gravity.
If you have weakness or paralysis in your lower body, or perhaps you flat black-out if you put too much physical energy into your lower half (thank-you, Hypotension!). It's not always possible to extend focus and pressure to your legs and feet!
Find a surface (this is the easy part because you have your knees at your disposal). Starting from your wrists, roll through your palm and then place each of your fingers down one by one and press into them as hard as you can without using your back or shoulders to add any excess weight. There should be a bit of a bend to your elbow and your spine should be as stacked as you are capable it so you are using your core and rooting down to the ground through your bottom or your back depending on your position.
Imagine you are pushing your hands and body away from the surface rather than pushing the surface away from you. It’s important to note that you don’t necessarily have to be upright or have movement in your upper body to complete this task either. This is about making a specific point of the body all of your focus and breathing pressure into it. So you can focus on your buttocks pressing into the chair, your hands resting against your belly, your head pushing backwards into a firm cushion. Let the piece of your body take root with purpose, intention and, most importantly, your breath.
Smuggle A Tomato
Becoming aware of where your neck, throat, shoulders and chin are can bring your focus to the essential mechanisms that sustain breathing, therefore, that frustrating thing called life. Commonly this is demonstrated by supple, suffering swans that could fit an entire fruit cart under their jaw. I don’t know about you but I can’t always move my neck that way or maintain the upright position necessary to accommodate a crop of honeydew. Good thing this technique is not about who’s melons are the biggest, it is about engaging the muscles and processes that you are using the facilitate panic and focusing them on facilitating concerted movement outside of your emotional state.
Whatever the fruit shortage is like where you are, or your physical abilities, you can imagine a blueberry, a lime, a dragon fruit, and visualise proudly displaying it using only your chin and chest and breath deep, that’s how everyone can have the best look at that produce. Head proud, shoulders back, neck long and not crunching behind. Once you’ve let everyone get a good gaze at your covert coconut (or whatever) bring the chin down, round the shoulders and gently hide it; don’t try to press your chin into your chest. What was once your grandest treasure must now be smuggled across a state-border! Hold it for another breath then show it off again to all the other fruit-pirates on the other side. Don’t worry if you can or can’t fit the Cai Mi Market beside your oesophagus. Again, this is about making a concerted effort to ease out of panic.
Anxiety and panic cause a sense of restriction and compression around the chest, back and upper-body. A gross, full upper-body movement can ease that feeling of encroaching doom. While a good ol’ stretch can be a release, what we’re looking for here is a measured, concerted movement that provides a sense of comfort and strength as well as relief.
Take a towel, an item of clothing, your walking aid, and hold it with both hands, shoulder width apart, close your chest. Really focus on using only your grip to rip that item apart, forcing your hands away from each other. Push into your hands so you’re pushing it away from your chest until your arms are as straight as you can manage in front of you without locking your elbows; you should feel a little shaking but not pain. Then slow as your panic will allow breathe in while you raise that cane, t-shirt, non-descript long object in front of you as though you’re going to bring it over your head and behind you. Follow that object with your nose with the intense focus of a truffle pig. Breath out when you reach your truffle- I mean limit and breathe deeply in and then out to lower everything back down again, pulling your arms and hands back to your chest. Then do it again. Reminder, no one expects a circus act here; there is no pressure to have fully straight arms or to lift them all the way above your head. Keeping that controlled and measured tension between your hands, your back, your shoulders activates the parasympathetic nerves enabling you to calm-tf-down.
This will always be my go-to when someone calls me in crisis before, during, or after a panic attack.
I need you to breathe. And usually I get told to f*ck off. To which my response is I promise I will after you take one single deep breath with me.
The increase in oxygen during a panic attack dysregulates EVERYTHING in the body making you hot, sticky and stressed. It increases pain and, therefore, adrenalin, making the cycle repeat until exhaustion sets in which is why the panic attack physically burns out. A burn-out is one solution. But it then means that you’re too exhausted for ANYTHING including managing the psychological factors that caused it in the first place. While a panic attack will absolutely pass, it can be a relief to feel some-what in control while it does. Draw focus on your chest. Depending on your mobility, you can do this sitting, standing, lying down and concentrate on what you have; if you’re wearing a graphic t-shirt, brilliant. Your nearest squish-mallow, great! Your hand, perfect! Put to your chest and try to make it move using only your breath as slowly as you can. In through the nose, out through the mouth. Skip holding the breath or counting unless you’re able, the aim here it to take longer to exhale than you take to inhale. You are absolutely aiming to capture your own type of heaving bosom; Sternly sternum into that sniff, Breast boobily into that breath. Yes, it absolutely will feel like you’re trying to push a concrete block through a swimming pool of honey but we’re not looking to build a house here, we’re looking to move the block even a millimetre.
While we know disability has an atypical impact on mental health, it is important that we create informative resources that reflect the autonomous aspects of Mental Health Management specifically for disabled people. Providing variations of grounding exercises, and providing representation of disability is reassuring for those of us who will, invariably, struggle with panic or anxiety. I NEEDED this. So, I made it. This article focused more so on physical parameters in disability, but I would love to hear from you about any adjustments or suggestions you would make to have Mental Health support be more accessible to any disabled person!