30 Aug 2015

Containment in TRE: Avoid ‘Oh My God’, Try Orient, Mobilise, Ground

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OMG Responding to overwhelm 2015-04-27 TRE short

Containment for Freezing, Flooding, Dissociation in TRE

Below is a mneumonic to help remember responses to contain someone who  is freezing, flooding or dissociating in TRE. These work as principles for the TRE Provider who is running a group or supporting an individual, but work equally well if adapted slightly for the person who is getting activated.

O M G

  • Its scary when people get activated
  • Probably best to avoid going ‘Oh My God’, try Orient, Mobilise and Ground
  • Activation, as used here, means increasing arousal is triggered as the neuroceptive circuits detect threat. Neuroceptive circuits are that part of our nervous system that is always checking ‘Am I Safe’? ‘Neuroception’ is a term coined by Stephen Porges.
  • Neuroception leads to progessive activation of the autonomic nervous system (ANS): Social engagement, mobilisation, immobilisation

Focus on the principles

  • Creating safety by balancing the ANS: down regulate the sympathetics, increase activity in the new vagus
  • Present time sensations is the goal
  • Safety via embodiment
  • Titration: A little and often is the best way to work with overwhelm
  • Put the brakes on anything going to quick or any sense of disappearing
  • Principles not protocols – be creative

O Orient 

  • Go Slow: Pause and give time. Acknowledge what is happening: ‘I notice there is a big charge here’ or ‘I notice you are going quick’ or ‘It seems hard for you to be here/you have drifted away’
  • Orient to you as the therapist. The therapist needs to be the safest thing in the room. The therapist needs to be present. Use a low, slow voice. Lots of eye contact and authentic facial expression. Hand holding can be really useful.
  • Orient to the environment: Do you like my earings, jumper, hair? Can you hear the rain or wind? How many lights can you see above you? Do you like my pictures on the wall? Distract people away from the edge of fear.

M Mobilise 

  • Mobilise out of immobilisation
  • Can you wiggle your toes, tense legs, tense arms.
  • New movements to generate sense of power in the limbs
  • Visualise slowly completing frozen movements
  • Sitting up and walking if needed
  • Take control and stop cycling processes, Instead of pausing you may need to be nimble and quick to break the cycling overwhelm
  • Maybe provide resistance as they move their limbs.

G Ground 

  • Body: Orient to body sensations. Out of thinking and emoting into safe sensations. How does that feel in your body right now? Simple descriptive words, avoid interpretation
  • Can you feel your feet? Downward focus away from hot, active, busy head. Can you feel your belly? Can you feel the back of your body? Check the weight, size and shape of limbs
  • Anything that helps someone come into the present moment
  • Change the breathing pattern
  • Self Touch: Hand on belly, hand on heart, rubbing hands, self squeezing down limbs

A quick reminder on freezing, flooding and dissociation.

Definitions are from David Berceli.

TRE Cautions and Retrauma 2014 Steve Haines.001

TRE Cautions and Retrauma 2014 Steve Haines.002

TRE Cautions and Retrauma 2014 Steve Haines.003

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