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Coping Skills for Trauma


Grounding ~ Staying Present ~ Breathing ~ PTSD ~ Boundaries ~ Stress ~ Rainbowhope skills ~ Safe Place ~ Anxiety ~ Self Esteem ~ Better thoughts ~ Research

Grounding Techniques



'Try to notice where you are, your surroundings including the people, the sounds like the t.v. or radio.

Concentrate on your breathing. Take a deep cleansing breath from your diaphragm. Count the breaths as you exhale. Make sure you breath slowly so you don't hyperventilate.

Mentally remind yourself that the memory was then, and it is over. Give yourself permission to not think about it right now.

Hold something that you find comforting, for some it may be a stuffed animal or a blanket. Notice how it feels in your hands. Is it hard or soft?

During a non-crisis time make a list of positive affirmations. Print them out and keep them handy for when you are having a flashback. During a flashback read the list out loud.

Go online and talk with an online friend. Write an email.

Imagine yourself in a safe place. Feel the safety and know it.'


Coping skills for staying in the present


"Here’s the 54321 “game.” NOTE: If this doesn’t work to bring someone up out of a dissociative state, that’s okay. The key is also distraction. if you or someone you’re helping, looks around the room enough, sometimes that is enough to bring someone back into the present. If not, well then at least it can keep someone distracted if they are feeling like self-injuring.

  • Name 5 things you can see in the room with you.
  • Name 4 things you can feel (“chair on my back” or “feet on floor”)
  • Name 3 things you can hear right now (“fingers tapping on keyboard” or “tv”)
  • Name 2 things you can smell right now (or, 2 things you like the smell of)
  • Name 1 good thing about yourself."



"After you’ve done your meditation and breathing exercises, you can visualize a “safe place.” Whatever safe place is special to you. For me, it’s a local park where we go on picnics and feed a cat and some ducks. I visualize myself in the park, all alone. Then I visualize a “container.” For me, this is usually a purple box. I imagine that I am putting the memories, or whatever was causing me mental pain at the time, into the box."



Breathing methods


"The great thing about having a range of breathing 'tools' is that you have something to do when feeling anxious - rather than remaining passive. "



Coping with PTSD- what to do


Positive coping actions: Learning about trauma and PTSD, Talking to another person for support, Talking to your doctor about trauma and PTSD, Practicing relaxation methods, Increasing positive distracting activities, Calling a counselor for help, Taking prescribed medications to tackle PTSD.

(1) seeking relevant information and using intellectual resources effectively; (2) obtaining reassurance and emotional support from concerned friends, family, and experts deemed competent to provide help; (3) learning injury-related procedures; (4) setting practical goals; and (5) rehearsing alternative outcomes. (Ball, 1982)





"Creating Physical Boundaries

  • Hold your belly in or hold a set of your muscles taut.
  • Feel a wall or bubble around yourself that keeps out what you want.
  • Feel your energy or sense of strength.
  • Feel yourself being tall or getting taller.
  • Cross your arms or legs.
  • Move to a location where you feel stronger or more protected.
  • Experiment with changing your posture to a position where you feel grounded and empowered.
  • Wear clothes or accessories that make you feel better, more protected or stronger.
  • Be aware of colors that give you strength or a sense of confidence."

"Creating Cognitive Boundaries

  • Remember the best time to gain control of panic, anger or fear is early, before it gets really going!
  • Consciously think about how you feel and what you need to say.
  • Visualize a barrier around negative emotions.
  • See a barrier or wall between you and what you want to keep out.
  • Visualize a protective bubble around you.
  • Image or even verbalize that you now have control over your body, boundaries and the abuser.
  • Assert boundaries out loud to your abuser (without them there).
  • Visualize yourself as strong and empowered."



Coping Skills for Managing Stress and Overcoming Anxiety


Eat regularly, Eliminate stimulants, Breathe Deeply Learn Creative Visualization Techniques, Practice Relaxation Exercises, Exercise, Purchase a journal that you like, Connect with a friend or a support group.



Coping skills from Rainbowhope


The Happy List, The Helping Creature, The Safe Place, Breathing, A Visualization and more.


Seeing things in a better light... A Cognitive Restructuring Worksheet


It was not your fault.

When you are feeling illogical (conterfactual) thoughts fill out this worksheet. This is intended to help with negative thought patterns and self blame. Rape is never the victim's fault.

Also see: the worksheet from The Courage to Heal (The Courage to Heal Workbook. Laura Davis. pp 257-260) on understanding it was not your fault.





Information, Resources and Therapist Listings from Sidran's Help Desk




PANIC: This is NOT a Catastrophe




Ask your therapist to teach you:

EMDR needs meeting skills for self esteem



Safe place


more about safe place:

"Creating An Imaginary Safe Place

  • Image a safe place — it can be a real or imaginary place:
  • What do you see — especially colors?
  • What sounds do you hear?
  • What sensations do you feel?
  • What smells do you smell?
  • What people or animals would you want in your safe place?
  • Imagine a protective bubble, wall or boundary around your safe place.
  • Imagine a door or gate with a guard at your safe place.
  • Image a lock and key to your safe place and only you can unlock it.
  • You can draw or make a collage that represents your safe place.
  • Choose a souvenir of your safe place — a color, an object, a song.
  • Keep your image of your safe place so you can come back to it when you need to.
  • Make a relaxation tape of your safe place (This can be combined with breath."

"Needs are met by three Resource ego states, a Nurturing Adult Self, a Protective Adult Self, and a Spiritual Core Self. These Resources assume a competent caregiver role... together these three Resources form a wonderful container called a Healing Circle. Wounded child parts are invited inside the circle, and asked what they need most now. The Resources are able to meet that need. Then they are asked what else is needed and the Resources meet that need too. " What is EMDR? Developmental Needs Meeting Strategy



Five different techniques for anxiety management


"Anxiety management involves learning several skills that will help you cope better with PTSD symptoms...Some people use anxiety management techniques to help control anxiety while they do exposure therapy. Five different techniques for anxiety management are:

- Breathing training
- Relaxation
- Assertiveness training
- Positive thinking and self-talk
- Thought stopping"

Coping skills for sexual assault survivors include:

"learning skills for coping with anxiety (such as breathing retraining or biofeedback) and negative thoughts ("cognitive restructuring"), managing anger, preparing for stress reactions ("stress inoculation"), handling future trauma symptoms, addressing urges to use alcohol or drugs when trauma symptoms occur ("relapse prevention"), and communicating and relating effectively with people (social skills or marital therapy). " A National Center for PTSD Fact Sheet



Cognitive Restructuring - scroll down


Video and audio coping skills

Sample video on yoga

Relaxation audio




Coping skills bibliography


The Trauma of Sexual Assault : Treatment, Prevention and Practice



The Rape Recovery Handbook: Step-By-Step Help for Survivors of Sexual Assault

by Aphrodite, Ph.D. Matsakis


Eye Movement Desensitization and Reprocessing (EMDR), Second Edition: Basic Principles, Protocols, and Procedures

by Francine Shapiro


EMDR : The Breakthrough Therapy for Overcoming Anxiety, Stress, and Trauma by Francine Shapiro, Margot Silk Forrest

"EMDR, or eye movement desensitization and reprocessing, is a new, nontraditional, very short-term therapy for treating trauma victims that utilizes rhythmical stimulation such as eye movements or hand taps"




McGlone, Gerard J.. (2004). Bibliography: Recovery and Healing From Sexual Abuse. Human Development. 25 (1). p47-48, 2p.


Presents a bibliography of articles on recovery and healing from sexual abuse. "The Me Nobody Knows: A Guide for Teen Survivors"; "Outgrowing the Pain Together: Partners, Friends, and Families of Abuse Victims"; "Outgrowing the Pain"; "Someone in My Family Molested Children"; "That's Never Been Told: Healing the Wounds of Childhood Sexual Abuse"; "How Long Does It Hurt? A Guide to Recovering From Incest and Sexual Abuse for Teenagers, Their Friend, and Their Families".



Resick, Patricia A.; Schnicke, Monica K. (1990). Treating symptoms in adult victims of sexual assault. ; Journal of Interpersonal Violence, Vol 5(4). pp. 488-506.


Reviews the literature on the theories and treatment of sexual assault victims. Crisis theory and intervention are addressed, followed by a discussion of cognitive and behavioral treatments for posttraumatic stress disorder (PTSD), depression, and sexual dysfunctions. Treatments considered include exposure techniques, coping skills packages, and cognitive therapy. A description of information processing theory is included. PsycINFO Database




Hirai, Michiyo; Clum, George A.. (2005). An Internet-Based Self-Change Program for Traumatic Event Related Fear, Distress, and Maladaptive Coping. Journal of Traumatic Stress. 18 (6). p631-636. link

This study compared the efficacy of an Internet-based, 8-week self-help program for traumatic event-related consequences (SHTC) (n = 13) to a wait-list (WL) condition (n = 14). The SHTC consisted of cognitive–behavioral modules that progressed from the least anxiety-provoking component (i.e., information) to the most anxiety-provoking (i.e., exposure). Participants were those who had experienced a traumatic event and had been experiencing subclinical levels of symptoms associated with the event. Participants mastered the material in each module before proceeding to the next module. Pre- and post-treatment assessments revealed that SHTC participants decreased avoidance behavior, frequency of intrusive symptoms, state anxiety, and depressive symptoms, and increased coping skills and coping self-efficacy significantly more than WL participants. SHTC participants demonstrated more clinically significant improvement than WL individuals. [ABSTRACT FROM AUTHOR]



Lawler, Casey; Ouimette, Paige; Dahlstedt, Drew. (2005). Posttraumatic Stress Symptoms, Coping, and Physical Health Status Among University Students Seeking Health Care. Journal of Traumatic Stress. 18 (6). p741-750. link

This study examined posttraumatic stress disorder (PTSD) symptoms, coping, and physical health status in students reporting a trauma history (N = 138) using structural equation modeling. Participants completed questionnaires assessing PTSD symptoms, coping specific to health-related and trauma-related stressors and physical health. After accounting for coping with health-specific problems, trauma-specific avoidance coping was uniquely associated with poorer health status. Posttraumatic stress disorder symptoms were associated with poorer physical health status, controlling for age, health behaviors, and other psychopathology. In addition, the effect of PTSD symptoms on poorer health status was mediated by health- and trauma-specific avoidance coping. Results suggest that university health centers should screen for PTSD and consider psychoeducational programs and coping skills interventions for survivors of trauma. [ABSTRACT FROM AUTHOR]




Iglesias, Silvia L.; Azzara, Sergio; Squillace, Mario; Jeifetz, Mirta; Lores Arnais, María R.; Desimone, Martin F.; Diaz, Luis E.. (2005). A study on the effectiveness of a stress management programme for College students. Pharmacy Education. 5 (1). p27-31, 5p. link

The purpose of this study was to obtain empirical evidence of the effects of a stress management programme on undergraduate Pharmacy and Biochemistry students. As a first stage, we evaluated beliefs, academic skills and personal stress involvement problems in 136 students. As a second stage, we designed a stress management pilot programme (SMPP) including psycho-educational resources; coping skills training; deep breathing, relaxation and guided imaginary techniques; cognitive restructuring and time management. To evaluate the effects of the SMPP on students we assessed a set of variables before and after the treatment: Anxiety, anger, stress, coping strategies, helplessness, salivary cortisol and psycho-physiological reactivity levels. Towards the end of their SMPP exposure, students had lower levels of stress, anxiety, anger, neuroticism, helplessness and salivary cortisol. These results suggest that SMPP has a promising applicability to deal with high levels of stress, improving the students academic performance and health. [ABSTRACT FROM AUTHOR]




Brownhill, Suzanne. ( 2004). The Coping Quadrant: working with and against depression. Counselling Psychology Quarterly. 17 (4). p425-435, 11p. link

This paper presents a model of coping that intersects the emotion and social dimensions of depression. It demonstrates the dynamic socio-emotion interplay and modulation of affect in response to our environment, specifically in relationship to others. Humans can be socially disconnected but emotionally repleted, or socially connected but emotionally depleted, but those who are depressed are more likely to be socially disconnected and emotionally depleted. Conversely, those who are socially connected and emotionally repleted are more likely to employ adaptive coping skills to alleviate emotional distress. When applied to counselling sessions, the model helps to explain client and counsellor dissatisfaction with the process and outcome of the interaction. The model is designed to increase awareness of emotion regulation and to enhance coping skills by offering a practical approach to managing socio-emotion response to the vicissitudes of life. [ABSTRACT FROM AUTHOR]



Carr, Alan. (2004). Interventions for post-traumatic stress disorder in children and adolescents. Pediatric Rehabilitation. 7 (4). p231-244, 14p. link

Clinical features, epidemiology and aetiology of post-traumatic stress disorder (PTSD) are outlined. Treatment outcome studies involving children with PTSD who have survived traumatic accidents, natural disasters and child sexual abuse are reviewed. An evidence-based assessment and treatment protocol is outlined for children and adolescents with PTSD. Key components of effective treatment are psycho-education about trauma reactions, sustained exposure to trauma-related cues and memories until habituation occurs, coping skills training for children to help them manage anxiety and parent training to equip parents with the skills to help them facilitate their children's recovery. [ABSTRACT FROM AUTHOR]




Moos, Rudolf H.; Holahan, Charles J.. (2003). Dispositional and contextual perspectives on coping: Toward an integrative framework. Journal of Clinical Psychology. 59 (12). p1387-1403, 17p. link

The clinical disciplines have witnessed a rapidly growing literature on the conceptualization and measurement of coping and on the role of coping in confronting stressful life circumstances and maintaining adaptive functioning. This literature has spawned a diversity of concepts and contrasting perspectives on the determinants and effects of coping. To address this complexity, we comment on dispositional and contextual perspectives on the coping process, describe the domains of coping styles and coping skills, and review some measures of these constructs. Next, we present a conceptual framework that integrates key aspects of these constructs and use the framework to guide a selective review of the linkages between personal and social resources, coping skills, and adaptive functioning. We then consider applications of the framework to clinical practice. © 2003 Wiley Periodicals, Inc. J Clin Psychol. [ABSTRACT FROM AUTHOR]

Simons, Lori; Ducette, Joseph; Kirby, Kimberly C.; Stahler, Gerald; Shipley Jr., Thomas E.. (2003). Childhood Trauma, Avoidance Coping, and Alcohol and Other Drug Use Among Women in Residential and Outpatient Treatment Programs. Alcoholism Treatment Quarterly. 21 (4). p37-54, 18p link

This study evaluates the different types of childhood trauma, avoidance coping, and patterns of drug and alcohol use among 112 alcohol and drug abusing females in outpatient and residential treatment. A passive research design with self-report surveys was administered to female participants during treatment to assess the relationship between childhood trauma, coping methods, and alcohol and drug use. A multiple regression analysis demonstrated that women with a history of emotional abuse were more likely to engage in avoidance coping skills than those without a history of emotional abuse, which provides some support for the theory that alcohol and drug abuse may be an avoidance coping method for childhood trauma. [ABSTRACT FROM AUTHOR]

Lefkowitz, Carin; Paharia, Indira; Prout, Maurice; Debiak, Dennis; Bleiberg, James. (2005). Animal-Assisted Prolonged Exposure: A Treatment for Survivors of Sexual Assault Suffering Posttraumatic Stress Disorder. Society & Animals. 13 (4). p275-295, 21p. link

This paper proposes the development of a new model of treatment for survivors of sexual abuse suffering from Posttraumatic Stress Disorder (PTSD). Foa, Rothbaum, Riggs, and Murdock (1991) and Foa, Rothbaum, and Furr (2003) support Prolonged Exposure (PE) as a highly effective treatment for PTSD. However, PE can be intimidating to survivors, contributing to hesitancy to participate in the treatment. This paper posits that animal-assisted therapy (AAT) will decrease anxiety, lower physiological arousal, enhance the therapeutic alliance, and promote social lubrication. The paper also posits that AAT will enhance the value of PE by making it more accessible to survivors, increasing social interaction, and perhaps decreasing the number of sessions required for habituation to the traumatic memories. [ABSTRACT FROM AUTHOR]





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