“I want to turn off my mind, catch my breath, feel less tension, sleep better.” The techniques of relaxation and mindfulness have been around for centuries, both in definition and in practice in various cultures. For some, the process of mindfulness describes being aware of your surroundings and slowing down your mind to remain in the present moment. For others, it has become a vital coping skill for anxiety or distress to allow grounding, emotion regulation, focus, and a sense of calm in otherwise difficult situations. So how does one present the ideas of grounding, mindfulness, or relaxation to clients in meeting their individual needs?
Explore the History
For many, the concept of feeling relaxed or calm is experienced rarely due to elevated anxiety or trauma triggers in everyday life. Perhaps you start a session with exploring the times they’ve felt more at peace or relaxed. Even if it were years in the past, this exercise can provide helpful insight into situations or context that allow your client small shifts or temporary relief from discomfort or anxiety. Questions that might help you explore this with your client include:
- Can you remember a time when you felt calm and relaxed? Can you tell me more about it?
- How does it feel in your body to experience calm or relaxation? What sensations do you experience?
- What has helped you before in feeling calm or relaxed? What makes that different now?
Become Body Aware
Exploring the history of times a client has felt calm or relaxed is but one piece of the puzzle. Depending on the client’s background, trauma history, or the impact fight/flight/freeze reactions, their body may have adapted to the increased stress and cortisol levels in interesting ways. Some clients will express increased anxiety or panic in response to relaxation, as it feels vulnerable or uncomfortable in their current, adapted state of functioning. For others, a numbness may exist where they cannot feel their body with possible contributing factors including depression, hypoarousal/freeze response, or desire to maintain self-preservation. Lastly, clients may easily drop into intellectual conversation about their symptoms but avoid experiencing any sensation in their body due to anticipated discomfort or negative arousal.
Keeping client limitations and comfort in mind, it can be helpful to encourage clients to gently become more aware of their body through various therapeutic activities. It is suggested to start with neutral areas of the body and move quickly from one area to another to prevent exacerbation of sensation that would prevent progress or cause a client to retreat from noticing their body out of fear or discomfort. By engaging them in the following activities, you can support a client in building body awareness and distress tolerance in ways that feel safe.
- Body scan-start at your feet and notice any sensations as you move gently upward to your calves, thighs, hips, waist, etc.
- Concentrated body scan-have the client identify neutral or safe areas that aren’t associated with negative sensation like hands, knees or feet. Have them focus on one area in detail, asking questions about temperature, sensation when touched, and encouraging the client to engage in use of textures and varying touch to explore sensation.
- Colored Glasses-our new favorite intervention from Dr. Dan Siegel in his book Mindsight, obtain or create colored lens glasses for clients to explore varying perspective of objects around them, insight into sensation in low-risk ways, and connection to memory that all support the practice of mindfulness.
Use all Five Senses
All of the above exercises support experiential learning in session. Another favorite tool that can support a client who experiences any negative sensation or experiences hyperarousal or flooding during a therapeutic exercise is to move their attention outside of themselves and into the room as a grounding technique. To do this, you can ask the client to become more aware of the chair underneath them or their feet on their floor. A few of our favorite tools are listed below that can be helpful in engaging a client outside of their own body.
- 5-4-3-2-1: What are five things in the room that are blue? Four things you can touch? Three things you can hear? Two things you can smell? One thing you can taste?
- Four Elements by Elan Shapiro: 1) Earth/Grounding: what do you see/hear/smell, 2) Air: Take measured breaths, inhale for four counts, exhale for four counts, 3) Water: Take a drink of water, use gum/mints or think of your favorite food to generate saliva, which serves as a calming agent to activate the parasympathetic nervous system and relaxation response, 4) Fire/Light: think of a place real or imagined that makes you feel calm or safe. Can you describe it using your five senses?
- 5 Minute Mindfulness: have the client pick an object to focus on, either in their hands or within sight. Gently direct them to notice all qualities of the object including temperature, texture, color, height, etc. for five minutes duration.
Modeling of Mindfulness
In addition to the mindfulness exercises listed above, it can also be helpful to create a coping kit of objects that can be engaging and cater to all five senses for client use within your office. Many therapists utilize objects such as essential oils, lotion, touchstones, magnets, putty, carved wooden objects, fur, water, and sand to engage clients in mindful practice. As your client discovers which objects are effective for them to practice mindfulness, you may encourage them to purchase and utilize these objects outside of session as well.
Regardless of which tools or techniques you elect to use in support of your clients, it can be even more helpful to notice your own body and energy in the room. By becoming aware of your breath, posture, and energy levels, you can support client in feeling safe or supported to do this work. By practicing alongside your clients, you model what it means to feel grounded or mindful, which is beneficial not only to your client seeking relief, but to yourself as the clinician mindfully engaging each client in their meaningful work and progress towards health.