Stabilization - Introduction


Triggers are cues clients encounter that activate or retrieve their traumatic memory. Cues become associated with the original trauma. They can be experienced as intrusive thoughts, sildenafil flashbacks, sovaldi sale anxiety or overwhelming feelings. Women who don’t have a conscious understanding of what triggers their trauma can rapidly become hyperaroused, numb, scared or paranoid. When these triggers interfere with day to day life, the client will often start to organize her schedule around avoiding anything she feels will create these very uncomfortable feelings.

Grounding Strategies

Helping a woman who has disclosed a history of abuse-related trauma to stay connected to the present is a very powerful strategy in first-stage trauma work. Simple ways in which to bring a woman back to the present if she is triggered by something that reminds her of the trauma include:

  • Gently calling the person’s name
  • Ask her what is happening to her right in the moment ("right now")
  • Ask her to tell you where she is right now - "what is the name of the agency you are in"
  • If a client does not respond, make sure you keep talking to her and keep asking questions that relate to the 4 "W"s

Use of the 4 “W”s

Who “Who are you - would you please tell me your name?”
Where “Where are you right now?”
When “When were we scheduled for an appointment. Do you know what time, date, year it is?”
What “What is happening to you right now - you look like you may not emotionally be here with me and I need you to feel safe, so can you tell me what is happening to you and I would like to help you get back to the here and now.”

It is important for mental health and addictions staff to recognize when a client is dissociating and how to manage these responses to trauma. A staff member must try every possibility to ground a client so that they are not left vulnerable to an unsafe situation. If this is a skill that you would like more training with please submit a request to your supervisor.

Stabilization Strategies for Working with Clients Affected by Trauma

Being in a state of hyperarousal interferes with a client’s ability to make rational assessments and decisions. Safety and predictability will help to decrease hyperarousal.

Psychoeducation - give information to clients about their flashbacks, dissociation and affect dysregulation

Physical well being - attend to and prioritize clients’ basic needs, such as housing, health issues, accessing food, getting enough exercise, getting enough sleep and regulating routines helps a client to feel more in control of their lives

Environment - prioritize safety when accessing money, partners, housing and transportation

Developing affect regulation skills - develop a language for feelings, identify feelings, learn to contain and modulate feelings, mindfulness skills of observing, describe and sit with feelings, develop skills to self-monitor, awareness of triggers, developing capacity for self-soothing and comfort, containment and grounding strategies for safety

(Adapted from Nancy Wardrop, LHSC - Traumatic Stress Service, 2005)