Down-Regulating Techniques (DRT’s)

 
 

PLEASE NOTE: This list is intended to be used by Dr. Kerri’s clients. While it may be helpful for others who come across it, please be aware that many of these techniques are covered during the course of counseling sessions with Dr. Kerri. This list is intended to be a reminder for my clients of skills that we have covered or will cover, and a way to encourage them to experiment with these skills regularly. The links are offered as potentially helpful resources, rather than an endorsement of the person(s), practice, or organization who created the videos.

for acute intensity:

  1. Focus on extending the out breath a teeny bit each time you breath out. It may feel excruciatingly difficult, but that’s okay – extending ever so slightly each breath is the goal.   

  2. Ice pack or a bag of frozen peas on the upper chest, or splash *cold* water on the face.

  3. Bite a lemon or suck on sour candy (e.g., “Warheads”).

  4. Wait. It will decrease. Pinky promise. Your nervous system can’t sustain an extreme level of intensity for very long. The intensity may come in waves. In between the waves, come up for air – pull out your list of what works from the options below.  

for regularly decreasing overall intensity and settling your nervous system:

  1. Scaling - rating the intensity of your physical and emotional experience on a scale of 1 to 10, 1 being no intensity, and 10 being complete loss of control. This cultivates mindfulness, objectivity, and can reduce emotional intensity just by creating some distance between you and your experiences. 

    • Tie this to an experience you do routinely (e.g., brushing your teeth) in order to make it easier to integrate into your routine.

    • Even if you forget during the day, it’s helpful to do this retrospectively -- “what was my highest intensity today? What was my lowest?” 

    • Getting used to scaling is helpful, because we use the same kind of scale during trauma processing (although it’s usually called the SUDS scale, which stands for Subjective Units of Distress.) 

  2. Intentional breathing - finding a rhythm of breathing that reduces intensity. Long, *slow* breaths are ideal to help to gently stimulate the vagus nerve. 

    • Breathing in through the nose and hitting the back of your throat with a slight snore sound produces a gentle vibration. 

    • Chanting or humming stimulates the same area.  

    • Long *slow* breaths in (i.e., not a sharp intake of air), pause in the middle (if helpful and it feels right), and aim for a longer breath out than in. 

    • Practice this for 3 to 5 breaths 3 to 5x/day, perhaps when you do your scaling. 

    • I will cover: Intentional breathing vs. “prescriptive” breathing techniques like box breathing, 4-7-8 breathing, etc. Please know that breathing is a very individual thing, so “prescribed” methods of breathing for relaxation do not necessarily work the same way for everyone. Experiment with breathing and find a rhythm that works for YOU.  

    • I will cover: Intentional breathing vs. diaphragmatic breathing or belly breathing. 

    • FYI, we naturally gravitate toward 5-5 breathing during prayer, meditation, etc. I don’t encourage this as a “goal”, but I mention it to be reassuring, if you find that you begin to naturally breathe in this way.  

    • Something to notice: be mindful of how your rib cage moves (or doesn’t) when you breathe. You may notice it does not expand in all directions when you begin intentional breathing, but it will, with practice over time, and with overall reduced muscle tension. Just notice. 

    • Add sensory experiences, to make the experience more rich and vivid (e.g., attaching a visual image, tactile experiences, fragrances, music, etc.) This expands the neurological wiring and allows you to access neural networks related to intentional breathing from multiple angles. 

  3. Voo breathing: pairing breathing with a specific sound that gently stimulates the vagus nerve. https://www.youtube.com/watch?v=oYOKFi4m-ic

  4. Grounding - a strong connection with the present moment makes it difficult for your brain to be simultaneously expending energy on rehashing the past or worrying about the future. 

    • Identifying experiences for each of your senses in the present moment (5 things I can see, 4 things I can hear, etc.) https://www.youtube.com/watch?v=30VMIEmA114 

    • Paying attention to physical sensations you otherwise wouldn’t: 

      1. The point at which the air enters and exits the body. 

      2. The point at which your bum meets the chair. Also, which cheek has more weight on it. :-) 

      3. The point at which your foot touches the floor. Press your foot into the floor, if you need to, to identify that particular spot. 

    • Paying attention to the qualities of a physical object: 

      1. Hold a rock -- notice the temperature and how it changes as you hold it, note the texture, the weight, the color, etc.

      2. Toss it back and forth from one hand to another. Notice how it feels when it lands in one hand versus the other. Notice the sound it makes when it lands.  

    • Earthing: electrophysiological exchange of info between our bodies and the earth. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3265077/ 

      1. Bare feet on the grass/earth.

      2. Tending to plants, even indoors. 

      3. Food prep -- cleaning or chopping veggies or herbs.

      4. Hug a tree. :-) 

      5. Swim or dip your toes in natural bodies of water.

  5. Engage the oculocardiac reflex (OCR) 

    • Eye pillow weighted with beans or rice. 

    • Palms against eyes with gentle pressure x30-60 seconds. https://www.youtube.com/watch?v=eYichuyiY8g

    • Eye muscle exercises (12 to 18 inch focus, shift to a more distant point, like the back wall of the room you are in, and back again). Be aware of how you feel, and slow it down as needed – too quick between one point and the other may produce dizziness.

  6. Mindfulness and Defusion - creating distance between ourselves and our thoughts.

  7. Bioenergetic Stress Relief (aka “the shaking video”): https://www.youtube.com/watch?v=_cGiKVWBBME

    • Suspend judgment and follow along with this video when you’re alone. Allow your body to move in the way she moves hers, and notice what happens. 

  8. Emotional Freedom Technique (EFT): a system of tapping along meridians to release energetic blocks, while speaking affirmations relevant to the situation. The official website for this technique is www.emofree.com, where you can find step by step tutorials. 

  9. Protective imagery: using visual imagery can help decrease intensity in response to intrusive memories or images, or can also be used during processing. 

    • A glass wall between you and the experience protects you from the sound while allowing you to see what’s happening (great for memories in which there is a lot of yelling or otherwise loud or activating noises). 

    • Changing the image to B&W rather than color.

    • Pushing the image out to 20 feet, or further, rather than experiencing it as if it’s happening right in front of your eyes, or behind your eyes.  

  10. 3 hand positions for connecting with the body. Experiment with using this along with your intentional breathing. Place your hands in one of the positions, or alternate between them, breathe, and wait for a shift down in intensity. 

    • First position: One hand lays flat on the area just under and between your collarbones -- your upper chest, and one hand flat on your diaphragm. 

    • Second position: One hand lays flat on your upper chest, and the other palm lays flat on your forehead.

    • Third position: One hand over the area where a bra strap would go, under one armpit, and the other hand on the other arm, grasping the bicep area (sorta looks like your arms are crossed.) 

    • Video of Peter Levine describing these positions as well as a few other similar techniques: https://www.youtube.com/watch?v=G7zAseaIyFA&t=51s 

  11. Self-havening (gently stroking arms, hands, cheeks). 

  12. Legs up the wall (yoga posture). https://www.youtube.com/watch?v=Q8uCrud5ijo 

  13. Nuggets! Anytime you have an experience that feels good, savor the experience first, make it rich and vivid (i.e., amp up your neural wiring), and then imagine yourself cupping that experience in your hands, wrapping it up in a little “nugget” and tucking it in your pocket. Anytime you’re feeling down, pull one of those nuggets out again and savor the experience again, letting it wash over you, and then tuck it back away. This lights up some useful wiring, and the trajectory effect will be helpful. 

  14. Music! Make yourself a playlist of music you find consistently peaceful and calming, no matter when you listen to it. Some of my favorites are CalmSound (https://www.calmsound.com/) or anything by Deva Premal (https://www.youtube.com/watch?v=NGn27OvFDZY). What works for one person doesn’t necessarily work for another, though, so find something that works for you and keep it somewhere easily accessible. 

  15. Warm epsom salt bath. 

  16. Visual imagery (Calm or Peaceful Place): During session, we’ll generate an image of a place that is calming and/or peaceful. A place that is just for you, that only you have access to, unless you choose to have others there with you. Make it rich and vivid -- visuals, smells, textures, sounds, maybe even taste. You can briefly visit this place anytime you need or want; let it wash over you and then tuck it away for the next time.

  17. Resource Team (AF-EMDR) - we will do this in session, before using AF-EMDR.

    • Create a team of characters/figures composed of 2-3 people in each of these categories: Nurturing, Protective, and Wise. 

    • Figures can be real or imagined, but should be “uncomplicated” relationships -- relationships in which you are most aware of this quality, rather than, for example, grief, if the person has passed. 

    • We often use this team in trauma processing using AF-EMDR.

  18. Bilateral stimulation (BLS) - we will use this in session, any time we are doing trauma processing.

    • Tapping (self or Theratapper), bilateral or biolateral music.

    • Any physical activity that involves both sides of the body. 

Experiment with all of these, as tolerated, with the goal of finding 3 to 5 techniques that are predictably good to great at decreasing intensity for you. Keep that list accessible – put it on your phone, keep it on a post-it note on your nightstand, or write it prominently in your planner. Make sure a loved one knows where to find that list, too, so they can help, when your cortex is taking a hiatus and you can’t remember what to do.