The PTSD Workbook

Before Doing the Work: Safety, Security, and Intention

You have decided you want to work on at least one aspect of the traumas that have impacted you. You may choose to use this workbook as part of your therapy or you may want to work on the exercises in the workbook by yourself. No matter what your choice, it is important that you feel safe and secure as you work. This chapter helps you prepare for your work with PTSD—whether it is your first attempt or you are returning to the work. It consists of a number of exercises that you can use to relax, center, and ground yourself in the present, as well as to protect yourself.

First, imagine yourself as you would want to be if the traumas of your life were not impacting you. What type of person would you be? How would you approach life? What would your hopes and dreams be? What would make your life feel full? Where would you live? What type of relationship with a spouse or partner would you have? What would your relationship to your own body be? If you have any chronic illnesses at the present time, how would they be different? What would your relationship with any Higher Power be? What celebrations of your life would you want to have? How would you organize and structure your day-to-day life? Take some time to address these questions or others that seem appropriate in your journal or notebook.

If you get upset while doing this exercise, look at those descriptions as your goals. You are simply aiming to return to a pretrauma existence to the greatest possible extent.

Safety

What does it mean to be safe? One definition of safety, proposed by both McCann and Pearlman (1990) and Rosenbloom and Williams (1999), is that safety is the need to feel reasonably invulnerable to harm inflicted by oneself and others. It is also the need to feel that those you value are reasonably invulnerable to harm inflicted by themselves or others. With those definitions in mind, if you are safe, you are reasonably able to prevent yourself from being hurt, or abused, or from experiencing traumatic events. As you protect yourself, you remain present and grounded in the here and now and you are able to make good decisions.

Staying Grounded

The word grounded means staying present in the current time, in contrast to “spacing out” or dissociating. You may have some particular ways to remain present when things come up that remind you of trauma or when you are dealing with past experiences. Trauma survivors have made many suggestions as to how to remain grounded. Some of these include:

using all your senses to be aware of your physical environment, and then talking to others about it
being aware of your physical body and how you look
being aware of your movements in space as you walk
exercising while being aware of what you are doing
making a plan for the day and sharing that plan with another
challenging yourself to a contest to increase the length of time you can remain in the present
watching television and telling yourself or others what you saw
doing routine activities in a different way; e.g., cleaning up the house in a different order
asking others to help you stay connected to them
talking to yourself about the present
planting your feet as firmly as you can on the ground in the here and now

Types of Safety

Recognizing your beliefs about safety and what you can do to change or challenge those beliefs is important if you are to protect yourself. There are different types of safety. Physical safety means that your body is not in danger. Maintaining it means that if a dangerous situation presents itself to you, you can recognize the danger signals, look at possible choices, act on those choices, and remove yourself from the situation if safety does not seem possible. Mental safety means that you are able to choose belief systems and patterns of thinking and awareness that get you where you want or need to go. Emotional safety means that you are able to identify how you feel in situations, recognize what your intuition tells you, and then act on these feelings and intuition, particularly when they alert you to danger. It may be important to practice feeling your feelings in order to build your awareness of them. Spiritual safety occurs when you learn to identify and trust in your beliefs about a Higher Power, God, or Supreme Being and then use those beliefs to protect you or to lead you to good decisions throughout your life.

Williams (1994) notes that establishing safety is the primary goal of therapy or self-protection before any work is done on memories of or emotional issues related to trauma. What cues do you have if you are physically, emotionally, mentally, or spiritually safe? Answering the following questions will help you look at your psychological need for safety (use your journal if you need more space):

Exercise: My Sense of Safety

How safe is your environment? Is your home safe?
___________________________________________

___________________________________________
What makes you feel safe physically when you are alone? With others? In different situations?
___________________________________________

___________________________________________
Are those with whom you live or interact safe? If they are, what makes the setting and those persons safe? If they are not, what makes them unsafe?
___________________________________________

___________________________________________
If you are not safe in your home, what can you do about it?
___________________________________________

___________________________________________
If you are not safe with or around those closest to you, what will make your situation safer?
___________________________________________

___________________________________________
How can you (and how do you) protect yourself?
___________________________________________

___________________________________________
How successful are your self-protective attempts?
___________________________________________

___________________________________________
When are you safest?
___________________________________________

___________________________________________
When do you feel safest?
___________________________________________

___________________________________________
How can you protect yourself when you are with people you do not know?
___________________________________________

___________________________________________

What do your answers to these questions tell you about you and your sense of safety?

___________________________________________

*****

There are times when safety is impossible to achieve unless you change your location. If you are a victim of domestic violence in any form (verbal, physical, sexual, emotional), it is of utmost importance that you get professional assistance to help make you safe (and to make your children safe, if you have children) so you can get out of the situation.

Exercise: Safety Assessment

As we said earlier, it is important for you to have safety if you are doing any work on trauma-related issues. Write the answers to the following questions, expanding on your answers as much as you need to.

Will you have a safe place in which to do the work?
___________________________________________

___________________________________________
Have you set aside a specific time or day or week to do that work?
___________________________________________

___________________________________________
Will you have safe things around you when you sit down to do the exercises in this workbook?
___________________________________________

___________________________________________
Will you have things around you to ground you, to soothe you, to make you feel good about yourself and the work you are doing?
___________________________________________

___________________________________________
If you are working with any therapists or helping persons at this time in your life, what makes that work safe or unsafe?
___________________________________________

___________________________________________
How will you protect yourself from your own strong feelings and thoughts that come up when you’re doing the work, particularly if those feelings and thoughts feel harmful to you?
___________________________________________

___________________________________________
It is important for you to consider your own personal safety in your beliefs and actions. Are you personally safe to yourself? Do you have any strong or life-threatening desires to harm yourself?
___________________________________________

___________________________________________
Do you have beliefs that are not safe; e.g., I believe that I am not entitled to heal, I believe I am a bad person, I believe I am responsible for the trauma that happened to me? If so, or at any point in your work when self-harming beliefs or desires occur, stop your work and get help to prevent any harm from coming to you from yourself. You are the most important person in your life, whether you believe that or not. If you are not safe with yourself, then dealing with traumatic experiences can possibly lead you to even more unsafe behaviors.
___________________________________________

___________________________________________
What can you do to contain any harmful beliefs or actions and prevent them from taking over and hurting you?
___________________________________________

___________________________________________
If you were to evaluate your personal safety within yourself, how would you rate that safety:
I am safe within myself 1 2 3 4 5 6 7 8 9 10 I am very unsafe
If you had trouble answering the previous question or rated yourself more toward the “I am very unsafe” side of the spectrum, here are some things you can do to help yourself, in addition to getting professional help:
Write down three things you enjoy doing and then do them.

Pick a positive feeling you want to have at the beginning of your day and then practice doing things to bring up that feeling.

Make a list of your negative, unsafe thoughts and then write three thoughts to counter each of them.

Notice when you begin to feel unsafe during a day; chart those times and what led to those feelings, then consciously do something that brings safety or self-comfort.

When you think safe thoughts, give yourself a reward with an activity or object that is healthy.

Do something that is positive spiritually for you.

Find your favorite soothing music and listen to it.

Avoid music that has themes of violence or is in a minor key.

Use earplugs to drown out excess noise, or get a white noise machine.

Avoid watching TV shows or movies that might trigger you.
Now that you have read the list of behaviors in question 11, which of them do you do regularly?
___________________________________________

___________________________________________
What are other things you can do to make yourself feel safe?
___________________________________________

___________________________________________

*****

Creating a Safe Place

One thing that you can do is to create your own safe place. In your safe place, you may just sit and meditate or think, or you may do (or imagine doing) an activity. Generally, your safe place needs to have limited access; in other words, only you and those you totally trust or wish to protect can gain access. Your safe place needs to provide you with a sense of protection and security. It does not necessarily have to be comfortable and cozy; it can be a rocky shore along a beach or a wild landscape. What matters most is that you are safe from the dangers outside this secure location.

Before you begin the following exercises, think back over the course of your life to any and all places in which you’ve been safe. If you have no safe place to which you can return, think of what might make a place safe. You can find or create a safe place anywhere you choose. Would your safe place be a rocky beach or an open meadow, a castle with a moat and drawbridge or a sunny forest? As you create or remember a safe place, think of its characteristics and then add any and all items you might want to bring—weapons, furniture, equipment, items that have meaning, need protection, or make you feel safe. It is important that this place is secure for you.

Exercise: My Safe Place

If you could create a safe place in your present physical reality, and if money and time were no consideration, where would your safe place be?

___________________________________________

Stay in your safe place. Look around you. What do you see? Concentrate on colors and visual elements that let the feeling of safety flow in. Then concentrate on sounds or silences that belong in your safe place, feeling that they bring the feeling of safety and let it grow stronger in you. Then smell the odors of your safe place and let the good feeling flow in. Whom do you see there? Concentrate on the feelings of safety that the other brings. What do you feel in your body while imagining your safe place? Concentrate on that feeling. Then open your eyes and look around you. In the space below, write down what you have just experienced.

___________________________________________

From now on, whenever you are in distress or feel the need, you can return to your good and safe place and draw strength from it (adapted from Ayalon and Flasher 1993, 73).

*****

Journal Exercise: My Safe Place Collage or Drawing

Draw or collage your safe place in your journal. A collage is a group of pictures, words, and objects put on a piece of paper to represent a theme. There are no right or wrong drawings, collages, or safe places; there is only what is right for you.

*****

Keeping Your Safe Space Safe

Before you begin to write more about your trauma, please take whatever time you need to reflect about your safe place and what makes or made it safe. You may take time to think about when you might have to use it. It is important for you to have a means to access your safe place quickly (Cohen, Barnes, and Rankin 1995).

If your safe place is in your home or in another physical location, it is important that you are able to keep that place private. It is not a place where children can come in and play or disturb your work. It is a place that has good energy. You may wish to clean that spot before you actually use it as a safe place. You may cleanse it with sage, cedar, sweetgrass, or incense. Make sure that it has nothing stressful or unsafe in it to jar you back to everyday reality (bills, paperwork, unfinished projects). You might put in something to give you white noise or perhaps include a miniature waterfall or fountain in the room. You may wish to find a book on feng shui and arrange the furniture in a way that seems to be healing. It is important that any energy you bring to this space is clean, new, and anger-free (Louden 1997). It is also important to bring things to your safe place that give you that kind of energy. Perhaps you have an object or picture that symbolizes who you want to be after you believe you are healed enough to continue on with a healthy life. Remember, when you create this safe place, it is important that you are able to see it, smell it, touch it, hear it, taste it, and feel it. It is a place where you can go whenever you choose, within seconds.

Exercise: Getting to My Safe Space

From now on, whenever you are in distress or feel the need to do so, you can use a symbol or phrase to return to your good and safe place and draw strength from it (Ayalon and Flasher 1993). You may use the space below to think of symbols that could stand for your safe place; for example, picture of a seashell (for a beach) or a small shell itself:

___________________________________________

A phrase that I can use to get to my safe place quickly is ______________________

*****

Getting to Your Safe Place through Visualization

When you created your safe place in your mind, you used visualization. Everyone uses this technique. Every time you daydream or create a fantasy in your mind, you visualize. If you choose, you may make a tape that helps you get to your safe place or to create any other pleasant visualization. This tape is private and is not to be shared with those you do not trust.

Checking In with Yourself

It is important that you learn how to notice how you feel in your body and mind and how you react when you remember, work on, or deal with the traumatic experiences that have happened to you. It may take practice for you to focus on your body and your emotions and become aware of how you are reacting. The following steps for checking in were developed by Rosenbloom and Williams (1999) to help you:

Stop whatever activity you might be doing.
Sit quietly for a short period of time.
Turn your attention inward and ask your body how it feels.
Notice if you feel any tension anywhere in your body (e.g., in your shoulders, stomach, jaw, or back).
Notice if you are holding your breath.
Notice if you are doing any behaviors that suggest tension (e.g., biting your nails, or picking at your skin).
Now notice any emotions you feel, if you are able to recognize them (are you fearful, sad, angry, lonely?).
Notice if you have racing thoughts or if you are able to stay focused.
If you’ve noticed any of the reactions listed above, take some time to use the deep breathing or relaxation techniques described in the next section.

Relaxation and Breathing Techniques

When you want to work in this workbook on specific areas that are problematic to you, you may want to use relaxation and breathing techniques either before you do the work, during the work, or after you have completed various exercises. But why do them? If you practice relaxation for several weeks, according to Benson (1984), you will have:

reduced symptoms of anxiety
fewer headaches and high blood pressure readings
less insomnia
a way to prevent hyperventilation
a way to gain more control over panic attacks
a way to reduce stress levels
a way to feel more at peace
more creativity

Schiraldi (2000) notes that there are important general guidelines for you to follow when you want to use relaxation techniques. It is important that you:

practice the technique or techniques you choose regularly—at least daily
concentrate as best you can while doing the techniques, trying to focus on the particular muscle groups and specific exercises
combine relaxation with exercise
trust in the power of the techniques to bring you some peace
go to your safe place if you feel anxious while trying the technique

Before doing any relaxation techniques, it is important to have four basic elements present (Benson 1975). They are:

A quiet environment that has as few distractions as possible. Even background noise can be a distraction. It is also important that you will not be interrupted.
A mental device that is a constant, e.g., a single-syllable word or sound, repeated silently or in a low, gentle tone. The repetition frees your thoughts and is your single focus. Benson suggests using the syllable “one” because it is a simple, neutral word.
A passive attitude to help you rest and relax without forcing your response, preventing your relaxed response from occurring. Disregard any distracting thoughts that enter your mind.
A comfortable position that is as restful as possible. This reduces muscular effort. You may support your head and arms. You may remove your shoes and prop your feet up several inches, if you choose. You may also loosen tight-fitting clothes.

Exercise: Deep Breathing

This first exercise is adapted from Davis, Eshelman, and McKay (1995, 27).

Lie down on a blanket or rug on the floor. Bend your knees up toward you and move your feet until they are about eight inches apart, with your toes turned slightly outward. Keep your spine as straight as possible.
Scan your entire body and identify any places that hold tension.
Put one hand on your abdomen and one on your chest.
Inhale slowly through your nose into your abdomen so that it pushes your hand up; your chest should move only a little bit. Hold your breath while you count to five.
Smile slightly and then exhale through your mouth, taking as long as possible. Make a shushing sound as you exhale.
Repeat this at least five times, perhaps eventually increasing the amount of time you spend deep-breathing to five to ten minutes.
When you’ve finished the exercise, again scan your entire body to see if any tension remains.
Once you are familiar with the technique, you can also use it while you are sitting or standing, whenever you feel tenseness in your body.

*****

Progressive Relaxation

You might also want to learn to relax by tensing and relaxing various muscle groups in your body. This is done using a technique called progressive relaxation. This technique helps you tense and then relax your four major muscle groups:

hands, forearms, biceps
head, face, throat, shoulders
chest, stomach, lower back
buttocks, thighs, calves, feet

You may practice this technique while you are lying down or sitting in a chair. The goal is to tense each muscle group for five to seven seconds and then relax that muscle group for twenty to thirty seconds, repeating the whole procedure at least twice. If the muscle group is still tense after you’ve done the procedure twice, you can repeat it for that group alone up to five times. You may also talk to yourself as you tense and relax, telling yourself anything that has to do with letting go of tension. There are numerous relaxation tapes you can buy that have this procedure, or you can read the following exercise into a tape recorder and play it back.

Another way to use progressive relaxation is to hold the tension in each of your muscle groups for about five seconds and then release the tension slowly while you say silently, “relax and let go.” Then, take a deep breath and, as you breathe out slowly, silently say, “relax and let go” again.

Exercise: Basic Progressive Relaxation Sequence

This sequence takes you from your head through your neck, shoulders, arms and hands, chest, back, stomach, hips, legs, and feet.

If you do make a tape of this exercise or the one that follows, allow enough time for each exercise (five to seven seconds to tense, twenty to thirty seconds to relax) on the tape so you do not rush yourself. Also, put in two repetitions for each exercise.

Wrinkle your forehead.
Squint your eyes tightly.
Open your mouth wide.
Push your tongue against the roof of your mouth.
Clench your jaw tightly.
Push your head back into a pillow.
Bring your head forward to touch your chest.
Roll your head to your right shoulder.
Roll your head to your left shoulder.
Shrug your shoulders up as if to touch your ears.
Shrug your right shoulder up as if to touch your ear.
Shrug your left shoulder up as if to touch your ear.
Hold your arms out and make a fist with each hand.
One side at a time, push your hands down into the surface where you are practicing.
One side at a time, make a fist, bend your arm at the elbow, and tighten up your arm while holding the fist.
Take a deep breath and hold.
Tighten your chest muscles.
Arch your back.
Tighten your stomach area.
Push your stomach area out.
Pull your stomach area in.
Tighten your hips.
Push the heels of your feet into the surface where you are practicing.
Tighten your leg muscles below the knee.
Curl your toes under as if to touch the bottoms of your feet.
Bring your toes up as if to touch your knees.

*****

Exercise: Quick Relaxation

Another quick way to relax is with whole muscle groups, tensing them for five to seven seconds and then relaxing them. This exercise is also adapted from Davis, Eshelman, and McKay (1995, 35–38).

Curl both fists and tighten your biceps and forearms as if you were a weight lifter posing, then relax.
Wrinkle your forehead and, at the same time, press your head as far back as is possible and roll it in a complete circle clockwise. Then reverse the roll. Then wrinkle up the muscles of your face in a frown, with squinted eyes, pursed lips, tongue pressed on the roof of your mouth, and shoulders scrunched up. Then relax.
Arch your back and take a deep breath into your chest. Hold it for five seconds and then relax. Take another deep breath, pressing out your stomach. Hold it for five seconds and then relax.
Pull your feet and toes back toward your face, tightening your shins. Then curl your toes and tighten your calves, thighs, and buttocks at the same time. Relax.

Successful deep muscle relaxation is a matter of practice. You may talk to yourself as you try to relax and tell yourself to let go or relax deeper in order to achieve a more complete relaxation. If you have muscle weakness or a muscular condition such as fibromyalgia, these exercises may not be for you. Check with your physician first.

*****

Another Relaxation Technique

This technique is best used when you have time to try to relax as fully as you possibly can. It makes a good script to record on tape.

First, find a comfortable position and close your eyes. For the next few moments, concentrate on your breathing; use deep breathing. Try to see and feel your lungs, sensing how they feel as you breath in (pause), trying to make them completely expanded (pause), and then exhaling and sensing how they feel as you release your breath. There is no right or wrong way to breathe. What is important is that you try to relax and not worry about any of the things happening in your everyday life.

Continue to concentrate on your breathing and your lungs, picturing them as you inhale, imagining them filling with strengthening oxygen, and picturing them exhaling as you relax. Now, in your mind’s eye, see or hear the message that says “relax” all over, in every bone, muscle, and nerve, tissue, feeling sensations of melting into relaxation.

Next, bring your attention to your left foot and ankle and, as you inhale, gently flex your foot. As you exhale, release and relax your foot. Now bring your attention to your right foot and ankle and, as you inhale, gently flex your foot. As you exhale, release and relax your foot. Let all the cares of the day drain out through your feet. Any noise you hear will only deepen your relaxation.

Now feel the muscles of your left calf. Inhale, contracting the muscles of your left calf and exhale, letting the calf relax. Now feel the muscles of your right calf. Inhale, contracting those muscles, and exhale, letting them completely relax. Of course, adjust your breathing rhythm to what is most comfortable for you, remembering to inhale relaxation, peace, and self-love and to exhale tension, the pressures of the day, and the impacts of trauma on you. Relaxing in this way is a learning process. It is a way to learn to be at ease, to be at peace with yourself, to be at peace with your world, and to relax.

Now bring your attention to the muscles of your left thigh. Inhale and contract these muscles, then exhale and feel relaxation pour in. Next, bring your attention to the muscles of your right thigh. Inhale and contract them, then exhale, feeling release through both your legs. Now shift your focus to your buttocks, inhaling and contracting the muscles. Then exhale and let your bottom relax.

Next, shift your focus to your stomach, inhaling and contracting your stomach muscles. Then exhale, letting your stomach muscles relax, relax, relax. Now bring your attention to your chest and inhale, feeling your chest fill with oxygen and power. As you exhale, release any tightness that may be there as you release all the tensions that are bothering you. Try to feel the feeling of relaxation as a conscious process in your mind and body.

Now bring your attention to your hands. As you inhale, close both of your hands tightly, making fists. As you exhale, release the fists. As you do so, consciously try to let go of everything onto which you are grasping, and to relax. You may open your palms as you relax to receive warmth and vitalizing energy from the world around you. You may also bring your palms, cupped, closer and closer together until you feel the energy that is between them. As you do this exercise, allow the sense of relaxation and energy to move upward through your hands into your forearms, elbows, and shoulders.

Next, focus your attention on your shoulders. As you inhale, contract your shoulders. Hold them for a few seconds in this position and then, as you exhale, feel the tension they have held release outward from them. Feel the point between your shoulders and the base of your neck. Allow warm energy to melt away any built-up tension and pressure that has been stuck there. Now feel the warm energy move up through your neck, allowing your neck to release and support your head as your neck completely relaxes.

Finally, turn your attention to the muscles of your face. Gently tense the muscles of your chin, your mouth, your eyes, your cheeks, and your forehead. Then let your entire face loosen and relax. Enjoy the relaxation you feel through your entire body for a few moments. If any part of your body is not completely relaxed, turn your attention to it. Inhale, and let the last bits of tension melt out of that part of your body. If your attention drifts, or if you feel drowsy, it is perfectly all right as long as you are safe, comfortable, and relaxed (adapted from Rosenbloom and Williams 1999, 28–30).

Trying Meditation for Relaxation

Some persons use meditation to relax and to calm themselves as they seek heightened concentration and awareness. If you are new at meditating, thoughts may come in to distract you as you try to calm and quiet your mind. If this happens, you may try to use some imagery to focus your awareness before doing the meditation. If you are able to create clear mental images of the following scenes or things, you might then be able to direct your focus to relaxing. Try to create a clear mental image, right now, of:

the face of your best friend
a turkey waiting to be carved
your bedroom in your present home
a glass of cold lemonade
a field of wildflowers
the aroma of cooking spaghetti sauce
riding in a race car at a racetrack
your bare feet on a sandy beach
the touch of velvet on your skin
a cat meowing

Use one of these images to focus your attention and then focus on meditating. If worries keep on entering, allow them to wander through your focus, noting them and allowing them to continue on without concentrating on them. It is also important to know how to deep-breathe and relax before you try to meditate. If this doesn’t work, you may repeat a word or syllable (such as “one” or “om”) over and over again, as Benson (1975) suggested. Try this at first for five to ten minutes, increasing it to fifteen minutes if you can.

When to Take a Break from Doing Work in This Workbook

If you have one or more of the following signs, it is important for you to take a break from the work in this book. This is not a book to do from start to finish as quickly as possible. Choose to do only the work that applies to you. You may use techniques from only one or two chapters or sections, or you may find that many of the chapters have techniques and exercises that will be helpful to you. If any exercises feel overwhelming to you and these signs come up as you are working on them, put the book away and do something else. These signs are adapted from Rosenbloom and Williams (1999). Put the work away:

if you begin to feel that you are not present in your body or are not aware of your surroundings, or if you begin to lose your sense of time (these are symptoms of dissociation)
if you begin to have flashbacks, or have more frequent or more intense flashbacks, of your traumatic experiences
if unmanageable feelings begin to flood you
if you experience anger, rage, irritability, depression, fear, anxiety, sadness, or other feelings that seem to be out of control or that seem to have no recognizable source
if you begin to injure yourself, or to injure yourself more seriously or more frequently
if you engage in addictive, compulsive behaviors, including abuse of alcohol, drugs, eating, sex, or working
if you begin to develop anorexia nervosa (you stop eating) or bulimia (you eat a great deal and then make yourself throw up)
if you become completely numb and are unable to feel emotion
if you become unaware of emotion
if you begin to isolate yourself and avoid others
if you have a dramatic change in any normal life pattern

If any of these signs appear, take care of yourself before you continue with your work. Should the reactions you are having become too intense, you may find that you need a few days or weeks away. Also, if you feel overwhelmed by your work and need support and guidance, seek the help of a qualified traumatologist, preferably one certified by ATSS, or the Association of Traumatic Stress Specialists.

You may also decide to use any of the following strategies for self-care while you are taking that break:

For physical self-care, you may decide to eat regular meals that are healthy and balanced, exercise, wrap yourself tightly in a blanket, sit in your favorite chair, get regular preventive medical care, get a massage, play sports, get rest and sleep, take a warm bath or shower, recycle, do housework or yard work, pound on a pillow, rip up a phone book, take a vacation.
For psychological self-care, you may decide you need or want to decrease your everyday stress, meditate, journal, listen to soothing tapes, find a certified trauma therapist, commit to doing something you want to do, read something frivolous, or say “no” to others’ requests.
For emotional self-care, you may decide you need or want to spend time with family members you love and like, reconnect with persons you love, watch your favorite movies or TV shows, listen to your favorite music, laugh or cry, play, or fight for a cause.
For spiritual self-care, you may decide you need or want to go to or join a church or other spiritual group, read a spiritually oriented book, spend time in nature, spend time being thankful for who you are and what you have, pray, or do something to help better the world or the lives of animals or nature.
For professional/workplace self-care, you may want or need to take your assigned breaks during your workday, see if you can use flextime on your job, try to finish assignments when (or even before) they are due, set limits, try to develop a good relationship with other workers or your boss, try to find something in your work that is rewarding to you, or balance other aspects of your life with your work (adapted from Pearlman and Saakvitne 1995).

Exercise: My Safety Net

As you work through your traumatic experiences and symptoms using this workbook, it is also important to have connections with others available when and if you need them. It is important to find others who care about you. If you don’t have family members who can help you, you may build connections with others through work, church, support groups (e.g., A.A., A.C.O.A.), or social organizations. You may list the phone numbers of these support persons below. However, if none of them is available when you are in crisis, remember you are able to stay safe even when they cannot be reached. At the end of this list, you may add ways to stay safe if no one is available.

The phone numbers I need to know include:

My best friend ___________________________
The local crisis line ___________________________
My partner or spouse ___________________________
My therapist(s) ___________________________
My doctor(s) ___________________________
The family member to whom I am closest ___________________________
My neighbor ___________________________
The local hospital ___________________________
My child(ren) ___________________________
If none of these persons is available and I feel unsafe, I can do the following things to remain safe until someone is available:
___________________________________________

*****

Working through the following pages may make you feel more vulnerable and in need of support from others. If you feel overwhelmed at any point, remember to use the relaxation and breathing strategies included in this chapter. You have many positive techniques you can to use to comfort yourself as you work through the exercises in this book. Now you are ready to begin your hard work. As you begin, keep the following passage from the German playwright Goethe in mind:

Until one is committed, there is hesitancy…the moment one definitely commits oneself, then Providence moves too. All sorts of things occur to help one that would never otherwise have occurred…Begin it now.