Anxiety is a normal response to stress and fear; everyone deals with some level of anxiety throughout their life. However, for many people, especially survivors of sexual or violent trauma, it can become a persistent and intense part of daily life. While traditional therapy can be beneficial for long-term healing, there are also simple techniques that can help calm the mind and body in the moment. This post looks at the science behind anxiety and introduces a few ways that are backed by research to help ease it.

Anxiety is the natural mental and physical reaction to stressful situations, being scared, or feeling threated⁶. During stress or a perceived threat, the brain’s emotional processing center, called the amygdala, signals the body’s “fight-flight-freeze” response in the sympathetic nervous system. The sympathetic nervous system floods the body with adrenaline which can cause the person’s heartrate to increase, breathing to become quick and shallow, and they may even feel nauseous or start shaking⁶. To calm the body down, a person has to engage the “rest and digest” functions of the body, using the parasympathetic nervous system which engaging the vagus nerve which slows heart rate and promotes relaxation⁷. To do this, the body needs to feel safe again by focusing on the present moment, and by paying attention to physical sensations and breathing¹². Once our mind and body is calm, we can think more clearly which helps problem-solving and emotional regulation. One way to remember the difference between the two systems is with this analogy: the sympathetic nervous system like a symphony, it heightens the emotional state. On the other hand, the parasympathetic nervous system is like a parachute, it slows you down and grounds you.

At times, anxiety may become present more than just in stressful or frightening situations. Anxiety disorders are the most common mental disorders in the United States, affecting 34% of people at some point in their life¹¹, with survivors of sexual violence reporting anxiety disorders over twice the rate of non-victims (8.73%, 3.75%, respectfully)². It’s not uncommon for survivors of sexual or violent crimes to experience emotional distress in the form of anxiety, including panic attacks, intrusive thoughts, and avoidance. Many survivors of violence find traditional therapy beneficial to work through symptoms of anxiety, however in moments of crisis or heightened emotions, many people may find the need for immediate techniques to help calm down and regulate emotions. Techniques such as mindfulness and grounding have been an effective way to help decrease anxiety attacks, particularly those that may arise unexpectedly or after a triggering situation⁸.

Grounding was developed as a way to express the mental and physical oneness with the earth  by Alexander Lowen in 1950’s⁹, and has been used as a therapy technique to help bring the mind and body back to present by engaging our five senses to slow down the nervous system, reduce heart rate, release muscle tension, and boost mental clarity⁵. Mindfulness originates from Buddhist teachings and is the process of slowing thoughts in the mind; in many ways it is considered to be a state of consciousness¹⁰. Both grounding and mindfulness are powerful tools to use to reduce anxiety, as well as provide additional health and wellness benefits.

Some common Grounding and Mindfulness techniques can be found below and may be done in a variety of locations or situations, most unobservable to others around.

Grounding Techniques

Grounding is a way to help anchor people in the present by focusing on sensations of the body and the persons surrounding. This helps the person calm the mind, disconnect from the distressing thoughts, and feel present in their body¹²

Sensory 5-4-3-2-1 Technique

This technique helps to focus on the present moment by using the five senses. This can help calm the mind by shifting away from anxious thoughts towards things you can see, touch, hear, smell, and taste. If you are in a place that you feel comfortable, you can say each item out loud as you find it. For example, “I see a ceiling light” or “I smell coffee.”

How to do it:

5 Things you can see – look around and find 5 things you can see (find 5 different patterns, colors, or textures).
4 Things you can touch – feel things around you and focus on the texture of the objects.
3 Things you can hear – listen to the sounds of your environment like cars driving, humming of lights, or even the sound of your breath.
2 Things you can smell – is there a sent to the air, a flower nearby, or a coffee if your hand.
1 Thing you can taste – can you grab a piece of gum, or drink nearby, or focus on the taste in your mouth.

Progressive Muscle Relaxation

This technique helps to reduce body tension and helps to physically relax. It is especially helpful for people who physically hold onto stress, such as clenching their jaws or tensing their shoulders.

How to do it:

• Sit or lay down in a comfortable position, preferably in a quiet place where you will not be disturbed. Take a deep breathe and relax your shoulders, continue slow deep breathing throughout the process. When ready you will tense a specific muscle group for a few seconds. Focus on the feeling of the tension, then release the muscle and focus on the feeling of the relaxed muscle. Slowly work thought your whole body.
• Start with your toes, curl them up and hold, then release.
• Then do the process with your calves, then thighs. Tighten, hold, release. Move to your buttock, then stomach, next your chest. Repeating the process of tightening, holding, and releasing.
• Next scrunch your shoulders up to your ears, hold and release. Move to your biceps, then hands, making a fist and holding then releasing. Lastly, scrunch your face as best as you can, holding then releasing.
• Repeat this process up and down your body 1 to 3 times.

Mindfulness Techniques

Mindfulness is the intentional process of focusing on the present moment, with acceptance and non-judgement. It allows you to sit in and acknowledge your thoughts and feelings without trying to change them or push them away. This can help teach both emotional regulation and attention regulation.

Dropping Anchor

Russ Harris has created the Dropping Anchor technique which helps the mind turn off “autopilot” bringing a person back to a more intentional state of mind. This will allow the mind to focus its attention on specific things instead of allowing it to obsess and worry.

How to do it:

Using the term “ACE” you will be able to refocus your thoughts.
A: Acknowledge your thoughts and feelings
C: Come back into your body
E: Engage in what you’re doing

For free audio recordings of guided dropping anchor technique, or more about this see https://www.actmindfully.com.au/free-stuff/free-audio/

Mindful Breathing

This technique helps to calm the body by taking slow deep breaths, focusing on feeling of the air coming in and out of the body. By slowing the breaths, you help to slow the heart rate and increase oxygen which increase relaxation. Also focusing your attention on the breathing helps to break anxious thoughts and release muscle tension.

How to do it:

Find a comfortable place to sit or lie down, preferably where you will not get disturbed. If you feel comfortable, close your eyes. Focus on slow deep breaths and pay attention to the air being inhaled and exhaled. To help focus your mind you may count breaths.

Try the 4-7-8 technique.

• Inhale through your nose for 4 seconds
• Hold the breath for 7 seconds
• Exhale through your mouth slowly for 8 seconds
• Repeat the cycle for several minutes or as long as you want.

Grounding and mindfulness techniques may take some time to get used to to feel their full benefits. Practicing these techniques on a regular basis will help you find what works best for you. Also, practicing will help regulate your emotions so that you may not experience anxiety attacks as severe as before, but if you do, you will have a tool in your toolbox to help should one pop-up. Also of note, while many people have little issues when learning these techniques, some people, especially those with generalized anxiety or depression, may experience “relaxation-induced anxiety,” which is when the body increases its anxiety during relaxation. It’s important to take your time learning these techniques in a place where you feel comfortable and safe, and to remember that you can pause or stop at any time⁴.

There are many other ways to help calm the mind and body. Talk to your medical doctor, or a mental health professional about your feelings of anxiety or other emotional distress you may be under.

Sources:

¹ACT Mindfully, Workshops with Russ Harris (2009-2025).  ‘Extra Bits’ eBooks, Worksheets and Handouts. https://www.actmindfully.com.au/free-stuff/free-audio/

²Gonggrijp, B., van de Weijer, S., van Dongen, J. et al. Exploring the Relationships of Crime Victimization with Depression, Anxiety, and Loneliness in Twin Families. J Dev Life Course Criminology 9, 455–482 (2023). https://doi.org/10.1007/s40865-023-00234-1

³Kelly A, Garland EL. Trauma-Informed Mindfulness-Based Stress Reduction for Female Survivors of Interpersonal Violence: Results From a Stage I RCT. J Clin Psychol. 2016 Apr;72(4):311-28. doi: 10.1002/jclp.22273. PMID: 27002222; PMCID: PMC4806391.

⁴Kim H, Newman MG. The paradox of relaxation training: Relaxation induced anxiety and mediation effects of negative contrast sensitivity in generalized anxiety disorder and major depressive disorder. J Affect Disord. 2019 Dec 1;259:271-278. doi: 10.1016/j.jad.2019.08.045. Epub 2019 Aug 19. PMID: 31450137; PMCID: PMC7288612.

⁵Koniver, L., 2024. Groudning to Treat Anxiety., Medical Reseach Archives, [online] 12(12). https://doi.org/10.18103/mra.v12i12.6024

⁶Leonard, J. (Nov. 1, 2024) What does anxiety feel like, and how does it affect the body? MedicalNewsToday. https://www.medicalnewstoday.com/articles/322510#complications

⁷Poli A, Gemignani A, Soldani F, Miccoli M. A Systematic Review of a Polyvagal Perspective on Embodied Contemplative Practices as Promoters of Cardiorespiratory Coupling and Traumatic Stress Recovery for PTSD and OCD: Research Methodologies and State of the Art. Int J Environ Res Public Health. 2021 Nov 10;18(22):11778. doi: 10.3390/ijerph182211778. PMID: 34831534; PMCID: PMC8619958.

⁸Shukla, A. (2019). A 5-Step Mindfulness Grounding Technique To Ease Anxiety & Why Mindfulness Works. Cognition Today. Retrieved from https://cognitiontoday.com/5-step-mindfulness-grounding-technique-to-ease-anxiety-why-it-works/.

⁹Shuper Engelhard, E., Pitluk, M., & Elboim-Gabyzon, M. (2021). Grounding the connection between psyche and soma: creating a reliable observation tool for grounding assessment in an adult population. Frontiers in Psychology, 12, 621958.

¹⁰Smalley, S. L., & Winston, D. (2022). Fully present: The science, art, and practice of mindfulness. Balance.

¹¹Szuhany, K. L., & Simon, N. M. (2022). Anxiety Disorders: A Review. JAMA, 328(24), 2431–2445. https://doi.org/10.1001/jama.2022.22744

¹²Transpersonal Psychology (2014). Mindfulness and Trauma Recovery: Grounding Techniques. https://transpersonal-psychology.iresearchnet.com/mindfulness-and-contemplative-practices/mindfulness-and-trauma-recovery-grounding-techniques/

Trigger Warning: This blog post discusses sensitive topics such as sexual assault. It’s important to take care of yourself while reading. Some suggestions are reading while you’re in a healthy headspace or knowing who you can reach out to if you become upset. Our 24/7 helpline for crisis calls based out of Central Florida is (407) 500-HEAL. To get additional support and/or learn about your local resources, the National Hotline can be contacted at 1-800-656-4673.  There is always someone ready to help.

What is a Traumatic Brain Injury (TBI)?

A TBI is an injury to the brain due to a sudden external trauma. This may seem like a very broad definition, but that’s because TBIs can be caused by a wide variety of events.  Some common causes are falls, car accidents, sports injuries, and assault. The severity of TBIs can range from a mild concussion that resolves itself within a couple of weeks, to severe injuries that result in long-term complications and disabilities.

What are the Symptoms of TBIs?

There is a wide range of symptoms associated with TBIs that depend on the individual and the severity of the injury. Symptoms may be present immediately after the trauma or may begin to appear days or weeks afterward. Some common physical and psychological symptoms are:

Physical symptoms:

• headache with or without light or sound sensitivity

• nausea and dizziness

• fatigue

Psychological/cognitive symptoms:

• confusion

• memory or concentration problems

• sleeping more or less than usual

• mood swings

• feelings of depression or anxiety

Medical Evaluation, Classification, and Long-term Impact of TBIs:

To determine the initial severity, the majority of TBIs are evaluated with the Glasgow Coma Scale (GCS) and classified as mild, moderate, or severe. Additionally, the Glasgow Outcome Scale (GOS) is often used to estimate the expected degree of recovery. The predicted outcomes are based on the initial classification. Mild indicates that symptoms will gradually improve in most cases, moderate indicates a positive recovery in 60% of patients, and a severe classification indicates an expected positive outcome of 25%-33% (Agarwal et al., 2020).

Throughout this post, these terms will be referenced in relation to certain statistics as they are determined by medical diagnoses. As a quick disclaimer, there are limitations to the GCS/GOS so in no way does it mean that a mild TBI is an “easy” diagnosis. Classification in this way can often hinder treatment because the terms mild and moderate can lead to a withdrawal of care too early. Conversely, a patient labeled severe may have a more favorable outcome than previously expected (National Academies of Sciences, Engineering, and Medicine, 2022). Although these assessments have some limitations, they are widely regarded as reliable and are considered an integral part of the physical evaluation after a brain injury.

In addition to the immediate impact, TBIs often result in lifelong health problems and disabilities. According to a study that collected information from participants 5 years after a TBI, 57% were moderately or severely disabled (Center for Disease Control and Prevention). In the US, this equates to over 5 million citizens, which is around 2% of the population (Brain Injury Association of America, 2022).

Groups at Greater Risk of Negative Outcomes:

The likelihood of experiencing long-term disabilities from a TBI depends on several factors such as the severity of the injury, socioeconomic status, and personal circumstances. Certain groups that are at a greater risk of long-term negative impacts include the following (Center for Disease Control and Prevention, 2021):

• victims of intimate partner violence

• racial and ethnic minorities

• those in correctional facilities

• people who experience homelessness

• service members and veterans

• people in rural areas

• people in a lower socioeconomic status or do not have access to health insurance

The Link Between TBI and Assault:

The third most common cause of TBIs, which makes up about 10% of all cases, is assault (Bown, 2019). The correlation between assault and TBIs is a severely under-researched topic, and the research that does exist is limited since many victims are not examined by a health care professional. However, an older study conducted by Dr. Valera, a researcher at Harvard Medical School, focused specifically on female victims of intimate partner violence. This study found that of the 99 participants, 74% sustained at least 1 TBI and 51% suffered multiple TBIs (2003). While this gives us significant statistics, it’s important to remember that TBIs can also occur from an assault outside of intimate partner violence. Additionally, Dr. Valera’s study focused solely on female victims, but male and nonbinary victims can experience TBIs as well.

Overview of Disabilities and Sexual Violence:

Disability is a general term that encompasses a wide range of impairments, including TBIs. While there isn’t much research on this specific topic, it was recorded by the Office for Victims of Crime that people with disabilities are at least twice as likely to be victimized (2018). A disability is defined as a physical or mental impairment that significantly limits activities of daily life. Although not a comprehensive list, a few of the categories are mental health disorders, intellectual disabilities, developmental disabilities, and sensory disabilities. People with impairments are at a higher risk of experiencing sexual violence which can be due in part to the following circumstances:

• Dependence on a caregiver may lead to compliance because the victim can’t afford to lose the caregiver’s support.

• People in assisted living facilities are in constant contact with a large number of the staff and may not be aware of how to report abuse.

• There may be limited access to resources when there is a caregiver present or in a group home.

• Individuals with cognitive impairments may have difficulty recognizing inappropriate behavior or may be unaware of their right to report.

TBIs can cause cognitive impairment that affects memory, perception of risky situations, and disabilities that require a caregiver. The reliance on a caregiver puts those with TBIs at a higher risk of assault and mistreatment (CDC, 2007).

If you or a loved one has a disability and has experienced sexual violence or abuse, there are resources available for support:

• Call 911 or contact your local police station to make an official report of abuse

• Call 800.656.HOPE (4673) or click here to speak to a National Sexual Assault Hotline Advocate

• RAINN online anonymous chat option to connect you with a trained specialist

• RAINN Sexual Abuse of People with Disabilities Resources

• Visit the Victim Service Center website for more information on crime victim services

How to Support Someone Who Has a TBI:

TBIs can be life-altering for the victim and their loved ones as well. It’s common for family and friends to feel helpless because it’s not always clear what you can do to help. Here are some recommendations when caring for a loved one with a TBI:

• Maintain a calm, patient, and understanding attitude

TBIs are incredibly overwhelming and can be disorienting when trying to readapt to normal, daily life. It’s common for someone with a TBI to have many negative emotions and feel distressed when having difficulty completing simple tasks. It’s important to stay calm and patient to help them feel supported.

• Educate yourself on the recovery from TBIs and expect inconsistency

Recovery isn’t always linear, and it’s normal for some days to be better or worse than others. It’s common for someone with a TBI to experience mood swings and be hostile towards you which can be difficult to understand. A lack of control over the situation may cause their anger to be displaced onto you in an effort to cope with the drastic changes that come along with TBIs.Reading into what TBIs do to the brain and understanding the ‘why’ behind their actions and words can help you appreciate the extent of what they’re going through.

• Help break down their tasks to promote simplicity

Previously simple tasks become extremely overwhelming after a TBI. A great way to help them feel confident and supported is to break their tasks into smaller steps. You can also do some of the bigger things for them that they may have difficulty with at first, and slowly reintegrate them back into their routine in small amounts.

• Monitor overstimulation and promote familiarity

Establishing a daily routine to promote familiarity in such a disorienting time can help lessen some of the distress they’re experiencing. Coping with the mental and emotional side effects along with the physical impact of a TBI can very quickly lead to overstimulation. Avoid conversations that are full of new information or sarcastic jokes. These situations can be hard for them to follow and may only lead to more frustration.

These are just a few common tips to keep in mind, but if you would like a more in-depth guide on how to care for a loved one with a TBI, please check out the following resources:

• Brain Injury Association of America Guide for Caregivers
• Mayo Clinic Patient Education “How to Help Someone Who Has a Brain Injury”
• Brain Injury Association Caregiver Information Center

Caregiver Support:

Helping someone recover from a TBI can impact caregivers as well and it’s normal to feel scared and overwhelmed. Caregivers have a heavy, time-consuming responsibility and it’s common to prioritize the well-being of others over your own. Caregiver burnout is the emotional and physical exhaustion that stems from neglecting your needs while taking care of someone else. Remember, you can’t take care of others unless you take care of yourself first. To learn more about how to support yourself and avoid burnout, check out the caregiver support resources from Mayo Clinic and BrainLine.

Final Notes:

If you believe you or a loved one are suffering from a TBI, it’s important to get medical care as soon as possible. While medical care is imperative in treating traumatic brain injuries, it’s important to seek emotional support as well. Please feel free to use Victim Service Center’s free counseling or call the 24-hour helpline at 407-500-HEAL (4325) for support during a crisis.

References:

1. 2018 NCVRW Resource Guide: Crimes Against People with Disabilities Fact … (n.d.). https://ovc.ojp.gov/sites/g/files/xyckuh226/files/ncvrw2018/info_flyers/fact_sheets/2018NCVRW_VictimsWithDisabilities_508_QC.pdf

• Agarwal, N., Thakker, R., & Than, K. (2020, February 3). Traumatic Brain Injury. American Association of Neurological Surgeons. Retrieved September 22, 2022, from https://www.aans.org/Patients/Neurosurgical-Conditions-and-Treatments/Traumatic-Brain-Injury

• Bown D, Belli A, Qureshi K, Davies D, Toman E, Upthegrove R. Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault. PLoS One. 2019 Feb 7;14(2):e0211684. DOI: 10.1371/journal.pone.0211684. PMID: 30730924; PMCID: PMC6366871.

• Brain Injury Awareness Month. Brain Injury Association of America. (2022, April 5). Retrieved September 22, 2022, from https://www.biausa.org/public-affairs/public-awareness/brain-injury-awareness

• Centers for Disease Control and Prevention. (2021, May 12). Health Disparities and TBI. Centers for Disease Control and Prevention. Retrieved September 22, 2022, from https://www.cdc.gov/traumaticbraininjury/health-disparities-tbi.html

• Center for Disease Control and Prevention. Moderate to Severe Traumatic Brain Injury Is a Lifelong Condition. https://www.cdc.gov/traumaticbraininjury/pdf/moderate_to_severe_tbi_lifelong-a.pdf.

• Centers for Disease Control and Prevention. (2007). Victimization of persons with traumatic brain injury or other disabilities: A fact sheet for professionals. Centers for Disease Control and Prevention. Retrieved from https://stacks.cdc.gov/view/cdc/11667

• Traumatic Brain Injury Categories Should Be Updated and Personalized to Better Guide Patient Care, Says New Report. National Academies of Sciences, Engineering, and Medicine. (2022, February 1). Retrieved September 22, 2022, from https://www.nationalacademies.org/news/2022/02/traumatic-brain-injury-categories-should-be-updated-and-personalized-to-better-guide-patient-care-says-new-report

• Valera EM, Berenbaum H. Brain injury in battered women. J Consult Clin Psychol. 2003 Aug;71(4):797-804. DOI: 10.1037/0022-006x.71.4.797. PMID: 12924684.