Introduction

Trauma affects different people in different ways. Some people recover relatively quickly from
trauma. Within three or four months, they feel “back to normal” and do not report any
symptoms or problems. Other people develop ongoing or chronic problems and may be
diagnosed with Post-Traumatic Stress Disorder (PTSD). PTSD can be a very complex
psychological issue and can affect people for many years.
Depending on your symptoms, your therapist may use a variety of techniques to help you
overcome your trauma. Treatments typically include Somatic Psychotherapy, Cognitive
Behavior Therapy (CBT), Exposure Therapy, Eye Movement Desensitization and Reprocessing
(EMDR), and many therapists today are using body-oriented techniques such as yoga, EFT
tapping, mindful meditation, and more.
Most therapists will focus on techniques that help you alleviate specific symptoms, as well as
techniques that address your relationships and your ability to find meaning in your day-to-day
activities. Medications may also be prescribed to treat specific symptoms of depression and
anxiety.
Whatever the treatment, your therapist will want you to practice new ways to handle your
emotions, manage upsetting thoughts and memories, and develop positive coping behaviors to
move you forward in life. And the best way to learn new psychological skills is through specific
“between sessions” assignments.
This workbook contains 20 “homework” assignment worksheets to help you understand how
trauma has affected you and to learn specific techniques to deal with your symptoms and
immediate concerns. This is not a self-help workbook. It was designed to be used with a
psychotherapist trained in treating trauma. It does not include every technique that is available,
but rather acts as a starting point for you to understand your trauma and begin the recovery
process.
It is important that you communicate with your therapist about what helps – and what isn’t as
effective. At the bottom of each worksheet, you will find a section called “Reflections on this
Exercise,” which will be particularly helpful for you to summarize what you learned and let your
counselor or therapist know what direction to steer your treatment.
Recovering from trauma can take time and it will certainly require some effort. Above all, I
recommend that you build a supportive network of family, friends, and professionals who can
help you throughout your journey.
-Angela M. Doel, M.S.

1
Table of Contents
What Is the Nature of Your Trauma? ............................................................................................ 3
Listening to Your Body ................................................................................................................... 8
Tracking Body Sensations Form ................................................................................................... 15
Tracking Your Nervous System .................................................................................................... 18
Body Scan ..................................................................................................................................... 19
Body Awareness Inventory .......................................................................................................... 22
Facing Trauma .............................................................................................................................. 26
Talking About Trauma .................................................................................................................. 31
Tracking Triggers Form ................................................................................................................. 35
Understanding How Trauma Impacts Trust ................................................................................ 36
Creating Your Safe Place .............................................................................................................. 41
Dealing with Frequent Nightmares ............................................................................................. 42
Understanding the Window of Tolerance ................................................................................... 46
Understanding Your Boundaries ................................................................................................. 51
What to Do When Your Boundaries are Violated ....................................................................... 55
Coping with Memory Problems Following Trauma .................................................................... 59
Understanding and Managing Depersonalization ...................................................................... 67
Learned Optimism ........................................................................................................................ 77
Identify Your Internal Resources ................................................................................................. 83
Understanding Post-Traumatic Growth ...................................................................................... 86

2
What is the Nature of Your Trauma?
Objective
To identify the specific nature of your trauma.

What to Know
Prolonged illness, homelessness, or witnessing a terrifying event are all examples of traumatic
situations. Trauma can be a single event (car accident, sexual assault, or natural disaster) or
repeated events (childhood abuse and neglect). It can be chronic (combat, ongoing domestic
violence, imprisonment). Some researchers believe any experience – and how it is perceived –
that is stressful enough to leave you feeling helpless, powerless, out of control, overwhelmed,
or profoundly unsafe can be considered traumatic.
Even though you have experienced trauma, you can move forward with your life. You can grow,
become resilient, and have a meaningful life. Your life does not end because of trauma. The
first step is to understand trauma and its consequences. In this worksheet, you will begin to
explore your trauma history.

What to Do
First, answer the following questions.
Were you directly exposed to a traumatic experience? Yes / No
If yes, explain. __________________________________________________________________
Were you a witness to a traumatic event/experience? Yes / No
If yes, explain. __________________________________________________________________
Were you told about it by a loved one? Yes / No
If yes, explain. __________________________________________________________________
Were you indirectly exposed to trauma? Yes / No
If yes, explain. __________________________________________________________________
Were you repeatedly exposed to trauma? Yes / No
If yes, explain. __________________________________________________________________
What is the nature of your trauma? Check off the statements that apply to you.
_____ physical assault (held at gunpoint, injured in a fight, attacked with a weapon, etc.)
_____ serious illness or extended hospitalization
_____ military combat
_____ sexual abuse
3
_____ car accident
_____ serious work-related accident
_____ child abuse or neglect
_____ natural disaster
_____ unemployment
_____ homelessness
_____ refugee situation
_____ job loss
_____ financial crash
_____ sudden and unexpected death of a loved one
Other (describe):
______________________________________________________________________________
______________________________________________________________________________

If you are able, describe what happened.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

4
Below is a list of problems that people sometimes have in response to trauma. Write down the
appropriate number to indicate how much you have been bothered by the problem in the past
month.
0 = not at all bothered
1 = a little bit bothered
2 = moderately bothered
3 = bothered quite a bit
4 = extremely bothered
_____ Repeated disturbing memories, thoughts, or images of the stressful experience.
_____ Repeated, disturbing dreams or nightmares.
_____ Suddenly acting or feeling as if the traumatic experience is happening again.
_____ Feeling very upset when something reminds you of the traumatic experience.
_____ Having physical reactions (e.g., heart pounding, trouble breathing, sweating) when
something reminds you of the experience.
_____ Avoiding thinking about or talking about the experience or avoiding having feelings
related to it.
_____ Avoiding activities or situations because they remind you of the experience.
_____ Trouble remembering important parts of the experience.
_____ Loss of interest in activities that you used to enjoy.
_____ Feeling distant or cut off from other people.
_____ Feeling emotionally numb or unable to have loving feelings for others.
_____ Feeling as if your future will somehow be cut short.
_____ Trouble falling or staying asleep.
_____ Feeling irritable or having angry outbursts.
_____ Difficulty concentrating.
_____ Being “super alert,” watchful, or on guard.
_____ Feeling jumpy or easily startled.
_____ Add up your score
If you scored between 0-18, these symptoms following a trauma may not be impacting your
daily life.
If you scored between 19-40, your trauma-related symptoms have a minimal effect on your life.

5
If you scored between 41-60, your trauma-related symptoms have a moderate effect on your
life.
If you scored 61 points or more, your trauma-related symptoms severely impact your life.
How do your symptoms disrupt your life? How do they affect your personal, social,
professional, or family life? Be specific.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Have you noticed any changes in your habits or behavior?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How long after the trauma have you had these problems? ______________________________

What are the 2-3 symptoms you find most distressing? _________________________________
______________________________________________________________________________

6
______________________________________________________________________________
______________________________________________________________________________

How are you coping with your symptoms? Be specific.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

How helpful was this exercise? _____

(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

7
Listening to Your Body
Objective
To increase your somatic (body) awareness and intelligence to help you better listen to all the
ways your body communicates with you.

What to Know
Somatic therapy, also known as somatic experiencing therapy (SET), aims to treat trauma and
other mental health issues through the connection of mind and body. This body-centric
approach works by helping you to release stress, tension, and trauma from your body.
You can practice sensing more and listening to your body by slowing down, paying attention to
bodily sensations, and listening with focus and curiosity. As you learn to listen and attune to
your body you will:
• become better at self-care.
• arrive at a deeper knowing, understanding, and love for yourself.
• become more aware of and responsive to your own needs and desires.
• improve your ability to set healthy boundaries.
• feel more grounded.
• increase your resilience during stressful situations.
• have greater access to pleasure, joy, and ease.
There are many ways you can listen to your body, including observing and naming what you
physically and emotionally experience. Here are some ideas.
1. Tune into the five senses. Mindfully and intentionally focus on what you hear, see, smell,
touch, and taste.
2. Notice your breath. The quality of your breathing is affected by stress and your emotions.
This is the foundational practice of mindful attention and somatic awareness.
3. Focus on physiological cues. You can receive information about which branch of the nervous
system is operating. The Sympathetic Nervous System (SNS) governs fight, flight, and taking
action, prompting the release of cortisol and adrenaline. The Parasympathetic Nervous System
(PNS) governs rest, digest, feed, and breed functions. The PNS helps calm and settle you down.
4. Observe and name sensations. Identifying sensations in the body offers you important
information so you can quickly and effectively respond to your own needs.
5. Tune in to facial expression and body posture. Your facial expressions and body posture
communicate much more than you may realize.
6. Pay attention to your “brace patterns.” This is the habitual way you hold your body in a
situation – whether your muscles are engaged or contracted. When you identify how you brace,
you can do something different, especially if it is painful or uncomfortable. Examples of brace
patterns include:

8
 • shrugging your shoulders up by your ears.
• clenching your jaw.
• sucking in your stomach.
• curling your toes.
• “hard-gazing” with your eyes, increasing muscle tension.
7. Notice impulses. Become aware of what your body wants to do so you can choose
differently. When you react without awareness, you might act out of integrity or engage in self-
destructive behaviors.
8. Tap into your emotions. All emotions have a corresponding motor program – an action or
gesture that expresses energy.
The language of the body is vast, varied, and nuanced. The better you get at listening to your
body, the more resilient you will be. This worksheet can help increase your somatic (body)
awareness and intelligence to help you better listen to all the ways your body communicates
with you.

What to Know
When you practice listening to your body, take an inventory of what you notice. You may
answer one or all of the following questions as you practice each day.
Do you get enough, healthy, loving, and safe touch every day? Yes / No
What tells you when the touch you are receiving is “just right?”
______________________________________________________________________________
______________________________________________________________________________

What sensations describe the kind of touch you enjoy?

______________________________________________________________________________
______________________________________________________________________________

How do you like to be held or touched?

______________________________________________________________________________
______________________________________________________________________________

What sense is most alive for you? _______________

Does this frequently change? Yes / No
What are you touching, seeing, smelling, tasting, and hearing right now?

9
______________________________________________________________________________
______________________________________________________________________________

Describe the quality of your breathing. Some words to describe your breath: fast, deep, slow,
steady, pressured, shallow, constricted.
______________________________________________________________________________

What parts of your body move when you breathe? Chest? Shoulders? Belly?
______________________________________________________________________________
How do changes in posture affect your breathing?
______________________________________________________________________________
______________________________________________________________________________

What are you craving? What tells you when you’re hungry? Do you know when you are full?
______________________________________________________________________________
______________________________________________________________________________

What is your body temperature? Just right? Chills? Hot flashes? __________________________
What is your digestion like? Do you feel bloated? Gassy? Can you feel your belly digesting after
you’ve eaten?
______________________________________________________________________________
______________________________________________________________________________

Is your heart rate steady? Pounding? Smooth? Even? Calm? Can you feel your heart beating?
______________________________________________________________________________

Are your eyes wet? Tearful? Dry? ______________

Is your skin clammy? Sweaty? Dry? Moist? Itchy? ______________
Can you feel air on your skin? Describe what it feels like. ________________________________
Do you have pain? Where does it hurt? What would help reduce the pain? _________________
______________________________________________________________________________

Where do you notice pressure? Does the pressure move in a certain direction?
______________________________________________________________________________

10
Do you have tension? Where? How intense on a scale of 1-10, where 1 = very little, to 10 =
extreme?
______________________________________________________________________________
______________________________________________________________________________

Where do you notice tingling in your body? Is it warm? Like pins and needles? How does it
move or travel in your body?
______________________________________________________________________________
______________________________________________________________________________

Is your body stance more open or more closed? What tells you that?
______________________________________________________________________________
______________________________________________________________________________

Is your eye contact a hard stare? A soft gaze? Are you avoiding eye contact?
______________________________________________________________________________

Is your jaw clenched, soft, or just right? __________________

How does your face feel? Soft? Tight? Do you know what your facial expression tells others?
______________________________________________________________________________
______________________________________________________________________________

What are your shoulders doing? Up by your ears or easily resting down?
______________________________________________________________________________

How does your neck feel? ________________________________________________________

How do your spine and back feel? Slumped? Rigid? Sore? Tight? Fluid? ____________________
Where do you notice feeling neutral, solid, or alive and well? Where feels good right now?
______________________________________________________________________________
______________________________________________________________________________

Where do you notice your body trying to get your attention? ____________________________
______________________________________________________________________________

Where does the sensation begin and end in your body? ________________________________

11
______________________________________________________________________________

How does your body want to express itself through movement or action?
______________________________________________________________________________
______________________________________________________________________________

What happens if you sit with an impulse without acting on it?

______________________________________________________________________________
______________________________________________________________________________

What might your impulses be telling you about what is happening right now?
______________________________________________________________________________
______________________________________________________________________________

Where in your body do you feel emotion? ___________________________________________

______________________________________________________________________________

What sensations come along with the emotion? Warmth? Tingling? Softness?
______________________________________________________________________________

What impulses are present with the emotion? ________________________________________

______________________________________________________________________________

What is your body doing when the emotion is present? Crying? Constricting? Eyes widening?
Jaw clenching?
______________________________________________________________________________

Which emotions give you more energy? _____________________________________________

Which ones feel draining or tiring? _________________________________________________
How does your body feel overall when you are in motion? ______________________________
______________________________________________________________________________

What kinds of movement does your body enjoy doing? Dance? Running? Yoga? _____________
______________________________________________________________________________

What is your body doing right now? ________________________________________________

12
 How is your energy level right now? Up? Low? Just right? Crashing?
_______________________
For the next two weeks, do the following exercise daily and fill in the chart.
1. Settle into a comfortable lying down or seated position.
2. Connect with the chair or the ground beneath you. Breathe and ground your body.
3. Scan your body, noticing tension, temperature, or anything else that stands out.
4. Focus your attention as you become aware of your entire body.
5. Rest your attention on areas of interest. For example, if your stomach feels tight, rest your
attention there and wait. See if anything shifts by just paying attention to the area.
6. Work through several areas of your body in this manner.
7. Try not to problem-solve or get caught up in details. Begin to ask some simple questions.
8. Notice how your body responds.
9. If you experience emotions, notice what comes up.
10. Simply listen to any insights or ideas that arise during this exercise. Refer to the questions
above as you complete the chart.
Date Your body feels: Your body senses: Your body story: Notes

13
Date Your body feels: Your body senses: Your body story: Notes

Did this exercise help you listen to your body? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What obstacles did you experience when completing this activity?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

14
 Tracking Body Sensations Form
What to Know
Body awareness is consciously connecting your mind and your body. When you were an infant,
you learned body awareness while crawling, walking, and climbing. As you age, body awareness
becomes second nature under normal circumstances (perception and spatial awareness, for
example).
Having good body awareness is beneficial because your body holds on to memories and
experiences, as demonstrated through your body language, posture, and facial expressions.
Your body may react to distress or trauma with an upset stomach, migraines, hormonal
imbalances, and more. Research indicates there is a relationship between emotional trauma
and the body.
Tracking body sensations helps increase body awareness and allows you to practice tools to
bring balance to your nervous system. You can learn to manage inner sensations. Perhaps you
only focus on uncomfortable sensations. But there are usually places in your body that are not
in distress or are in less distress – or even feel good.

What to Do
Over the next two weeks, focus on increasing your body awareness. For example, you may
notice you clench your jaw when you are stressed, or your shoulders are tense while you are at
work. Before you begin tracking, answer the questions.
How do you feel about your body?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Are there parts of your body you are unhappy with? Why? Explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Which parts of your body do you like or appreciate? Why? Explain.

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

15
Use the chart below to record your body sensations for two weeks. Pay close attention to inner
sensations (pleasant and uncomfortable). Note the date, describe the sensations, and write
down any thoughts associated with the sensations. In the fourth column, write down any
emotions or feelings you think might be associated with your physical sensations. Write down
any triggers, and what you did to soothe or calm yourself (if appropriate).
Date Sensations What do you How do you Triggers? What helped?
think? feel?

16
 Date Sensations What do you How do you Triggers? What helped?
think? feel?

After two weeks, answer the following questions.

How do you feel about your body?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Are there parts of your body you are unhappy with? Why? Explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Which parts of your body do you like or appreciate? Why? Explain.

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

What changes in your body awareness made a difference?

_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

17
 Tracking Your Nervous System
This worksheet will help you identify how and what you can do to feel safe, get connected, and
calm down. Use the chart below to track your nervous system. When you engage your nervous
system, you teach it to help you become active, engaged, or calm. There are three systems to
consider:
1. When you connect with others, you can trigger neural circuits in your body that calm the
heart, relaxes the gut, and shuts down the fear response. The Social Engagement System is
activated by talking to a trusted loved one, spending time with a pet, or doing pleasurable
activities with other people.
2. The Sympathetic Nervous System is engaged when you are active and playful (such as when
you are dancing), playing sports, stretching your body, or journaling.
3. The Parasympathetic Nervous System activates when you practice intentional breathing,
listen to soothing music, receive healthy touch, or listen to a calming voice.

Social Engagement Sympathetic Nervous Parasympathetic Nervous System

System
What makes you feel connected? When do you feel active? What calms you down?

How do you reach out to others? How can you develop healthy What healthy habits support your
habits that engage your SNS? calm state?

18
Body Scan
Objective
To practice the mindfulness technique “body scan” to relax the mind and body and feel a
greater sense of balance.

What to Know
This mindfulness skill in Dialectical Behavior Therapy (DBT) is called the body scan. While sitting
or lying in a comfortable position, you will bring your mind’s awareness to one part of your
body at a time, scanning up from the feet to the head. This is an effective way to build
tolerance for being present in your body and tolerate feelings and sensations without
judgment. The more awareness you bring to this process, the more sense of empowerment and
control you can have.
During a body scan, you will notice your physical sensations without needing to do anything
about them. This takes practice and patience. Approaching this exercise with a spirit of curiosity
can help. Rather than, “Oh no! My heart is beating fast,” you can practice saying, “Oh. I feel my
heart beating. Well, let me just feel it beat and notice what that’s like. Nothing bad is
happening. I can be with my body as it is.”

What to Do
Set aside 20 to 30 minutes. Or, if that feels like too much at first, try 10 minutes to start. But
don’t rush through it—give yourself the gift of this experience of being in your body.
If you find your thoughts drifting off, simply bring your mind back to focusing on that part of
your body. You may keep your eyes open or closed.

Begin by simply noticing your body. Notice any sensations you feel—aches, itches, tingles.
Notice any feelings you are aware of—calm, serenity, fear, anxiety, whatever it is for you. Just
notice without judgment and with acceptance. There is nothing you need to do. Nothing bad is
happening in this moment.

Feel the weight of your body. Notice your body on the chair or the floor.

Take several long, deep breaths. Notice your chest or belly expanding, bringing air into your
lungs, helping you to relax.

Starting with your feet, notice any sensations—tension, vibrations, temperature, or pressure.
There is no right or wrong. Just notice. If you notice you are holding any tension throughout this
body scan, try to release that tension.

Progress up through your body, from feet to ankles, calves, knees, thighs, hips, buttocks, pelvis,

19
abdomen, chest, hands, arms, shoulders, back, neck, jaw, face, scalp. Each time, notice any
tension, vibrations, temperature, or pressure.

Continue to breathe deeply and slowly. Come back to noticing your entire body, connecting all
parts together, just noticing without judgment and with acceptance.

Take a few deep breaths and come back into the present moment slowly and with kindness.
Practice this skill once a day or, if that is not possible, try 3-4 times a week to start.

Record when you do the body scan and what it was like:

When/where practiced How long? How did it feel?

20
Reflections on This Exercise

What did you learn about yourself by doing the body scan? What did you notice about your
thoughts and emotions?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What was the main obstacle you encountered? What was easy or pleasant about the body scan
exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How often will you commit to practicing the body scan skill in the coming week (or month)?

_________________________________________________

How helpful was this exercise? _____

(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)

What could you do differently to make progress in this area?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

21
 Body Awareness Inventory
What to Do
Read the following list as you scan your body from head to toe. For each section, write down
what you notice.
1. Sensations. Notice and write down any physical sensations you are experiencing, such as
tingling, warmth, tension, or discomfort. Rate the intensity of these sensations on a scale of 1
to 10, with 1 = very mild, and 10 = very intense.
________________________________________________________________ Rating: _______
________________________________________________________________ Rating: _______
________________________________________________________________ Rating: _______
________________________________________________________________ Rating: _______
2. Emotions. Reflect on any emotions you are currently experiencing. Are you feeling sad,
anxious, angry, or joyful? Pay attention to how these emotions manifest in your body. Do you
notice any changes in your heart rate, breathing, or muscle tension? Describe the physical
sensations associated with your emotions.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

3. Breath. Bring your attention to your breath. Notice the rhythm, depth, and pace of your
breathing. Is your breath shallow or deep? Is it slow or fast? Are you breathing from your chest
or your diaphragm? Take a few slow, deep breaths and observe how it affects your body.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

4. Tension. Check in with your muscles and notice if there is any tension or tightness. Pay
particular attention to areas where you tend to hold stress, such as your jaw, shoulders, or
abdomen. Rate the intensity of these sensations on a scale of 1 to 10, with 1 = very mild, and 10
= very intense.
________________________________________________________________ Rating: _______
________________________________________________________________ Rating: _______

22
________________________________________________________________ Rating: _______
________________________________________________________________ Rating: _______
5. Posture. Become aware of your posture. Are you sitting, standing, or lying down? How is
your body positioned? Is your spine straight or slouched? Are your shoulders hunched or
relaxed? Notice how your posture affects your overall sense of well-being and any sensations
you feel in your body.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

6. Movement. Reflect on your physical movements throughout the day. How do you walk,
gesture, or use your body in different activities? Are you aware of any habitual patterns of
movement or posture that may be contributing to physical discomfort or stress?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

7. Body Image. Consider your thoughts and feelings about your body. Are you comfortable and
accepting of your body, or do you experience judgment or criticism toward it? Notice how your
body image affects your emotions and sensations in the present moment.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

8. Intuition. Are there any sensations, feelings, or hunches you are experiencing in your body
that may be providing insight or guidance? Trust your body's wisdom and take note of any
messages it may be sending you.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

23
9. Self-Care. Reflect on how you have been taking care of your body. Have you been prioritizing
self-care activities such as sleep, nutrition, exercise, socialization, and relaxation? How does
your body feel in response to the care you are providing it, or the care you may need to
prioritize moving forward?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

10. Grounding. Focus on your body's connection to the ground. Feel the weight of your body
against the surface beneath you. Notice the points of contact between your body and the
ground. Allow yourself to feel supported and anchored in the present moment. How does it feel
to be firmly rooted to the ground beneath you? Reflect on how you feel when you are not
grounded.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Next, circle any of the words that describe your current experience.
Agitated Pulsing Shivering Liquid Restless
Loose Calm Strong Lengthening Trembling
Light Burning Moving Relaxed Sleepy
Heavy Wringing Still Choking Frazzled
Shaking Twisting Streaming Alive Pushed
Tight Hot Contracted Electric Bubbly
Pins and Needles Pain Rotating Pressure Racing
Numbness Cold Vibrating Flowing Prickly
Weak Tense Irritated Quivering Pulling
Numb At ease Held Wrapped Crooked
Blissful Flexible Inflexible Dead
Add your own descriptive words: __________________________________________________

24
After completing this body awareness inventory, take a moment to reflect on your observations
and insights. How do you think your body sensations, emotions, feelings, and self-care
connected to your overall well-being and mental health?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Did any of your answers surprise you? Why or why not?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Use the figure to highlight areas of your body where you

felt sensations. Use colored pens, markers, or crayons,
and add words to describe what you felt. You may also
use the box below to draw how the sensations feel in
your body.

Remember, consistent body awareness exercises can be

a valuable tool to help you connect with your physical
sensations, emotions, and intuition – as well as promote
self-care and self-regulation.

25
Facing Trauma
Objective
To identify how avoiding things related to trauma has affected your life and develop ways to
face your distressing thoughts and feelings.

What to Know
Did you know that approximately 61% of men and 51% of women have experienced at least
one traumatic event in their lifetime, according to the U.S. Department of Veterans Affairs?
There are many kinds of trauma, and no two people will react in the same way to a given
traumatic event. Accidents, death, war, loss, sexual assault, and other violent acts are easily
seen as major traumas, but many people experience ongoing distress related to less “obvious”
traumas, including neglect, divorce, emotional abandonment, verbal abuse, chronic criticism,
bullying, job loss, and so on, whose impact tends to be minimized in our culture.
Memories and feelings associated with any type of trauma can linger for weeks, months, years,
and even a lifetime, unless they are addressed and processed. What does it mean to process
trauma? Experts agree the one thing you should not do is avoid the thoughts and feelings
associated with trauma. Facing the memories and feelings associated with trauma can be
challenging and should be done cautiously and thoughtfully, but the payoff is a clear mind,
lighter heart, and genuine healing – leading to a more fulfilling and authentic life.
This worksheet is designed to help you identify how trauma affects your daily life and gives you
tools and resources to face your thoughts and feelings even though they may be disturbing.

What to Do
In the space below, write a summary of a traumatic situation that is currently troubling you and
you find yourself not wanting to think about. Just share the facts.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

26
In what ways do memories of the trauma affect you? For instance, problems sleeping,
flashbacks, nightmares, physical illness, depression, anxiety, substance abuse, dysfunctional
relationships, poor job or school performance, and so on. Be as detailed as possible.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What feelings come up when you think about the trauma? For instance, sadness, fear, guilt,
shame, anger, worry, and so on.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

27
What do you do to avoid the unpleasant feelings related to your trauma? For instance,
overeating, abusing drugs or alcohol, numbing out, avoiding talking about it, getting angry at
yourself, lashing out at others, and so on.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What are your fears when you think about remembering and working on your trauma on your
own or in therapy? For instance, “I’d go crazy,” “I’d lose it,” “I’d start to cry and never be able to
stop,” “I’d be so angry I’d want to kill people,” “I wouldn’t be able to function,” and so on.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Identifying and acknowledging the depth of the impact of trauma on your life is an important
first step. Most experts recommend working with a therapist or counselor familiar with trauma
recovery to see if you suffer from Post-Traumatic Stress Disorder (PTSD) or another
psychological disorder.
Here are some ways to cope with traumatic memories instead of avoiding them. Identify ones
that might work for you.
Find someone to talk to. If you tend to avoid talking or thinking about your trauma, you might
be making matters worse. Know you are not alone. It is okay to ask for help. Sharing your
feelings and concerns and, if/when you are ready, your past experiences, takes courage but the

28
benefits are worth it. If your symptoms are severe, please find a licensed mental health
professional who has experience working with trauma.
Practice mindful breathing. Pay attention in a nonjudgmental way to your breath. Notice
inhales and exhales, and where you feel the air enter—the nose or mouth? Notice the rise and
fall of your chest and belly. Release any worry or judgment. If your mind wanders, bring it back
to the breath. There are many apps, YouTube videos, and other resources available to help you
learn and practice mindful breathing. Studies show that deep, slow, diaphragmatic breathing
(abdominal breathing) can “trick” the brain into thinking you are relaxed, lowering your “fight-
or-flight” reactions. NOTE: If focusing on your breath is triggering traumatic memories, shift
your focus to something outside yourself such as colors, sounds, or objects in the environment.
Learn meditation. There are many kinds of meditation you can learn—some involve repeating a
mantra, simple sound, or phrase to yourself while sitting in a comfortable position with your
eyes closed. Some people like to think the word “peace,” “calm,” or “relax.” Some forms of
meditation do not require you to close your eyes, which can be uncomfortable for some
people. Apps include www.insighttimer.com, www.calm.com, or www.headspace.com.
Practice yoga. Researchers found that trauma and associated memories can be stored in our
bodies and cause distress. Yoga offers the opportunity to move safely and gently through
various positions and stretches, which can help release stuck emotions and help you become
more aware of the connection between your mind and body—leading you to feel stronger and
more empowered.
Find a practitioner that is trained in EMDR (Eye Movement Desensitization and Reprocessing)
therapy. This is an effective treatment in helping people process and release traumatic
memories. You will work with a trained therapist who gives you specific verbal instructions,
using sounds or lights, to guide you to “relocate” memories from one part of the brain to
another. This process can help you experience the memories as actually being in the past, so
they no longer interfere with your life.
Attend a support group for trauma survivors. Many communities offer support groups through
local hospitals, mental health centers, or religious institutions. Meetups or self-help groups for
survivors can also be helpful. Breaking through the isolation and feeling less alone are known to
be key elements of recovering from trauma.
Are you interested in trying any of the above suggestions? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

29
Choose one to try. What will you do?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

What did you learn from this exercise that you did not know before?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What are some remaining fears and worries about facing your trauma?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How motivated are you to work on facing your trauma? What do you think you will gain by
receiving help?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How helpful was this exercise? _____

(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What else can you do to make progress in this area?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

30
Talking About Trauma
Objective
To create a plan for dealing with memories and feelings associated with the trauma.

What to Know
Memories and feelings associated with trauma can linger for weeks, months, years, and even a
lifetime—unless they are addressed and processed. Along with memories and feelings, there
are other things you might experience related to trauma. Check off the statements that apply
to you.
___ anxiety, fear, or worry about your safety or the safety of others

___ worry the event will happen again

___ decreased attention, focus, or concentration

___ change in job performance

___ irritability with others

___ angry outbursts or aggression

___ withdrawal from people or activities

___ avoidance of events or activities

___ physical problems, like headaches, stomachaches, or chest pains

___ constant thinking about or talking about the event and/or the details of what happened

___ over- or under-reacting to bells, physical contact, doors slamming, sirens, bright lights, or
sudden movement

___ nightmares or disturbing memories

___ sleep problems (for example, you cannot fall asleep, or you frequently wake up during the
night)

___ avoidance of places that remind you of the trauma

___ emotional numbness – you have a hard time feeling anything

This worksheet is designed to help you identify how trauma affected you, and you will create a
plan to help you process the thoughts and feelings associated with what happened.

What to Do
Write a summary of the traumatic situation. Just share the facts.

31
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What triggers you or causes you to react strongly?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What feelings come up when you are triggered? For instance, sadness, fear, guilt, shame, anger,
worry, and so on.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What do you do to avoid being triggered? For instance, lash out at others, numb out by scrolling
through social media, and so on.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
The next page will help you create a plan to cope when you have thoughts, sensations, and
memories of the trauma.

32
 ________________________________’s Coping Plan

I know I’m triggered when I:

___________________________________ ____________________________________
___________________________________ ____________________________________
___________________________________ ____________________________________
Things that help me when I’m triggered:

Good ways I can distract myself Safe people I can reach out to (name, phone #):
when I’m upset:

How I keep myself safe:

33
Reflections on This Exercise
How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

34
 Tracking Triggers Form
Triggers are your body’s early alarm system. Tracking them can help you understand what your
body is trying to tell you. Use this chart every week and document your triggers in a neutral
way. Be curious and stay open to what your triggers show you. Fill in each column and discuss
your chart in-session with your therapist. Note the day and time and describe the trigger.
Describe what happened (the event or situation), and rate the intensity from 1 to 10, where 1=
least intense, to 10 = most intense. Describe where in your body you experienced sensations
and how you responded (what did you do and how did you react?). Finally, write down what
you learned about yourself.
Day/Time Trigger What Intensity Location in Response What did you
happened? (1-10) body learn?

35
Understanding How Trauma Impacts Trust
Objective
To identify how to rebuild trust after trauma.

What to Know
After trauma, it is normal to have problems with trust. Underneath trust is a belief that others
are reliable and responsible. When you develop basic trust, you grow as a healthy, self-reliant
person with good self-esteem. You trust yourself and others.
Over the course of your life, people hurt you, take advantage of you, and do other harmful
things, all of which can lead you to disbelieve, distrust, doubt, and become cynical or skeptical.
These are normal reactions but difficult to live with as you try to maintain healthy, productive
relationships.
To rebuild trust, you first need to become aware of why you stopped trusting. This worksheet
will help you identify how to rebuild trust.

What to Do
Think about situations with people that influenced your trust. Put a check next to the items
below that apply to you. Someone:
__hurt or attacked you (physically and/or emotionally).
__stabbed you in the back when you least expected it.
__abandoned you in a dangerous situation.
__took advantage of you.
__cheated on you.
__was disloyal by showing an absence of allegiance, devotion, obligation, or faith.
__stole important things from you.
__was deceitful by deliberately misleading you.
__took credit for your achievements.
__lied.
__was unfaithful in different situations.
__was dishonest by breaking rules to gain an unfair advantage in a competitive situation.
__failed to help when you needed it.
__made mistakes.

36
__disappointed you.
__made promises they failed to keep.
__showed a lack of concern for your feelings and needs.
__forgot things that were important (like an anniversary or birthday).
__kept secrets.
Write down other situations that happened to you.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Choose one of the above situations, circle it, and answer the following questions.

What did you think while it was happening?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What did you feel when it was happening?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What did you do when it was happening?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
What would you do now?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

37
Name the people in your life with whom you have concerns about trust.
On a scale from 1 to 10, how much do I feel I can trust ___________________________: _____
(where 1 = I cannot trust this person at all, to 10 = I trust this person completely)
Why?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

On a scale from 1 to 10, how much do I feel I can trust ___________________________: _____
(where 1 = I cannot trust this person at all, to 10 = I trust this person completely)
Why?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

On a scale from 1 to 10, how much do I feel I can trust ___________________________: _____
(where 1 = I cannot trust this person at all, to 10 = I trust this person completely)
Why?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

On a scale from 1 to 10, how much do I feel I can trust ___________________________: _____
(where 1 = I cannot trust this person at all, to 10 = I trust this person completely)
Why?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Describe a situation when one of the above people hurt you.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

38
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
How did you feel?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Can you tell the person how deeply you were hurt? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

If you can have a conversation with this person, let them know what you need to rebuild trust.
Write about your experience.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Can you forgive this person? Why or why not?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Can you trust this person again? Explain.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

39
Can you forgive yourself? Some people think if they were more clever or wise, this would not
have happened to them. Is this true for you? Explain.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How will you know you have changed your feelings and behaviors regarding trust? Describe.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What can others do to support you as you move toward trust and away from trauma?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

40
Creating Your Safe Place
Objective
To decrease distress and increase relaxation using the ‘Creating Your Safe Place’ relaxation
technique.

What to Know
This 20-minute audio will help you calm down, relax, and imagine a safe place.
Click here to listen to this audio.

Right click the link to download the audio to your computer, and from there you can transfer it
to a smartphone or other audio player. Use it whenever you feel distressed.
Use the following chart to record your daily relaxation practice. Make several copies of this
chart and keep a record of the time you spend practicing this technique until it becomes a
habit. You want it to become routine—something you do without thinking, like brushing your
teeth. It is also useful to note your general mood, both before and after, your daily relaxation
exercise.
Day Time Minutes you Mood before Mood after
meditated
Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Did this activity help you calm down and feel relaxed? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

41
Dealing with Frequent Nightmares
Objective
To identify the possible causes of your frequent nightmares and use positive imagery rehearsal
to reduce their occurrence.

What to Know
While you may think frequent nightmares are a problem that occurs mostly with children,
between 2-8% of adults say that they suffer from nightmares. This can include frequently
waking up during the night, usually during the second half of the sleeping period, or during
naps, and recalling with vivid detail a disturbing or frightening dream. These dreams often
involve scary images or themes that threaten one’s survival or safety.
There are various reasons that some adults have frequent nightmares, including sleep apnea
and post-traumatic stress disorder (PTSD). Certain medications, including anti-depressants and
medication for high blood pressure, can trigger nightmares. Other substances such as alcohol or
recreational drugs can also cause frequent nightmares. If you are currently taking medication or
using substances, consult a physician to determine if nightmares are a side effect. If you
experience delusions or hallucinations during the day, it is an indication you should get a full
evaluation by a qualified psychiatrist to address your nightmares.
Nightmares can reflect unresolved or current stresses that occur during the day. They can also
reflect recent or past trauma, in which you relive an event in your sleep, perhaps as a way for
your mind to understand or come to terms with trauma. Frequent nightmares can become
habitual. That is, anything the mind does repeatedly can become reinforced and strengthened,
making it hard to break the pattern. The experience of ongoing nightmares can lead not only to
disrupted sleep but to low energy, moodiness, depression, anxiety, and poor performance at
school or at work.
This worksheet will help you identify the possible causes of your frequent nightmares and to
see if positive imagery rehearsal can help reduce their occurrence.

What to Do
Indicate the overall frequency of your nightmares to the best of your ability—every night? 3-6
times/week? Weekly? Bi-weekly? Monthly?
______________________________________________________________________________

Indicate the overall severity of your nightmares to the best of your ability, where 0 = mild, 3 =
moderate, 5 = severe: ________
How have nightmares negatively affected your life? Be as detailed as you can.
______________________________________________________________________________
______________________________________________________________________________

42
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What are the recurring themes or images, if any, that you experience during your nightmares?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Research have found that learning relaxation exercises, meditating, or listening to pleasant,
guided imagery audio recordings before you go to sleep can help.
Newer approaches to dealing with chronic nightmares include Imagery Rehearsal Therapy (IRT),
where you think about images you would like to dream about before you go to bed. This is
thought to “break the habit” of recurrent nightmares. Sometimes a nightmare can become
more neutral or positive. Sometimes a nightmare can disappear forever.
Please note: If you are having nightmares because of trauma (recent or past), please work with
a qualified therapist to address your concerns and decide whether IRT is an appropriate
treatment for you.
If you would like to practice IRT by yourself, try the following:
Choose one recurring nightmare that you would like to work with to start your IRT
practice. Do not choose one that involves reliving a traumatic event. Instead, think of
one that is troubling but not terrifying. Focus on one nightmare at a time until it is
resolved. Continue the practice for at least a week after each recurring nightmare goes
away.

What nightmare would you like to work on to start? Describe it.

______________________________________________________________________________
______________________________________________________________________________

43
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Create a different ending to the story of your nightmare. Rewrite your dream! Make the ending
calm, peaceful, positive, or neutral, as opposed to another violent or negative ending.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Before you fall asleep every night, rehearse or visualize the same dream with your new ending.
Record your experiences below. You may repeat this process with additional nightmares.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

44
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

Use a journal or sketch pad to keep track of your ongoing IRT work or other tools you are using
to cope with frequent nightmares. Write your ideas here.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Which of the nightmares you are working with were the easiest to resolve or diminish in
intensity or frequency?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Whom can you talk to about the nightmares that might be more difficult to resolve on your
own? Write down the names of friends, trusted mentors, or mental health professionals who
might help.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How helpful was this exercise? _____

(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

45
Understanding the Window of Tolerance
Objective
To expand your window of tolerance and identify ways to manage hyper-arousal and hypo-
arousal.

What to Know
You can more easily cope with stressors and triggers when you can manage your emotions. If
you struggle to manage the anxiety, anger, or pain brought on by everyday stressors, it is
helpful to understand “the window of tolerance,” a concept originally developed by Dr. Dan
Siegel. This refers to the optimal zone of arousal for you to function in a healthy manner day-to-
day. If you learn to successfully operate within this window, you can begin to effectively
manage and cope with emotions.
If you have a history of trauma, it can be even more difficult to stay present and calm – and you
may have a very narrow window of tolerance. Daily stressors and triggers may frequently push
you out of your window of tolerance. Minor stressors may cause you to get angry, numb out, or
feel anxious – leading to hyperarousal or hypo-arousal. Your window of tolerance might close
altogether when you are:
• hungry or dehydrated
• exhausted
• feeling lonely or isolated
• in physical pain
• threatened
• scared
• reminded of painful memories
What is Hyperarousal? Known as the “fight, flight, or freeze response,” it is a heightened state
of activation and energy. Your nervous system kicks into high alert even when there is no
danger. You may be triggered by a perceived threat, traumatic memories, or certain emotions.
Check off any of the following symptoms of hyperarousal you have experienced.
____ angry outbursts
____ feeling out of control
____ impulsive or risky behavior
____ overwhelming anxiety
____ problems sleeping
____ inability to focus or concentrate
____ racing thoughts

46
____ emotional overwhelm
____ feeling unsafe
____ panic
____ tight or tense muscles
____ defensiveness
____ inability to make meaningful connections with others
____ desire to run away
____ lashing out at others
____ other? ___________________________________________________________________
When do you find yourself hyper-aroused?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What is Hypo-arousal? Known as the “shutdown” or “collapse” response, this state can be
triggered by feeling threatened, recalling traumatic memories, or experiencing emotions
associated with past trauma. Check off any of the following symptoms of hypo-arousal you
have experienced.
____ binge watching shows
____ depression
____ lack of feelings, energy, and feeling “dead” inside
____ feeling disconnected
____ inability to say “no”
____ ashamed
____ binge eating episodes
____ numbness or emptiness
____ spacing out
____ inability to be present or stay present with your feelings
____ excessive drug or alcohol use
____ staring blankly

47
____ inability to speak
____ feeling like you are outside your body or that your surroundings are “unreal”
____ socially withdrawn
____ other? ___________________________________________________________________
When do you find yourself hypo-aroused?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

When you are in your window of tolerance, you may feel pressure or stress, but it does not
bother you. You will know you are in your window when you can:
• effectively cope with what is happening in the moment.
• control your impulses.
• connect with others.
• tolerate your emotions.
• self-soothe in healthy ways.
• think and feel at the same time.
• adjust your reactions to fit situations.
• learn and process new information.
When do you find yourself in your window of tolerance?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Depending on whether you are experiencing hypo- or hyperarousal, you can use different
strategies to suit your needs.
When you are hypo-aroused, try:
• physical movement.
• describing three things you see in your surroundings in full detail.
• smelling essential oils or other strong aromas.
• painting, drawing, or engaging in other artistic activities.
• mindfully eating crunchy food.
• stretching or doing yoga.
• using a heavy weighted blanket.
• doing any activity that fully engages your senses.

48
When you are hyper-aroused, try:
• using diaphragmatic breathing (slow, deep breaths).
• shaking or stomping out excess energy.
• doing heavy work like lifting objects or pushups.
• exercising.
• playing a team sport.
• drinking from a straw.
• meditating.
• using any healthy strategy to release anger.
To expand your window of tolerance and increase your capacity to experience emotions, you
first must recognize when you are experiencing emotions outside your tolerable zone. Then you
can identify how you feel and how your emotions impact your body. You can begin to manage
your window of tolerance by:
• becoming aware of how you feel and symptoms you are experiencing.
• learning techniques for regulating intense emotions.
• using strategies to tolerate discomfort and distress.

What to Do
Over the next two weeks, use the following techniques (or any of the strategies described
above) when you find yourself outside your window of tolerance.
o Breathwork
o Guided Imagery – imagine yourself on a swing, paying attention to the feeling of
movement
o Positive Containment Imagery – place the intrusive thoughts or images in a chest
or other container and lock it securely until you are ready to process them
o Safe Place Imagery – imagine yourself in a real or imaginary place where you feel
calm and content
Note the date and whether you were hyper- or hypo-aroused. Use a rating scale from 0-10 to
rate your level of hyper/hypo-arousal before and after you use a tool or technique, where 0 =
extremely hypo-aroused, and 10 = extremely hyper-aroused. Describe your feelings and how
they are impacting your physical body. Describe the technique you use or activity you engage in
to move back into your window of tolerance. Finally, describe whether the technique or tool
was effective.

49
Date Hyper- or Feelings Impact on Level Technique used Effective? Level
hypo- body before Y/N after
aroused?

Did this exercise help you expand your window of tolerance and identify ways to manage
hyperarousal and hypo-arousal? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Reflections on This Exercise

How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

50
Understanding Your Boundaries
Objective
To identify your boundary issues and use strategies to feel more empowered by
setting limits, protecting yourself when you are vulnerable, and taking safe risks.

What to Know
Setting interpersonal boundaries is an important part of establishing your identity and it is an
essential aspect of mental health and wellbeing. Boundaries are like a semipermeable
membrane, and you create them by the limits you set, based on what you will tolerate. You set
limits around people and time, that is, limits around who you allow into your life and limits
around what takes up your attention and time. Boundaries can be physical or emotional, and
they can range from loose to rigid, with healthy boundaries falling somewhere in between. If
you lack appropriate boundaries, you may struggle with telling others how you feel (fear of
rejection or ridicule), worry how others perceive you (desire to people-please), strive to make
everyone happy (at work, school, home, and so on). You may even stay in unhealthy
relationships, where you feel trapped, overwhelmed, or manipulated.
Mental health depends on understanding your boundaries with everyone in your life. After
trauma, boundaries may shift and change.
Boundaries let others know what is and what is not okay or acceptable, so you feel respected
and safe. This worksheet will help you identify your boundary issues and learn strategies for
feeling more empowered by setting limits, protecting yourself when you are vulnerable, and
taking safe risks.

What to Do
Are you aware of some looseness in your boundaries? If so, describe.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Perhaps your boundaries are too rigid, leaving you isolated and cut off from others. Are you
aware of some rigidity in your boundaries? If so, describe.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Describe a time when your boundaries were either too loose or too rigid.
______________________________________________________________________________
______________________________________________________________________________

51
______________________________________________________________________________

You can start to be proactive in setting boundaries. Healthy boundaries can be flexible when
needed. They are fluid, able to adjust to change and unexpected events. Here are some
strategies you can use.
• Learn ways to say NO.
• Learn ways to say YES.
• When it is MAYBE, take some time to consider your thoughts and feelings before you
respond.
• Know how you expect to be treated.
• Understand that the timing of your responses is important.
• Say, in different ways, that you will not tolerate poor treatment.
• Be clear and firm about how you prefer to be treated.
• Be respectful, thoughtful, and responsible when setting boundaries.
• You can say, “I don’t want to talk about it right now,” “I don’t need your feedback,” “I need
time for myself,” or, “I prefer not to go out after work for a drink.”
• Respect other people’s boundaries, even if you do not agree with them.
• If your boundaries are incompatible with people you are close with, find a
compromise.
The following are statements that reflect a positive approach to personal boundaries. Rate each
statement from 1 to 3, with 1 = never, 2 = sometimes, and 3 = always. If a statement does not
apply to you, write NA.
____ I trust others by observing their behavior over time.
____ I look to myself first to fulfill my personal needs.
____ I share my thoughts and feelings with people I trust.
____ I seek emotional intimacy with the people who care about me.
____ I seek physical intimacy only in trusting and caring relationships.
____ I make my own decisions about my relationships.
____ I focus on my own needs and goals without being influenced by others.
____ I consider the consequences of my decisions and how they affect others.
____ I do not allow people to take advantage of me.
____ I maintain my personal values no matter what other people say or believe.
____ I can take care of myself when I feel emotionally vulnerable.
____ I am aware when someone infringes on my rights.
____ I can say ‘no’ if I feel that someone is asking for something I do not wish to give.

52
____ I am aware of the personal boundaries of others and respect them.
____ I don’t take advantage of others.
____ I don’t change my opinions or do something against my values to get someone to like me.
____ I don’t allow people to take advantage of my time or money.
____ I trust the decisions I make about my relationships.
____ When in doubt, I seek advice from people I trust, but I still make up my own mind.
____ I have a clear idea about who I am and what I want from life.
____ I recognize that people are not “mind readers” and I clearly communicate my needs and
feelings.
____ I can be assertive and still consider the rights and needs of others.
____ Total score
If your score is 40 or less, you probably need to work on your boundaries.
If you scored 41 or above, you may need to work on some areas, but in general you have
healthy boundaries in place.
Review your answers and pick one area of your personal boundaries you would like to work on.
In the space below, describe an incident that illustrates this problem.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Now describe how you would behave differently in this situation to reflect healthier personal
boundaries.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What else can you do to strengthen your boundaries?

______________________________________________________________________________

______________________________________________________________________________

53
Reflections on This Exercise
How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

54
What to Do When Your Boundaries are Violated
Objective
To identify ways to cope when someone violates your boundaries.

What to Know
Boundaries are limits you set for yourself that determine what you will and will not participate
in or allow. They are more about what you do than getting another person to change.
Boundaries keep you physically and emotionally safe. They are the ultimate form of self-care
because they help you prioritize what is best for your mental, emotional, and physical health.
They allow you to advocate for yourself in relationships. Boundaries keep relationships healthy,
but when others violate them, it is painful and stressful. When violations occur repeatedly, the
relationship can become unhealthy and feel unsafe.
If you lack boundaries, you may:
• believe your needs do not count.
• frequently doubt yourself.
• easily fall into the “people-pleaser” role.
• feel like your relationships are more like obligations.
• begin to resent others.
• lose self-respect.
• may not trust yourself.
• allow others to treat you poorly, say cruel things, or otherwise abuse you.
What does a healthy boundary look like? Healthy boundaries depend on your actions and
choices. You might:
• say no.
• not volunteer your time if your schedule is already overloaded.
• avoid spending time with unkind people.
• leave the room if someone is disrespectful to you.
• end a relationship with a toxic family member.
Why would someone violate your boundaries? Perhaps the person is unaware how their
behavior hurts you. Some people grow up having their own boundaries violated, so they fail to
recognize the importance of boundaries and lack the skills. Or sometimes people violate
boundaries to gain control, manipulate, or get what they want from others. When someone
violates your boundaries, it is natural to feel powerless, but there are ways to take your power
back. Here are some suggestions.
1. Set strong, clear, consistent boundaries. You cannot control how people respond, nor can
you force people to respect your boundaries. You can control yourself and your choices, and
you can stick to your boundaries regardless of what others choose to do.

55
2. Write it down. Record boundary violations and your responses to check for weaknesses in
your boundaries. If you notice you fail to consistently set healthy boundaries, make
adjustments. Writing down violations will help you decide what to do next.
3. Be clear. Decide what you will accept, and what you will not accept from others. Perhaps you
have set a boundary mentally but allow it to be pushed or broken. Write down your boundaries
and say them out loud to a supportive person who will help you stay true to them.
4. Accept. Some people will not respect your boundaries no matter what you do. It may be
disappointing to realize you will need to decide whether you want to continue relating to
people who violate your boundaries.
5. Detach. Some people intentionally violate boundaries to hurt you, get a reaction out of you,
or exert control. Avoid engaging in the same arguments with these people. You can choose to
ignore them or laugh off their comments to shift the power.
6. Limit or cut off contact. You have choices, and even if it is a family member, you may decide
your wellbeing is more important than putting up with repeated boundary violations.

What to Do
Visualize yourself and your personal boundaries (emotional, mental, and physical). What do you
need to feel safe? Make a list and speak them aloud to a trusted, supportive person.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Write down recent boundary violations and how you responded.

Date Boundary violation Your response

56
Now, imagine someone you want to set a boundary with. What will you say to them?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Who is violating your boundaries? The nature, power differential, and closeness of the
relationship can make a difference in how you will address the person.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Is the boundary violator(s) willing to change? Are they willing to work with you to improve the
relationship? Are they sensitive to your needs or feelings? Why or why not?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

How long has this been going on? Longer behavior patterns might be more difficult to change.
Explain.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Has the boundary violator been physically aggressive? Explain. If the person violating your
boundaries has been violent or threatened violence, proceed with caution. Get help from
supportive people, professionals, and/or law enforcement.

57
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Are you setting clear, consistent boundaries? Boundaries must be clear and consistent if you
are dealing with someone that does not respect you. This person may look for holes in your
boundaries and use them against you. Describe the situation.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Make a statement that affirms your motivation and commitment to your personal boundaries.
I require _________________________________________________ to feel safe. I need you to
respect my boundary by _________________________________________________________.
Consider my boundary request by _________________________________________________.
I will no longer _________________________________________________________________.
If you are consistent and clear, and present others with your statement, there may be people
who continue to disrespect your boundaries. Whom? Would you consider disengaging or
ending the relationship altogether? Why or why not?
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________

Reflections on This Exercise

How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

58
Coping with Memory Problems Following Trauma
Objective
To use strategies for accessing memories and monitor your “memory bugs.”

What to Know
You may be haunted by recurrent, involuntary, intrusive, and distressing memories of a
traumatic event. The memories might be even more upsetting than the event itself. Becoming
aware of your memory issues, knowing they will go away, and having the patience to work
through them allows you to move forward with your life.
Experiences result in two types of memory. One is conscious and includes verbally accessible
sensory information. The second type is unconscious and is automatically retrieved when you
are in a traumatic situation.
Researchers have identified several types of memory problems following a trauma:
• Hypermnesia is a vivid or almost total recall of the past. You may display an extraordinary
ability to recall details about specific events.
• Hypomnesia (amnesia) refers to difficulty remembering the past. Lacunar amnesia is the loss
of memory about one specific event.
• Retrograde amnesia (RA) is a loss of access to memories of events that occurred or
information that was learned before the trauma.
• Anterograde amnesia is a loss of the ability to create new memories after the event that
caused amnesia. Long-term memories from before the event usually remain intact.
• Dissociative amnesia involves the inability to recall important personal information that is too
extensive to be explained by ordinary forgetfulness.
• Confabulation is the production of fabricated, distorted, or misinterpreted memories without
the conscious intention to deceive.
• Allomnesia is an illusion of memory, or distorted memories, of something in the past that
really happened, but it is distorted.
• Pseudomonas (hallucinations of memories) refers to memories of something that did not
happen.
• False memory is a phenomenon where you recall something that did not happen, or your
memories are very different from the way it happened.
• Flashbacks (involuntary recurrent memory) are vivid experiences in which you relive some
aspects of a traumatic event or feel as if it is happening right now.

59
In the weeks after a trauma, intrusive memories are common. Over time, intrusions become
less frequent and distressing.
Memory has many functions, and it is vital for maintaining your identity. Memory issues related
to trauma are often reflected in your perception of your identity. This worksheet will help
remind yourself who you are by remembering your life before the trauma.

What to Do
The following are a series of activities that include strategies for coping with memory problems.
When you experience memory problems, go to a safe place, and ask yourself the following
questions. Write down your answers in the left column. After you have answered all the
questions, take a break, and then answer the same questions thinking of your present
circumstances.
1. What adjectives would you use to describe yourself? Write at least ten positive or neutral
adjectives.
Before the Trauma After the Trauma

2. What activities did you enjoy? What activities didn’t you enjoy?
Before the Trauma After the Trauma

60
3. Where did you like going? What places did you avoid?
Before the Trauma After the Trauma

4. What did you like to eat?

Before the Trauma After the Trauma

5. How did you spend your free time? Whom did you spend your time with?
Before the Trauma After the Trauma

61
Pick five ordinary objects (photos, pencils, mugs, books, and so on) in your home. For each
object, write a short account of how you got it and who gave it to you (or, maybe, you bought it
yourself). Remember the details. Where do memories of this object take you? Do you have any
other associations when you look at the object? What are they? How do your thoughts make
you feel? What bodily sensations do you have? Do this activity once per week, using a different
set of objects each time.
Object 1: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Object 2: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Object 3: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Object 4: ______________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Object 5: ______________________________________________________________________

62
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Choose two or three close friends and ask them to tell you all about you. Summarize their
answers below.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Visiting places from earlier in your life can help you retrieve memories you have not recalled for
many years, vividly and in detail. For each place you visit, write about it. Focus on your senses
(smells, sights, sounds, colors). Compare your perception of the place now with how you
remember it.

63
Place: ____________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Place: ____________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Place: ____________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Think about a time in your life and concentrate on your sensations and experiences.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Talk to parents, siblings, old friends, and former teachers about ideas and attitudes you had.
Write down their responses.
Person you talked to: ________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Person you talked to: ________________________________________________

______________________________________________________________________________

64
______________________________________________________________________________
______________________________________________________________________________

Person you talked to: ________________________________________________

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

If you are ready, visit the place(s) associated with the traumatic memory. Write about the visit.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Finally, monitor your memory bugs. A memory bug, or a memory leak, is a disturbance or glitch,
a short-lived fault, in your memory. Every time you experience a memory problem write it
down on the following chart for 21 days. At the end of the exercise, review the entries and see
if you can spot patterns.
Date and Memory Situation Thoughts Emotions Physical
time glitch sensations

65
 Date and Memory Situation Thoughts Emotions Physical
time glitch sensations

Reflections on This Exercise

How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

66
Understanding and Managing Depersonalization
Objective
To understand how depersonalization is affecting your life and identify techniques to address it.

What to Know
Depersonalization occurs when you perceive yourself as ‘unreal,’ and you may experience this if
you are anxious or stressed. Chronic depersonalization could occur if you experienced trauma,
or if you have been exposed to prolonged stress or anxiety. It can also be a symptom of several
other disorders. It is characterized by a change in the perception or experience of the self,
where you feel detached from—as if you are an outside observer of—your mental processes or
body (e.g., feeling as if you are in a dream).
If you experienced intense stress or trauma, you may experience one or more of the following:
• a split between your mind and body—sensations, feelings, emotions, or behaviors feel
like they are not your own
• feeling stiff, like a robot or machine; feeling waxy and disoriented in space and time
• detachment within your personality, as if different parts of you do not fit with each
other
• feeling like you are watching your life being lived without you taking part in it
• feeling you have changed so much that this new person is not you
• your name might seem strange, not belonging to you when somebody calls you
• using the stereotypical perception of the self as an example of some defining social
category, e.g., soldier, truck driver, or housewife
• not understanding your symptoms—they do not make sense
What to Do
Read through the following statements and mark each statement with either “Yes” if it is true
for you, or “No” if it is not true for you. For each statement you marked “yes,” choose the
appropriate number in the Frequency and Duration columns.
Statement Yes No Frequency Duration
0 = never, 1 = rarely, 1 = several seconds,
2 = often, 3 = very often, 2 = several minutes,
4 = all the time 3 = a few hours,
4 = one day,
5 = several days,
6 = more than one week

1 I feel hollow and empty

inside.
2 I’ve lost my sense of
myself.

67
3 I feel like I’m observing
myself from the outside,
looking in.
4 I feel like an automaton
or robot.
5 My head feels empty,
without thoughts.
6 I stopped laughing,
crying, and feeling pain as
I used to.
7 My body feels very light.
8 I don’t feel anything in
dangerous situations.
9 I pay a lot of attention to
my bodily sensations
and/or my thoughts.
10 My body and mind seem
disconnected.
11 I don’t enjoy anything,
have no favorite foods,
music, or activities.
12 Parts of my body are not
mine.
13 Suddenly, I feel strange
and detached.
14 I feel flat and lifeless.
15 My belly is tight.
16 Familiar voices feel
unreal.
17 I feel parts of my body
getting larger or smaller.
18 I hallucinate.
19 I am suicidal.
20 I feel like hurting other
people and being
vengeful.
21 When I look at my
reflection in the mirror, I
see another person.
22 My perceptions of time
and space have changed.
23 I have sleeping problems
or nightmares.
24 I fear I might be going
crazy.

68
 25 I don’t feel any affection
toward my family and
friends.
26 I feel like I’m outside my
body.
27 I must touch myself to
feel real.
28 I feel I have a physical
illness that is untreated.
29 I don’t understand
myself.
30. I am so alert, like I have
overdosed on caffeine.

If you answered YES to statements 2, 3, 6, 10, 13, 16, 22, 25, 26, and 28, give yourself 10 points
for each answer.
If you answered YES to statements 1, 4, 5, 7, 9, 11, 14, 15, 29, and 30, give yourself 20 points for
each answer.
If you answered YES to statements 8, 12, 17, 18, 19, 20, 21, 23, 24, and 27, give yourself 30
points for each answer.
Add up your score: ______
Now, for each frequency and duration mark, add as many points to the score as the number
you put down in frequency and duration columns. For example, if you answered YES to
statement 25, that is 10 points, you marked frequency as 3, and duration as 2. In total that is
10+3+2=15 points for statement 25. Do this for all 30 statements.

Total Score: ______

If your score is equal to or less than 200, then your trauma may be classified as MILD.
If your score is between 200 and 300, then your trauma may be classified as MEDIUM.
If your score is higher than 300, then your trauma may be classified as SEVERE.
Please note this questionnaire is neither the only one nor the best. Please consult other
questionnaires.
Treatment for Depersonalization
Treatment depends on the underlying cause(s), and whether your depersonalization symptoms
are physical or psychological. If depersonalization is a symptom of neurological disease, then
diagnosis and treatment of the specific disease is the first approach. Contact your physician.
Also, if your score indicates your trauma is severe, please seek help from a mental health
professional as soon as possible.

69
If your depersonalization is mild to medium, you may try some of the following strategies and
activities.
1. Stay grounded. During depersonalization, you might experience a wide range of thoughts
and feelings. Some odd, while some will feel familiar and connected to the events of your daily
life. Some will be unfamiliar, upsetting, or strange to you. Mastering, containing, regulating, and
communicating your feelings in an appropriate way might take time and learning, but once
these skills are acquired, you will feel empowered and no longer disconnected.
2. Nurture yourself. What are your physical and emotional needs? When things are difficult,
imagine you are taking care of someone important to you. Eat, sleep, exercise, and fulfill all
your needs and wishes. A spiritual practice may help to sustain you daily.
3. Maintain your boundaries. Boundaries maintain your personal integrity. You might already
know you have the right to say “no” when your boundaries are crossed. There are probably
things you do not want to do, experience, or communicate at that moment and at that place
and time. Respectfully, kindly, and firmly say, “No.” Others might invade your space with the
best of intentions, but you do not have to accept this. You dictate your space and determine
what goes in and out of that space. When you maintain your boundaries, you can cope with
different people and situations more effectively—feeling you have more power and control in
situations.
4. Be aware of your thoughts and emotions. Learn how your sensory self responds to different
situations. Label those experiences. Remember your past experiences with each emotion. Know
what triggers them. Are you satisfied with your reactions and experiences? Are you frustrated
you cannot adequately express yourself? What else do you need to learn?
5. Create a strong support system. These are the people who know, encourage, and nurture
you. They like you for who you are, and they are willing to help you become your best self—
people you can turn to just to listen and be there for you. They are the opposite of people who
put you down, discourage you, manipulate you, and encourage you to be impulsive, revengeful,
or hopeless.

6. Create a psychological toolbox. Where can you keep your coping tools? It can be a box with
pictures, drawings, poems, inspirational messages, or special memories. This is a storage place
for your life management tools and strategies you develop and use to cope with past
challenges. Be patient, and over time your personal “toolbox” will contain a lot! In very
challenging times, you may need to seek professional help to gain a broader perspective and
add more strategies to better manage a certain situation. Anything that helps you grow and
become more grounded is always a welcome addition to your toolbox.

70
Selfie Diary
This activity can also help you overcome depersonalization. Take a selfie of yourself every day
for at least ten consecutive days.
Selfie Day Date/Time Where were What were the circumstances? When I took the
you? Describe the situation in which selfie, I thought and
you took the selfie. felt:
1

10

If possible, print out your selfies and paste them on the following pages in the order in which
they were taken.

71
Paste selfie day 1 here. Paste selfie day 2 here.

Paste selfie day 3 here. Paste selfie day 4 here.

Paste selfie day 5 here. Paste selfie day 6 here.

72
 Paste selfie day 7 here. Paste selfie day 8 here.

Paste selfie day 9 here. Paste selfie day 10 here.

Now, look at your selfies. Choose the one you like the most and describe it.
I took this selfie on ___________ (morning/afternoon/evening/night) while I was
________________________. I remember feeling ________________________________.
Looking at this selfie, I see myself as ___________________________________________ and I
feel __________________________. I chose this selfie as my favorite because
_____________________________________________________________________________.

Now, choose the one you like the least and describe it.

I took this selfie on ___________ (morning/afternoon/evening/night) while I was

________________________. I remember feeling ________________________________.
Looking at this selfie, I see myself as ___________________________________________ and I

73
feel __________________________. I chose this selfie as my favorite because
_____________________________________________________________________________.

Continue taking selfies (one a day!). Copy the table and paste sheets and fill in the information
about each selfie. On every tenth day, write two short descriptive paragraphs, one for your
favorite selfie and one for your least favorite.
Vigorous Physical Activity
Another approach to dealing with depersonalization is engaging in vigorous physical activity for
which you are medically fit. Do this every other day for at least ten days or until you have done
five activities. It is important to keep regularity in the rhythm of your activities. It does not have
to be the same activity each time. After completing each activity, fill in the following chart.
Activity Type of activity After completing the activity, After completing the activity, I
Date and how long? my body and my muscles feel: think and I feel:

Answer the following questions.

Which type of activity made you feel most yourself? ___________________________________
Which type of activity made you feel like a stranger? __________________________________
What sensations did you experience during this activity? _______________________________
Did you do the activity alone or you were with someone? ______________
If you had company, how did the presence of the other person(s) make you feel? ___________
______________________________________________________________________________
Which of the activities you did would you consider doing on a regular basis? Why? __________
______________________________________________________________________________

74
If you did the same activity every time, why? ________________________________________
What other activities would you consider doing? _____________________________________
Bathroom Exercise
To address symptoms of depersonalization, experts suggest you take a shower or bath every
day for at least ten consecutive days. While doing so, pay attention to your thoughts and
feelings before and after bathing. Every time you towel yourself dry, report to yourself out loud
which part of your body you are toweling. For example, “I am toweling my left leg.” Pay
attention to body sensations as you are doing this. Describe the sensations, including what you
are thinking and feeling. Write this information down in the following chart.

Before taking the shower/bath After taking the shower/bath

Bodily Thoughts Feelings Bodily Thoughts Feelings
sensations sensations
Day 1

Day 2

Day 3

Day 4

Day 5

Day 6

Day 7

Day 8

Day 9

Day 10

75
Reflections on This Exercise
How helpful was this exercise? _____
(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)

What did you learn from this exercise?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

76
Learned Optimism
Objective
To practice strategies for becoming more optimistic, including applying the “ABCDE” technique.

What to Know
Optimism is an attitude characterized by hope and confidence in success and a positive future.
It is the belief, faith, and self-assurance that more good things than bad things will happen in
your life. When difficult things happen, optimists accept the challenge and choose to identify
both resources and skills that can help them cope.
People who experience trauma and believe they have the skills to cope have a more positive
outlook on life. Positive morale leads to perseverance, effective problem-solving, and healthy
coping.
Learned optimism refers to developing the ability to view the world from a positive point of
view. By challenging negative self-talk and replacing pessimistic thoughts with more positive
ones, you can learn to become more optimistic.
• Failure and success. Optimists take failures and setbacks in stride. Pessimists tend to see
everything – especially a challenging or negative event – as a conspiracy against them. While an
optimist will always think of at least one positive reason why they should do something, a
pessimist thinks of ten reasons against doing it.
• Permanence. Optimists believe negative or difficult events are temporary rather than
permanent. They bounce back quickly from failure. Pessimists may take longer to recover – or
they may never recover – and generalize while pointing to permanent causes.
• Pervasiveness. Optimists know how to handle helplessness, while pessimists believe that a
problem in one area of life means their whole life will be ruined. Optimists allow positive events
to generalize to other areas of their lives.
• Personalization. Optimists are confident and think critically, exploring what can be done for
the better and how things can improve. Pessimists blame themselves and resort to
helplessness.
This worksheet will help you practice strategies for becoming more optimistic.

What to Do
Here are some ideas to practice being more optimistic.
1. Create a "movie” of your best life. Include specific details, like how you look, how you feel,
how you behave, where you live, and what you are doing. Spend time in your safe place every
day and play this movie in your mind. This simple mental training exercise might boost your
mood and influence the way you think and feel about yourself and the possibilities for your life.
2. Self-nurture with the Inner Advocate. As your Inner Critic starts talking, let out your Inner

77
Advocate, a powerful ally who believes in you, promotes you, supports you, protects you, and
empowers you. Talk to yourself in the second person. Say things like, “You can do this. You are
a good person. You easily make friends,” and so on. You might recall a role model who inspired
you. Ask yourself, “What would ____ do and say?”
3. Write down your daily “done wells.” Recognize what you did well every day and
congratulate yourself. Take a few moments every day to write about what you did well. Get in
the habit of rewarding yourself, which reinforces optimism.
4. Nurture a healthy body. Optimism is easier when you feel good. Factors that interfere with
having a healthy body include lack of sleep, poor eating habits, self-destructive behaviors, too
little exercise, and too much stress. If you know your priorities and goals, be disciplined and
“train” for them like a professional athlete. Be sure to include rest days!
5. Look for improvement and take small steps. For example, running around the block may
seem small when your goal is to finish a marathon, but it is a small step in the right direction.
6. Minimize difficulties to progress. Become aware of the obstacles you may encounter. Sort
them into categories: internal, external, people, situations, and so on. Do not ignore obstacles,
simply look at them from a different perspective. Change your strategy and discover what you
need to overcome them.
7. Focus on solutions. If you start to obsess about a problem, stop, take a break, do a U-turn,
and replace problem-focused thinking with solution-focused thinking.
8. Use the ABCDE Model. According to Martin Seligman, anyone can learn optimism. He
developed a simple method to respond to adversity.

Adversity – the challenging event

Belief – how you interpret the event
Consequences – the feelings and actions that result from the beliefs
Disputation – find evidence to argue or debate your interpretation of the event
Energization – follows a successful dispute
Here are the steps to follow:
• understand your current reaction and interpretation of an adverse event
• keep a journal for two days in which you note adverse events and the beliefs and
consequences that followed
• return to the journal to highlight pessimism so you can dispute it
• dispute your interpretation by creating “counterevidence” to the negative beliefs
• successful disputation usually leads to energization, when you actively celebrate the process

78
Describe an adverse situation you recently experienced. Be specific and stick to the facts.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What were the very first words you said to yourself? What did you think?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How did it make you feel? What did you do? Be specific.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Match the consequences with the beliefs. Do they match?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

79
There may be evidence that contradicts your beliefs. Write them down.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Describe the adverse event from a different angle. Are there discrepancies with your first
description?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What positive effects did disputation have on you? Make a list.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What will you do the next time you find yourself in a similar situation?

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

80
Now, choose one of the eight suggestions described above. For two weeks practice the activity
and note your experiences every day. Fill in the following chart with the date, what you did, and
how you felt afterward.
Date What you did How you felt after

81
Reflections on This Exercise

Did this exercise help you become more optimistic? Why or why not?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How helpful was this exercise? ______

(1 = not at all helpful, to 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

82
Identify Your Internal Resources
Objective
To identify inner resources to effectively manage hypo- and hyper-arousal.

What to Know
Triggers may be all around you and lead to hypo- or hyper-arousal. Even though it may
sometimes feel like symptoms arise randomly, trauma symptoms rarely spontaneously occur.
Instead, symptoms are often triggered or cued by something in your internal (anything that
happens internally such as thoughts, memories, or feelings) or external environment (anything
that happens outside your body, such as a stressful situation).
One way of coping with symptoms is by increasing your awareness of these triggers and
identifying your “inner resources” to manage hypo- and hyper-arousal, which often occurs
when you are triggered.
Identifying your inner resources can help you cope with stress and trauma symptoms. The first
step involves noticing your triggers. What stresses you out or prompts a trauma response?
Then, you can reflect and experiment with your internal resources.

What to Do
In the chart on the following page, think about the triggers you experience and where they
would fall on the arousal continuum. For example, hyper-arousal triggers are anger, excessive
worry, or anxiety. Hypo-arousal triggers might be feeling frozen by fear or avoidance. The
stronger the trigger, the greater the arousal. Read the examples and write down your triggers.
Then, think about what might help you cope. What inner resources can help you cope?
Resources are unique to each person.
If you are in your optimal zone, you may feel strong and optimistic even if you are dealing with
stress. Or your arousal might be manageable – you do not feel highly anxious or frozen. Some
people report this zone supports their sense of wellbeing and flow.
Reflect on “how” you are helped. Think about how you get from arousal to inner resource so
you can learn to take control of your triggers. Commit to practicing using your inner resources
to help you feel self-regulated, grounded, and within the optimal zone. When experiencing
stress, you will not habitually respond with hyper- or hypo-arousal symptoms. Instead, you will
feel in control and calm.

83
Hyper-arousal My family member is My triggers when I’m hyper-aroused:
screaming at me.

I feel anxious and want

to lash out. My coping techniques (inner resources):

I take 5 deep belly

breaths.

I get there by:

Optimal zone I’m grounded and My triggers when I’m hyper-aroused:

connected. I use my
tools to calm down and
manage the issue at
hand. My coping techniques (inner resources):

I get there by:

Hypo-arousal I feel frozen and put My triggers when I’m hyper-aroused:

things off to avoid
dealing with problems.

I feel hopeless and My coping techniques (inner resources):

depressed.

I’m going to take a walk

outdoors and stretch my
body. I’ll call my best I get there by:
friend

84
Reflections on This Exercise

Describe how you got from an activated place (hyper- or hypo-arousal) to successfully using
your inner resources to cope?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

What are the top three things you can do to cope when you are triggered?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

Did anything surprise you about this activity? If so, describe.

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

How helpful was this exercise? _____

(1 = not very helpful, 5 = moderately helpful, 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

85
Understanding Post-Traumatic Growth
Objective
To complete an inventory identifying aspects of your post-traumatic growth (PTG).

What to Know
As you recover from trauma, you have choices. Researchers have discovered four options you
face following trauma: succumbing to adversity, surviving with diminished quality of life,
becoming resilient, and thriving. The concept of thriving promotes growth beyond survival, or
Post-Traumatic Growth (PTG). PTG is a process of significant and often positive shifts in
thinking, feeling, behaving, and relating to the world, including increases in:
• self-efficacy
• optimism
• community connectedness
• spirituality
• faith
• compassion
• family closeness
• material gain
It is the characteristics of the subjective experience of the event – rather than the event itself –
that influence PTG. The following are key areas of PTG.
1. Greater appreciation for life. You may treasure moments of peace or connection you
previously took for granted. You might have a renewed sense of priorities and develop an
improved capacity to focus attention and resources on your most important values.
2. Strengthened spiritual beliefs. The social support received from others who share similar
beliefs can help you recover. Spiritual beliefs can help you restructure your worldview.
3. Enhanced relationships. You might become warmer, more vulnerable, and closer to others.
Belonging to a group, sharing, and communicating may open new doors. You may be more
empathic and willing to invest more energy into your relationships.
4. Increased personal strength. Mastering adaptive coping skills can change your perception of
events. The ability to accept situations that cannot be changed may open you to new
experiences.
5. Discovering new options. Armed with new skills, you can find the determination to go on.
Learning adaptive problem-solving skills can help you face new possibilities.
6. Increased creativity. You might find it easier to try new, creative ways of doing things. You
can become more playful and appreciate different art forms. Creativity makes life more fun.
You might write letters, keep a diary, draw, or sing.

86
This worksheet will help you identify aspects of your own PTG.

What to Do
For each statement, rate the degree to which this change has occurred in your life. Mark the
statements on a scale of 1-7, where 1 = minimal/not important, to 7 = maximum/very
important.
_____ 1. I have discovered new interests.
_____ 2. I am more optimistic than before.
_____ 3. I have learned how to change what needs to be changed.
_____ 4. My priorities have changed.
_____ 5. I appreciate my own life.
_____ 6. I can achieve closeness and intimacy with people.
_____ 7. I am more spiritual or religious.
_____ 8. I feel more compassion and empathy toward others.
_____ 9. I see opportunities.
_____ 10. I am stronger than I was.
_____ 11. I have new meaning and purpose in my life.
_____ 12. I am more creative in the things I do.
_____ 13. I know I can count on certain people when I need help.
_____ 14. I discovered my strengths and passions.
_____ 15. I identified new values.
_____ 16. I am more aware of my worth.
_____ 17. I believe there are good people in this world.
_____ 18. I am more playful.
_____ 19. Other people have noticed I am changing for the better.
_____ 20. I know what is important in life and what is not.
_____ 21. I have more faith than before.
_____ 22. I trust my curiosity to lead me.
_____ 23. I am more lighthearted than before.
_____ 24. I care about people, animals, and the planet.

87
_____ 25. I use my imagination much more than before.
_____ 26. I don’t see the world as black and white; I see options.
_____ 27. I put more energy into my relationships.
_____ 28. I want more meaning and less “stuff” in my life.
_____ 29. I see much more potential in my life.
_____ 30. I have become a realistic dreamer.
The questions above refer to the six key categories of PTG. Add your score for each key area.
PTG Question # Total Points by PTG Topic
Appreciation of Life 2, 4, 15, 20, 23
Spirituality 7, 11, 21, 24, 28
Other People 6, 8, 13, 17, 27
Myself 5, 10, 14, 16, 19
Possibilities 1, 3, 9, 26, 29
Creativity 12, 18, 22, 25, 30

Copy the statements you marked with less than 4 in the left column of the table below. In the
right column, write what you can do to improve your score.
Low-score statements What actions can you take to improve your score?

88
Review the statements you marked with 5 or above. In the table below, copy these statements
in the left column. In the right column, write a short description of how each changed your life.
High-score statements How did this change your life?

Reflections on This Exercise

How helpful was this exercise? ______

(1 = not at all helpful, to 10 = extremely helpful)
What did you learn from this exercise?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

89