Useful Definitions:

• Mindfulness Meditation (1): A technique that helps reorient someone into the present moment through non-judgmentally observing and accepting one’s current state of being. It is often learned through meditative practices.

• Grounding (2): A state of being where a person is able to stay present in their body and be aware of their current thoughts, emotions, and physical sensations.

Put together, a person may practice mindfulness, in part by using grounding techniques, to become more connected to themselves and their surroundings in the present, temporal moment.

What are common elements of a grounded state?

• Holding awareness of the present moment you are in

• Maintain attention of physical body sensations

• Being curious about and accepting your current thoughts and emotions - taking note of but not responding to or judging yourself for them

• Aware of and able to respond to outside stimuli - eg. answer questions or follow instructions

Sometimes it can be helpful to think about how grounded you feel using a point-based likert scale (eg. 0-10).

*Note: The goal isn’t necessarily to be 10/10 grounded. It is more useful to be curious about and take note of how you feel, non-judgementally and with acceptance.

Common elements of being less grounded?

• The past and/or future dominate your thoughts

• Overthinking, worrying, angry, or anxious thoughts

• Having difficulty being aware of sensations in our body (ie. spacing out), such as touch on a region of skin, chest movements while breathing, or intensity of sensations (eg. pain, discomfort, or tingling)

We all move along the ‘grounding continuum’ (0-10 scale) throughout our day or week. We can easily reduce our sense of grounding when our ‘ego’ is threatened, which can lead to us ignoring unpleasant thoughts, emotions, or physical sensations. Examples the ‘ego’ being threatened include negative self-evaluation, wanting to please or appease someone, or fear of failure (1,3). Instead, it can be helpful to acknowledge these thoughts, emotions, and physical sensations and utilize grounding strategies (see below) to reduce their impact on you.

Is being relaxed the same as being grounded?

Not particularly. Think back to a time when you’ve been day dreaming; you may feel very relaxed but your thoughts are often ‘off with the clouds’ and not directed towards the present moment.

What are some strategies to regain a sense of being grounded (3)?

• Bring your attention to your breath - the rise and fall of your chest or the feeling of air entering and leaving your lungs

• Rubbing or gently squeezing the body (eg. legs, arms, face) to return sensation in the skin

• Change your posture (eg. lie down, sit, stand, or walk) and take note of where/how your body is contacting the ground

• Engage your senses (sight, smell, hearing, touch, or taste) in your present environment - examples include looking around your room at different objects, sucking on an ice cube, or listening for sounds

Mindfulness-Based Stress Reduction (MBSR) is an intervention that utilizes grounding and mindfulness meditation to enhance a person’s ability to manage and reduce stress, various pains, sleep quality, fatigue, and general physical functioning (4). Another practice guideline (1) on the management of low back pain added MBSR to its list of treatments that may have a role in symptom management. This is an important acknowledgement of the potential for this type of intervention but more research will be needed in order to support its proposed wide ranging benefits.

Grounding techniques, to support mindfulness, are a common component of the interventions I offer during my Physiotherapy sessions. If you are interested to learn more about my background in working with patients to manage chronic pains follow the link to my bio here!

References:

1. Ronhovde, S. (2021). Module 1 and 2 lectures [powerpoint notes]. Retrieved from Global TRE® Certification Training.

2. Toward Optimized Practice. (2017). Ambassador Program guideline for the evidence-informed primary care
   management of low back pain, 3rd Edition: Background document. Institute of Health Economics. https://actt.albertadoctors.org/CPGs/Lists/CPGDocumentList/LBP-guideline.pdf

3. TRE For All. (Undated). Areas of Understanding and Awareness in the Practice of TRE. Distribution limited to Trainees of the Certified TRE Provider program.

4. US Department of Health and Human Services. (2019). Pain management best practices inter-agency task force report: Updates, gaps, inconsistencies, and recommendations. Washington, DC: US Department of Health and Human Services.

- Thanks for reading and keep looking for more posts in the future on other ‘hot topics’ in the world of Physiotherapy and Physical Rehabilitation!