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Welcome back to the second part of the 28 PTSD techniques based on senses that you can use in your Immigration Evaluations.
In last week’s post, we covered the senses of sight and taste, as well as some movement and grounding techniques. In this article, we are focusing on the senses of smell, sound, taste, and touch.
Consider that the application of PTSD techniques in Immigration evaluations can work with children and adults as well.
Let’s dive in!
The sense of smell is our most primitive sense and has a close link with memory. There are probably specific smells that you associate with some childhood memories or particular people.
In the same way, particular smells may trigger our clients’ symptoms. Perhaps they reported this to you as an avoidance symptom; they avoid certain places or people because they find that the smell arouses distressing memories, thoughts, or feelings associated with their trauma.
But smells can also have a healing property.
#11 – Aromatherapy
Studies have shown that lavender, in particular, has a relaxing effect on the mind. I know that some therapists use essential oils in their offices, so that is one option.
But if you don’t want or can’t diffuse, use essential oils. Instead, you can have some lavender-scented lotions, sachets, or even play-dough. In addition to lavender, there are other scents with anxiety-relieving properties. There are a lot of different scents that are used for PTSD symptom relief.
#12 – Scent memories
As I mentioned above, the sense of smell evokes strong memories. Help your client come up with memories of a time they felt safe, and ask what scents they associate with that time, place, or person. Then you can work with your client to recreate those smells and keep them in a small box they can access as needed.
For example, can they keep a small jar of vanilla extract to recall the memories of baking cookies with their grandmother?
Of course, it is not easy to recreate all scents(the smell of warm earth after a summer shower is pretty hard to put in a jar!), but you can also help them develop a list of scents that they associate with soothing, calm times.
When describing traumatic events, clients sometimes can recall an exact sound that galvanizes the event for them. But, clients can use sound to soothe and heal from trauma.
Please always use your best clinical judgment when using these tips and techniques and seek additional supervision if needed.
#13 – Music
Of course, the first thing that comes to mind under the category of sound is music. Indeed, the American Music Therapy Association states that “music therapy has been shown to have a significant effect on an individual’s relaxation, respiration rate, self-reported pain reduction, and behaviorally observed and self-reported anxiety levels.”
Beyond contacting a music therapist in your community, you can help clients discover what types of music they may find soothing. It may be a soft tune for some, while others will prefer robust and deep bass tones. All that matters is that it is gentle to your client. You can help your client put together a playlist ahead of time to listen when they are distressed.
#14 – Beating on a drum
At its most basic, the repetitive beat of the music can help calm an anxious mind. What better and easier way to create that beat than with a simple drum? When clients can make their beat with a drum, this can help them regulate their emotions while choosing how hard and fast a rhythm they want.
#15 – Metronome
Like a drum, using a metronome can give clients a calming, repetitive beat, and they can adjust it to any speed they prefer. Of course, you can keep one in your office, but I also like this free app, which has the look of an old-school metronome, and you can access it easily on the phone.
#16 – Chanting or praying
When I ask clients what they do to distract themselves from intrusive thoughts, many of them tell me that they repeat a particular prayer repeatedly. Almost all significant religions use some prayer or chant. Work with your client to identify if their spiritual traditions have a specific prayer or chant that they might find soothing.
#17 – Calming nature sounds
Connecting with nature has many benefits, and even when it’s not possible (or practical) to go out, clients can benefit from listening to the sounds of nature. There are tons of free apps and recordings that offer almost every imaginable environment sound, from waves at the beach, to crickets in the woods, to a thunderstorm. As always, be mindful of what your client will find helpful, as one sound could be soothing to one person but may trigger a memory of trauma in another.
We tend not to think about taste unless we’re eating something, but there are ways to be more mindful about taste, which can be a good skill for clients who have experienced trauma.
Please remember always to use your best clinical judgment when using these tips and techniques and seek additional supervision if needed.
#18 – Sucking on a hard candy
Paying close attention to the taste (and feel) of something can help a client refocus their attention away from a distressing thought. Hard candy is perfect for this because it tends to last longer and comes in various tastes. Thus, it is also a very portable technique, as a client can discreetly suck on a piece of hard candy in almost any setting. Of course, if trying this with a young child, be careful of any choking hazard.
#19 – Sipping on a warm beverage
Similar to sucking on a piece of candy, sipping a warm beverage can help a client refocus their attention to a specific taste and away from a distressing thought. Warm drinks are easy to offer in an office setting, and clients can also take them home. Some choices could include herbal teas (this is one of my favorites) or warm cider. It’s probably best to stay away from caffeinated beverages, such as coffee, as caffeine has a stimulating effect and could leave a client feeling more jittery than relaxed.
#20 – Sucking on very sour candy
Unlike tip #18, this is not a soothing but rather a disruptive technique that would interrupt a client’s intrusive thoughts or even help bring them back in touch with their body if they are dissociating. Additionally, these candies are not meant to be tasty but almost intolerably sour. Use caution, though, as there are reports that eating too many or too often can cause damage to a person’s tongue.
#21 – Comfort foods
There are foods that we all associate with comfort for a variety of reasons. Some common ones are chicken noodle soup and mac-n-cheese, but anything can be comfort food if it has a positive association.
While we don’t want clients to always turn to food to soothe themselves, there are times when the act of mindfully preparing and eating comfort food can serve as a form of self-care. You can work with your client ahead of time to make a list of foods that they find comforting, being mindful of cultural differences.
Fun fact – did you know that skin is our largest organ? It’s true!
And since it covers our entire body, it means that we are wired to experience the world through touch. For susceptible people, this can be distressing, and for clients who have experienced trauma, contact often associates with pain.
As always, senses can soothe and heal, and nowhere is this more applicable than the sense of our touch. More techniques fall under the category of touch than any other sense. So, let’s get started!
#22 – The healing power of water
Water can have many healing properties, and studies have shown the various positive effects of hydrotherapy. One of the most soothing techniques is to surround yourself with water. If you are fortunate enough to live near a lake or the ocean, going for a swim can be relaxing, although just standing in the water can be enough to calm a person. If a pool or the beach is not accessible, soaking in a warm tub can have the same effect. As always, be sensitive to each client’s particular needs, especially if there is any water-related trauma in your client’s past.
#23 – Weighted blankets
Studies such as this one have shown that weighted blankets can help decrease insomnia, which is a common complaint from clients that have experienced trauma. Weighted blankets are available in a variety of sizes, weights, colors, and fabrics. A standard guideline is that the blanket should weigh 5- 10% of a person’s body weight and never feel restrictive. You can keep a small lap-sized weighted blanket for clients to use in your office.
#24 – Peter Levine’s Holding Technique
Peter Levine is a well-respected trauma specialist who created Somatic Experiencing as a way to heal trauma. Somatic Experiencing is a powerful tool to add to your array of therapeutic offerings, and there are trainings available all over the world. In the meantime, this video shows a simple technique called the “Holding Technique” that creates an “island of safety” that you can easily teach to your clients to use at any time.
#25 – Squares of different textures
I’ve used this technique mainly with children, but there is no reason that it cannot adapt to adults. You can place several small squares of different fabric types (burlap, denin, chenille, velvet, satin, etc.) in a small box and invite the client to touch them one by one. As clients feel different surfaces and textures, I ask them to notice those they like and don’t. I direct clients to pay close attention to the look and feel of the fabric as a way to encourage mindfulness.
#26 – Holding a smooth stone
Holding a smooth stone is another simple exercise in mindfulness, where the client will focus on something concrete and straightforward. I have a small dish of smooth stones in my office of various sizes. Similarly, a client could carry a small rock with them. While sitting with the client, you can ask them to run their fingers over the stone, notice the contact points, and feel the weight of the stone in their hand. Invite them to pay attention to the temperature of the rock; is it cool to the touch, or does it warm up being in your hand?
#27 – Ice pack
When clients get lost in a dissociative state or overwhelmed by intrusive memories, feeling an intense change on their skin can help them regulate and be present again. A simple ice pack works well for this and can be placed on the neck of wherever the client chooses.
#28 – Pet therapy
Animal-assisted therapy has been proven as an effective treatment for a variety of disorders. Some clinicians even have therapy animals in their offices. While that may not be an option for everyone, you can still encourage your clients to pet or cuddle with their pets when feeling distressed. If your client doesn’t have or can’t have a pet, you can encourage them to borrow one from a friend or even go to their local animal shelter to visit the animals there.
Well, that wraps up our list of 28 techniques to use with clients with a trauma history!
I hope you’ve found them helpful.
Remember that the Immigration Evaluation process is not regulated, and each clinician evaluates based on the information they have. There are no established clinical evaluation techniques that all must follow.
However, these can be used to your advantage if you understand and learn to utilize the PSTD techniques based on the senses.
I’m Cecilia Racine, and I teach therapists how to help immigrants through my online courses. As a bilingual immigrant myself, I know the unique perspective that these clients are experiencing. I’ve conducted over 500 evaluations and work with dozens of lawyers in various states. Immigrants are my passion, I believe they add to the fabric of our country.
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