Mindfulness Skills for Trauma and PTSD: The Safe Place, the Container, and Mindfulness Reflections

Kirby-Reutter

United States Department of Homeland Security

Key Points

  1. The safe place is a guided visualization in which the client identifies a secure and peaceful place, real or imaginary. The therapist walks them through the five senses around that place, and they are asked about the emotional experience of being there. The client identifies where in their body the place is located, to keep it with and inside them.
  2. In the container exercise, the client is asked to imagine a container in which to store present and future distressing thoughts and feelings. The client is reassured that they are the only one to have the key for and to know the location of their container.
  3. When practicing mindfulness, it’s important for clients to reflect on their new experiences, guided by questions from the therapist.
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The Safe Place

Another approach to mindfulness is through imagery or guided visualization. The safe place exercise helps a client to identify a place that is peaceful and safe for them, real or imagined.

Maria mentioned that she loves the beach, that it could be her safe place. Then she was asked, when you imagine yourself at the beach, what do you see, hear, smell, touch, taste? Once the five senses have been explored, ask what emotions appear as they imagine themselves in that location. Maria said that she just felt a sense of peacefulness.

Maria was then asked if she could feel the peacefulness physically in her body. It’s important to help the client identify a specific location in their body, because then they will understand that the safe place is within, not outside, their body. For Maria, her safe place is not really on the beach, but in her chest. That’s a resource she can take with her and use anytime, whether she’s at the beach or not.

The Container

The container is a great exercise for trauma survivors, because it teaches them to contain trauma memories that may be overwhelming, and helps them process one memory at a time when doing trauma work.

  • Ask the client to imagine a physical (box, vault, safe, trunk), electronic (USB, DVD), or virtual (digital folder) container. For Maria it was a secret well in a field of flowers.
  • Make it clear that the client is the only person who knows about this container, knows its location, and has the key or password to access and secure it.
  • Explain that whenever a triggering thought or emotion arises, the client can imagine placing it in their container.

Mindfulness Reflections

As Maria learned these exercises, she was also taught to reflect on them. Mindfulness reflections are about reflecting back on the experiences and seeing what has been learned.

Maria was asked to choose one of the mindfulness exercises she’s been practicing, and to focus and reflect on it. She chose mindful soccer games. Then she answered four questions.

  • What did you notice when you were mindful (playing soccer)?
    Maria said that she was able to concentrate better and score more goals. She noticed that she sweated a lot, was out of breath, her heart beat faster, and she had a mild leg cramp.
  • What was different about this experience, about playing mindfully vs non-mindfully?
    Maria said she doesn’t usually pay attention to sweating, shortness of breath, rapid heartbeat, or mild leg cramps.
  • How does what you learned relate to your symptoms (anxiety, depression, panic, PTSD)?
    Maria said, “Some of those things that I noticed when I’m playing soccer, like the sweating, the heart palpitations, or shortness of breath, are actually the same things I feel when I have a panic attack.” She realized that as she was playing soccer she was supposed to sweat, be out of breath when running around, and her heart is supposed to beat faster when exercising. She realized she could experience panic attack symptoms without actually having one.
  • How does what you learned relate to your personal life goals?
    Maria realized that if she can be more mindful of playing soccer, she can also be more mindful in other areas of her life. It was very important for her to learn to be mindful of her playing, because that’s an enjoyable and safe arena in which she learns the new skills. She can then apply them to less safe or enjoyable areas of her life. And if she learns that mindfulness helps her score more goals, she knows it will also help her achieve other goals.

Looking for practical everyday tools? These print-friendly handouts and worksheets are just what you need. Click on the following links to download the PDFs:

1- Mindfulness Exercises: A Pocket Guide

Mindfulness Exercises: A Pocket Guide is a handy tool designed to help clients foster self-awareness, reduce stress, and enhance focus through simple mindfulness exercises. This handout explores various techniques, including the body scan, mindfulness of the five senses, mindful breathing, and mindfulness of enjoyable activities, offering straightforward instructions and underlining the purposes of each practice. By cultivating the art of mindfulness, clients can foster acceptance and presence in each moment, enhancing their therapeutic journey.

Instructions

Mindfulness Exercises: A Pocket Guide is a straightforward resource designed to be used by your clients as part of their therapeutic journeys. During sessions, introduce each exercise, guiding clients through the process and highlighting the benefits of each practice. Emphasize the nonjudgmental aspect of mindfulness, and reassure clients that the aim of these exercises is to develop an observational and accepting approach to their thoughts, feelings, and sensations. This handout serves as a practical extension of your therapeutic work, empowering clients to practice mindfulness consistently and independently.
* Encourage clients to use these techniques as homework, asking them to record their experiences on Mindfulness Exercises: Practice Worksheet.

2- The Container Exercise Guide

The Container Exercise Guide is a comprehensive tool designed to aid therapists in facilitating the container exercise. This technique helps clients to manage and compartmentalize overwhelming emotions and memories more effectively. The guide outlines the purpose, process, and key points of this technique, making it a go-to resource for therapists aiming to empower clients toward autonomous distress regulation.

Instructions

Use this guide to apply the container exercise with your clients more effectively. Begin by explaining the purpose and benefits of the exercise. During your session, guide them through the visualization process, ensuring they feel comfortable and in control of their imagined container. Encourage the client to practice placing distressing thoughts or emotions into the container, both in-session and independently. This exercise can form part of the toolkit used to improve coping with traumatic memories and emotions.

3- The Safe Place Visualization Guide

The Safe Place Visualization Guide is a practical tool for therapists aiming to harness the power of guided imagery to foster feelings of calm and security in clients. This therapeutic tool allows clients to create and access a safe, peaceful, imaginary space, for the promotion of emotional resilience and self-soothing. The guide contains a clear step-by-step process, from identification of the safe place to its immersive sensory exploration and emotional-physical anchoring.

Instructions

Use this guide to explore the safe place exercise with your clients. Initiate the safe place visualization by explaining the concept and its potential benefits. Facilitate the identification of a safe place and guide the client through a detailed sensory exploration of this imagined space. Assist them in recognizing the emotions associated with their safe place and locating those feelings within their body. This exercise should be practiced during therapy sessions while you provide guidance and constructive feedback. Over time, the client should develop an increased capacity to evoke feelings of peace and security independently and at will.

4- Mindfulness Exercises: Practice Worksheet

Mindfulness Exercises: Practice Worksheet is an essential resource for clients practicing mindfulness. It guides them to document and reflect on their experiences during four different exercises: the body scan, mindfulness of the five senses, mindful breathing, and mindfulness of enjoyable activities. This process not only aids in enhancing self-awareness but also facilitates open dialogue between client and therapist about the mindfulness journey. Remember that this worksheet is not a test, but is a tool to help clients hone their focus on the present moment and cultivate self-acceptance.

Instructions

Encourage clients to use Mindfulness Exercises: Practice Worksheet as a supportive tool in their mindfulness practice. Reinforce the concept that this worksheet is not meant to evaluate performance, but to deepen understanding and awareness of mindfulness experiences. Ask them to fill in the worksheet honestly and bring it to therapy sessions. This can provide valuable insights into their progress, areas of struggle, and the overall effectiveness of mindfulness exercises, and can inform the direction and focus of subsequent sessions.
* Use this worksheet alongside Mindfulness Exercises: A Pocket Guide.

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Mindfulness Skills for Trauma and PTSD: The Safe Place, the Container, and Mindfulness Reflections

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