What do you find helpful when inner tension comes up in therapy?

I recently had a session with a therapist where I went into high tension with trembling after talking about a difficult topic. She did a mindfulness exercise with me, I had to focus on my body, etc. This made everything worse. That picture of me sitting there and focusing on my body somehow is burned into my memory now. Next thing she tried was talking about things I'm good at, interests and so on, this at least distracted me and helped a little bit.


When I'm at home, a cold pack on the side of the neck helps the most, but that isn't always possible in therapy.

• Cold pack on the side of the neck
• Focusing on strengths and interests

It depends what the inner tension is.

In the earlier years of therapy, my T trying to get me to focus on my body and breathing would be THE worst thing to suggest. When I'm trying to escape my body.

These days, what helps is gentle reminders of being in the here and now. Her changing her tone of voice to a soft one. Her talking.

If the inner tension is because what she is saying is giving me a conflicting internal dialogue, then what helps is expressing that internal dialogue and working out what part is saying what and what each part needs.

My therapist has asked me what I need or what helps me and over time we've discovered together what works. For me, breathing is my best go to, but when I'm disassociating (I actually do this a lot in therapy), it's hard for me to do anything or to respond. My therapist waits, gives me some space, and then gently asks me to breathe (or whatever your go to is). What also helps is distraction. So my therapist will ask me simple, safe questions to try to get me to come back into the room.

He also reminds me I'm in a safe place by saying, "You're safe here in the office." He'll try to ground me by asking me to look at the things around me, to feel the sofa underneath me or my feet on the floor. All of these things are gentle reminders of where I am and that I am ok and can come back to where I need to be.

I have a bunch of different tools for that,
-breathing - count it in your head four in eight out.
-grounding - i am in my t's office, I am safe, today is Tuesday.....
-tapping - hard to explain but its like slapping your thighs to a good song.

Grounding is the first go to. Sometimes I find myself doing it unconsciously - even in therapy. T asks that I'm thinking and....I'm in your office, there's a stuffed tiger by the door, my wife is downstairs.........

I think that grounding is super great, but also a lot of trauma is held in the body and for me personally jumping straight to grounding or bringing myself to my body doesn't help right away, my bodies learnt coping skill is to exit my body so the opposite can throw up big huge red alarm system in my brain "we gotta get outta here!!"

Excluding basic grounding techniques:
- I tend to tell my therapist what I am feeling and we talk out what triggered the tension
- Take a moment to just sit in silence and let the feeling follow through till it leaves
- Change the topic (I have DID so may be more effective for me than others, changing topic tends to = a switch happening)
- Take a short walk or doing some jumping jacks, getting the fight/fight energy out
- Discuss a positive
- Intentional shaking
- I have this spikey sensory roller that helps me a lot to relieve tension

You could bring a insulated water bottle filled with ice to your sessions if it would help!