Grounding Techniques for functional & dissociative seizures (Non Epileptic Attack Disorder)

When a seizure is about to happen, you go into what is known as a dissociative state. You may feel as if you are detached from your surroundings or as if the room is moving around, or just get a feeling of unreality. Not everyone gets this kind of feeling, sometimes known as an ‘aura’. As a way to combat that weird feeling and to try and stop the seizure from occurring, you can try sensory grounding. If you don’t get a warning then grounding probably won’t work for you.

This is a way of bringing your focus back into the present moment.

Understanding and Improving Your Skills at Grounding:

(This section is written by Dylan Williams, one of our peer support group members)

There are numerous grounding techniques that people use to help when they feel a seizure may be coming on. Although non-epileptic seizures (NEAD) are not completely understood by the medical profession, we know from evidence that psychotherapeutic interventions can be helpful in managing NEAD. Most psychotherapies work by giving your mind increased understanding, and new tools to manage itself; therefore beyond “out of the box” techniques for grounding, we can also pursue greater understanding and develop new tools, individually tailored. This is suitable for NEAD seizures because they are complex, and there are a wide variety of causes, triggers, and symptoms.

Grounding is not just about repeating a technique, or simply noticing how you feel; it is a philosophy of mindfully observing. Grounding can be achieved through almost any activity or state of inactivity, once you understand how mindful observation works. In the early stages of mindfulness, one learns to recognise and “put to one side” an internal voice (perhaps that is anxious, or critical, etc.), and consider approaching situations with a new, more impartial perspective. You may be aware of having some environmental or subconscious triggers for seizures, which can be difficult to manage or interpret. Often focus can become too consumed by certain input, and we become unaware of other things around us. Mindfulness can help hone our awareness and channel focus towards experiencing our environment and our inner thoughts differently, with a greater focus on the present moment. Mindful techniques often traverse the detail and substance of experiences, but crucially, without passing judgement or interpretation.

Grounding techniques are more than just distraction; they can become a philosophy of living. Working through mindfulness exercises you can begin to practice taking control of your mind, rather than always trying to control your surroundings. Practice makes perfect, and there are hundreds of free and paid resources out there to help you learn mindfulness practice, and expand your skills at grounding. A few example resources are listed at the bottom.

For some people with NEAD, trying to reduce seizure events can leave people feeling distressed, vulnerable, and defensive, because avoided memories and experiences have become irrational triggers or associations. These associations can be understood as chaotically interpreted input – not processed mindfully. This is one reason why understanding a broader perspective on grounding, can be particularly helpful for people with NEAD. Working on your grounding skills with other people, or with a psychotherapist can sometimes be more effective. Utilising an already externalised voice requires relinquishing a bit of “power”, or “control” in process, and may help tackle more deep-rooted internalised interpretations.

Hopefully you will be able to consider and explore grounding techniques, with some insight into how you can find an approach that is right for you. As you develop your skills, you will more become proficient, and be able to apply the philosophy of mindful observation as a dynamic grounding tool.

Some Examples of Things to Try:

We are all different, so you may need to experiment a little to find the technique, or combination of techniques that works for you.

Ask yourself some questions such as ‘where am I’, ‘what’s the date today?’, ‘who is the current Prime Minister?’, ‘what’s the capital of Japan?’ etc. By focusing on these types of questions, you can reorient yourself back in the present.

Counting: Try counting backwards from 100 in sevens or remembering your eleven times table, or perhaps adding up the numbers in your birth date and dividing by three. Anything that helps you to really focus your mind in the present.

Senses: Focus on what you can hear both in the room and outside. Really listen and identify each sound as you hear it. Alternatively, focus on any smells. Tell yourself what it is you are hearing/smelling and describe it to yourself. Try holding something rough in your hand such as a stone, a shell, a twig etc. and rubbing it whilst really focusing on how it feels. Concentrate on how the ground feels under your feet (if appropriate slip your shoes off) or how solid the chair you are sitting on is underneath you. Lots of people find music helpful, either listening to it or singing themselves. Some people find putting their hand into cold water, or applying a cold compress helps.

Distraction: Try different things to see what works for you. On our Facebook group, someone has a metronome that they focus on. You could also try snapping an elastic band on your wrist, turning on some music, popping some bubble wrap, clearing out your handbag, stroking your dog/cat whilst telling it how you are feeling or perhaps you could start planning your dream holiday right down to details such as what clothes you will pack. Several have also found it helpful using fidget toys, for instance a fidget cube.

Useful links:

Find mindfulness courses in your area

Free downloadable audio tracks

Mindfulness Meditation listening & thoughts – YouTube video

Mindfulness Meditation exploring difficulties – YouTube video

Mindfulness Books:

The Mindful Way Through Anxiety

Wherever You Go There You Are

Mindful Games