Highlights: 

• Research estimates that roughly 5 percent of the US population—13 million adults—have PTSD.
• Prior to the pandemic, it was estimated that about 7-19 percent of workers who experience workplace trauma will go on to develop PTSD. This estimate is likely to change, as findings from the latest Mental Health Index reveal that the risk of PTSD among employees is up by 121 percent since 2020—witnessing a 36 percent jump just in the last year alone.
• While the nature of one’s job (think trauma-exposed occupations like healthcare, social, and service work) can increase the risk of PTSD, highly underestimated is the threat that various workplace conditions, like abusive leadership styles, power imbalances, microaggressions, and cutthroat environments, pose to such risk.
• Poor concentration, mood swings, fatigue, and substance use are some of the hallmark signs of PTSD in employees, while organizational symptoms like lower productivity, poor performance, frequent accidents, and interpersonal conflicts can indicate the presence of PTSD in the workplace.
• Organizations must leverage prevention strategies, including organization-wide training and psychoeducation, in concert with traditional treatment strategies to effectively mitigate the presence of PTSD in the workplace.
• Mindfulness, breathwork, and grounding techniques are three key coping mechanisms that employees can adopt to prevent against or manage PTSD.

“What if every time you answered your phone, you were directly tied to tragedy? You hear panic: ‘A car just crashed;’ ‘My house is on fire;’ or worse…all you hear is screaming.”

This is how Darlene Illi, consultant and former 9-1-1 operator, begins her TEDTalk on PTSD prevention at TEDxBearCreekPark back in February of 2020, a mere few weeks shy of a global catastrophe that would dramatically shift our understanding of PTSD and trauma.

“I worked as a 9-1-1 operator for 20 years,” she explains. “And every time I answered my phone, I was instantly connected to someone’s crisis—possibly their worst day, but for me, it was my workday.”

Despite being somewhat aware of the emotional turmoil her job was surely inflicting on her, it wasn’t until she received a phone call from a woman who mentioned that she had PTSD, that Illi began to reconsider what she was really experiencing while at work: trauma.

“What do you think of when you hear post-traumatic stress disorder?” She then asks the crowd. “I picture soldiers returning from war zones. But because of this image, we can tend to have a narrow view of who can fall victim to this stress and trauma injury,” she warns.

“[And] I have to be honest, I dismissed her, and I completely dismissed the possibility that she could have that stress and trauma injury because I didn’t see her in that picture,” she then admits, adding, “And I’m embarrassed to say this because, even though I was a 9-1-1 operator, clear signs and symptoms of stress and trauma injuries were not part of our workplace awareness; there was no plan for us to follow. We didn’t know the many faces that can fall victim to stress and trauma…and because of this, we didn’t know we could fall victim, simply by sitting in an office answering 9-1-1 calls constantly connected to crisis.”

This “constant connection to crisis” that Illi is referring to—otherwise known as “vicarious” or “secondary trauma“—is a phenomenon that has received a lot of media and scientific attention since the onset of the COVID-19 pandemic. In fact, 9-1-1 operators like Illi make up just part of a large swarth of workers, among them physicians, nurses; EMTs and paramedics; nursing home staff; mental health professionals; and other essential workers, whose perceived risk of trauma has since been reconsidered in recent times, as emerging studies continue to reveal the psychological distress many have endured just by witnessing others’ trauma throughout the pandemic.

But while soldiers and “frontline” workers have been the focus of the bulk of literature that exists on trauma and post-traumatic stress disorder (PTSD), others’ constant connection to crisis—thanks in large part to their phones and the extensive and increasingly graphic coverage of traumatic events—is starting to broaden our understanding of just who is at risk of trauma and challenging our understanding of what exactly “counts” as trauma. Just look at teachers, bank tellers, grocery store clerks, and even massage therapists in the US, for instance—research shows that all of them can experience trauma and develop post-traumatic stress symptoms just from hearing about traumatic events like active shooting situations that have affected their places of work in other parts of the country.

Pandemics, gun violence, and large-scale deaths aside, many trauma and mental health experts underscore that even smaller-scale incidents, including incremental or “cumulative” exposure to trauma over time—can trigger post-traumatic stress responses. “When big things happen, we just assume ‘Okay, this is trauma,’ but we don’t want to do that,” cautions Caroline Asirvatham, counseling psychologist and Team Lead at Workplace Options. “We don’t want to be dismissive of smaller things that count as trauma. People always think it has to be big and dramatic, and that it has to be physical: you need to have a physical wound. But it doesn’t matter.”

With that said, growing research is beginning to highlight the many overlooked conditions of the workplace that can be traumatic for some workers and even lead to the development of PTSD. Apart from the more overt instances of trauma—from onsite deaths, accidents, injuries, or outbreaks, to exposure to distressing or disturbing situations as a result of the nature of the job (think: social workers, firefighters, journalists)—studies reveal that even toxic work cultures can traumatize workers, from abusive bosses to narcissistic coworkers; heavy workloads and poor work-life boundaries.

Workplace-Induced Trauma: What to Know

Back in March of 2021, in a viral tweet that has since amassed more than 5,000 retweets, 6,000 replies, and nearly 50,000 likes, Desmond Hardy, a keynote speaker and technology strategist, asked: “Has anyone ever had toxic workplace PTSD? Like, the chime sound of an incoming email evokes your ‘fight, flight, or freeze response?’ Just me?”

The responses were astounding:

“I had a coworker who was so abusive that I memorized the sound of her gait down the hall and would lock my office door and turn off my light when I heard her coming,” was one user’s reply.

“I had to quit a job because my boss was so toxic I started developing muscle spasms in my face,” was another’s.

“Yes [and] it’s incredible the amount of trauma that a workplace can make you feel. I have Slack PTSD. I sometimes hear those notifications in my sleep.”

“The fact that my first thought about voicing how much I relate to this was ‘What if the wrong person sees it and things somehow get worse even though I don’t work there anymore?’ just shows the lasting effect of being a part of a toxic and abusive workplace.”

While people often joke about being “scarred” by past jobs and trade horror stories about their “jobs from hell,” the truth is: emotional workplace trauma is real, and it’s rampant. So much so that some have started to use terms like “CTSD: corporate traumatic stress disorder,” and “business” or “career trauma” to describe the long-term psychological damage that many corporate cultures inflict on their workers, from the ‘cult’ of overwork or glorification of workaholism, to the violation of workers’ right to disconnect, and so much more.

What’s important for employers to understand, experts like Asirvatham argue, is that there is no definitive list of triggers for PTSD: it all comes down to an individual’s perceived sense of safety—whether physically or psychologically—and their perceived sense of autonomy or control in maintaining that safety. That said, while one employee may be able to endure a toxic work culture ‘just fine,’ that doesn’t invalidate another’s traumatic response to it.

Common types of toxic or otherwise traumatic workplace conditions that have been linked to PTSD include:

• Safety hazards. Although she emphasizes that workplace traumas are not all physical, Asirvatham does contend that threats to workers’ physical health that exist in the workplace can be a source of trauma—especially when not addressed. “For example, if an employer neglects or doesn’t take care of a safety requirement, or if one of their employees falls sick because they didn’t follow a COVID-19 guideline, or if they didn’t keep their elevators or their workspace safe and some accident happens due to that, or if they didn’t keep their ventilation clean and an infection was spread around, or their security systems are no good—these are all things that directly can cause physical danger to workers, and that in itself can be a trauma.” Being asked to perform manual and laborious tasks they aren’t properly trained or equipped for, such as operating or performing maintenance on heavy machinery, are also examples of potentially traumatic safety risks.
• Bullying, harassment, and assault. Whether that be verbal, physical, or sexual, experiencing any form of cruel, violent, aggressive, or violative behavior has been proven to cause PTSD in some employees, as employees endure psychological distress as a result of their physical or emotional injuries; lose trust in their employees as well as their leaders if such instances go unaddressed; begin to doubt or second-guess their experiences, blaming or gaslighting themselves; and above all, lose all sense of safety at work.
• While the physical and psychological ramifications of the more overt or intentional forms of racism—like racial violence—are well-understood, perhaps lesser known are the long-term effects that more covert, subtle forms of racism, i.e. microaggressions, can have on people of color: such as if a Latinx employee is mistaken for custodial staff, or a Black woman is told her hair is unprofessional. In fact, researchers have argued that the combined impact of these two different forms of trauma—otherwise known as racial trauma—can trigger long-term symptoms that resemble symptoms of PTSD and should thus be considered as such.
• Power imbalances. As is the case within personal relationships, work-induced trauma and PTSD are often the result of an imbalance of power, in which one person—like a boss or coworker—has more of if not all of the power, while the other person is or feels powerless. Organizational hierarchies can enable trauma by creating or perpetuating workers’ fear of retaliation for speaking out against emotional, physical, or psychological abuse; their fear of being placed on the chopping block or having the rug ripped out from under them; and the feelings of insecurity, helplessness, and isolation these things may inspire as a result.
• Abusive leadership styles. One of the most consequential aspects of a toxic workplace when it comes to workers’ mental health and wellbeing is the presence of an abusive boss. This can include a leader who manipulates or threatens his or her employees to work over the weekends, to work late hours every day, to work during their PTO. It can also include a leader who publicly humiliates an employee in front of his or her peers, and/or harshly criticizes and berates them. Persistent mistreatment at the hands of a gaslighting boss who makes an employee doubt his or her experiences or narratives has also been proven to evoke symptoms of PTSD.
• Cut-throat competition. In another reply to Hardy’s tweet, one user claimed to have toxic workplace PTSD, admitting, “I keep waiting for someone on my team to throw me under the bus to save themselves.” In toxic work environments where abusive bosses pit employees against each other within hierarchical structures, some employees can develop PTSD due to persistent anxieties or fears about being let go and losing their job, of being reprimanded by their bosses, of being sidelined or manipulated by their peers. In organizations where cut-throat competition is the norm, employees are also likely to overwork, get less sleep, have little trust in or support from those around them, and have a poor work-life balance, all of which can have long-term effects on their psyche.
• Moral injuries. Taken from the military, “moral injuries” refer to the psychological distress that a person experiences after doing something that goes against their ethics or moral beliefs. For instance, within healthcare settings, this can include doctors having to make decisions about which patients can go on ventilators and who will have to go without when there is a shortage—as was seen during the height of the COVID-19 pandemic. In a toxic work environment, this might include being asked to mistreat or bully a coworker, sidestep them for a promotion, fire them on behalf of a boss, and things of that nature.
• Drinking culture. Similar to being asked to do things that go against their personal beliefs, research also suggests that workplace drinking culture and the pressure to participate in it that a majority of employees claim to feel can not only cause stress and anxiety—making it traumatic in its own right—but can also exacerbate verbal and physical workplace aggression and perpetuate other toxic conditions that are also linked to PTSD.
• Rejection of requests for accommodations or time off. Whether it’s a request for a raise, a promotion, time off (whether PTO, sick leave, or family leave), or a disability accommodation that’s being denied, losing that lack of autonomy or control over oneself and one’s situation—in addition to facing up against a disrespectful, dismissive, and untrustworthy boss—can cause one to feel psychologically unsafe in the workplace.
• Isolation from support. When abusive bosses pit colleagues against each other and force their staff to work overtime and on the weekends, this can create distance between workers and their peers, their friends, their family, and other support systems in their lives. Workers may feel alienated from their coworkers due to gossip, bullying, or competitive spirits, they may miss out on needed opportunities to relax and recharge, namely family time, by having to work late, and most consequentially, they may bring their problems home with them—one of the more prominent markers of PTSD.

Symptomology and Impact on the Workplace

As Asirvatham underscores, what one person might experience as trauma may not be as traumatic for others. Likewise, while researchers estimate that over 90 percent of people will experience a traumatic event at least once in their lifetime, that is obviously not to say that over 90 percent of people will develop PTSD—although this does not mean that they won’t have an adverse reaction to what they experience. As Dr. Itai Danovitch, a psychiatrist at Cedars-Sinai, explains, “It’s normal to have [an initial] fear response to something traumatic. Typically, that fear response diminishes over time. The intensity of the memory fades and we move on with our lives.”

With PTSD, on the other hand, the memories don’t fade, he continues. “They feel very present and can intensify over time and they can influence our thoughts, emotions, and our ability to function.” Thus, what differentiates PTSD from a “normal” stress response, is that symptoms of PTSD will persist long after the event has passed—for at least a month in order to receive a diagnosis—and will furthermore interfere with daily functions, relationships, and one’s overall quality of life. Additionally, while fear, anxiety, stress, and other responses are to be expected immediately following a traumatic event, the onset of symptoms for PTSD can—and oftentimes will—follow a different timeline, arising anytime within days, weeks, or even years following an instance of trauma.

Thus, when it comes to monitoring the signs and symptoms of PTSD in the workplace, it is imperative that leaders do so consistently. Whether leaders are inspired to monitor for symptoms in the aftermath of some type of workplace trauma, or they simply want to assess whether PTSD is playing a role in undesired outcomes like low productivity or productivity, high turnover, absenteeism, and the like, this is not a strategy they can develop a definitive timeline for, but rather, will have to continue to work at. After all, there is no clear timeline for when PTSD symptoms will start, or when they will hopefully dissipate.

That said, symptoms of PTSD that leaders should remain vigilant for include:

• Lack of focus
• Anxiety or panic attacks
• Hypervigilance and hyperreactivity
• Mood swings
• Exhaustion or fatigue
• Avoidance behaviors
• Self-isolation or social withdrawal
• Self-blame or self-hatred
• Depression, hopelessness, or despair
• Apathy or numbness
• Cynicism, detachment, or loss of purpose
• Substance use or misuse
• Physical health complaints

Moreover, some signs that might also indicate the presence of PTSD in the workplace include:

• Decreased productivity
• Diminished performance
• Absenteeism
• Increased conflicts
• Frequent accidents, illnesses, or injuries
• Higher turnover
• Increased costs, healthcare spending
• Reduced bottom line

Risk and Protective Factors

As with all other disorders, risk factors do exist that contribute to a person’s propensity for PTSD. These include genetic risk factors: “If a person comes from a household with a very strong history of anxiety or mood disorders, [substance use disorders], they are considered to be more genetically prone,” Asirvatham confirms. A personal history of anxiety, mood, or substance use disorders, or any other mental health condition can also predispose someone to PTSD, as can adverse childhood or household experiences, i.e., childhood trauma, abuse, or neglect, feeling unsafe in one’s environment, or lacking strong social support.

Being a member of a marginalized population can also increase one’s risk of PTSD, as they deal with the reoccurring trauma of discrimination, bigotry, violence, etc. “People from certain cultures who have suffered long-lasting oppression in any of its form are much more prone to develop PTSD,” admits Asirvatham. “The LGBTQ community, for example, will always suffer more and will be more prone to mental health issues.” Women are also more than twice as likely as men to develop PTSD, research shows.

“But what matters more than these things,” Asirvatham urges, “are your protective factors. Your support system, your self-care, your coping skills, your spirituality, your finances—all of these things,” can reduce one’s risk of PTSD, she says. When there’s an imbalance between risk and protective factors, where higher risk factors like anything from dysfunctional families, poor financial status, or coming out of abusive, toxic relationships or spaces prevent the development of necessary protective factors like self-care, accessing support, limiting substance use, that’s when risk factors become a cause for concern, she admits.

Nevertheless, research strongly indicates that leveraging protective factors to treat or prevent against PTSD altogether can have a much more profound impact than working solely to limit the threat of risk factors, allowing individuals to find meaning in the face of trauma and subsequently lead more fulfilling lives in its wake. Thus, when it comes to addressing trauma in the workplace, fostering employee resilience becomes just as if not more important than simply minimizing the presence of adverse work conditions in order to protect workers’ against PTSD or any other trauma-induced mental health condition.

Prevention and Treatment Strategies: The Importance of a Double-Sided Approach

As Illi despairs later in her speech, “no one told us that preventing the pain of PTSD is far easier than treating the trauma.” To that statement, Asirvatham agrees.

Especially in today’s state of permacrisis, more organizations are coming to terms with the fact that trauma will—if it doesn’t already—impact their workplace. The digitalization and hybridization of work are only amplifying this concern, as the boundaries surrounding what constitutes “workplace trauma” are becoming increasingly fluid as people’s work and personal lives become increasingly intertwined.

However, because of the stigma that has long-since shrouded mental health issues—especially more complex conditions like PTSD—and the subsequent myths it has perpetuated (like the one Illi mentioned about how only soldiers can develop the disorder), workplaces are largely far behind when it comes to touting robust and effective strategies for tackling trauma. Specifically, far too many of these strategies rely on reactionary efforts, always succeeding the traumatic incident—and oftentimes far too long after the fact (think of the delay times that likely exist between unobserved incidents of bullying, harassment, microaggressions, near-miss accidents, etc., and the organization’s response)—and focus far too heavily on siloed, individual approaches to care that overlook the role that organization-wide prevention, psychoeducation, and peer support and training can play in mitigating the harmful effects of trauma in the workplace.

That being said, arguably the first and most necessary change that organizations need to make to their crisis- or trauma-response strategies is a cultural one. “One thing is we just need to be open to talking about these things,” argues Asirvatham. “I know it’s cliché that we keep saying we need to talk about trauma in the workplace, but in reality, how much of that do we really do?” she asks, as experts reduce most workplace conversations around mental health to lip service: making positive, albeit vague statements regarding mental health and help-seeking in the abstract, while failing to engage in explicit, constructive dialogue with staff about the state of their mental health and what specific supports they have access to in order to improve it.

To assess whether this last statement applies to their workplace, Asirvatham says it’s important for them to ask themselves questions like: is this an organization where employees feel like they can approach their leaders about their mental health? Are they given the space to come to work and express things like, “I’m a survivor,” or “I’m dealing with trauma and it hasn’t been easy,” and actually have a conversation around that without any repercussions? Without thinking that they might get fired, or might not get promotions, or wonder what their peers or leaders will think of them?

“The first step is always to make sure that organizations are creating a positive work culture where vulnerability and talking about trauma are accepted without any repercussions,” she says. “That’s the underlying issue that [undermines trauma-response strategies]: having to worry about what will happen after speaking out.”

To prove to employees that their workplace is a safe space and that leaders genuinely care for their wellbeing, some experts have stated that employers need to move away from an aggressive “What’s wrong with you?” approach to a trauma-informed and open-minded “What happened to you?” approach, leveraging psycho-educational trainings, webinars, modules, and other resources to help leaders and peers (i) understand the risks associated with PTSD, (ii) recognize signs and symptoms of PTSD in staff, (iii) proceed with caution when approaching someone with suspected PTSD, and (iv) refer them to the right support.

This approach might include offering emotional intelligence and empathic listening training to management so that they can learn how to engage in non-judgmental, open dialogue with their staff following an instance or trauma or after they notice an employee who is struggling. When leaders use expressions like “I care about you and I’m worried about you, is everything okay? Are you comfortable telling me what’s going on, and do you want to talk about it?” and explicitly express a desire to help and ask how it is they can help, they can avoid potentially re-traumatizing their employees or contributing to their psychological distress. Once leaders have listened to an employee explain their situation, offering follow-up support like, “Are you aware of the help that’s available to you through our benefits package and EAP provider? Do you need help locating any services or resources? Would you like me to help you connect with care right now?” also signal to employees that they will not be accosted for seeking help, thus encouraging them to do so.

Providing general training for staff on topics ranging from anything from conflict resolution, effective communication, active listening, to addressing implicit or unconscious bias and tackling mental health stigma is also an effective way to create a culture that promotes mental wellness and psychological safety—important protective factors against PTSD. Raising employees’ awareness of what the disorder can look like can also help normalize reactions and help employees learn how to effectively cope or seek additional help to manage their symptoms.

“There needs to be a lot of awareness all throughout the year,” Asirvatham argues, “so that people know that if they’re experiencing X, Y, or Z, that it might be trauma,” and from there, can identify what treatment options are available to them and how they can go about accessing them. “I would say awareness and psychoeducation—focused not necessarily on trauma, but on wellness in general are really important first steps,” she contends.

The second essential step that must be taken toward preventing trauma and PTSD in the workplace is by creating a psychologically safe work environment and reinforcing psychological safety within all policies, practices, and procedures. For those who still operate within a physical workspace, this might include making sure that the premises are secure and that workers feel physically safe from harm, whether that’s by monitoring who is coming in and out of the building to prevent against intrusions; making sure that heavy machinery is being operated with care to avoid accidents, injuries, or deaths; making sure that parking lots, common areas, bathrooms, entrances and exits are well-lit and monitored; and making sure that staff is aware of emergency exit plans in the event of an emergency.

But, for the majority of organizations who have made at least a partial transition if not a total transition into the digital sphere, creating a “psychologically safe work environment” will look a lot differently: rather than protecting them against physical dangers associated with the workplace, creating a safe digital workplace instead entails the maintenance and protection of employees’ work-life boundaries and, by extension, balance; making sure that they are well-equipped and well-supported to adjust to any additional changes made to the technology that they use, how they work, what they do for work; ensuring that an open line of communication is kept amongst teams, between staff and their leadership, and that all communication is respectful, compassionate, and honest; and making sure that all employees have access to social support as well as crisis support as needed.

For workplaces that are touched by trauma, there are also steps that employers can make to create a supportive environment for those struggling with post-traumatic stress and/or PTSD. These include:

• Scheduling rest breaks
• Allowing for flexibility during the workday
• Offering clear instructions
• Leveraging schedule reminders, checklists, tape recorders, and other tools to help those with poor concentration or memory
• Providing desktop or computer monitor mirrors so that employees struggling with hypervigilance or hyperarousal may see what’s behind them
• Allowing employees to pursue treatment even during the workday
• Offer access to free on-site or online yoga, meditation, and exercise classes
• Organize peer-led support groups or peer-to-peer mentoring to encourage employees to support each other
• Ask employees what accommodations are needed that would make them most comfortable
• Hire critical incident response teams to come in and conduct trauma screenings, trainings, and counseling

Lastly, the final area that organizations need to focus on in order to effectively prevent and/or treat PTSD in the workplace is their benefits package: making sure that employees have access to the tools, resources, and services needed to receive timely mental or physical health support as needed to protect against PTSD, or to help them process trauma and their personal stress response as needed. “‘Whether its physical wellness, nutrition, mindfulness—anything to do with wellness, does this organization actually promote that?'” That is the question that Asirvatham says employers must answer when they look at their culture and benefits. “‘Do we promote and stand by wellness—not just as a term to use, but as a lived practice?'”

In order to promote wellness through one’s benefits package, staple offerings include access to an EAP or holistic wellbeing provider, access to 24/7 crisis lines, screening and wellbeing assessments, substantial healthcare coverage, including mental and behavioral health services, and access to virtual, in-person, and telehealth services.

What Employees Can Do

While it is employers’ responsibility to have these supports in place and to offer these services and programs that can help build up employees’ coping skills and foster greater resilience against post-traumatic stress, Asirvatham also underscores how important it is for employees to understand the important role they play in preventing and treating PTSD. “For most trauma survivors, they need to understand what the work entails when we talk about coping. Whether that’s therapy or medications or holistic healing—like traveling or self-discovery—we want to make sure that they know that the trauma was not their fault, but that healing does require effort on their part,” she explains.

“Like if I was physically hurt, for example,” she adds, “even if it’s not my fault, I still need to do my rehab, my physio and all of that in order to heal.” When a person is suffering psychologically, whether from post-traumatic stress or simply from any form of distress, there are simple cognitive-behavioral techniques that individuals can practice to effectively heal from, if not at least cope with and manage their symptoms, she explains, starting with writing one’s thoughts down. This is especially important for trauma survivors, she asserts, “because, for trauma survivors, their thoughts are their first concern: it’s their thought patterns or cycles that create anxiety, and lead to their unease, nervousness, fatigue.” By journaling, Asirvatham says that survivors can work toward transforming their negative thoughts into positive thoughts, or at the very least, into neutral thoughts, so that they can better cope with the range of emotions that they might feel.

Secondly, she urges that it’s important for individuals to pay attention to the mind-body connection—emphasis on body. “People always think it’s about the mind,” she admits, when in reality, the first thing to be impacted by trauma is the nervous system. Thus, to better cope with the stress that one might feel in a moment of crisis or panic, people need to pay more attention to their nervous system.

“There are a few things that help us talk to our body in the moment,” she explains: movement, breathwork, and grounding exercises. “These are the only things that immediately provide a certain level of regulation to a very dysregulated nervous system. You need to move on a constant basis,” she argues, adding that people should look for ways to add exercises into their daily schedules, or find ways to go for walks or move around after stressful situations or potentially traumatizing or re-traumatizing situations. “The more you move, the more endorphins get released, and the better your body feels; you don’t feel threatened anymore. So that’s one way to soothe the mind-body connection.”

The second way to appeal to the mind-body connection is through breathwork. While the amount of time that people should spend inhaling or exhaling will vary depending on the person, she cautions, the goal is to breathe deeply. “You want to be able to inhale as much as you can and exhale as much as possible until you feel better,” she argues. “And this can also become part of one’s daily routine. [In fact], most survivors might have exercises and some form of breathing relaxation techniques they use very regularly in their life, instead of [waiting until their stress response is activated] to do these things,” she adds. “If they have it in their lifestyle, it helps them even prevent the intensity of breakdowns and being triggered. So, it’s not only something that people can do in the moment, but also something that can become a lifestyle routine in itself.”

The final way in which people can work to calm their body and soothe the mind-body connection is by grounding. “Grounding simply means bringing your awareness back into the present moment,” she explains. When the body becomes dysregulated, it starts to feel unsafe; this feeling is only exacerbated as one’s thoughts get lost in the past or in the future as they relive past trauma or worry about what’s to come. “Therefore, we want to bring our attention back to the present. We want to say, ‘I’m in my house right now,’ or ‘I’m next to my loved ones,’ or ‘No one is going to hurt me, I’m fine.'”

In order to communicate those messages to the body, she explains, requires the use of one’s senses to guide them back to a state of relaxation. “For example, ‘Can I look at something that will bring me a sense of calm?’ It can be a poster in front of you, a picture of your loved ones, anything like that. ‘Can I touch something which makes me feel safe?’ It can be a cozy blanket or a squeezing ball in your hand. ‘Can I taste something, or hear something that is pleasant?’ Anything that allows you to ground yourself and come back to the present moment is something that you can do on the spot to relax and manage your stress.”