Coping With Flashbacks and Dissociation in PTSD

Coping With Flashbacks and Dissociation in PTSD PTSD Coping Print Coping With Flashbacks and Dissociation in PTSD By Matthew Tull, PhD twitter Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder. Learn about our editorial policy Matthew Tull, PhD Medically reviewed by Medically reviewed by Steven Gans, MD on August 05, 2016 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on December 06, 2019 Post-Traumatic Stress Disorder Overview Symptoms & Diagnosis Causes & Risk Factors Treatment Living With In Children In This Article Table of Contents Expand Understanding Flashbacks Understanding Dissociation Know Your Triggers Identify Early Warning Signs Learn Grounding Techniques Enlist the Help of Others Seek Treatment View All Many people with post-traumatic stress disorder (PTSD) struggle in coping with flashbacks and dissociation, which may occur as a result of encountering triggers, that is, reminders of a traumatic event. To the extent that people are not aware of their triggers, flashbacks and dissociation can be incredibly disruptive and unpredictable events that are difficult to manage. However, you can take steps to better manage and prevent flashbacks and dissociation and stay in the present. Illustration by Brianna Gilmartin, Verywell   Understanding Flashbacks Flashbacks are considered one of the re-experiencing symptoms of PTSD. In a flashback, you may feel or act as though a traumatic event is happening again.?? A flashback may be temporary and you may maintain some connection with the present moment or you may lose all awareness of whats going on around you, being taken completely back to your traumatic event. For example, a rape survivor, when triggered, may begin to smell certain scents or feel pain in her body similar to that which was experienced during her assault.?? Understanding Dissociation People with PTSD may also experience dissociation.?? Dissociation is an experience where you may feel disconnected from yourself and/or your surroundings. Similar to flashbacks, dissociation may range from temporarily losing touch with things that are going on around you, kind of like what happens when you daydream, to having no memories for a prolonged period of time and/or feeling as though you are outside of your body. Dissociation in PTSD Know Your Triggers In coping with flashbacks and dissociation, prevention is key. Flashbacks and dissociation are often triggered or cued by some kind of reminder of a traumatic event, for example, encountering certain people, or going to specific places, or some other stressful experience.?? Therefore, its important to identify the specific things that trigger flashbacks or dissociation. By knowing what your triggers are, you can either try to limit your exposure to those triggers or, if that isnt possible (which is often the case), you can prepare for them by devising ways to cope with your reaction to those triggers. In addition to reducing flashbacks and dissociation, knowing your triggers may also help with other symptoms of PTSD, such as intrusive thoughts and memories of a traumatic event. Identify Early Warning Signs Flashbacks and dissociation may feel as though they come out of the blue and they may feel unpredictable and uncontrollable. However, there are often some early signs that you may be slipping into a flashback or a dissociative state.?? For example, your surroundings may begin to look fuzzy or you may feel as though youre separating from or losing touch with your surroundings, other people, or even yourself. Flashbacks and dissociation are easier to cope with and prevent if you can catch them early on. Therefore, its important to try to increase your awareness of their early symptoms. Next time you experience an episode, revisit what you were feeling and thinking just before the flashback or dissociation occurred. Try to identify as many early symptoms as possible. The more ?early warning signs you can come up with, the better able you will be to prevent future episodes. PTSD Early Warning Signs Learn Grounding Techniques As the name implies, grounding is a particular way of coping that is designed to ground you in the present moment. In doing so, you can retain your connection with the present moment and reduce the likelihood that you slip into a flashback or dissociation. In this way, grounding may be considered to be very similar to mindfulness. To use grounding techniques, you want to use the five senses (sound, touch, smell, taste, and sight).?? To connect with the here and now, do something that will bring all your attention to the present moment. Here are a few grounding techniques you can try: Sound: Turn on loud music. Loud, jarring music will be hard to ignore. And as a result, your attention will be directed to that noise, bringing you into the present moment.Touch: Grip a piece of ice. If you notice that youre slipping into a flashback or a dissociative state, hold onto a piece of ice. It will be difficult to direct your attention away from the extreme coldness of the ice, forcing you to stay in touch with the present moment.Smell: Sniff some strong peppermint. When you smell something strong, its very hard to focus on anything else. In this way, smelling peppermint can bring you into the present moment, slowing down or stopping altogether a flashback or an episode of dissociation.Taste: Bite into a lemon. The sourness of a lemon and the strong sensation it produces in your mouth when you bite into it can force you to stay in the present moment.Sight: Take an inventory of everything around you. Connect with the present moment by listing everything around you. Identify all the colors you see. Count all the pieces of furniture around you. List off all the noises you hear. Taking an inventory of your immediate environment can directly connect you with the present moment. Grounding Techniques for PTSD Enlist the Help of Others If you know that you may be at risk for a flashback or dissociation by going into a certain situation, bring along some trusted support.?? Make sure that the person you bring with you is also aware of your triggers and knows how to tell and what to do when you are entering a flashback or dissociative state. Seek Treatment In the end, the best way to prevent flashbacks and dissociation is to seek out treatment for your PTSD. Flashbacks and dissociation may be a sign that you are struggling to confront or cope with the traumatic event you experienced. Treatment can help with this.?? You can find PTSD treatment providers in your area through the Anxiety Disorder Association of America website, as well as UCompare HealthCare. The International Society for the Study of Trauma and Dissociation (ISSTD) also provides a wealth of information on the connection between trauma and dissociation, how to cope with dissociation, and provides links to therapists who treat trauma and dissociation.