Coping strategies and grounding techniques for flashbacks and extreme distress
Grounding techniques can be very useful when we feel really distressed, particularly when the distress makes us feel very unreal or detached, or it feels like we are in a different situation to where we really are.
A flashback is part of the brain's way of working to process the trauma so that the experience can be filed away as a past memory (rather than a current threat). This will enable your healing. We can help this process by allowing the flashbacks to happen, rather than fighting or avoiding them. We can cope with them by getting our heads out of the past (trauma) and into the present (safety), by using grounding techniques.
Anxiety often makes us feel very detached, dissociated, or unreal. Grounding techniques help to bring us back to the here and now, with an awareness of our own bodies. They are strategies that help us to be in the present moment, in reality, rather than in the traumatic experience of the past or current distress.
Practise them, and learn what works best for you - whether it's a mental strategy like telling yourself you're safe now, or maybe doing something more physical. The aim is to turn your focus of attention away from the past or current distress, and into the here and now of reality and safety.
Tell yourself you are having a flashback or anxiety attack and that this is okay and normal.
The worst is over - it happened in the past, but it is not happening now.
Tell yourself: That was then, and this is now. However terrible you feel right now, you survived the awfulness then, which means you can survive and get through what you are remembering now.
Open your eyes and put a light on (if it's dark).
Look around the room, notice the colours, the people, the shapes of things. Make it more real.
Listen to and really notice the sounds around you: the traffic, voices, washing machine, music etc.
Notice your body, the boundary of your skin, how your clothes feel on your skin, movement in your hair as you move your head, really feel the chair or floor supporting you - how that feels in your feet, your legs, your body.
Pinch yourself - that feeling is in the now, the things you are re-experiencing happened in the past. That was then, and this is now.
Stand up and put your feet firmly on the ground
Move about: stretch, stamp your feet, jump up and down, dance, run on the spot, rub your arms and legs, clap your hands, walk, remind yourself where you are right now.
Use 5,4,3,2,1: Think about 5 things you can see, 4 things you can hear, 3 things you can touch (and touch them), 2 things you can smell or like the smell of, and 1 slow, deep breath.
Notice what is right now - and notice how different it is to the distressing memory.
Breathe Mindfully: breathe deeply down to your belly; put your hand there (just above our navel) and breathe so that your hand gets pushed up and down. Imagine you have a balloon in your tummy, inflating it as you breathe in, and deflating as you breathe out. When we get scared, we breathe too quickly and shallowly and our body begins to panic because we're not getting enough oxygen. This causes dizziness, shakiness and more panic. Breathing slower and deeper will stop the panic.
Rub your arms and legs. If you have lost a sense of your body, rub your arms and legs so you can feel where your body starts and ends, the boundary of you. Wrap yourself in a blanket and feel it around you.
Walk, and really think about walking - mindfully. Notice the way your body moves, how your feet move and feel as you walk, notice your leg muscles, and the way your arms feel as they swing. Notice the movement in your hair, and the sensation of moving air on your skin. Notice the sensations of breathing as you walk.
Describe (and say out loud if appropriate) what you are doing right now, in great detail. Or describe doing a routine activity.
Try to think about different things, almost like playing mental games, for example: count backwards in 7s from 100, think of 10 different animals, 10 blue things, one animal or country for each letter of the alphabet, say the alphabet slowly, say the alphabet backwards etc.
Carry a grounding object with you. Some people carry a stone or other small object, perhaps which has personal meaning, to comfort and touch when you need to.
Get support if you would like it. Let people close to you know about flashbacks or how anxiety attacks affect you, so they can help if you want them to. That might mean holding you, talking to you, helping you to reconnect with the present, to remember you are safe and cared for now. If there is no-one, use a helpline.
Self Care: flashbacks and anxiety are powerful experiences which drain your energy. Take time to look after yourself afterwards. You could have a warm, relaxing bath or a sleep, a warm drink, play some soothing music, or just take some quiet time for yourself. Be kind to yourself.
Ask yourself questions in order to bring yourself into the present. Write down your own questions, for example:
Where am I, right now?
What day is it?
What year is it?
How old am I?
Where do I live?
Use Positive Coping Statements. You might prepare a coping statement, for example: "I am (name), I am safe right now, this is just a memory - that was then and this is now. I am in (place) and the date is (date). This flashback will pass".
Make an emergency or soothe box you can use another time, and fill it with meaningful and helpful objects or reminders.
Download an mp3 onto your phone such as First Aid for Panic, or use another from here:
Remember you are not crazy - flashbacks are normal and they are helping you to heal.
When you feel ready, you might want to write down about the flashback or anxiety attack, and how you got through it. This will help to remind you that you did get through it, and can again.
NOW: Mindfulness for busy people
Coping With Flashbacks - this page as PDF
Self Help Books
Overcoming Traumatic Stress: A Self-Help Guide Using Cognitive Behavioral Techniques
The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms
Overcoming Trauma And PTSD: A Workbook Integrating Skills from ACT, DBT, and CBT
The Everything Guide To Overcoming PTSD: Simple, effective techniques for healing and recovery