How to Ground Someone Having Flashbacks

Many survivors of trauma experience flashbacks, or memories and reminders of the traumatic event or details surrounding the event. People often feel as though they are reliving a moment in the past where something very scary or harmful occurred. Flashbacks can cause people to experience heightened emotions, panic attacks, or to dissociate (feeling disconnected from oneself or one’s surroundings). Grounding is an important aspect of trauma recovery, as it helps people reconnect to the present moment and cope with flashbacks.

People who have experienced trauma can benefit greatly by having someone in their life to support them when they need it the most. It’s essential to strike a balance between being helpful and respecting each person’s autonomy and boundaries. Never underestimate the power of asking someone permission before jumping in to help. Many trauma survivors have experienced a loss of autonomy and power over their own lives and bodies, and consent is a key aspect of safe and healthy relationships.

What Are Flashbacks?

Flashbacks are when someone re-experiences a past traumatic event in the present moment. Flashbacks differ from regular memories in that these thoughts and feelings are unwanted and intrusive, and cause significant distress or dissociation. This sense of “nowness” is what distinguishes flashbacks from other memories, even ones that are unpleasant or hurtful. 

Researchers are investigating the various brain structures associated with flashbacks and have found that flashbacks and regular memories involve different areas of the brain. It’s long been understood that the hippocampus was highly involved. However, a new theory proposes that the parts of the brain that involve emotions and bodily sensations are more active during a flashback, and these areas include the amygdala, insula, and motor areas. Experiencing a flashback is more than just remembering a past event. It really does feel like the trauma is happening again, because that is what the brain senses at the time.

Types of Flashbacks  

There are several types of experiences someone can have when experiencing a flashback. 

• Visual flashbacks are when someone “sees” images associated with the traumatic event in their mind. Not everyone is a visual thinker, and not all people will experience this. For people who do have the ability to visualize, they may mentally “see” disturbing and upsetting images.
• Emotional flashbacks occur when someone experiences the emotions associated with a particular event. This can happen alongside visual flashbacks or not. Many people experience a flooding of emotions, including fear, anxiety, panic, sadness, and anger. 
• Somatic flashbacks occur when someone experiences body memories and physical sensations related to the trauma. This can sometimes involve physical sensations of pain and discomfort. 
• Dreams or nightmares about the content of traumatic events can occur for some people, while others may have troubling dreams not related to the specific event itself. 
• People who experience flashbacks often also experience disassociation. This is when someone feels disconnected from their body, or zones out and doesn’t remember stretches of time. 

Common Triggers 

There are several common things that can trigger trauma responses, including flashbacks, and they include:

• Sensory triggers, or sounds, smells, sights, textures that remind one of the event
• Anniversary dates and seasonal triggers
• Environmental similarities to trauma location
• Increased stress levels and lack of sleep
• Intrusive thoughts and memories
• Exposure to traumatic events in the media, real or dramatized, even ones not specifically related to one’s personal experiences

Recognizing When Someone Is Having a Flashback

There are several external signs that someone is experiencing a trauma flashback. If you see any of these, that may be an indication that they are having a flashback and could possibly use some support getting through it.

Behavioral Signs  

• Speaking in the present tense about past events
• Defensive or protective body postures
• Seeming unaware of current surroundings
• Repetitive movements or freezing

Physical Symptoms 

• Rapid breathing or hyperventilation
• Sweating and trembling
• Dilated pupils
• Pale or flushed skin

Emotional Indicators

• Intense fear or terror disproportionate to the situation
• Panic or extreme emotional distress
• Confusion about time and place
• Appearing "not present" or distant

Immediate Steps to Take

It’s important to know what to do next when someone is experiencing a flashback. 

Stay Calm and Assess Safety  

First, manage your own emotional response. Check in with yourself and ensure you can act calmly and rationally, without adding to the person’s distress. Additionally, safety is a priority, so ensure the environment is safe and that no one’s safety is at risk. If there are safety or serious medical concerns, please reach out to emergency services. 

Announce Your Presence Gently  

Let them know you’re there and use a calm, steady voice. Avoid making any sudden movements or loud noises. Stay within their line of sight if possible, and don’t approach them from behind. 

Respect Boundaries

Respecting boundaries is key. Many survivors have touch aversion, so ask before you make any physical contact, and keep an appropriate distance from them. Additionally, consent is crucial in establishing a sense of safety and trust. Ask the person if you can support them, and explain that you suspect they’re experiencing a trauma flashback and that you want to help.  

Grounding Techniques to Use

There are several ways to support someone in grounding themselves in the present moment.

Verbal Grounding Methods  

Asking questions or providing reminders can help to reorient someone. This can include orientation questions, such as asking what the date is, their location, or age. Use their name and relationship to you, such as “Hi John, I’m your wife, and I’m concerned about you.” Gentle reminders of reality and present-focused statements, such as “you’re with me at home and you’re safe,” used without forcefulness, can help bring them back into the present.

Sensory Grounding Techniques  

The 5-4-3-2-1 technique engages the senses and can be a very helpful way to ground someone.

Ask them to describe five things they see, four things they hear, three things they can feel or touch, two things they smell, and one thing they can taste. You can support someone in this process by offering several of the items below:

• Scented items (coffee, essential oils, mint, light a candle)
• Textured objects to hold (stress ball, fabric, fidget toy)
• Temperature changes (cold water, ice pack, warm beverage)
• Sounds (music, nature sounds, your voice)

Physical Grounding Approaches 

Physical grounding techniques can help someone shift their focus from emotions and thoughts to their body.

Several prompts to help someone do this include encouraging them to feel their feet on the ground or try walking barefoot on grass or carpet. They can also press their hands against a wall or surface, or squeeze a pillow. Guided breathing exercises are one of the most effective strategies for managing anxiety, and by modeling slow breathing with them, this can help their nervous system begin to re-regulate.

Environmental Adjustments 

Making small changes to the environment can have a significant impact on ensuring safety and increasing comfort levels. Many people experience sensory overload, so doing things like reducing extra noise, dimming lights, or opening windows for fresh air can help their nervous system cool down. Ensure emotional and physical safety, for example, by removing triggering objects or unsafe things in the space. 

What to Say (and What Not to Say)

Many people struggle to find the words to say when someone is in need of support. Here are a few ideas and tips to help those who do.

Helpful Phrases  

A few suggestions for things to say to support someone experiencing a flashback include reminders of safety, such as "You're safe now." The verbal grounding methods mentioned above can be helpful in supporting them in grounding themselves in the present moment. Also, saying something along the lines of "You're having a flashback; I know this is hard, but remember it will eventually end,” can help them know what’s going on during a potentially confusing and scary moment. Additionally, if you’re not sure what to say or do, try asking, "Is there anything I can do to support you? What do you need?"

Avoid These Phrases  

Just as important as knowing what to say is knowing what to avoid. Saying things like “Calm down" or "Snap out of it" isn’t helpful, nor is demanding they stop or control their emotions. If experiencing a flashback was that simple to recover from, they certainly would if they could. Saying things like "It's not real," "It's all in your head,” or "Just forget about it" are highly invalidating, as the person quite literally feels as if they are experiencing the trauma memory as it is happening in the present. Survivors often try to forget and move on, but find that no matter how hard they try, they can’t. Also, asking details about the trauma during their time of crisis would be highly insensitive and inappropriate.

Tone and Delivery  

Most of our communication isn’t what we say, but how we say it, and the non-verbal facial expressions and body language we use. Use a clear and slow speech, a calm tone, keep things short and simple, and most importantly, be patient.

After the Flashback Subsides

Once the person starts to come out of the worst of the flashback, they still need some support and perhaps a debriefing. Ask how you can best support them in that moment.

When to Seek Medical Attention 

There are several indicators that medical attention may be needed, such as if there are any signs of injury during flashback, if they express self-harm or suicidal thoughts, or if they request professional help. Additionally, if they disassociate for long periods of time and aren’t able to return to the present moment, professional help may be needed.

When to Call for Emergency Help

There are resources for people experiencing severe flashbacks. It’s important to know when to seek out professional support. 

Crisis Situations Requiring Immediate Intervention  

The 988 National Crisis Hotline can be a valuable resource if you’re unsure about what to do and no one is in immediate danger to themselves or others. They can provide local mental health crisis resources to assess for treatment options. 

The 911 emergency number should be utilized when someone is exhibiting an active self-harm or suicide risk, is exhibiting violent behavior toward self or others, is unable to return to reality, or in case of medical emergencies (injury, heart problems, breathing). Be prepared to inform them of your location, signs and behaviors you observe, any safety concerns, and whether the person has any underlying medical conditions. 

Takeaway

There are several grounding strategies that help most people emerge from a flashback, including grounding through their senses, physical grounding, having meaningful support, and adjusting their environment. Remember that having patience and compassion is key. What the person is experiencing isn’t in their control, and some flashbacks can feel terrifying. There is good reason to have hope. People who get professional treatment for their trauma-related symptoms, like flashbacks, recover faster than those who don’t, so encourage your loved one to seek out treatment options and be consistent with appointments with their care team. 

Recovery from flashbacks and post-traumatic stress disorder is possible. If you or your loved one is looking for mental healthcare for PTSD recovery or crisis support and prevention, reach out to us at Willow Health today. We offer same-day or next-day appointments with both a psychotherapist and a psychiatric medication clinician, who can assess your needs and identify a plan for individualized care. 

Frequently Asked Questions

Here are some answers to some commonly asked questions about flashbacks.

How long do flashbacks typically last? 

The duration of a flashback can vary drastically. People can experience them for a few seconds or up to several days. 

Can flashbacks be prevented? 

While it’s not possible to prevent all flashbacks, as one will likely encounter triggers as a part of daily life, it is possible to see their frequency and severity reduce over time with effective treatment.

Should I bring up the flashback later? 

Communication is key, and if you have concerns about your loved one, share them at a time that feels right. 

What if grounding techniques don't work?  

If the person is unable to regain nervous system regulation after trying several grounding and self-soothing techniques, seeking out professional support, such as calling the 988 hotline or their treatment team, is advised. 

Sources

Full article: Re-experiencing traumatic events in PTSD: new avenues in research on intrusive memories and flashbacks 

Media Exposure and the Risk of Post-Traumatic Stress Disorder Following a Mass traumatic Event: An In-silico Experiment

Trauma Reminders: Anniversaries - PTSD: National Center for PTSD  

Post-Traumatic Stress Disorder - National Institute of Mental Health (NIMH) 

PTSD Basics - PTSD: National Center for PTSD 

Social support and posttraumatic stress disorder: A meta-analysis of longitudinal studies - ScienceDirect