PTSD Coping Coping With Flashbacks and Dissociation in PTSD By Matthew Tull, PhD 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 process Updated on May 04, 2022 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD 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 Print Table of Contents View All Table of Contents Understanding Flashbacks Understanding Dissociation Know Your Triggers Identify Early Warning Signs Learn Grounding Techniques Enlist Help Seek Treatment Flashbacks can be common in PTSD (post-traumatic stress disorder). Many people with PTSD struggle to cope with flashbacks and dissociation, which may occur as a result of encountering triggers that remind them of the traumatic event they experienced. Flashbacks and dissociation can be incredibly disruptive and unpredictable. This is particularly true when people are not aware of their triggers. 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 one of the re-experiencing symptoms of PTSD. In a flashback, you may feel or act as though a traumatic event is happening again. What Is a Flashback? A flashback is a PTSD symptom that involves vividly re-experiencing a traumatic event. These episodes may occur suddenly and unexpectedly in response to a trigger that reminds you of the trauma. A flashback may be temporary and you may maintain some connection with the present moment. Or you may lose all awareness of what's going on around you and be taken completely back to your traumatic event. For example, a rape survivor, when triggered, may begin to smell certain scents or feel pain similar to what they experienced during the assault. What Is Abreaction? 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 order to cope 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, going to specific places, or some other stressful experience may trigger a flashback. By knowing what your triggers are, you can try to limit your exposure to those triggers. If that isn't possible (which is often the case), you can prepare by devising ways to cope with your reactions to 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 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 you're 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, it's 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. Grounding can be similar to mindfulness. Grounding techniques 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. 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. Taking an inventory of your immediate environment can directly connect you with the present moment. Smell Sniff some strong peppermint. When you smell something strong, it's very hard to focus on anything else. In this way, smelling peppermint can bring you into the present moment, slowing down or stopping a flashback or an episode of dissociation. Sound Turn on loud music. Loud, jarring music will be hard to ignore. As a result, your attention will be directed to that noise, bringing you into the present moment. 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. Touch If you notice that you're 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. 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. They should know how to tell when you are entering a flashback or dissociative state, and how to respond to help you. Research suggests that PTSD reduces social support resources, but that having strong social support helps lessen the impact of the condition. Reaching out for help and building your support network are essential when dealing with trauma-related symptoms. Seek Treatment In the end, the best way to prevent flashbacks and dissociation is to seek out treatment for your PTSD. Experiencing 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. Psychotherapy There are several different types of psychotherapy that can be helpful for treating PTSD and reducing symptoms of flashbacks and dissociation. Some of these include: Cognitive behavioral therapy (CBT) is an approach to talk therapy that helps people identify and change thoughts and feelings that contribute to symptoms. Cognitive processing therapy (CPT) is a form of CBT that focuses on changing perceptions of traumatic events. Eye movement desensitization and reprocessing therapy (EMDR) helps people process trauma using bilateral eye movements. You can find PTSD treatment providers in your area through the Anxiety Disorder Association of America and UCompare HealthCare. The International Society for the Study of Trauma and Dissociation (ISSTD) also provides a list of therapists who treat trauma and dissociation, along with other resources. Medications There are no FDA-approved medications specifically for the treatment of flashbacks or dissociation. However, some prescription medications may help people manage symptoms of PTSD. These include: Selective serotonin reuptake inhibitors (SSRIs) such as Zoloft (sertraline), Prozac (fluoxetine), and Paxil (paroxetine) Selective norepinephrine reuptake inhibitors (SNRIs) such as Effexor (venlafaxine) If you or a loved one are struggling with PTSD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. A Word From Verywell Flashbacks and dissociation can be disruptive and distressing, but there are steps that you can take to help cope with these troubling symptoms of PTSD. Understanding your triggers can help. Working with a mental health professional can also help you learn new coping strategies and process the thought and emotions related to the traumatic experiences. Dissociation After Trauma May Indicate Increased Mental Distress in the Future Frequently Asked Questions How do you deal with PTSD flashbacks? If you are experiencing a flashback, work on grounding yourself in the moment. Remind yourself that you are safe and focus your attention on your senses. The 5-4-3-2-1 coping technique, which involves practicing deep breathing while progressively focusing on a sight, feeling, sound, scent, and taste, can also be an effective grounding strategy. What are flashbacks like? While the experience can vary for each individual, for many, it feels like living through the traumatic experience all over again. It's much more than a memory—it also involves feeling the same emotions and sensations that accompanied the trauma itself. A person who is having a flashback may have thoughts, feelings, sensations, perceptions, and physical reactions that feel very real. How do you stop flashbacks? If you are able to recognize that you are having a flashback, you may be able to take steps to stop it. Remind yourself that what you are feeling is a flashback and that the trauma is over. Practice deep breathing and ground yourself by focusing on your senses. Think about things that would help you to feel safer in the moment and take steps to make yourself feel more secure. How do you prevent flashbacks? Understanding your triggers and learning to spot the early warning signs of a flashback can be helpful for preventing them. Having a plan in place for what you can do to feel safer and stay in the moment is essential. Talking to a mental health professional and learning new coping strategies can also be useful for preventing future flashbacks. 12 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. 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