6 Steps to Help Someone Get Out of a Flashback

​Written by: Kaycee Beglau, PsyD

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Whether it’s a friend, relative, or partner, we sometimes find ourselves with someone who suddenly begins to experience the acute effects of trauma. This typically presents as sudden fear or panic, flashbacks, intrusive negative thoughts related to the trauma, or dissociative states where the person appears to “not really be there” anymore. Of course, these experiences may be frightening, confusing, and overwhelming for the person experiencing them, and they may also be for the person witnessing them as well. If you are in a relationship with someone who frequently experiences these symptoms in your presence, it may be beneficial and empowering to have a sense of what might be helpful for the person in that situation.

However, it is important to note that the purpose of this article is to highlight some quick and concrete strategies to help the person re-orient or “ground” during or after an acute trauma reaction, and it is not intended to imply that anyone in a personal relationship with another trauma survivor should take on the role of being an actual therapist. Think of the information in this article as a “first aid kit” for flashbacks – it’s to help you when you need it and should not be used in place of actual treatment from a trained professional.

What to Look For:

• Sudden difficulties communicating or responding
• Person seems disoriented
• Frozen, wide-eyed stare, clenched or fluttering eyes
• Inability to make eye contact
• Dysregulated, uncontrollable flood of emotions, such as crying, screaming, shaking (panic)
• Calling out for help, repeatedly saying “no” or trying to run away
• Curling into a fetal position or trying to hide
• Seemingly unaware of or disconnected from the present
• Making movements or gestures as if responding to something that is not really there

What to Do:

 1. DO NOT TOUCH someone (even a loved one) in an active flashback. 
This may be extremely triggering for them and the physical touch may inadvertently be experienced as part of the traumatic memory/flashback. As they are starting to come out of it and are becoming more oriented, it’s ok to ask permission to touch them (for example, placing a hand on their shoulder, a safe embrace, or using touch to guide the person to a better location). If they say “no” or appear to shutter or recoil, respect this as an indication the person does not want to be touched at that time.

2. Do not ask them to talk about the flashback details.
It’s ok to ask if they are having a bad memory or if they feel like something bad is happening to them right now. It’s important to keep in mind that if a person is having a flashback, they are overwhelmed and flooded. This is not the time to try to get them to talk about anything related to the trauma. They need help coming back to the present moment, regulating their nervous system, and feeling safe again.

3. Orient to present time and surroundings.
Identify yourself and announce where you are and say something present-oriented, such as your name and relation to the person, even if they know you well. Let them know where you are and remind them they are safe in the present moment. For example: “Laura, this is Sarah, your sister. You are here with me in your house in Florida. It’s May, 2019. It’s just me and you and nothing bad is happening to you right now. You’re safe here with me.” 

4. Use a warm, but firm voice to give instructions.

• Ask them to listen to the sound of your voice. Ask them to indicate they can hear you and know who are.
• It’s very helpful to get a person in a flashback to open their eyes and begin looking around the room. This is key in helping them gradually be able to realize they are in the present (where it’s safe), as opposed to in the past when the traumatic experience actually occurred. Repeat this in a calm, but firm voice until they are able to do so.
• Ask the person to look around the room and name as many colors as they can, name the objects they see, find something close by that makes them feel safe and comforted (e.g., a beloved pet, a favorite blanket, an article of clothing or a piece of jewelry) and ask them to hold on to it and describe it to you in as much detail as possible.
• Instruct the person to put both feet on the floor to literally “ground” them in the present moment. I like to ask people to wiggle their toes, gently press their heels into the floor, and to notice what it feels like to be supported by the ground beneath them. 
  
  

5. Repeat grounding or safety phrases as much as needed.
Again, continue to use a warm, but firm voice consistently. The person may be relying on the presence of a supportive voice to “guide” them out of the flashback experience. You can continue to say things like:

• It’s ok, you are here with me now.
• It’s all over, you have already survived this.
• He/she/they can’t hurt you anymore.
• You are safe, you aren’t in danger anymore.
• You are no longer in __________ (e.g., parent’s house, city or country of traumatic event, etc.)
• You are an adult now, which means you are safer, you have more resources, you have more choices.
  
  

6. If necessary, continue with more structured breathing or grounding exercises.

• If the person is hyperventilating or appears to be panicking, you can ask them to take some slow, deep breaths with you. It can help to mirror this for them and do it along with them. Ask them to notice what their breath feels like as they breath in and then to notice what it feels like to breathe out. See if they can take a deep breath in for the count of 4 and then breath out for a count of 4. Repeat until breathing has stabilized.
• For further grounding strategies, continue to ask the person to look around the room as much as possible. You can transition to using all 5 senses (sight, sound, smell, taste, and touch) if something “stronger” is needed. Ask the person to name 5 things they see, 4 things they touch, 3 things they hear, 2 things they smell, and 1 thing they taste. Feel free to offer assistance by giving access to scented candles or lotions, mints or chewing gum, or anything else that would likely be soothing.

 
Key Points to Keep in Mind:

• Be warm, firm, and consistent
• Be calm and patient and don’t give up
• Do not push and try not to get scared or frustrated yourself
• Repeat as much as necessary and don’t worry about sounding like a “broken record”

• Once the person is fully out of the experience, you can ask the person for feedback about what was helpful and what wasn’t. Make a plan for next time and please follow up with professional help if needed.