Flashback grounding techniques for anxiety and PTSD

Part of an ongoing series about life with complex post-traumatic stress disorder

Grounding techniques are meant to stabilize you, bring you back down to earth, when you’re having intense emotions, reactions, or lack thereof. They are not substitutes for working on trigger management or regulation of your emotions, but they are helpful for short term situation management. The techniques that are most helpful will vary a lot depending on the types of symptoms or flashbacks people experience. For someone with PTSD and C-PTSD like me, sometimes I need to practice grounding where I have a visual flashback when I see in my head events replaying, have intrusive negative thoughts or feelings, or when I experience emotional flashbacks, which are the most common for me. Sometimes I have regressions where I feel very small and young, sometimes I feel extremely angry, and other times, I feel frozen, paralyzed, out of it, or sad.

It’s important to note that there are ways to develop emotional regulation skills that mean you may not need grounding as often. The DBT workbook is especially good for this. But if you’re like me and often have multiple flashbacks a day, you are in the process of stabilizing your life for trauma processing, or are in the process of doing your processing, grounding it is!

Here’s my personal list of how to ground myself — this is always evolving, and only what works best for me, right now. I follow the steps until my negative thoughts or strong emotions subside.

1. Take a deep breath
2. Stop rocking/pacing/eating
3. Sit up if I’m lying down, sit down if I’m moving around
4. Put both feet on the floor
5. Say out loud which emotion I am experiencing (and if helpful, read the Pete Walker emotional flashback sheet)…this can be really self-validating.
6. See what I can hear or feel — what colors do I see? Am I touching anything with a texture? Name 3 things I can see that are blue.
7. Check if I am hungry, cold, hot, or if anything hurts.
8. Turn on music.
9. Open the windows or walk outside.
10. Drink a cold glass of water.
11. Eat something sour, like a hard candy.
12. Do jumping jacks.
13. Watch a video (some super normal comforting channels I like include the Try Guys, the the Coolirpa sewing channel, and tv shows like Parks and Rec. Just a note that sometimes I find the pre-ads triggering, especially around Halloween, so maybe mute until the video’s on if you’re feeling fragile)
14. IF PANICKING — Text my best friend, try crisis text (HOME to 741741), then try one more friend.

Most flashbacks I have pass within 5–10 minutes. Some grip me for a few hours. Over the holidays this year I was fighting with my Dad, and am pretty sure I was stuck in a complete freeze response for multiple days where I had a lot of difficult, intrusive thoughts. Main clue ins for me are: Do I feel like I want to smash something? Am I not breathing? Are my stomach or jaw muscles clenched? Is it past the time when I’d normally eat or do something else? Am I crying or feeling scared? Do I feel an impulse to call out for help? Can I not remember what I am supposed to be doing? Have I been in the same position for longer than 5 minutes without moving? Is there a sound/image/memory playing in my head, loudly, that only I can hear?

If I can, I like to find the cause of a flashback, and verbalize it out loud. A lot of my angrier flashbacks, I think the anger needs to be let out somehow (see Pete Walker’s book, The Tao of Fully Feeling). Here’s how I try to handle the angry ones:

1. Notice/observe I’m feeling excessively angry.
2. Try to name what is making me angry. Sometimes I like to ask myself questions out loud — Oh, are you upset that they forget to call you back to schedule a follow up appointment? Does that make you feel like no one is caring for you, and you have to do everything yourself? Or, are you upset that your vision issues are making it hard for you to finish work right now, and that makes you feel worthless because you’re less productive? …usually something will eventually resonate.
3. If I can figure out why and pause enough when I’m upset, I like to tell myself out loud that it’s ok in some way. I.e…“You had to take care of yourself very early as a child, and that was not normal. It must be very hard for you to continue feeling abandoned when you are an adult. But, you are a grown up now, and you have skills to take care of yourself and resources you did not have them.” Or, “You were set some very high expectations very young, and that was really hard for you. Sometimes these high expectations are carrying over into adulthood. But, your worth as a person is not tied to your ability to perform for or parent other people anymore. You are not going to be punished if you do not finish something, especially while you are recovering from an illness. You are great and deserve kindness.”
4. If in an emotional flashback where I’m just really mad, so mad it’s gripping me and I can’t figure it out, I like to:
   - Slam a door. Ten times if I need to.
   -Shout about what I’m mad about, as loud as I want (Why didn’t they call me? Don’t they know I was counting on them?! No one cares!)….sometimes this free form, letting myself be angry tells me more about my root feelings anyway. Usually if I shout enough, it turns into crying, which is good and a healthy release. There are a lot of emotions in my life I was not allowed to feel or process because it wasn’t safe, and I have to let myself do that now.
   -Throw my phone far away if it’s triggering me, on a soft surface like a bed or carpet.
   -Otherwise, I move expensive electronics far away. In my lifetime I’ve broken several phones and one laptop. It’s just, iPhone are so smashable, and a lot of the stuff that enters my phone is really triggering. If I can’t and I’m mad about something online, sometimes I’ll smack my keyboard. That usually just makes my hand hurt, and then I can nurse it for a while and be sulky. Sometimes being sulky is better than being angry. (Remembering that I’d have to go to the Apple store often helps me pause before I smash my phone. But sometimes I feel like the outside work is bothering me so much, I need a break. The last two times my phone smashed, was because my phone had triggered me 5x times in a row, in already very stressful situations. Apple Care, screen protectors, and OtterBox cases are allies in this flashbacks vs. electronics battle)
   -Find something I can throw or smash that is not dangerous or valuable. Example: Kicking a cardboard box around the kitchen. Throwing a ball against the wall hard. Going to do some cardio at the gym and racing up a hill on the exercise bike until I’m worn out. Things I’ve tried that have not worked: Slamming down coffee mugs, a honey bottle (omg the floor was sticky for days), slamming weak doors where the frame pieces cannot deal with slams, and so on.
   -Someone in the Pete Walker book liked having a phone book they could hit with a belt, but I haven’t tried that because 1) no one has phone books anymore 2) I’m pretty sure I’d hurt myself by accident.