Coping with Trauma Dissociation and Flashbacks in Recovery

One of the most common mental health disorders that co-occurs with addiction is Post-Traumatic Stress Disorder (PTSD), and it can be a significant hurdle for those in recovery to overcome while committing to sobriety. PTSD is often triggered in individuals who experience or witness a traumatic event, like a physical or sexual assault, abuse, accident, disaster, or other serious events. While these kinds of events are certainly traumatic, the disorder manifests when people continue to experience a ‘fight-or-flight’ response after the event. Instances of trauma-related dissociation and flashbacks are common in people who suffer from PTSD and can impact recovery progress and regular life.

Understanding Dissociation and Flashbacks

For many individuals, dissociation is one of the most effective and direct defenses against intrusive, triggering, or traumatic flashbacks. This mechanism is characterized by depersonalization, the feeling that you are not yourself, and derealization, the feeling that the world is not real.

This ‘out-of-body experience’ is a way in which the brain can alter conscious states to accommodate significant stress and fear caused by inescapable and overwhelming experiences of past trauma.

Instances of dissociation and traumatic flashbacks are a normal part of having PTSD and doctors use this criterion to diagnose the condition. They can manifest in several ways, some of which include:

• Recurrent, involuntary, and intrusive thoughts about the traumatic event
• Distressing nightmares – these nightmares may be repetitive, and contain events or recollections related to the trauma
• Dissociative reactions (flashbacks) – these may be situations in which someone feels like they are experiencing trauma all over again, and can result in brief disengagements with reality to a complete loss of awareness of self and surroundings.
• Avoidance – persistent avoidance of stimuli that can be triggering or serve as a reminder of trauma, most often by blocking memories or thoughts, and by avoiding people, places, and objects of association (can also result in dissociative amnesia).

Coping with Trauma-Related Dissociation

Developing an array of healthy coping mechanisms to push through instances of PTSD-related dissociation and flashbacks can help keep you on track in your recovery from addiction and in your mental health healing journey. Here are some tips that can help you when a more immediate response, like medication or psychiatric help, is out of reach:

Mindfulness and Meditation

An effective technique to disrupt a cycle of dissociative flashbacks is to practice mindfulness, particularly by meditating. One such technique is practicing breath work, which involves sitting in a quiet space, closing your eyes, and deeply inhaling and then exhaling in a continuous pattern. Breathwork is particularly effective in grounding and centering since it helps you focus on your body and the present moment.

Other forms of meditation, like yoga or sound baths, are also effective strategies to mitigate trauma-related flashbacks and dissociation. They can promote improved emotional regulation and are associated with the release of endorphins and neurotransmitters, which can improve mood regulation.

Activate the Five Senses

One way to re-center yourself during a period of dissociation or flashbacks is by engaging all five of the senses: touch, taste, smell, sight, and sound. Start with sight: what do you notice around you? Take stock of your surroundings – creating a mental list of the elements in your environment can be helpful. Then, move to smell. What kinds of scents are lingering in the air around you? Sometimes attributing these scents to positive memories can also help ground you. Then, what do you taste? Activating this sense may be a little harder if you’re not eating something or chewing gum, so it’s often helpful to look for things near you that you can taste. Next, take stock of what you hear. Catalog the sounds around you – where do they come from? Who, or what, is making them? Finally, consider what you feel. Touch the objects around you, and take note of their shape. Even consider the feel of the clothing you’re wearing. Activating the five senses in times of anxiety, fear, or dissociation is an effective way of re-centering yourself by focusing on the immediate present.

Physical Grounding

Sometimes leaning into the sensation of touch can be an effective way to re-center your focus into the present, and away from traumatic memories. You can do this by feeling unique sensations. Some objects you can touch include ice cubes, which are shockingly cold, or the side of a mug, which might be warm. You can even touch things with unique textures, like a fuzzy rug or a soft flower. Engaging touch in this way can also re-center you into the present, helping reduce the effects of PTSD symptoms.

Exercising

An effective treatment for anxiety, fear, dissociation, and other PTSD-related symptoms is exercise. Exercise of any form, but particularly cardio, is another tool to center and ground the body in the present moment, since it is grueling and strenuous, and requires a high level of focus. This can help interrupt the dissociative cycle of a PTSD flashback. Additionally, exercise releases endorphins and neurotransmitters like dopamine and serotonin, which are associated with the brain’s mood regulation. As a result, getting some exercise can help shift your mood, which can also interrupt a cycle of flashbacks.

Exercise can also reduce the instances of PTSD-related flashbacks and dissociation because it is an effective tool in the management of anxiety, depression, and other mental health afflictions. Exercise helps improve cognition, improve exposure and desensitization to internal arousal cues, and reduce inflammatory markers associated with anxiety and PTSD.

Treatment Options for Trauma Dissociations

Coping strategies are oftentimes not enough to overcome the trauma at the root of PTSD symptoms. While they may be effective temporary treatments, PTSD should be treated by a therapist or psychiatrist, the latter of whom can prescribe medications to assist the healing process and help you recognize triggers. Nevertheless, developing healthy coping mechanisms is a crucial step to healing and supporting you through trauma flashbacks.