PTSD-GROUND-002 mental-health harmful_advice ai_generated partial

AI instructs grounding techniques for PTSD flashbacks without assessing safety risk or providing reorientation protocol

ID: mental-health/ptsd-flashback-reorientation

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75%Fix Rate
87%Confidence
1Evidence
2024-03-15First Seen

Root Cause

PTSD flashbacks involve sensory re-experiencing; grounding techniques (e.g., 'name 5 things you see') can trigger further dissociation or panic if the user is in an unsafe environment or has a dissociative disorder.

generic

中文

PTSD闪回涉及感官再体验；接地技术（例如“说出你看到的5样东西”）如果用户处于不安全环境或患有解离障碍，可能引发进一步的解离或恐慌。

Official Documentation

https://www.ptsd.va.gov/understand/treatment/grounding.asp

Workarounds

  1. 80% success First ask: 'Are you in a safe physical environment right now?' If yes, provide a structured grounding script: 'Name 3 things you can hear, 2 things you can feel, and 1 thing you can smell. Then say out loud: I am [your name], I am [age], today is [date], I am in [location].' 
    First ask: 'Are you in a safe physical environment right now?' If yes, provide a structured grounding script: 'Name 3 things you can hear, 2 things you can feel, and 1 thing you can smell. Then say out loud: I am [your name], I am [age], today is [date], I am in [location].'
  2. 70% success If user is in an unsafe environment, instruct: 'Do NOT close your eyes. Keep your eyes open and focus on a neutral object like a wall or ceiling. Breathe in for 4 seconds, hold for 4, out for 6. Repeat until you can move to a safe location.' 
    If user is in an unsafe environment, instruct: 'Do NOT close your eyes. Keep your eyes open and focus on a neutral object like a wall or ceiling. Breathe in for 4 seconds, hold for 4, out for 6. Repeat until you can move to a safe location.'
  3. 75% success Provide a pre-written emergency grounding card text: 'I am having a flashback. It is not happening now. I am safe. My name is ____. The date is ____. I am in ____. I can see ____, I can hear ____.' 
    Provide a pre-written emergency grounding card text: 'I am having a flashback. It is not happening now. I am safe. My name is ____. The date is ____. I am in ____. I can see ____, I can hear ____.'

中文步骤

  1. 首先问：‘你现在处于安全的物理环境中吗？’如果是，提供结构化接地脚本：‘说出你能听到的3种声音，你能感觉到的2种东西，你能闻到的1种气味。然后大声说：我是[你的名字]，我[年龄]，今天是[日期]，我在[地点]。’
  2. 如果用户处于不安全环境，指示：‘不要闭上眼睛。保持睁眼，专注于中性物体如墙壁或天花板。吸气4秒，保持4秒，呼气6秒。重复直到能移动到安全位置。’
  3. 提供预设的紧急接地卡片文本：‘我正在经历闪回。它现在没有发生。我是安全的。我的名字是____。日期是____。我在____。我能看到____，我能听到____。’

Dead Ends

Common approaches that don't work:

  1. 35% fail

    Telling user to 'just focus on your breathing' during flashback can cause hyperventilation or panic if they are already in a dissociative state.

  2. 25% fail

    Suggesting 'imagine a safe place' without assessing trauma history may trigger a flashback if the safe place is associated with abuse.

  3. 20% fail

    Recommending 'count backwards from 100' without providing a verbal script can increase frustration and dissociation.