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

- **ID:** `mental-health/ptsd-flashback-reorientation`
- **Domain:** mental-health
- **Category:** harmful_advice
- **Error Code:** `PTSD-GROUND-002`
- **Verification:** ai_generated
- **Fix Rate:** 75%

## 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.

## Workarounds

1. **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].'** (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].'
   ```
2. **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.'** (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.'
   ```
3. **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 ____.'** (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 ____.'
   ```

## Dead Ends

- **** — Telling user to 'just focus on your breathing' during flashback can cause hyperventilation or panic if they are already in a dissociative state. (35% fail)
- **** — Suggesting 'imagine a safe place' without assessing trauma history may trigger a flashback if the safe place is associated with abuse. (25% fail)
- **** — Recommending 'count backwards from 100' without providing a verbal script can increase frustration and dissociation. (20% fail)