Are recurring episodes of dissociative symptoms, such as feeling penetrated, triggered by physical or emotional stimuli, still considered flashbacks or post-traumatic stress disorder (PTSD) symptoms, despite previous healing and therapy?

From the Guidelines

Yes, recurring episodes of dissociative symptoms like feeling penetrated that are triggered by physical or emotional stimuli can still be considered flashbacks or PTSD symptoms, even after previous healing and therapy. These experiences, known as re-experiencing symptoms, can persist or recur despite therapeutic progress, as noted in the study by 1. The symptoms you are describing, such as feeling penetrated, can be classified under the category of intrusion symptoms, which include distressing memories, dreams, or flashbacks of the traumatic event, as outlined in the study by 1. Treatment typically involves trauma-focused psychotherapy such as Cognitive Processing Therapy (CPT), Prolonged Exposure (PE), or Eye Movement Desensitization and Reprocessing (EMDR), as recommended by the guidelines developed through a Delphi process in the study by 1 and 1. Some key points to consider in managing these symptoms include:

• Working with a trauma-informed mental health professional to develop coping strategies and possibly adjust treatment approaches
• Using self-care techniques like grounding exercises, mindfulness, and identifying personal triggers to help manage these episodes when they occur
• Considering medication options, such as SSRIs, which are FDA-approved for PTSD, as mentioned in the example answer It's essential to note that trauma memories can be stored differently in the brain, causing the body and mind to react as if the trauma is happening again when triggered, as explained in the example answer. Even after significant healing, certain triggers may still activate these trauma networks, highlighting the importance of ongoing support and management. Given the most recent and highest quality study available, it is recommended to continue therapy and work with a trauma-informed mental health professional to develop coping strategies and manage these episodes, as suggested by the study by 1 and 1.

From the Research

Understanding Flashbacks and PTSD Symptoms

• Flashbacks are a common symptom of post-traumatic stress disorder (PTSD), which can be triggered by physical or emotional stimuli, and may manifest as dissociative symptoms, such as feeling penetrated, even after previous healing and therapy 2, 3.
• The experiences described, including feeling penetrated, triggered by physical or emotional stimuli, may still be considered flashbacks or PTSD symptoms, despite previous healing and therapy, as they are recurring episodes of dissociative symptoms 4, 5.

Treatment and Therapy

• Trauma-focused psychotherapies, such as Prolonged Exposure (PE), Cognitive Processing Therapy (CPT), and Eye Movement Desensitization and Reprocessing (EMDR), are recommended as first-line treatments for PTSD, and may be beneficial in addressing recurring symptoms 2, 3, 6.
• Cognitive Behavioral Therapy (CBT) is also an effective treatment for PTSD, and has been shown to be comparable to other trauma-focused therapies in terms of efficacy and compliance 5.
• Medications, such as sertraline and paroxetine, may be used in conjunction with psychotherapy to treat PTSD, but are not recommended as first-line treatments, and benzodiazepines or other sedative hypnotic medications should be avoided due to their potential to exacerbate symptoms 2, 6.

Recurring Symptoms and Treatment

• Recurring episodes of dissociative symptoms, such as feeling penetrated, may indicate that additional therapy or treatment is needed to address underlying trauma and prevent future symptoms 3, 4.
• A mental health professional can help determine the best course of treatment for recurring symptoms, and may recommend a combination of psychotherapy and medication to manage symptoms and improve overall well-being 2, 6.