Sunday, March 05, 2006

Flash!

What's a flashback?

Flashbacks are memories of past traumas. They may take the form of pictures, sounds, smells, body sensations, feelings or the lack of them (numbness). Many times there is no actual visual or auditory memory. One may have the sense of panic, being trapped, feeling powerless with no memory stimulating it. These experiences can also happen in dreams.

Terrifying, unbearable, scary, uncontrollable, confusing....these and many more words are what a survivor uses to describe how a flashback feels.

Not knowing why a flashback happens makes dealing with them confusing for survivors.
Emotionally loaded, flashbacks bring back feelings from the original attack. Thoughts, actions and emotions that a survivor kept repressed during their attack may be to blame for some of these vivid memories.

The very fact that flashbacks seem to be uncontrollable and unpredictable, makes stopping flashback memories seemingly just another pain to bear.

When we begin to understand why we have flashbacks and are not paralyzed by them, we can move further along the path to healing. Flashbacks are a natural process of healing and they are safe. Your mind is now telling you that it is no longer necessary to block such memories.

So how can we deal with these flashbacks?

1. Three Options

When dealing with a flashback there are actually three possible options. At the first sign of an oncoming flashback, you need to quickly determine which option you are choosing.The techniques used for each of these options are the same, but how you combine them and the intensity which you will use them will vary to bring about each of the three. This is not to say that you will be able to control your flashbacks all the time, sometimes it will be stronger than you. If what triggered your flashback was strong enough, then you might not be able to control or escape it. During such times, get yourself to the safest place possible and keep using techniques to manage the acceptance of the flashback.

Option One: Accept

The first option is to accept the flashback at full intensity. It looks like a ridiculous choice at first glance, but one of the reasons that you have flashbacks in the first place is to help your mind process the information contained in the flashback. There are times when this is going to be the best option because the information is going to come out anyway. So when the time and place are right, prepare yourself and try to control the flashback only enough to keep yourself safe. How do you know when the time and place are right? Well, there are several factors that may help indicate when it is safe enough to Accept a flashback at full force. The first of these is a safe environment, by safe I mean comfortable and comforting. This may be your bedroom, living room, or even your therapist's office. The second is the existence of a support person, or someone you can talk to afterwards if you need to. This could be a significant other, close friend or therapist.
Limiting the times a flashback is accepted at full force can significantly improve how deal the more devastating memories are dealt with.

Option Two: Control

The second option is to Control the flashback, or rather to make an attempt to diminish the effects of the flashback. In order to Control the flashback, you need to increase the effort you put into the coping techniques you have (or those listed at the bottom of this article). I find it useful to also continue to remind myself that I am safe and that I cannot be hurt. Controlling and Escaping flashbacks work by interrupting the thought processes involved in the flashback. Since flashbacks are basically electrical impulses within the brain, I look at this as short-circuiting the flashback process. When you have a song you don't particularly like stuck in your head, the only way to get rid of it is to hear a song you like and replace the thought that is keeping that song in your head. Short-circuiting a flashback is the same thing you are attempting to replace one thought process with another. Controlling is not the full replacement of a flashback but a redirection of the flashback onto a different and safer circuit. To do this, you will be using your coping tools to interrupt the thought process. You may need to interrupt the flashback several times to Control the impact, and it may take several efforts to cause a single interruption. Mixing your coping methods around and using them in combination are ways of intensifying the attempt at interruption. If your environment is familiar and you can feel safe, or if you are with someone who can give you a measure of safety, then Controlling the flashback may be the best option.

Option Three: Escape

The final option is the Escape of the flashback. Again, remember that this may not always be possible, but never give up your attempts. Mix up your coping methods and combine them, try the more intense methods and try new methods. Escape is both tiring and difficult, but it can be done.

2. Take Notes

- What triggered the flashback?
- What was your goal? (Accept, Control or Escape)
- Did you accomplish your goal?
- What coping techniques did you use?
- Which of these techniques helped, which didn't?

Having these notes can help create a better plan for flashback management.

3. Coping Techniques

Nearly anything you can do to help cope with your flashbacks is a good thing. I say nearly everything because anything that does harm to yourself or another person is simply inexcusable in my opinion. I feel I have a right to say this because like many out there with PTSD, I resorted to self-injury in an attempt to deal with some of the memory I recovered. Not only was self-injury ineffective, it put me in a very dangerous position.
Resorting to causing yourself pain to cover other pain simply amplifies your agony. You may temporarily feel what you believe to be relief but once things return to normal and the flashback is gone, there is additional pain to deal with and at times, serious injury as well. I view seeking affection from others and Alcohol and Drugs the same way (with the exception of drugs prescribed by my own doctor or therapist). They may not do visible harm like cutting yourself, but the damage is done and the problems are compounded.

Techniques When You Are Alone:

Memory Games
(Good for visual flashbacks)


One of the easiest ways to cope or manage a flashback is by distraction. Try to remember something challenging such as the lyrics to a particular song, or a favorite poem. This can helpinterrupt the flashback by redirecting the activity in your brain.
For some reason, memory games work well when I am having flashbacks that involved my hearing and balance.

Some of the more effective memory games I have used are:

- Humming songs or remembering the lyrics to songs
- Naming facts I learned in school


Ice Cube
(Good for physical flashbacks - like feelings of touch or sensations)

This has been my most important tool in dealing with physically oriented flashbacks. The technique was actually taught to me by a Viet Nam Veteran who said he used it for every single flashback, adding "usually it helps, but sometimes it can't." I have found it to be effective to some degree almost every time I have tried it.
The idea is simple, take a fairly large ice cube and hold it tight in one of your hands throughout the flashback. The cold feeling keeps that part of you grounded to some degree and the physical sensation gives you something solid to focus on besides the memory you are reliving. It is important to hold the ice cube fairly tight and in the same hand for the duration of the flashback. I experimented with switching hands and holding it lightly and the technique lost much of its effectiveness.

I always use this technique in addition to some of the others when attempting to Escape or Control.


Wall Spotting
(Good for auditory, or hearing, flashbacks)

This technique involves selecting 4 or 5 brightly colored items in the room that are easily within vision and moving your focus between them. Make sure to vary the order and allow yourself to lock onto the items briefly before shifting to the next item. Keep this up throughout the flashback and continue for a short time afterwards.

Following the same pattern can actually cause you to become more involved in the flashback because your mind becomes used to the pattern and builds on it. By varying the pattern, you disrupt the thought processes involved in the flashback.

I suggest continuing the eye movements for a while after the flashback ends to allow yourself to get more focused on the present since I use this technique mostly for flashbacks with a visual element.


Cold Water on Your Face
(Good for any type of flashback)

This one is simple and can help with any type of flashback. This idea is one of the first ones any of us find that helps. Remember that it can continue to help. Try and use water cold enough to give yourself a good shock. There is a bit more evidence on why this works, it is called the "Mammalian Diving Reflex" or simply the "Diving Reflex" and relies on the fact that our bodies want to survive.

Sudden immersion in very cold water (below 70 degrees) triggers the Diving Reflex. The body reacts by lowering the heart rate, increasing blood pressure, and shutting down circulation to all but the body's core. The result is a lowered metabolism that conserves energy, which helps cold water survival. This is also why near-drowning victims in cold water have a much higher survival rate.

The effect on a flashback is fairly drastic. In short, the brain is shocked and interrupts the flashback to survive what may be a life-threatening immersion in freezing water. For this reason, make sure you use the coldest water available and use a good amount of it.


Techniques When a Friend is Available:

Counting
(Good for intense and strong flashbacks)

This is a technique I came up with while assisting a friend with a panic attack. I call this Counting for lack of a better term. The idea, like most of the techniques above, is to confuse the mind and disrupt the thought processes. To do this, remember that random is good.

Basically, your friend would make you repeat whatever they are saying and would start by following a predictable pattern. Throwing in random words breaks the pattern up and causes a brief disruption in the flashback. This can be very powerful against the more intense flashbacks and I tend to use it only when I am in great need.


The sample below is meant to illustrate both why I call it counting and how it can work.

One
Two
Three
Eight
Five
Six
Seven
Green
Forty-seven
Nine
Ten
Eleven
Cow

I am unsure why this has been effective, but I do know it will not work alone. If you are selecting the order, than the order is not random, there are no surprises. The surprises catch us off guard and our reaction of "One, Two, Three, Eight?" is often enough to lessen the impact of fairly intense flashbacks.


Fizz-Buzz Counting
(Good for intense and strong flashbacks)

I use an "advanced counting" technique to recapture my focus... it is derived from an old group game we used to play - we called it "Fizz - Buzz". Instead of simply counting sequentially, any time a number contains the digit 7 or is a multiple of 7, the word "Buzz" is used; when a number contains the digit 5 or a multiple of 5, the word "Fizz" is used. This is pretty easy up into the early 100s... when much more focus and concentration are required!

Example:

One
Two
Three
Four
Fizz
Six
Buzz
Eight
Nine
Fizz
Eleven...

It can be done without a friend. If you mess up, you're supposed to compliment yourself! Pick any compliment, but pick a compliment. Then start again.


***


For more tips please visit:
Flashbacks
Coping with Flashbacks: Goals and Techniques for Handling the Memories
Hints on How to Cope With Flashbacks
Flashbacks: A Natural Process of Healing
Tips for Recovery


I have such flashbacks from time to time because of a past event that shook me. I found the aforementioned to be beneficial, I haven't tried them yet but I think that I will when and if I pass through something that requires the use of these techniques.
I hope that this doesn't happen to anyone and, if it does, I hope that these techniques aid you.


Breaking the Chains:

"Thought is only a flash between two long nights, but this flash is everything."


Henri Poincare

4 comments:

MD said...

fiiiiiiiiiiiiiirst :D:D:D:D:D

ok now let me go read the post hahhahaha :D

MD said...

very educating, i must say. i keep getting flashbacks too. not of just one incident but a few that hammer my mind and lead to anxiety attacks. my mind becomes my enemy. i think i shud try the tips u mentioned. at that moment, anything that can get my mind away from that horror collage is just what i need.

this one rocks seraph...i love it...thanks for posting this :$

Dots.. said...

fine MD fine u win.. ! hmm..

if flashback was a human i would be honored to shoot him and cut him into pieces...

Seraph said...

md

firstly, congrats on winning :p
i know what u mean by saying that they give anxiety attacks, sometimes u wish u had a remote control that could control your mind! too bad that such a thing doesn't exist.
i'm glad u liked it, i just hope that it's useful.

dots

let's go get shotguns ;)