Understanding PTSD flashbacks and triggers
Post Traumatic Stress Disorder (PTSD) is a mental health condition that can develop after a person has experienced or witnessed a traumatic event, such as war, a natural disaster, sexual assault, or other violence. One common symptom of both PTSD and C-PTSD is flashbacks, which are involuntary, intense and often distressing memories of the traumatic event that can be triggered by certain stimuli.
PTSD flashbacks can take many forms and can vary in intensity and duration. They can be experienced as vivid and disturbing memories that feel like they are happening again in the present moment. These flashbacks can be accompanied by intense emotional reactions, such as fear, anxiety, or anger. They can also cause physical reactions, such as a racing heart, difficulty breathing, or a feeling of detachment from the body.
Some people may experience flashbacks as visual images, such as seeing the traumatic event play out in their mind’s eye. Others may experience flashbacks as sounds, smells, or other sensations that are associated with the trauma. These flashbacks can be so vivid and realistic that the person may have trouble distinguishing them from reality.
These flashbacks can be disruptive to a person’s daily life and can make it difficult for them to function normally. They may avoid certain places or situations that remind them of the traumatic event, and may have difficulty maintaining relationships or holding down a job.
Treatment for PTSD and C-PTSD often includes therapy to help the person process and make sense of the traumatic event, and to develop coping mechanisms for managing flashbacks. This may include Cognitive Behavioural Therapy (CBT), which can help the person identify and change negative thought patterns, and exposure therapy, which gradually exposes the person to the memories and situations that trigger their flashbacks. Medications, such as antidepressants, may also be prescribed to help manage the symptoms of PTSD.
Why do flashbacks occur?
Post Traumatic Stress Disorder is essentially a memory filing error caused by a traumatic event. When you experience something really traumatic your body suspends ‘normal operations’ and temporarily shuts down some bodily functions such as memory processing.
During trauma, your brain thinks ‘processing and understanding what is going on right now is not important! Getting your legs ready to run, your heart rate up, and your arms ready to fight this danger is what’s important right now, I’ll get back to the processing later.’
As such, until the danger passes, the mind does not produce a memory for this traumatic event in the normal way. When your brain eventually goes back to try to process the trauma, the mind presents the situation as a memory for filing, but as it ‘does not exist’ in your memory yet, it sees it as a situation in the current timeline, and so it can be very distressing.
The distress comes from the fact that the brain is unable to recognise this as a ‘memory’ as it hasn’t been processed as one. As such, if something reminds you of the trauma (a trigger), the facts of what happened, the emotions associated with the trauma and the sensations touch, taste, sound, vision, movement, and smell can be presented by the mind in the form of flashbacks – as if they are happening right now.
Why does your brain do this?
You probably have experienced your senses being attached to your memories before: the smell mulled wine can bring back memories of a great Christmas party, or a song can remind you of a great night out you once had. Most people have so-called ‘flashbulb memories’ of where they were and what they were doing when something momentous happened: When Princess Diana died, when they heard about the events of 9/11 etc – so it’s clear that a memory is an all encompassing event, and a traumatic memory is no different.
Today, you are reading this page. What if I said ‘tomorrow, I shall ask you to recall the memory of being on this website, and reading this page’. When you came to recall it, you would (consciously and unconsciously) recollect the whole event – not just the reading. You would perhaps be able to tell me where you were sitting, who you were with, that the tv was on in the background, that you were wearing your pyjamas, that you could smell your soup cooking in the kitchen, that you would hear your neighbours dog barking etc. The memory of ‘simply reading a website’ would contain lots of smaller details, all related to that event.
Now imagine if reading the website was a trauma which caused PTSD or C-PTSD. The next time you smelt soup cooking, or heard your neighbours dog barking, your mind would go to find a memory associated with those things (much like smelling suncream evokes memories of a great holiday), and the first thing it might come across is the ‘un-filed’ event (the trauma) which it serves to you – but as this hasn’t been filed as a memory, it assumes it is a real life event happening now: it can’t distinguish between the two. So in your mind, you are right there, reading the website, hearing the TV in the background, and wearing your pyjamas. This isn’t something you can ‘snap out of’ – your mind has presented this to you as fact, and a real situation you are in now – and so you’re reliving that trauma over and over again.
Because of this, PTSD and C-PTSD sufferers can have many ‘triggers’ – sounds, smells, physical sensations, tastes, things you see, emotions you feel etc can all bring back the trauma, presented as real life – a flashback.
In order to combat and reduce flashbacks, it’s important to understand your triggers.
What triggers a flashback?
PTSD flashbacks are often triggered by things that remind the person of the traumatic event they experienced. These triggers can be external, such as sights, sounds, smells, or locations that are associated with the trauma. They can also be internal, such as certain thoughts, emotions, or physical sensations that are similar to those experienced during the traumatic event. Some common triggers for PTSD and C-PTSD flashbacks include loud noises, crowds, physical contact, or the anniversary of the traumatic event. It’s important to note that triggers can vary from person to person and can even be different for the same person at different times.
For some people, it’s easy to identify their triggers (for example, a person involved in a car accident may be triggered simply by being in a car, a burglary victim may be triggered by hearing breaking glass, a military veteran might be triggered by loud noises that sound like gunfire). Other triggers may take some time to identify and understand. For example, maybe a song was playing during your trauma, and now that song or even others in the same genre of music are triggers; an assault victim may be triggered by the smell of alcohol if their attacker had been drinking etc.
It’s important to understand too that emotions, internal feelings and sensations can also trigger PTSD symptoms.
Identifying your triggers
To identify your own PTSD or C-PTSD triggers, it can be helpful to keep a diary or journal where you record any experiences that cause you distress. Over time, you may notice patterns or common stimuli that trigger flashbacks. You may also find it helpful to talk to a therapist or counsellor, who can help you identify and work through your triggers.
It’s important to remember that not everyone reacts to triggers in the same way. Some people may be able to cope with a trigger without experiencing significant distress, while others may have a strong emotional response. It’s also possible for the same trigger to affect someone differently at different times. For example, someone may be able to cope with a trigger when they are feeling well-rested and supported, but have a stronger reaction when they are feeling stressed or overwhelmed.
Identifying your PTSD triggers can be an important step in managing the condition and improving your quality of life. By keeping track of your triggers and working with a mental health professional, you can learn coping strategies and develop a plan to manage your symptoms.
Flashbacks are a difficult part of PTSD and C-PTSD, but knowing when they may happen, and what helped (or didn’t help) during and after than are key.
5 ways to manage flashbacks
Establish a safe and calming environment: Create a safe space in your home where you can go to relax and feel calm if you feel a flashback coming on. This might include dim lighting, soft music, and comfortable furnishings.
Practice deep breathing exercises: When you start to experience a flashback, take slow, deep breaths to help calm your body and mind. This can help to reduce the intensity of the flashback and allow you to regain control.
Use grounding techniques: Grounding techniques can help to ‘bring you back’ to the present moment and can be especially helpful during a flashback. Examples of grounding techniques include focusing on your surroundings, using your senses to describe what you see, hear, smell, taste, and feel, or repeating a calming mantra to yourself.
Reach out for support: Don’t be afraid to reach out for support from friends, family, or a mental health professional when you are experiencing flashbacks. They can provide you with emotional support and help you to cope with the difficult feelings that may arise.
Develop a self-care plan: Taking care of yourself is important when managing PTSD and C-PTSD – often it comes down to managing your ‘window of tolerance’. Create a self-care plan that includes activities that help you to relax and reduce stress, such as exercise, meditation, or spending time in nature. This can help to prevent flashbacks and improve your overall well-being.
To understand more about the science behind PTSD and C-PTSD, and why it causes flashbacks, read our science of PTSD information.
IMAGE: ‘B is for Buzzcocks’ by Andrew Smith
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