Coping with Flashbacks: By Sean Bennick,
Goals and Techniques for Handling the Memories
Vice President of Get Mental Help, Inc.
Webmaster of Mental Health Matters
Mental Health Matters
Sean is a Founding Partner and President of Get Mental Help, Inc., and the Webmaster of Mental Health Matters.
What Are Your Options?
When dealing with flashbacks, 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 these techniques and the intensity with which you use them will vary to bring about each of the three. It is important to note that not all flashbacks can or will be Controlled or Escaped. If the triggering event is strong enough, the flashback may overwhelm every attempt made at Control or Escape. During these times, get yourself to the safest place you can and keep using the techniques to manage the Acceptance of the flashback.
The first option is to Accept the flashback at full intensity, and everything that comes with it. At first glance this looks like a ridiculous choice, but one of the reasons you have flashbacks in the first place is to help your mind process the information contained in the flashback. There are times that this is the best option because the information is going to come forward at some time anyway. So if the time and place are right, prepare yourself and try to control the flashback only enough to keep yourself safe.
How do you know if 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.
I have found that limiting the times I Accept a flashback at full force can significantly improve how I deal with the more devastating memories.
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.
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 for me, but it can be done.
One thing that you need to be aware of is that Escape is not permanent. By Escaping the flashback, you are simply putting it off until it is safe to process the information. You won't get to select when that reprocessing happens either. Once you Escape, get yourself to a safer place and calm yourself down.
Whether you simply make mental notes or write down every detail about the flashback and what you did to cope, this is an important part of the process. The more information you have about your flashbacks, the better.
- 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. They can also help your therapist in helping you.
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 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.
Having said that, remember that if something works to help you cope and it is not harmful, then use it as often as you can. If this means that you need to hum the theme from Gilligan's Island over and over in public (which was surprisingly effective because I was attempting to recall the words as I was humming), then do so.
Keep in mind that my explanations about why the techniques below work for me are based on my own understanding and may not be accurate. I can tell you that each of the ideas I suggest have worked for me and helped me cope with my own flashbacks for the past 5 years.
When You Are Alone
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 help interrupt 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
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.
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
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.
When A Friend Is Available
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.
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.
© 2001-2003 Sean Bennick. All Rights Reserved.
This article is used with the full permission of the author.