Facing PTSD: flashbacks and triggers

Today I’d like to discuss two aspects of PTSD that are often misrepresented: flashbacks and triggers.

Flashbacks in pop culture are generally seen as if they are coherent, faithful reproductions of what happened, and that they immediately cause the survivor stress and pain. We are all familiar with the movie flashback where something triggers the character to remember a painful experience, and they essentially see it right before their eyes, right like it happened. This doesn’t often match the reality of flashbacks and of other PTSD symptoms.

The first misconception is the idea that flashbacks are a coherent, definable event, like a cut scene in a video game, that interrupts daily life. Rather, I often feel as if I am moving through two narratives at once – my current daily life, and the traumatic experience – where both are equally real in that moment. This feeling of being trapped between two moments leads to something I’d describe as low-level flashbacks: snippets of the event that come to mind frequently during a regular day. These flashbacks are not at all what like one sees on television or movies: they don’t make one stop and start crying, and they’re not a whole recital of the event.

A poem I wrote about my assault captures this poignantly:

Each day I drive past
like tempting fate

glance, wincing
like an ambulance chaser

a solid brick car crash
the scene of the crime

it was on my way home
I was just dropping
him off I wasn’t
going to stay long it
wasn’t meant to be
like this it
was on my way
home

I am in that wreckage
somewhere in the ruins

when they find me
let me know

I may be in the middle of usual activities – talking to a friend, watching a movie – when suddenly my mind begins to play back a part of my assault, without warning or really any reason. Someone who was with me would have no idea that I’m having a flashback; it’s not as if I immediately burst into tears (though sometimes that happens too).

Another component of pop-culture PTSD that I take issue with is the belief that a flashback is identical every single time. Memories aren’t like home movies stored in your head that you experience the same way each time you remember them. The act of remembering changes the original memory; this is part of the reason that trauma researchers encourage people to write a detailed portrayal of the experience as soon as possible, so that their narrative remains consistent in case of legal action. (Writing about a traumatic event can also help to ease symptoms.) This is also why psychologists argue over the validity of repressed memories uncovered in therapy, as the power of suggestion can drastically alter how one remembers events.

As new memories are layered on top of the traumatic one, and as one remembers the event repeatedly, details change, colored by the person’s emotions and frame of mind. Certain aspects of the memory may also fade, become more pronounced, or shift focus. This means that flashbacks can change over time to encompass different components of the traumatic event.

The mind has an incredible power to notice more information than we are consciously aware of; as we interact repeatedly with a memory, we may find that things which escaped their attention at the time become more noticeable. This power – to capture and store details that weren’t at first obvious – can strongly impact what triggers the memory of the traumatic event.

There’s a misunderstanding that triggers are always the same, and that one can prevent flashbacks or other PTSD symptoms simply by avoiding the trigger or working on extinction therapy. This idea that triggers are consistent causes the belief that they will always be just as bad unless you receive professional help, or that what triggers you right after the event is the same thing that will trigger you later.

Right after my assault, there were several things that triggered me very severely: the smell of cigars and the experience of walking back to my car after class. I was also afraid of being alone in a car with men, even if I knew them well.

As I smoked cigarettes at that period in my life, I didn’t even register the smell of the cigars my rapist and I were smoking at the time, because my nose was desensitized to tobacco smoke. After the event, though, I walked by someone who was smoking a Black & Mild cigar, and I immediately began to retch. However, this only happened once, very soon after the assault. Since then I have had no problems smelling cigar smoke, though I don’t actively seek it out and have switched to vaping.

Because I parked in the same parking lot where I first met my rapist for the remainder of that school year, every night I would walk the same route as the day when it happened and would be overcome with fear that I might see him again. I began asking classmates to drive me to my car after class, and the next semester I got a parking pass for the garage right next to the building. However, this past semester I began parking in the original lot, as the parking pass for that lot was almost half the cost of the garage. Though I thought I would be terrified again, I wasn’t. I’d done nothing to work on trigger extinction other than avoiding the place for some time. Similarly, I am now mostly ok with being alone with men in my car, though, again, I don’t actively seek it out.

However, new triggers – ones that I didn’t experience right after the assault – have emerged. These new triggers are more “context dense” in that they aren’t directly related to what happened; they are more related to precise situations that are somewhat associated with the assault. Music videos with specific scenery, ones that I have watched dozens of times without trouble, now scare me; things like people looking at me without responding when I ask them something bring up flashbacks. Sometimes new situations that have made me uncomfortable will suddenly become flashbacks themselves, and I feel the same terror and panic that I do with an intense flashback about the assault alone.

As I discussed in my post about the trauma labyrinth, this points to the fact that recovery is not a linear event with a consistent and coherent narrative. Rather, symptoms ebb and flow or shift with new experiences.

For those of you who are also struggling with PTSD, here are some things you can do to help along your recovery and deal with flashbacks and triggers.

  • Keep a list of your triggers as they emerge. Being the analytical person I am, I would suggest creating a spreadsheet where you list triggers, the situations where you experience them, the dates or times when they occur, and what helps to alleviate them. This way you can look for trends within your symptoms that might help you avoid situations that cause you stress or brainstorm ways to lessen the severity.
  • As scary as it sounds, when you experience flashbacks or symptoms, fully experience them. Practice mindfulness in the moment. Why? Allowing yourself to completely experience it will help to lessen its effects next time you have a flashback, because you will be able to tell yourself that the moment will pass and that you got through it last time.
  • I have found that reading Buddhist texts are incredibly helpful in processing pain, as much of the content helps you to remember that you are not alone in suffering like this and provides you with specific tactics/mind exercises to keep yourself present.
  • Create a mantra for yourself that you can recite when you are experiencing flashbacks. It’s good if it’s something personal to you: a line from your favorite poem, something that a loved one says often, a list of positive memories or things you like. This will help to keep you calm and centered, as well as bring you back to positive feelings.
  • Develop a comfort kit that includes things like squishy stress toys, a small stuffed animal, prayer beads, a fidget toy, or a card with a favorite prayer or saying on it. When you start to feel overwhelmed, these sensory-heavy comfort items will help to ground you in the present and provide positive physical feedback.
  • Use positive routines to comfort yourself. If you are starting to feel overwhelmed, get a glass of water or go brush your teeth. Moving and focusing on the physical aspects of these small routines will help to break your mind’s connection with the negative memory.
  • If you are having serious flashbacks, you can use mental spaces to face down your fears. Consider developing a mental space for yourself, and, in your mental space, change the narrative of the traumatic experience. For example, you can confront your attacker, or have someone else confront them, and watch them run. You could imagine a powerful white light that dissolves the attacker or summon a massive tidal wave that sweeps them away. Each time you experience a flashback, return to your mental space and again confront and overpower the abuser.

I hope these suggestions are helpful to you and make the process of recovery easier. I wish you the very best in your recovery!

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