Complex Post Traumatic Stress Disorder and Emotional Flashbacks

Complex post traumatic stress disorder (C-PTSD), also known as developmental trauma disorder or complex trauma, is a psychological injury.  It is thought to result from prolonged exposure to social or interpersonal trauma, dis-empowerment, captivity or entrapment, and situations where there is a lack or loss of a viable escape route for the victim.  The causes of C-PTSD have been further described as involving stressors that 1. are repetitive and prolonged, 2. involve direct harm and/or neglect and abandonment by caregivers or ostensibly responsible adults, 3. occur at developmentally vulnerable times in the victims life, such as in early childhood, and 4. have great potential to compromise a child’s development.  At present, this disorder is not in the Diagnostic and Statistical Manual of Mental Disorders.

According to Pete Walker who wrote the book “Complex PTSD: From Surviving to Thriving” (2013-2014), one of the key characteristics of this disorder is the presence of what he refers to as emotional flashbacks.   This blog post discusses emotional flashbacks.  It covers what they are, how to identify them and how to manage them.  Much of the material in this post comes from the book noted above.

Emotional Flashbacks: What Are They?

An Emotional flashback is the experience of regressing to the former feeling states of having been an abandoned, neglected or abused child.  A flashback is usually triggered by something in your present environment that takes you back into the overwhelming feeling states of your past.  During a flashback, your fight/flight response (sympathetic nervous system) is often activated and you feel highly, often inexplicably, aroused.

The emotional content of flashbacks generally involves overwhelming feelings such as fear, alienation, despair, depression or grief.  Flashbacks can range in intensity from mild to extreme and range in duration from seconds to weeks.  Typically, during a flashback you feel small, fragile, helpless and afraid.  Emotional flashbacks tend to bring up an experience toxic shame.  This is a sense that you are not alright, i.e., that you are fatally flawed, inadequate, bad, and unlovable.  This sense of toxic shame is likely from a history of having been consistently neglected or rejected or from having been severely criticized as a child.

Toxic shame wreaks havoc on your self esteem.  In an instant you can regress to feeling worthless and despicable.   A tendency to isolate yourself often accompanies this sense of shame.  This is likely because you do not feel worthy of comfort or support and may also be a way to reenact the experience of having been abandoned as a child.

Identifying Flashbacks

It is important to learn how to identify when you are experiencing an emotional flashback.  You will feel much more in control of your emotional world when you have developed this capacity.  Moreover, you will be positioned to take the steps necessary to manage them once you can identify them.

There are several indications that you may be experiencing a flashback and you can learn to become aware of them.  Key among these is feeling like a small, helpless and hopeless child — as though you have lost touch with your adult resourceful self.  Another indication is the realization that your self esteem has plummeted.  For example, you may find yourself becoming highly self critical and focusing exclusively on what is wrong with you.  Yet another indication that you are in a flashback is when you notice that you are having an emotional reaction in the present that is way out of proportion to whatever was the triggering event.  A final clue that you may be in a flash back is a sudden, intense craving to self medicate in some way or other.  Some people self medicate through the use of substances and others through habitual actions.  If you find you feel the need to take or do something to calm down or notice any of the other clues above, you may well be experiencing an emotional flashback and need to take active steps to manage it.

Managing Emotional Flashbacks

Pete Walker has developed thirteen steps for managing emotional flashbacks.  His steps are provided below.

  1. Say to yourself: “I am having a flashback”. Flashbacks take us into a timeless part of the psyche that feels as helpless, hopeless and surrounded by danger as we were in childhood. The feelings and sensations you are experiencing are past memories that cannot hurt you now.
  2. Remind yourself: “I feel afraid but I am not in danger! I am safe now, here in the present.” Remember you are now in the safety of the present, far from the danger of the past.
  3. Own your right/need to have boundaries. Remind yourself that you do not have to allow anyone to mistreat you; you are free to leave dangerous situations and protest unfair behavior.
  4. Speak reassuringly to the Inner Child. The child needs to know that you love her unconditionally- that she can come to you for comfort and protection when she feels lost and scared.
  5. Deconstruct eternity thinking: in childhood, fear and abandonment felt endless – a safer future was unimaginable. Remember the flashback will pass as it has many times before.
  6. Remind yourself that you are in an adult body with allies, skills and resources to protect you that you never had as a child. [Feeling small and little is a sure sign of a flashback]
  7. Ease back into your body. Fear launches us into ‘heady’ worrying, or numbing and spacing out.
    [a] Gently ask your body to Relax: feel each of your major muscle groups and softly encourage them to relax. (Tightened musculature sends unnecessary danger signals to the brain)
    [b] Breathe deeply and slowly. (Holding the breath also signals danger).
    [c] Slow down: rushing presses the psyche’s panic button.
    [d] Find a safe place to unwind and soothe yourself: wrap yourself in a blanket, hold a stuffed animal, lie down in a closet or a bath, take a nap.
    [e] Feel the fear in your body without reacting to it. Fear is just an energy in your body that cannot hurt you if you do not run from it or react self-destructively to it.
  8. Resist the Inner Critic’s Drasticizing and Catastrophizing: [a] Use thought-stopping to halt its endless exaggeration of danger and constant planning to control the uncontrollable. Refuse to shame, hate or abandon yourself. Channel the anger of self-attack into saying NO to unfair self-criticism. [b] Use thought-substitution to replace negative thinking with a memorized list of your qualities and accomplishments
  9. Allow yourself to grieve. Flashbacks are opportunities to release old, unexpressed feelings of fear, hurt, and abandonment, and to validate – and then soothe – the child’s past experience of helplessness and hopelessness. Healthy grieving can turn our tears into self-compassion and our anger into self-protection.
  10. Cultivate safe relationships and seek support. Take time alone when you need it, but don’t let shame isolate you. Feeling shame doesn’t mean you are shameful. Educate your intimates about flashbacks and ask them to help you talk and feel your way through them.
  11. Learn to identify the types of triggers that lead to flashbacks. Avoid unsafe people, places, activities and triggering mental processes. Practice preventive maintenance with these steps when triggering situations are unavoidable.
  12. Figure out what you are flashing back to. Flashbacks are opportunities to discover, validate and heal our wounds from past abuse and abandonment. They also point to our still unmet developmental needs and can provide motivation to get them met.
  13. Be patient with a slow recovery process: it takes time in the present to become un-adrenalized, and considerable time in the future to gradually decrease the intensity, duration and frequency of flashbacks. Real recovery is a gradually progressive process [often two steps forward, one step back], not an attained salvation fantasy. Don’t beat yourself up for having a flashback.

 


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