What is… a flashback?

In this series, I dig a little deeper into the meaning of psychological terms.

This week’s term: flashbacks

Flashbacks involve the intense, vivid re-experiencing of memories as though they’re occurring in the present tense.  This most often happens with trauma-related memories.  The flashbacks are usually involuntary and intrusive, and don’t result from a conscious attempt to retrieve the memories.  Involuntary memory retrieval occurs more rapidly and with less associated cognitive effort than voluntary memory retrieval.  Involuntary memories tend to lack the contextual information associated with voluntary memories.

Flashbacks are a core symptom of PTSD, but they may also occur in other mental health conditions, including depression, acute stress disorder, and OCD.  Drug use, such as LSD, may also be associated with flashbacks.

Flashbacks may involve only specific aspects of the memory, and may include information from any of the five senses and/or the emotional experiences associated with the memory.  Explicit factual memory is not well developed until a child reaches about five years old, but people may experience flashbacks to earlier ages based on implicit emotional memories.  A study of veterans who were prisoners of war, flashbacks continued for up to 65 years following the associated traumatic event.

The exact neurophysiological mechanisms behind flashbacks are unknown, but several regions of the brain appear to be involved based on differences in neuroimaging studies comparing activation during voluntary memory retrieval compared to flashbacks.  Food deprivation, stress, and temporal lobe seizures have been identified as possible triggers for flashbacks.

When a flashback ends, grounding techniques using the five senses or breathing exercises may be helpful in reorienting to the present time.

Trauma-focused therapy, such as eye movement desensitization and reprocessing (EMDR), can help with processing the trauma memories and managing flashbacks.

A technique suggested by Mount Sinai Hospital is to use a dissociated perspective, visualizing the scene in which the flashbacks occur as though it was happening on a movie screen rather than directly to you.  A step beyond that would be to imagine having a remote control that adjustment of elements like brightness, volume, and distance of the screen.

Retired Canadian Lt.-Gen. Roméo Dallaire, who led the United Nations mission in Rwanda during that country’s genocide, has spoken openly about his experience of PTSD.  In an interview with CBC, he described flashbacks this way:

“The sounds they come out, often, unexpectedly, when I’m watching just normal news from Syria or somewhere and they’re talking about refugees or a bombing. I don’t see it as images. I hear them there. I go back and I hear the people in the compound in the King Faisal Hospital area where over 100 were killed by bombs and splattered all over the place and the screaming and the yelling. I smell the smell of the cordite and the blood and the dung. I feel the warmth and I feel the fear.”

If you’ve experienced flashbacks, is there anything you have found helpful?

 

You can find the rest of my What Is series here.

Sources:

 

PTSD Treatment Options: An Overview from Mental Health @ Home Store

 

Visit the Mental Health @ Home Store for premium mental health resources including a mini e-book on PTSD Treatment Options: An Overview, which covers a number of evidence-based therapies for PTSD.

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17 thoughts on “What is… a flashback?

  1. BeckiesMentalMess.wordpress.com says:

    Last weekend was made of nothing but flashbacks to me. My brain was shooting them from early childhood to adulthood with rapid fire.
    The only things that helped me through it all, (After it subsided) was to listen to nature sounds of birds, and lay down. I was too mentally and emotionally fried to do much else.

  2. tal.seaa says:

    I am currently doing the EDMR in my therapy sessions and even though some flashbacks are more intense than others, it does help me process my emotions that I was feeling in those flashbacks. I don’t get flashbacks throughout the day, but I do get nightmares…which is interesting.

  3. Meg says:

    I’ve found EMDR to be very helpful. I need to get more of it, but I’ve been dragging my feet because I hate therapists. I used to have two bad memories that haunted me all the time, but now one of the memories is flattened, but the other isn’t yet; hence my need for more EMDR, I think.

    The Mount Sinai technique sounds interesting, but I think it would encourage dissociation, and I already dissociate all over the place. Very thought provoking. Also, the thought of my bad memories having been filmed would probably ruin me. But I’m sure Mount Sinai means well!

    • lavenderandlevity says:

      Yeah, my thought when reading that was “I’m so expert at PTSD management I’m using the Mount Sinai technique involuntarily.” I mean…I won’t say dissociation as an involuntary defense/coping mechanism wasn’t how I survived for most of my life, but there is that pesky bit wherein I forgot how to feel. Oh, and then it stopped working. This all feels very geared towards single instance or later-life trauma, where there is an actively remembered “before” event, and discrete, time-bound flashbacks with auditory or visual components. I’ve had nightmares like that a plenty, but never waking flashbacks. Mine are all the visceral emotional kind, and it sucks because – never having had a remembered “before” trauma and having so much recent trauma – it becomes incredibly hard to tell if something is a “flashback” or a true “gut instinct” of a new instance of similar trauma. It’s so hard to tell, and emotional flashbacks can feel almost like the default. This is why I tend to personally believe C-PTSD should have made it into the DSM, though I do believe it can be acquired after childhood (which I know not everyone does.)

      • ashleyleia says:

        I completely agree with you on c-PTSD. And while perhaps there could be a place sometimes for taking a more detached view of trauma, framing it as dissociation seems like a bad choice.

      • Meg says:

        I believe it, too. I’ve encountered a handful of people who developed C-PTSD as adults. Are there really people who don’t believe it exists, or that it can’t happen in adulthood? Huh.

  4. Scott Becker says:

    Although I haven’t found anything that works, what I have found is to simply weather the storm and to give myself a break. It doesn’t last longer than a few minutes and like sneezing from an allergy it will pass!

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