In this series, I dig a little deeper into the meaning of psychological terms. This week’s term is 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 they 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.
How flashbacks occur
A flashback 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 isn’t well developed until around age 5, but people may experience flashbacks to earlier ages based on implicit emotional memories. A study of veterans who were prisoners of war found that flashbacks continued for up to 65 years following the associated traumatic event.
The exact neurophysiological mechanisms are unknown, but several regions of the brain appear to be involved based on differences in neuroimaging studies comparing activation during voluntary memory retrieval vs. flashbacks. Food deprivation, stress, and temporal lobe seizures have been identified as possible triggers.
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 the what is… series in the Psychology Corner.
PTSD Treatment Options: An Overview, a mini-ebook that’s available from the MH@H Download Centre, covers a variety of evidence-based therapies for PTSD.