Coping with flashbacks

Remembering the past is important. It defines who we are. But sometimes the process of storing an experience as a memory can go awry.

These memory disturbances can present later in life where the event is relived in the form of a flashback.

Flashbacks are a psychological phenomenon. They are sudden, involuntary and vivid. In many cases these powerful memories of past experiences are closely linked with traumatic events, but they can also present as a positive memory where an event is fantasised or romanticised.

Facts about flashbacks

• Mostly associated with traumatic events and Post-traumatic stress disorder (PTSD), flashbacks can be happy, sad, terrifying or exciting.
• Flashbacks can abruptly enter a person's awareness without a conscious attempt to recall the memory. 
• The memory may be so intense the person relives the experience. They may be unable to recognise it as memory and not something happening in 'real time'. 
• Flashbacks may take the form of pictures, sounds, smells, body sensations, feelings, or a lack of them (numbness). 
• There may be no visual or auditory memory. A person may have a sense of panic, of being trapped, or feeling powerless, but there's no memory stimulating these feelings. These experiences can also happen in dreams. 
• Flashbacks may have no relevance to what is happening in the present. 
• Flashbacks can last from a few seconds to a few hours. A person may alternate between current reality and past reality, or may or may not act as if they are in the original traumatic situation. 

Techniques if you are experiencing a flashback

If you are experiencing a flashback, it's important to tell yourself that it's not an actual event and that your reaction is a common response. 

Try to keep your eyes open and look around, remind yourself that the feelings and sensations you are experiencing are from the past and that the worst is over and you survived.

Over time it is possible to develop strategies to manage or minimise these flashbacks. The list below offers some common techniques that may work for you. 

Breathe

When we're scared our breathing can become erratic, resulting in our body panicking from lack of oxygen. This can cause feelings of fear, pounding in the head, tightness, sweating, feeling faint, shakiness and dizziness. 

Calm breathing – also known as diaphragmatic breathing – can help you regain control and slow your breathing down when you feel stressed or anxious. The purpose is not to avoid anxiety, but to help you 'ride out' the feelings.

Anxiety Australia and Cleveland Clinic have strategies to help you with this. 

Grounding

This technique helps to 'ground' or immediately connect you with the present. 

Keep your eyes open so you can see and focus on what is around you right now. Speak out loud and describe what you are seeing and doing. For example, 'I'm sitting on a brown chair, and the fabric is really soft. It's velvet. The carpet is beige and there is a yellow couch in the corner.'

Some grounding strategies include:

• Use your five senses – sight, hearing, taste, smell and touch. Look at colours, shapes of things and people nearby. Listen to your breathing, or nearby sounds from traffic or nature. Feel your body and what it's touching: your clothes, the chair, other objects or the floor supporting you. Taste different foods. Smell scents: perfume, food or flowers.
• Think about different things: count backwards in 7s from 100, think of 10 animals, one country for each letter of the alphabet, or say the alphabet backwards.
• Move about. Stretch, stamp your feet, jump up and down, rub your arms and legs, or clap your hands.
• Use positive coping statements, such as: 'stop, and breathe, I can do this', or 'this will pass, I have done this before, and I can do it again, it won`t last forever'.
• Carry something familiar and comforting in your pocket that you can stroke or hold when a flashback occurs. Keep an elastic band around your wrist and 'ping it' to bring yourself to the here and now.
  

Progressive muscle relaxation

When you are stressed or anxious your body may respond by tightening its muscles. The progressive muscle relaxation technique works in the reverse and teaches you how to relax your muscles.

All you need to do is find a quiet, comfortable space and focus on slow, regular breathing for a couple of minutes. Once you are settled, systematically move around your body tightening different muscle groups – such as your neck and shoulders – for ten seconds, then release them. Try to synchronise the muscle tightening and relaxation with your breathing. 

This technique can help lower your overall stress levels and is a way to relax when feeling anxious.

Boundaries

Boundaries help you feel protected from the outside world. During a flashback you may lose the sense of where you leave off and the world begins, as if you don't have skin. Try wrapping yourself in a blanket, hold a pillow or stuffed animal, go to bed, or sit in a closed space. 

Self-care

Flashbacks can drain your energy, so it helps to take time to find ways to unwind and destress. 

There's a proven relationship between stress and mental illness. It can worsen an episode, or even result in symptoms returning. Try to find a balanced lifestyle and identify coping strategies that will help you with the ongoing management of stress. 

Get support

You may prefer to be alone during a flashback. But if you can, let your loved ones know you are experiencing flashback. They may be able to help just by being there. You can also let them know about your triggers. 

Flashbacks can cause significant distress, and it is useful to foster new ways of caring for yourself. Be patient. Developing effective ways of coping in the here and now takes time.

If you need professional support please speak with your treating doctor, call SANE's free counselling service on 1800 187 263, or contact Lifeline on 13 11 14.

To connect with others who understand living with flashbacks, visit our safe and anonymous Forum community.