What is an emotional flashback?
I’m Sarah Lee and I’m a private psychotherapist working online. I’m based in Manchester and have been working with clients for 10 years, helping them to recover from childhood trauma, childhood emotional neglect and cptsd.
In this post, I’m going to cover:
What is a flashback?
What is the difference between PTSD and CPTSD?
What is an emotional flashback?
What causes emotional flashbacks?
How can therapy help?
What is a flashback?
When we talk about flashbacks we are normally referring to PTSD or CPTSD (complex trauma). CPTSD is also known as C-PTSD, developmental trauma, relational trauma or childhood trauma. For more information please read What is CPTSD and do I have it? and What is childhood trauma?
Flashbacks can take various forms although most people assume that a picture or image is involved, this is not the case and can lead to confusion, fear and misunderstanding even among professionals. You are not going mad, and this can be improved, you can learn how to deal with your flashbacks.
PTSD flashbacks
PTSD is often caused by a single point trauma, that is a one time event that does not reoccur. Car accidents or other accidents, single acts of violence, natural disasters, fires or severe illness of yourself or a loved one or death of a loved one can (but do not always) cause PTSD. PTSD stands for Post Traumatic Stress Disorder and occurs after the event. It is fairly common for people to relive elements of a traumatic or upsetting event shortly following it and does not mean that they have or will develop PTSD. It can be part of the natural process of coming to terms with the event and is not considered as a potential issue until you have experienced symptoms for more than 1 month. Of course, this does not make it easier to deal with reliving the event and also doesn’t mean you can’t get support from friends or family, your GP or reach out for counselling or psychotherapy.
What is the difference between PTSD and CPTSD?
Whereas PTSD is a single point event (a one time event, see above), complex trauma is caused by many events or by multiple traumas. This can be through war, trafficking or refugee status, or by experiencing chronic ongoing stress (which normally starts in childhood). Complex trauma can be caused by any type of abuse; emotional, physical or sexual or by physical or emotional neglect. Physical neglect is where food, shelter, clothing or health care was missing or not provided and emotional neglect (also know as CEN or Childhood Emotional Neglect) is a lack of emotional support or safety to be yourself and feel your own emotions.
Is CPTSD an official diagnosis?
Although CPTSD does not appear in the DSM 5 (the diagnostic manual used in the US) it does appear in the ICD 11 (which is used in states belonging to the World Health Organisation). What this means in reality is that if you visit a medical practitioner or Psychiatrist, it will depend on your country location as to whether CPTSD is recognised and diagnosed.
In the US where they primarily use the DSM, CPTSD falls under the umbrella of subtypes of PTSD. If you have health insurance or access government funded health services this might affect the type of care you can access and you should check this with the relevant party.
In the UK, the NHS does recognise CPTSD.
Treatment type and length depends on your area and access to treatment.
There is also likely to be long waiting lists for therapy.
Private therapy offers you greater choice and control over your treatment. If you have private health insurance they may cover some or all of the cost. Please note your therapy provider will need to be registered with the insurance company to be reimbursed in this way and again you should check this before deciding how to proceed.
What is a CPTSD flashback?
When most people think of flashbacks, they think of images.
CPTSD flashbacks or emotional flashbacks are flashbacks to the emotions from the past or to the experience of an event in the past.
For example; your boss says you’re useless (totally unprofessional but still a possibility) and because of the emotional and verbal abuse you suffered as a child your boss calling you useless feels enormous to you.
You are suddenly hit by a wave of emotions and feeling of helplessness that other people might not understand or might feel is ‘over the top’. You are actually dealing with the current abuse from your boss and the traumtic events from your past all at once.
What causes emotional flashbacks?
Emotional flashbacks (also called amygdala hijacks) occur when an emergency response is triggered by the amygdala in the brain. One of the amygdala’s functions is to connect memories with emotions. When someone with complex trauma experiences something upsetting or scary that matches part of a traumatic experience from their past, it feels to them as if the event from their past is happening in the present day and they relive these overwhelming emotions. For many people a lot of their emotional damage happened in childhood when they did not have any help and had very little power to change their experience and this means the emotions can be overwhelmingly intense, alarming and panic inducing.
What is fight, flight, freeze, friend, flop?
Although many people have heard of fight or flight, they often haven’t heard of the other responses.
When someone is very overwhelmed, their body will initiate an emergency response by sending out signals and hormones to protect itself.
This is what causes people to fight (to protect themselves) or run away.
What is a freeze response?
By far the most frequent emergency response is freeze, where the body shuts down and freezes. It is very frequently overlooked and it can be very upsetting when people are asked why they ‘didn’t do anything’ during an attack or abuse. They did not ‘do nothing’ rather they froze as their body attempted to protect them.
What is a friend response?
A friend or fawn response is a kind of cooperative approach in an attempt to get the other to back down or to appease them. This is sometimes known as fawning or people pleasing.
What happens during an emotional flashback?
An emotional flashback is a feeling flashback rather than a visual flashback (although there may be other components such as images, sounds or smells or tastes).
A feeling flashback really relates to the past but is so confusing and overwhelming that is common for the person experiencing it to be unaware of what is happening. This can look like ‘switching off’, ‘going blank’, stopping talking, staring into the distance, crying, hyperventilating, or anxiety symptoms such as pounding heart or feeling as if it is difficult to breathe.
How is an emotional flashback different to a panic attack?
An emotional flashback can cause a panic attack but they can also occur independently. A panic attack is a response to extreme anxiety and or stress and does not necessarily need to have been triggered by a past event.
What does an emotional flashback look like?
An emotional flashback can look like a very extreme response to what someone else might consider a small issue, event or problem.
For example if you take two people who are taking their driving test, person A might feel anxiety before the test and notice their physical response and feel better after the test has finished. Person B might start feeling anxious in a similar way to person A. The difference is that our past plays a part in our current behaviour and emotions because we use them as a template, relive what was said to us, and often act on autopilot (even when it doesn’t work).
So person B might recall other situations where they felt anxious and if these events are overwhelming, traumatic or distressing enough, person B loses sight of the fact that the past event is finished and they are safe.
Trauma goes round on a loop in our head without us understanding that is an event from the past. The driving examiner might look at person B and see ‘an overblown’ response to a driving test, when they are actually responding to one (or even a series) of traumatic events on top of the driving test.
Person B might, if they have awareness feel intense shame, fear, or anxiety. If they don’t have awareness (which is very common) they might feel like something terrible is happening and simply switch off.
Since the fight, flight, freeze, friend, flop (also known as fight, flight, freeze, fawn, flop) is triggered, they might simply end the test, run away, be unable to function or be unable to remember what happened. If asked what happened they may simply reply ‘I don’t know’ or ‘I can’t remember’.
What are emotional flashbacks confused with?
Amygdala hijacks can be confused with anxiety or panic attacks. You might also hear judgmental accusations from others (or from yourself) that you can’t cope, you aren’t strong enough, you’re making a fuss, you’re making a big deal out of a small issue or mountains out of molehills. This is not true and is unhelpful and invalidating.
Does the person always know they are in a flashback?
No, they don’t. It’s common for people coming into therapy for complex trauma not to realise when they are in a flashback. They might instead view their response as appropriate or proportionate or believe they are simply ‘over reacting’ or a ‘drama queen’.
How can therapy help?
Therapy helps with emotional flashbacks in a number of ways.
You get an expert view - I have a lot of experience in noticing and understanding people’s expressions, tone of voice, experience and posture. Most people (through no fault of their own), simply don’t have the experience to do this.
I can help you to learn how to come out of a flashback - with time this is a skill that can be learned, as the person gets more practice, the flashbacks shorten in length, there are longer times between flashbacks and recovery is quicker.
I can help you map your triggers - I can point out patterns that it’s hard to notice yourself, I can help you make links between events and symptoms and provide suggestions for dealing with flashbacks.
Understanding yourself better empowers you - disempowerment, feeing powerless and helpless is part of the trauma and your response to it. The better you understand yourself, the more empowered you will feel and you will be able to make connections quicker and explain them to others. Confusion is often embarrassing and debilitating, whereas knowledge is power.
I can empathise and relate to your situation - it is often embarrassing for people to explain their response or symptoms and empathy or hearing some of my experience helps to lower shame and allow people to feel less alone.
Further resources for flashbacks
One of my favourite resources for dealing with flashbacks is Pete Walker’s flashback management:
http://www.pete-walker.com/13StepsManageFlashbacks.htm
Anything that helps you to feel calmer and grounded will be helpful to you. If you are not yet at the stage where you are able to bring yourself back this does not mean it won’t or can’t happen. With guidance and support you will find the process gets quicker and easier and you will develop more empathy for yourself and your past.
You don’t have to do this on your own anymore, book a free 15 minute call without even picking up the phone, by clicking here and find out how I can help.