Flashbacks are hallmark features of both PTSD and complex PTSD. Remembering traumatic events is in some ways beneficial. For example, it allows us to review the experience and learn from it. Also, by replaying the events, their emotional charge is diminished.
However, sometimes the process breaks down and the memories remain powerful and frightening. Sometimes they seem to appear at random, and at other times they can be TRIGGERED by a particular event such as a film with a scene that shows a person suffering from a similar trauma to that suffered by the person watching it.
Traumatic memories can manifest themselves in any of the 3 ways listed below:
- INTRUSIVE MEMORIES
These are often intense, vivid, and frightening. They can be difficult to control, especially at night.
Sometimes a flashback may be very detailed, but at other times it may be a more nebulous ‘sense’ of the trauma.
Sometimes the person experiencing the flashback feels that they are going mad or are about to completely lose control, but THIS IS NOT THE CASE.
2) INTRUSIVE MEMORIES
These are more likely to occur when the mind is not occupied. They are more a recollection of the event rather than a reliving of it. When they do intrude, they can be painful. Often, the more we try to banish them from memory the more tenaciously they maintain their grip.
These can replay the traumatic events in a similar way to how they originally happened or occur as distorted REPRESENTATIONS of the event.
HOW RELIABLE ARE MEMORIES OF TRAUMATIC EVENTS?
There used to be a concern that some memories of trauma may be false memories. However, the latest research suggests that memories of trauma tend to be quite accurate but may be distorted or embellished.
However, false memories CAN occasionally occur. This is most likely to happen when someone we trust, such as a therapist, keeps suggesting some trauma (eg sexual abuse) must have happened.
It is important to remember, though, that parents or carers will sometimes DENY or DOWNPLAY and MINIMIZE our traumatic experiences due to a sense of their own guilt. In other words, they may claim our traumatic memories are false when in fact they are not.
Very traumatic memories may sometimes be REPRESSED (buried in the unconscious with no conscious access to them). In other words, we may forget that a trauma has happened/ this is a defense mechanism. Sometimes the buried memories can be brought back into consciousness (eg through psychotherapy) so that the brain may be allowed to process and work through the memories allowing a recovery process to get underway.
TRAUMA, MEMORY, AND THE BRAIN:
New memories are stored in the region of the brain known as the hippocampus. However, not all memories that enter the hippocampus are stored by the brain permanently.
Only some are transferred to the cerebral cortex for long-term storage; the rest fade away. The more important the memory, and, in particular, the more intense the emotions connected to the memory are, the more likely it is to be permanently stored. This process is called memory consolidation.
When an event occurs that is very threatening or damaging to us, the stress of this causes stress hormones ADRENALIN and CORTISOL to be released into the brain.
The effect of these stress hormones is to strengthen the memory of this threatening or damaging event.
The stress hormones released into the brain (in particular, the amygdala) also ensure the memory of the negative event becomes strongly associated with the emotions (such as fear and terror) that it originally evoked.
So, for example, if we are viciously attacked and maimed by a savage and demented Rottweiler, cortisol and adrenaline will be released into our brain to ensure that the memory is indelibly stored. These same stress hormones will also ensure that the emotions we felt at the time of the attack, such as fear and terror, also become strongly associated with the memory of our unfortunate encounter with the less than friendly canine miscreant.
This way of storing such memories evolved for the survival value it confers on our genes.
Also, when extremely traumatic events occur, the hippocampus can become so excessively flooded by stress hormones such as cortisol and adrenaline that it incurs damage.
This damage can then alter the way that the traumatic event is stored. Because of this, the memory may become:
– ‘foggy’ / ‘blurry’
– inaccessible to conscious awareness
Furthermore, the memory of the extremely traumatic event may become highly invasive – especially when the person in possession of the memory is reminded of the traumatic event (even tangentially) – and constantly breakthrough into consciousness wholly unbidden, re-triggering the release of excessive amounts of stress hormones into the brain; this can lead to:
– obsessive rumination about the traumatic event
TRAUMA AND NON-DECLARATIVE MEMORY :
Our long-term memory can be divided into :
1. Declarative Memory (sometimes called explicit memory or narrative memory) – it is the part of our memory that we use for the conscious recall of facts or events.
Declarative memory depends upon language in order to organize, store and retrieve the information that it holds.
2. Non-Declarative Memory (sometimes called implicit memory, procedural memory or sensorimotor memory) – it is this part of our memory that allows us to automatically retrieve information connected to something we have learned without conscious deliberation.
For example, we can get on a bike and ride it without having to concentrate on exactly how we’re doing it or go over in our minds the steps involved in how we learned to do it; indeed, we need not even remember when or how when learned to do it (I certainly don’t) – nevertheless, the necessary ‘know-how’ has been unconsciously, permanently retained.
Non-declarative memory, unlike declarative memory, does not depend upon language for the organization, storage and retrieval of information. Because of this, non-declarative memories are frequently very hard indeed to describe in words (try explaining all the tiny body and muscle adjustments necessary to maintain balance whilst riding a bicycle – yet the memory of exactly how to do this has been faithfully, unconsciously stored, courtesy of your non-declarative memory!).
TRAUMATIC EXPERIENCES ARE FREQUENTLY STORED AS NON-DECLARATIVE MEMORIES :
Due to their utterly overwhelming nature, we often can’t completely and linguistically, mentally process our traumatic experiences which prevent them from being stored in declarative memory; when this happens, the traumatic experiences are instead stored in our non-declarative memory.
THE FRAGMENTARY NATURE OF INCOMPLETELY PROCESSED TRAUMATIC MEMORIES :
The incompletely processed traumatic memories stored in non-declarative memory tend to be very fragmentary in nature. As we have seen, too, they are not stored in linguistic form but, instead, often in the form of :
– bodily sensations (e.g. muscular tension, increased heart rate, hyperventilation)
– images (e.g. these might come to us in nightmares or intrusively and unheralded during our waking hours as a result, often, of unconscious triggers – see below)
– emotions (e.g. extreme anger or fear)
Also, our unconscious, non-declarative memories may express themselves through chronic, seemingly inexplicable symptoms and behaviors.
WHY WE FIND IT HARD TO ARTICULATE OUR TRAUMATIC EXPERIENCES :
Because the memory of our trauma has not been properly processed at the linguistic level we are likely to find ourselves unable to articulate our traumatic experiences in any coherent manner.
Bodily sensations, images, emotions, symptoms, and behaviors linked to our non-declarative memories of our original, childhood trauma may be triggered whenever anything even remotely reminds us of this trauma.
In this way, we may find ourselves re-enacting aspects of our original trauma in our everyday lives months, years, or, even (in the absence of effective therapy), decades after the actual experience of our childhood trauma is over.
How to Cope with Difficult Memories :
Flashbacks and Intrusive memories can be very painful and emotionally distressing, and, according to Ehlers et al. (2010), three main factors need to be considered when aiming to eliminate, or, at least, reduce the negative impact of, these kinds of memory. They identified the three factors as follows :
- Becoming aware of what is triggering the memories
- Understanding how the individual is interpreting the memories
- Identifying and understanding behavioral and cognitive responses to the memories
With this in mind, let’s look at strategies that we can implement to help manage our problem memories:
1) Flashbacks: strategies that are helpful in managing them:
There are three main ways which can help us to achieve this:
a) PLANNED AVOIDANCE
b) ‘GROUNDING’ TECHNIQUES (which act as DISTRACTORS)
c) THOROUGH REVIEW OF THE FLASHBACK (this technique is connected to the psychological technique known as DESENSITISATION – by repeatedly exposing oneself to the feared object, or, in this case, memory, gradually weakens its negative psychological impact)
This technique involves avoiding TRIGGERS that, by experience, we know trigger our traumatic memories. This can provide valuable ‘breathing space’ until we feel ready to try to process and make sense of our memories, usually with the help of a psychotherapist. In order to use this technique, it is necessary, of course, to, first, spend some time thinking about what our personal triggers are.
This technique is based on DISTRACTION; the rationale behind it is that it is impossible to focus on two different things at the same time. So, the idea of the technique is to strongly focus on something neutral, or, better still, something pleasant – the brain, when we do this, will be unable to focus on the memory which was giving rise to distress and emotional pain.
It does not really matter what we choose to focus on in order to distract us – it might even be, say, the chair in which we sit: what is its color, its shape, its texture and feel to the touch, the material from which it is made…etc…etc..? I know this sounds rather silly, but, if we concentrate on it like this for a while, almost as if we were carrying out a forensic examination (think Poirot or Sherlock Holmes), it can act as a powerful, temporary distractor when we feel, potentially, we could be overwhelmed by our thoughts and memories.
We can implement the grounding technique by using what is known as ‘GROUNDING OBJECTS’ – this term refers to physical objects (ideally, easily transportable, so, a full-sized model of, say, Stompy the Elephant, for instance, might not be such a great idea). But, seriously, it could be something as simple as a shell from the sea-side – it can really be anything, just so long as it evokes a feeling of safety and comfort. When feeling distressed, the object can be held and looked at with the intense focus referred to above in the description of the grounding technique. Also, as Proust helpfully pointed out, aromas can be very evocative – something relaxing such as lavender could be used.
As well as using grounding objects, we can also use what is known as ‘GROUNDING IMAGES’. This involves thinking of a place in which we feel safe, secure and comforted. It is a good idea to make the image as intense and detailed as possible (although people’s ability to visualize varies considerably – I’m hopeless at visualizing).
If you are able to visualize it in such a way as to allow you to mentally interact with it (e.g. imagine walking around in the location you are imagining) so much the better. To get to the safe imaginary place in your mind, it is also useful to have what is known as a ‘LINKING IMAGE’; again, as this is an imaginary way of linking (getting) to the ‘location’ it can be anything; for example, when feeling distressed, you could imagine yourself ‘floating away to your ‘safe place’. Once mentally ‘located’ in the safe place, it is again helpful to imagine then ‘place’ as intensely as possible, using our old friend the GROUNDING TECHNIQUE, so that it almost feels you are really there, where NOTHING CAN HARM YOU.
It is also possible to employ the assistance of what are referred to as “GROUNDING PHRASES‘. These can be very simple, such as “I am strong enough to deal with this, I always get through it’, or, even more simply, ‘I’m OK’. We can try to bring these phrases to mind and repeat them to ourselves when we are feeling distressed.
There is even a technique known as ‘GROUNDING POSITIONS’. This, very simply, refers to altering our body’s position to produce a psychological benefit; for some, this might be standing up straight with shoulders back to produce a feeling of greater confidence; for others, it might be curling up in bed in embryo position to produce a feeling of greater safety and security. Such techniques, whilst, possibly, sounding vaguely silly, can be surprisingly effective.
THOROUGH REVIEW OF THE FLASHBACK :
This technique is connected to the psychological technique known as DESENSITISATION – repeatedly exposing oneself to the feared object, or, in this case, memory, gradually weakens its negative psychological impact.
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