Chronic Illness in Marriage, Mental Health, Mental Illness in Marriage

Understanding Post Traumatic Stress Disorder and Flashbacks

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From her window, a young girl witnesses her life-long friend and neighbor commit suicide.

A soldier watches in horror, as a helicopter carrying his fellow soldiers crash and go up in flames leaving no survivors.

A little boy beaten senseless by his own father has to endure painful, yet lifesaving medical procedures.

In a dark alley, a young woman is raped at knife-point.

A faithful and devoted wife discovers her husband’s addiction to pornography and has had numerous affairs throughout their entire thirty-year marriage.

PTSD

Illustrated above, we see various examples of traumatic events that have the potential to lead to post-traumatic stress disorder (PTSD), a common psychological disorder associated with the experience of such trauma. 

PTSD refers to a constellation of symptoms (such as intrusive memories flashbacks, guilt, insomnia, etc) that a person might experience after witnessing one or a series of life-threatening events.

What kind of events?

Traumatic reactions have been linked to the experience of war, mass violence (e.g., the terrorist attack of 9/11), natural disasters (e.g., Hurricane Katrina), fires, vehicle accidents, plane crashes, torture, physical and sexual assault, child abuse, spousal abuse, abandonment, etc. 

Some people, such as military members and emergency workers, because of their occupation (which includes frequent exposure to traumatic situations), have an added risk of developing PTSD.

Many people are surprised to learn that PTSD is a fairly new diagnosis and did not exist before 1980.

Historically, most doctors (except military psychiatrists) assumed that exposure to horrific events in war could result only in temporary stress reactions, but this view changed following Vietnam, when some psychiatrists insisted that many veterans still suffered from severe stress-related symptoms long after having returned from the war….These psychiatrists argued…that the same kind of stress reaction occurred in survivors of other highly stressful events such as “rape, natural disaster, or confinement in a concentration camp.” Eventually these efforts led to a new diagnosis, called PTSD, being included in DSM-3.

According to the current edition of APA’s diagnostic manual, DSM-5,² the diagnostic criteria for PTSD include, for instance:

  • Exposure to real or threatened violence, injury, or death
  • Repeated re-experiencing of the trauma (e.g., as flashbacks)
  • Avoidance of trauma-related feelings or thoughts
  • Irritability and hypervigilance
  • Negative feelings and assumptions about the world or oneself

In case you have experienced trauma and, having read the above criteria, feel that you have some of the above symptoms, you might want to visit this website.  That link takes you to a very short screening tool, called Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).

PC-PTSD-5 helps identify people who might have PTSD. Please remember, this is only a screening tool, and not intended to diagnose.

If your results indicate potential PTSD, please visit your health provider for more in-depth testing.

Treatment

There are a number of treatments are available for PTSD, such as medications both conventional and alternative, (did you know that CBD and medical marijuana have been proven to be just as effective as Prozac and other drugs with few undesirable side-effects for treating the symptoms of PTSD?), psychotherapy and coaching, art, music, and movement therapies, yoga and meditation, and many more.

There are many effective psychological treatments for trauma. According to Dr. Paula P. Schnurr, the treatments with the “best evidence” are prolonged exposure therapy (PE), Cognitive processing therapy (CPT), and eye movement desensitization and reprocessing (EMDR).

P.E involves imaginary and real-life exposure to situations that have been avoided due to their associations with the trauma. CPT is primarily focused on changing beliefs that have become exaggerated as a result of the trauma (e.g., I have no control over anything in my life). Finally, EMDR aims to help the patient process traumatic memories (e.g., by focusing on a memory while following the repetitive hand movements of the therapist visually).

In short, both pharmacological and psychological treatments available for PTSD and can help.

What are Flashbacks?

Flashbacks are vivid, involuntary, and sudden memories of past personal experiences. In most cases, these powerful memories are directly linked with traumatic events.

Understanding Flashbacks


Flashbacks are psychological phenomena during which a person relives a past event or perhaps even fragments of a past experience. They typically occur involuntarily, abruptly entering an individual’s consciousness without the aid of premeditation or conscious attempts to recall the memories, and may be very intense. As flashbacks involve past events, they could have absolutely no relevance to what is actually happening at present.

While individuals typically associate flashbacks solely with visual information, other senses such as smell, taste, touch, and hearing may also be actively involved during the episode. Flashbacks are able to elicit a considerably large array of emotions. Some flashbacks are so intense, that it may become nearly impossible to distinguish the memories from the present moment.

Conversely, some flashbacks may be devoid of auditory and visual memory and may lead a person to experience feelings of dissociation, entrapment, numbness, helplessness, or panic. Many individuals report the onset of flashbacks after surviving a near-death experience or perhaps some other traumatic situation.

Who Might Be Affected by Flashbacks?


People with post-traumatic stress disorder may experience flashbacks as a recurring symptom of the condition. Post-traumatic stress disorder may develop after exposure to military combat, verbal/emotional/psychological/physical, or sexual abuse, or perhaps even a potentially fatal event such as a vehicle, plane or train crash.

In addition to PTSD, other mental health conditions such as depression, acute stress, and obsessions and compulsions are actually associated with the development of flashbacks. The use of some illicit drugs –  as for instance lysergic acid diethylamide (LSD) – may also increase the likelihood of flashbacks occurring.

Flashbacks and Mental Health 

Flashbacks may have a profound effect on a person’s mental health. As a result of the emotionally charged and uncontrollable nature of flashbacks, affected individuals may find their ability to carry out everyday activities, such as basic grooming and hygiene become greatly diminished. Loss of function can severely impact the quality of life, which in turn could be a contributing factor in mood issues such as depression and anxiety.

The deep emotional distress caused by flashbacks may be more immediate. Feelings of helplessness, disorientation, confusion, and complete powerlessness may often follow a flashback. An individual may become caught up in the flashback and dissociate, scream, cry, harm themselves, show intense fear, exhibit other behaviours that may lead to feelings of intense shame and embarrassment after the episode. These behaviours are damaging to the self-esteem and create inexplicable tension in interpersonal relationships, (especially if you are prone to flashbacks during intercourse like I am).  Unfortunately, this is very common for victims of childhood sexual abuse and sexual assault.

The Science behind Flashbacks

While the exact causes of flashbacks have not yet been identified, neuroscience and neuroimaging investigations have revealed information regarding how they occur. Neural scans of individuals experiencing flashbacks show that specific brain areas, such as the mid-occipital lobe, primary motor cortex, supplementary motor area, and regions of the dorsal stream, are highly activated during the episode. Recent research also suggests that factors like stress, food deprivation, and temporal lobe seizures may play a crucial role in the onset of flashbacks.

Coping with Flashbacks

Some individuals may isolate themselves emotionally in order to survive the aftermath of highly traumatic events.  (I’m very bad at this!) However, these survivors may find that the previously isolated body sensations, emotions, and thoughts are still expressed in the present – sometimes many years after the conclusion of the crisis. Occasionally, it may even seem as if the intrusive memories and sensations come from out of nowhere.

By working together with a qualified therapist, many individuals develop an improved ability to cope effectively with flashbacks. In addition to providing further education on flashbacks, a therapist or psychologist can help a person in treatment gradually unearth and address the cause of the trauma – ensuring that previously repressed actions, sensations, emotions, and thoughts are expressed in a safe and healthy environment.

A therapist can even teach those in treatment various coping mechanisms. These may include:

  • Recognizing the flashback is not an actual event
  • Remembering escape is possible
  • Remembering to breathe
  • Actively using  the 5 senses to reorient oneself
  • Recovering sufficiently from the flashback
  • ecoming patient with oneself throughout the experience

Researchers are now exploring the potential for using visuospatial tasks as “cognitive vaccines” to be able to} help prevent traumatic flashbacks.

I struggle each and every day with the demons of my past. Flashbacks are a constant battle as I am forced to re-live and re-experience painful events that have occurred throughout my life. Painful events such as:

  • Childhood abuse
  • Sexual abuse as a child
  • Sexual assault
  • Witnessing my mother being beaten nearly to death twice
  • The attempted suicide of my son (four times by the age of 18)
  • My own attempts at suicide
  • Domestic violence
  • Abandonment and betrayal by my husband

Click HERE to read my story.

A flashback is not merely a short-term memory flash of an original event but a complete, total reliving and re-experiencing of the event(s). The re-living is a total assault on your present sensibilities, transporting you back through smells as acute as the morning dew on an heirloom rose; taste as real as a recently eaten sirloin steak; visuals vivid as a 3D movie in high definition with the power to completely and totally block out all awareness of whatever is presently happening around you in reality.

You are unwillingly transported back to the event in totality not just in memory. Anyone in the room with you no longer exists. It’s as if they disappear down a tunnel of reality in which your tentative grip is already severed. Loved ones no longer exist. Just about all that exists is the event which may have happened more than 30 years ago, but in your mind, it is as if it happening RIGHT NOW.

The unbearable pain of trauma never goes away.  EVER!

If you are a loved one is suffering from the effects of PTSD, there is help and hope.  Please visit my growing Resource Center for more information and resources.

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