Triggers and Flashbacks Triggers and Flashbacks

What is a flashback? Triggers and Flashbacks

A flashback, or involuntary recurrent memory, is a psychological phenomenon in which an individual has a sudden, usually powerful, re- experiencing of a past experience. These experiences can be happy, sad, exciting, or any other emotion one can consider.

The term is used particularly when the memory is so intense that the person "relives" the experience, unable to fully recognize it as memory and not something that is happening in the here and now.

The “reliving” experience not only involves all the senses (sight, hearing, taste, smell and touch), but also the feelings and body sensations associated with the experience. Flashbacks

❑ Sometimes there is no actual visual or auditory memory.

❑ The person may have a sense of panic or being trapped

❑ Or a feeling of powerlessness, with no apparent memory stimulating it Flashbacks

During the initial crisis, the survivor had to insulate her/himself from the emotional and physical pain of the trauma. We call this dissociation.

In order to survive, that insulated part of the self remained isolated, unable to express the feelings and thoughts of that time.

It is as though the survivor put that part of her/his self into a time capsule, which later surfaces and comes out as a flashback, feeling just as intense in the present as it did during the crisis.

When that part comes out, the survivor is experiencing the past as if it were happening today. The intense feelings and body sensations occurring are frightening because the feelings/sensations are not related to the reality of the present and many times seem to come from nowhere. Triggers and Flashbacks

What is a trigger? Triggers

❑ They are very personal

❑ A trigger can be activated by any one or more of the five senses:

❑ Sight

❑ Sound

❑ Touch

❑ Smell

❑ Taste Triggers

Is avoidance a helpful survival strategy?

Can a survivor realistically avoid things that trigger them? Triggers

Is avoidance a helpful survival strategy?

Can a survivor realistically avoid things that trigger them?

To answer that, we need to know what is going on inside the brain. The “front” and “back” parts of the brain

The front brain is our thinking centre. It is responsible for evaluating, choosing, planning, reflecting, reasoning, and empathy.

“Front” brain

“Back” brain

(the smoke alarm)

The back brain is responsible for survival and emotions. It is the brain’s alarm system and is able to sense danger. We are unconscious to the actions of the back brain and have no control over what it does. The amygdala and hippocampus store memories of fearful situations So they may be recognised in the future

amygdala Raise the alarm

“What do you know “I have traumatic about cigar smoke” memories of cigar smoke.”

hippocampus The triggering of the alarm by the amygdala is reckoned to take around 7 milliseconds. (that’s the time it takes to blink) Let us suppose that a sexual assault took place by:

❑ A man ❑ With a dog ❑ In a forest ❑ Wearing a red jumper ❑ Smelling of alcohol

Then all these things will be added to the “threat list” in the hippocampus So next time we encounter:

❑ A man ❑ Or a dog ❑ Or a forest ❑ Or a red jumper ❑ Or a smell of alcohol

The amygdala sets the alarm off. Look out! Threat coming! This is what we call a trigger

Remember that this alarm has been triggered by the back brain. There is no checking or rational thought involved.

A delay might make the difference between life and death. React first, ask questions later.

(This is how the back brain keeps us alive and safe) Triggers

Is avoidance a helpful survival strategy?

Can a survivor realistically avoid :

❑ All men ❑ All dogs ❑ All forests and trees ❑ All red jumpers ❑ All smells of alcohol Could triggers be neutralised rather than avoided? Triggers

The term “trigger” has been used to describe three things but they can be managed differently

❑ True Triggers

❑ Distressing Reminders

❑ Uncomfortable Associations Uncomfortable Associations

❑ These are links that are made with a previous trauma

❑ For example: “I don’t like pictures of dogs and trees because they remind me of where the abuse took place”

❑ A negative association has been made between the trauma and something otherwise quite neutral.

❑ The reaction takes place within the brain, not the body.

❑ The front-brain is still on-line and engaged

The key to dealing with them is reframing, by the front left brain. Reframing

❑ Create a new association

❑ For example: Picture a different tree in a peaceful orchard, in beautiful surroundings. You are sitting in the sun under the tree.

❑ Write the new association down, and try to remember it every time you think of trees.

❑ So when you think of trees, imagine the new association - the orchard.

❑ Repetition is the key. Distressing Reminders

❑ These evoke memories of a traumatic event

❑ They cause negative and averse feelings

❑ But the front brain is mostly on-line and they occur mostly within conscious thought (we know why we were triggered)

❑ It is an emotional reaction partly in the front brain and partly in the back brain

The key to dealing with them is soothing or grounding, which will engage the front right brain. Soothing

Soothing is about letting our mind and body know we are safe, by getting back into the window of Tolerance.

❑ Nothing bad is going to happen here and now.

❑ Breathing is the easiest way. Of all the automatic functions performed by the back brain, breathing is the only one which can be over overridden consciously by the front brain.

❑ Sensory awareness – what can I see, feel, smell, taste, hear?

❑ Cognitive awareness - Where am I? What is today? What is the date? What is the month? What is the year? How old am I? What season is it?

❑ Bodily awareness – listen to your heartbeat, move around or change how you sit, feel how hot or cold you are. True Triggers

❑ These occur when our smoke alarm is activated by the amygdala

❑ It is usually a real re-experience (You can “feel” yourself in a forest with a man in a red jumper, with a dog and smelling of alcohol)

❑ The front brain has gone off-line

The key to dealing with them is Just Notice, which will engage the front brain.

Initially this might only occur afterwards, but, with practice, it can gradually begin to happen more and more at the time. Just Notice

It’s difficult to do at the time, because we are in flight or fight mode

❑ Self-compassion turns down the sensitivity of the smoke alarm.

❑ The trigger is just one of those things. I was just triggered.

❑ Keep telling our self “I am safe”.

❑ Base what we say to ourselves on external reality rather than internal feelings.

❑ I’m just triggered, it’s just a tree, it’s just a dog, it’s just a red jumper, it’s just my smoke alarm.

It’s just trying to keep me safe. Triggers

❑ The brain is plastic and can be changed

❑ But these processes are hard work and require dedication and repetition

❑ It’s like learning a new skill (eg playing the piano, driving a car, learning a language). It takes time and repetition

But the rewards are phenomenal Acknowledgement

Some of the material in this presentation is taken from an article written by Carolyn Spring, Director of Positive outcomes for Dissociated Survivors, who is hereby acknowledged.