A flashback is a spell of reliving a traumatic event in which the person partly or wholly loses awareness of the present, whereas an intrusive memory is an unwelcome recollection the person still knows is a memory. During a flashback, stay at a safe distance, speak calmly, say the person’s name and where and when they are now, and avoid sudden touch, which can be taken as an attack.
Intrusive memories and flashbacks are involuntary returns of a traumatic event into current experience, usually set off by a sensory reminder.
Reliving Is Different From Remembering
An intrusive memory is distressing but the person keeps hold of the present: they know they are by the fire, that the event is over. A flashback is different in kind. Sights, sounds, smells and body sensations return as if happening now, and awareness of the present narrows or disappears. The body responds with fear, a racing heart and tensed muscles, and the person may not hear, or may not understand, what is said to them. The two lie on a continuum rather than being separate categories.
Reminders Set Them Off, Often Without Warning
Triggers are sensory in the main: a smell of smoke, a particular sound, a time of day, a tone of voice, a texture. They can be obvious or personal and strange. This is why Trigger Management begins with working out what sets a particular person off, from them, rather than guessing.
What It Looks Like From Outside
- A fixed or vacant stare, not responding to name
- Sudden fear, crouching, shielding, or fighting a person who is not there
- Speaking as if in the past event
- Afterwards: confusion, exhaustion, shame
Responding During A Flashback
- Keep your distance and keep yourself safe. A person reliving a fight may strike out. Do not block their way out of a space.
- Speak calmly and slowly, using the person’s name. Keep sentences short.
- Orient them. Say where they are, what the date or season is, that the event is over and that they are safe now. See Orientation Phrases.
- Offer something to attend to in the present: a cup of cold water to hold, or the instruction to press their feet into the ground. See Physical Grounding.
- Ask before touching, or do not touch. Grabbing can read as an attack.
- Stay afterwards. Offer water and quiet. Do not demand an account of what they saw.
Rule Out Other Causes
A person who is unresponsive, jerking rhythmically or does not recover in a few minutes may be having a seizure (see Medical Emergencies). Hallucinations in a heavy drinker who has recently stopped can be alcohol withdrawal, which can be fatal (see Alcohol Withdrawal (Dangerous)). Fever, head injury and exhaustion also cause confusion.
Common Mistakes
- Shaking, slapping or shouting. It adds a threat to a person who already thinks one is present.
- Insisting they “snap out of it” or “face it” now. Forcing recall during a flashback deepens the experience.
- Asking them to describe it afterwards, to “get it out”. Unsupervised retelling can intensify the memory; see Narrative Exposure (Telling the Story).
Safety
Keep sharp tools, weapons and fire out of reach of the person during an episode where possible, and keep a second person nearby so that no one has to restrain or confront them alone.
What’s Next
- Learn next: Grounding Techniques — the methods behind the steps above
- Combine with: Dissociation — the related state of detachment from the present