Practical advice and tips
What should I look out for?
- A detailed history may, for example reveal experiences of specific traumas. These may be experienced directly, witnessed or through being told repeated graphic details of horrific events.
- A person may re-experience such events through flashbacks, nightmares or intrusive vivid thoughts.
- There may be signs of avoiding triggers, situations, feelings, people, thoughts of the event.
- The person may hold critical thoughts about themselves or the world, which are associated with feelings of blame, guilt, shame, disgust, anger or contempt.
- They may show signs of high arousal in their body such as anxiety, anger, reckless self-destructive behaviour, hyper-vigilance, sleep disturbance, sleeping problems.
- There needs to be evidence of significant impact upon one of more areas of functioning, such as relationships, work or social activities.
What issues sometimes go alongside PTSD?
- Alcohol and substance misuse as a means of self-medication in order to control symptoms in the short-term.
- Depression may be associated with the impact of symptoms, for example, on friendships, activity, work or changes in the perception of self.
- Personality difficulties can develop with chronic early trauma or chronic unresolved PTSD.
- Dissociation can occur when the trauma is intense or the person is trapped in trauma for a long time. The person has learned to habitually disconnect from reality in order to escape the horror and to protect themselves.
- Emerging evidence suggests a strong link between PTSD and psychotic symptoms.
- Continuing difficulties with relationships, work, finance, housing and other welfare issues are common.
What can I do if I accidentally trigger a flashback?
- This can and does happen. These are part of a person’s normal experience and it is unlikely you are causing harm, although it can be distressing for the other person to see.
- Firstly, remain very calm.
- Remind the person they are safe and that is not happening to them now.
- Ground the person in the present: hold a familiar object, notice feet on the floor.
- Distract the person: a discussion about television, sport, their family.
- Add controlled breathing, slowing the out breath.
- Mindfulness: Notice happenings in the present moment.
- Speak to a trauma therapist who may be able to offer more ideas.
- Next time take care during discussions to prevent the person visualising the event as far as possible.
Tips on Managing Flashbacks
How to know you are having a flashback
- You feel small or numb.
- You see images from the past as if they are happening now (or hear things or have bodily sensations).
- You experience the intense emotions that you had at the time of the event.
Remind yourself that:
- These feelings and sensations are past memories that can’t hurt you now.
- You may feel afraid, but you are not in danger anymore.
- The flashback will pass.
- You have skills and support you didn’t have at the time.
Gently direct your body to:
- Slow your breathing.
- Notice your fear but try to continue what you are doing, for example, making the tea.
- Feel your feet on the ground and stand up straight.
- Find someone safe to be with.
- Notice what is around you by finding four red objects, for example.
Over the longer term:
- Resist criticising yourself for your reactions.
- Try to be kind to yourself.
- Allow yourself to grieve for what you have lost.
- Cultivate safe relationships and seek support.
- Learn to identify the triggers to the flashbacks.
- Develop the courage and resources to face your fears.
- Is there additional knowledge or information that you could add to the flashback that perhaps you did not know at the time?
Consider more:
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