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The Difference Between a Typical PTSD Flashback and an Emotional Flashback From C-PTSD

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Editor's Note

If you’ve experienced sexual abuse or assault, the following post could be potentially triggering. You can contact The National Sexual Assault Telephone Hotline at 1-800-656-4673.

When we hear the acronym “PTSD,” short for post-traumatic stress disorder, one of the first words that comes to mind is “flashback.” Though we may have some general ideas of what a flashback is, many of us don’t know what it’s really like to experience one. Even if you live with flashbacks yourself, there can be a lot of variation from person to person, so it’s important to know the telltale signs.

• What is PTSD?

We wanted to shed some light on what kinds of flashbacks people with PTSD can experience and what it’s like to experience them — so we spoke to Patrick Walden, LICSW, a trauma-informed treatment specialist who has been practicing in Western Massachusetts for 12 years.

He told The Mighty there are two major kinds of flashbacks: typical flashbacks and emotional flashbacks. He said the differences in these types of flashbacks often comes down to a diagnosis of PTSD or complex-PTSD (C-PTSD).

PTSD is a mental health issue that can occur in people who have lived through a specific (and often time-limited) traumatic event or series of events like war, a serious car accident, sexual assault or natural disaster. C-PTSD, on the other hand, is the result of prolonged exposure to trauma over longer periods of time, often during the formative years of childhood.

Though typical flashbacks are most commonly associated with PTSD, folks with C-PTSD can experience them as well. Flashback triggers may also change as an individual progresses through life. For example, a person who was abused in childhood may experience onset or re-emergence of flashbacks if they have a child who is the same age they were when their own abuse began.

To open up the discussion on typical PTSD flashbacks and emotional flashbacks, we asked Walden to share his therapeutic insight. In addition, we’ve included some community responses that share what it’s really like to experience typical flashbacks and emotional flashbacks.

Here are two types of flashbacks people with PTSD can experience:

1. Typical Flashback

Walden told The Mighty a typical flashback is characterized by a sudden onset re-experiencing of a traumatic event in an individual’s life. He said this might feel like you’re visually seeing the upsetting event over and over in your head, but it’s more intense than just a memory:

An example would be someone who was violently attacked by a dog becoming triggered by watching a movie that contained a dog attack in it. The sight of the dog’s fangs on the screen would trigger the image of the actual dog’s fangs that once attacked the individual, and it would be common for the individual, in present time, to time travel in their mind back to the event where it would replay like it’s own movie reel.

In addition to experiencing visuals of the traumatic event, someone in a typical PTSD flashback may also re-experience sounds and other sensations that were present at the time of the trauma, like an attacker’s voice, the screeching of tires, etc.
Though the person watching the movie about a dog bite in the above example is completely safe in actuality, they don’t feel safe. They are reliving all the feelings still attached to the memory of being attacked by a dog — and to the individual affected, it really feels like it’s happening again.

This is something Mighty contributor Monica Sudakov touched on when she wrote about experiencing a flashback of her past sexual assault in her piece, “Having a Flashback Is Not Simply Recalling a Memory.” [Editor’s Note: The below except contains some details about Sudakov’s sexual assault that may be distressing for some readers, so please read at your own discretion.]

I relive, in absolute vivid detail, a particularly horrible experience. Things like the smell of his breath, the steam on his glasses, the blue towel with multi-colored fish hanging on the towel rack, the taste of his saliva, the feeling of his rough hands against my skin, even the exact blue jean skirt and checkered top I’m wearing bunching up against my skin are intensely and painfully felt. All the while, it’s as though I’m trapped by my mind and my body. An endless loop of remembering and feeling.

If you experience flashbacks due to PTSD or traumatic experiences, you’re not alone. We encourage you to connect with other survivors in The Mighty community by posting a Thought or Question on the site with the hashtag #TraumaSurvivors.
For more on PTSD, check out the following stories from our Mighty community:

2. Emotional Flashback

When we think of flashbacks due to trauma, our minds often jump to the kind of typical PTSD flashback we described above. Walden told The Mighty typical flashback symptoms are fairly straightforward, making them much easier to identify and diagnose than emotional flashbacks — the type that often affects survivors of complex trauma.

An emotional flashback is when someone who has survived complex trauma feels “taken over” by an emotional experience (like feeling scared, abandoned or unsafe) that often stems from childhood. Rather than re-experiencing a specific traumatic event in a relatively short period of time, an emotional flashback, Walden said, can last for hours or days, sometimes even weeks.

Walden told The Mighty that during a typical PTSD flashback, an individual revisits an upsetting traumatizing event, while in an emotional flashback, the individual revisits the complicated, leftover emotions of prolonged trauma.

To better understand how emotional flashbacks work, we first need to understand how the brain responds to fear. When our brains perceive a threat in our environment, we instinctually go into “fight-flight-freeze” stress response mode. One of the major players in the fight-or-flight response is the amygdala, a small almond-shaped structure in the brain’s limbic system that can trigger physiological responses like an increased release of stress hormones and blood flow to large muscle groups, and a higher heart rate.

During stressful events, our stress response systems in the brain and body instinctually take over by overriding thinking and decision-making structures in frontal lobes of the brain. In the case of flashbacks (either emotional or typical), the amygdala sends signals to the body as if it is in danger — even if there is no real threat, merely a perceived one years after the trauma.

Pete Walker, M.A., MFT, calls emotional flashback events ‘amygdala hijackings’ because the sufferer, in present day, is re-experiencing the way it felt during the frightening, confusing and abandoned feelings-states of childhood,” Walden explained.

Walden said when the brain’s amygdala, or fight-or-flight response, is “hijacked,” a person’s traumatized feeling state takes hold and casts a distorted shadow over your current reality, almost like a dark emotion cloud rolling in overhead.

For example, if someone was sexually abused as a child, they might experience an emotional flashback seeing their current loving partner and co-parent touch their child in a non-sexual way. Despite rationally knowing their partner touched their child in an acceptable way, the experience may trigger past feelings of confusion, abandonment or general lack of safety.

When past trauma feelings are triggered in this way, Walden said although the individual in an emotional flashback might desire nothing more than to be loved and cared for, they might pick a fight with their partner based on their current (but past trauma) feeling that no one can be trusted. They might believe their partner is out to cause them (or their child) emotional harm, even when there is no evidence in reality to support that.

So what does it actually feel like to be in the midst of an emotional flashback? The answer will vary from person to person, but Mighty contributor LC wrote about her experience in her story, “What It’s Like to Feel an ‘Emotional Flashback.’” Her story can give you a better understanding of what it’s like to feel trapped in a traumatic emotional state. She wrote:

I can’t shake the anxiety; something awful is about to happen, surely. But nothing comes, nothing happens. I feel it in every inch of my body, stomach flipping over, chest tight, breathing shallow. I get frustrated; I just want how I’m feeling to stop. I try to go back to sleep, to shut out the overwhelming foreboding haze. But I can’t sleep; my body is in fight or flight mode…

I’m not having any visuals with this flashback, but the emotions surrounding it are extreme. Panic, fear, loneliness, abandonment, loss of control, infinity thinking (this will never end), and so much emotional pain tries to break through.

If you struggle with or have experienced emotional flashbacks before, you’re not alone and there is help available. For information on types of therapy that can be helpful for trauma survivors, head here. For more on C-PTSD and emotional flashbacks, check out the following stories from our Mighty #TraumaSurvivors community:

Originally published: June 12, 2019
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