Trauma memory is
stored very differently to regular memory. Significant
trauma memory has not been processed. It is stored in the
limbic right side of the brain managed by the amygdala. It
is stored in affective and sensory fragments (sight,
smell, sound, taste, touch).
There is a difference between
simple forgetting, denial, repression and dissociation.
"We must learn to
distinguish among: not remembering (simple forgetting), burying
memories (repression), and, never consciously knowing
whole of a memory (traumatic dissociation)".
Trauma and its aftermath can
have a profound long term psycho-neurobiological impact upon
the trajectory of the developing brain.
Trauma memory that has not
been processed in the usual way is encoded with an
activated limbic system and stored in the right side of the
brain in a ‘state dependent way’. This traumatic event
memory is unavailable to conscious attempts at remembering
because the material has never been ‘processed’. The cortico-hippocampal region or the ‘processor’ in the
temporal lobe of the brain is inhibited in its functioning
at the time of the trauma whilst, it seems, that the
limbic, more primitive area of the brain responsible for
amongst other things affective and sensory functioning, is
fully operational and therefore encodes the incoming
signals. These signals, (flashbacks are then
interpreted by the left side of the brain attempting to make
sense of the incongruent somatic, sensual, and affective
fragments) are often re-experienced much later,
sometimes, years, when a similar level of emotional arousal is
felt. These flashbacks are usually a combination of emotions
and body feelings, and the experience of them can be quite
overwhelming. The re-experiencing of this old traumatic
material, does open up a second chance to more completely process the trauma. Whilst
trauma material remains stored, unprocessed, in the
right side of the brain it is not able to be understood or
consciously retrieved. The ability to make conscious sense,
or articulate the traumatic event through words is limited
as these are left hemisphere processes. Trauma memory often
emerges as pictures, sounds, taste, smell, somatic and/or
emotional states .i.e., it is stored in the ‘state’ of
arousal. State dependent memory when triggered is usually
fragmented and those fragments can be experienced as if the
traumatic event was ‘just happening’ in the present time.
(abreaction). The lack of cortico-hippocampal involvement in
the original processing and in the consequent retrieval of
the ‘state dependent trauma memory’ means that there is no
or little ‘localization in time’ or ‘date stamp’ on the
memory. With no time orientation the memory may be
experienced as just happening, which is very confusing for
the trauma survivor.
Managing flashbacks is
achieved by reducing arousal, re-orienting the self in the
present, acknowledging the feelings from the past and naming
FLASHBACKS, AND INTRUSIVE
How are flashbacks different
from intrusive thoughts?
First of all, flashbacks
are not thoughts. They are perceptual experiential
i.e., imagistic, sensory (sight, sound, smell, taste,
touch), and emotional. (right brain experiences) Thoughts
involve both language and
awareness-of-the-self-that-is-thinking. Both of these
may be lost during flashbacks.
'Intrusive thoughts come
to us already formed into language. Flashbacks don't.
Flashbacks lie outside of language.
With normal intrusive
thoughts, there is always a clear connection between self
and the intrusive thought. We own that thought and
accept it as mine. The 'therapeutic' work that needs
to be done with intrusive thoughts is to fit that
major life event - and its personal implications - into our
understanding of ourselves and our world to this new idea.
"I need some time to wrap my mind around this."
Flashbacks are fragmented
images, sensations, and affects. The 'therapeutic work' for
a flashback to finally stop involves bringing those
fragments into language. We must make the right and left
brain connections, i.e., develop a narrative of what
from Dell, P)
Protocol for Management of
(somatic and affective memory)
First begin to count
backwards from 100 to zero by whatever is slightly difficult
eg: by two's three's seven's etc. You will need to
concentrate for this task to work. Each time you get off
track go back to 100 and start again. As your physiological
arousal reduces you will be ready to begin the protocol.
Identify what is happening
in your body, ie: I am feeling, seeing, sensing,
tasting, smelling (name the sensations)..........
Identify what emotions
your are experiencing, ie: anxiety, fear, terror,
sadness, anger, guilt, shame (name
it)..........(whatever the identified emotion is.....
assume an opposite body posture ie: 'anxious', stand
with hands on hips, then continue with the protocol in
this new body posture)
I am remembering (name the
traumatic incident in two words only) - eg: the rape,
the abuse, the day..........
past and present: Whilst I was sitting here (where, eg:
bedroom - name, place).......... I am..........years
old, the year is..........I can see (describe
I am wearing
(name...........) I am allowing myself to remember what
happened then .......... (name the trauma)
I choose to validate my
survival of the past experience: (the trauma..........it
was terrible, then, but it is not happening now. I am
here (name where)..........remembering my
powerlessness back then. I am in control now.
I choose to tap my feet left / right right / left
right / left
Count backwards from 10 to
zero whilst slowly breathing in and out
Self injunction: I
choose to be safe, I choose to be present with
myself and my reality
I am here, feeling my feet
on the floor
I am OK, and it is OK, to
be here and aware in the present feeling sad about my
past. IT WILL PASS. I have a future.
This work is very useful done
on a gym ball.
(Linda Bearup: adapted from
Babette Rothschild 2000)