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TRAUMA AFTERMATH: Memory (Flashbacks)

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 intact memories (repression), and, never consciously knowing the whole of a memory (traumatic dissociation)". 'Calof. 1995'.

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 them.

FLASHBACKS, AND INTRUSIVE THOUGHTS:

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 happened. (adapted from Dell, P)
 

Protocol for Management of flashbacks
(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.

  1. Identify what is happening in your body, ie: I am feeling, seeing, sensing, tasting, smelling (name the sensations)..........

  2. 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)

  3. I am remembering (name the traumatic incident in two words only) - eg: the rape, the abuse, the day..........

  4. Differentiate, separate past and present: Whilst I was sitting here (where, eg: bedroom - name, place).......... I am..........years old, the year is..........I can see (describe surroundings)..........

  5. I am wearing (name...........) I am allowing myself to remember what happened then .......... (name the trauma)

  6. 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

  7. Count backwards from 10 to zero whilst slowly breathing in and out

  8. Self injunction: I  choose to  be safe, I choose to be present with myself and my reality

  9. I am here, feeling my feet on the floor
    (tapping feeling.........thinking..........seeing..........

  10. 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)

 

 

Lindy Bearup lindybearup@gmail.com
 

Moonyah acknowledges that we work on the land of the Wurundjeri Traditional owners.

 

"Yesterday is already a dream and tomorrow is only a vision,
but today well lived - makes every yesterday a dream of happiness and every tomorrow a vision of hope"
old Sanskrit proverb.