Using Present Moment in Self-Therapy & CPTSD Flashback Management
Emotional flashbacks are the most prominent symptoms of complex PTSD (C-PTSD). Just as PTSD visual flashbacks bring back the past experiences, so do emotional flashbacks in complex PTSD arise as a response to real-time triggers that bring back the emotional memories from the past. In both conditions, an individual interprets and experiences the present situation as if it was a traumatic situation from the past.
Recovering from CPTSD involves healing on multiple levels: bodily, emotional, relational, and mental. Some of the recovery work must be performed on the relational level, either with a skilled therapist or someone we can trust (e.g. friend, partner, fellow C-PTSD survivor). This is because the root cause of this condition is an unhealthy pattern of relationship that occurred in childhood – e.g. abandonment, emotional deprivation, emotional abuse. When we are recovering, there are parts of our mind that will only activate when we engage in relationships – and so the need for another individual to help us bring forgotten parts of ourselves.
Other half of the recovery is based on self-therapy or simply self-healing. Throughout the recovery, we're not only building healing relations with others, but also with ourselves. CPTSD affects us on all levels, some of which can be accessed without the assistance of others. For example, engaging in various forms of bodily healing such as dancing, yoga, or sports will support us in recovering our relationship to our bodies. Mindfulness and remaining present will assist us with coping with dissociation, emotional dysregulation, numbness, and building self-awareness and understanding. Developing supportive internal dialogue will help us to rebuild our self-esteem, self-image, inner strength and inner resources.
Therefore, managing emotional flashbacks can be performed by using both approaches: relational and individual. In other words, we can work through flashbacks with an individual we trust (e.g. friend, therapist), or we can engage in the self-therapy process. From my own experience, both approaches are needed to build necessary resources for the recovery. In particular, relational healing should be performed first in order to provide us with a secure frame of reference we can go back to when engaging in self-therapy work. CPTSD often causes us to mistrust ourselves, makes our mind quite chaotic, and reduces our inner strength and esteem almost to zero. Self-therapy might be difficult in such situation, so building some inner security through relational healing might be necessary.
In this article I will describe a simple method of flashback management based on cognitive-behavioural psychology. It's intended for people who have performed at least some of the recovery work and are at the stage of having some understanding of their condition. That it not to say that people early in recovery won't benefit from this technique, but in order to use it – there needs to be a healthy, stable and secure part of the mind that is no longer affected by trauma.
What is cognitive-behavioural psychology? The major premise is that our thoughts, emotions and behaviours are connected and by influencing one, we can change the other. Second, we are ruled by our schemas and beliefs. Our thoughts, emotions and behaviours are driven by how we interpret our experience. For instance, if I believe (either consciously or unconsciously) that I am worthy and competent, I will arrange my life in a way that fits this interpretation.
A large part of cognitive-behavioural approach is based on building skills of self-awareness, self-regulation, and autonomy. An important part of this process is becoming our own therapists or coaches by learning how to manage our emotions, thoughts and behaviours (mental mastery).
Using this theory is particularly helpful in flashback management because it offers us a way of interpreting and understanding our experience. If we break down the emotional flashback, we can see that it is composed of several elements:
A. Trigger – what's triggering the flashback, why is it arising, what are the causes, how did it develop
B. Reaction – what are we feeling during the flashback, what are our thoughts and beliefs, how do we interpret our experience in that moment
C. Consequences – how will we act as a result of our reaction (e.g. avoidance, approach, compensation / fight, flight, freeze or fawn).
Emotional flashbacks can cause us to behave in ways we are not particularly proud of. For example, being criticised on a business meeting can send us on an emotional trip where we start experiencing the present moment as if it was a childhood situation of being abused by our father. As a result, we might freeze, leave the meeting abruptly or start lashing out on people. Not very productive behaviour for an adult.
From the above example, we can see that the reaction is driven by the schema that then triggers thoughts, feelings and responses to the experience. A schema involves a cluster of beliefs about ourselves, others and the situation in general (e.g. I'm being criticised so I must be useless and because of that, I will be abandoned. And so, I must run before that happens).
In order to address the flashback and reinforce new schemas we need to work with our self-awareness and ability to stay present. I broke down the flashback management into four steps:
1. Observe
Knowing that you are in the emotional flashback is the key. Stay present and observe your emotions: what are you feeling, why, what has triggered the feelings, what are you thinking.
2. Express
Journaling can be particularly helpful in self-therapy. Write down everything you can about your experience. Talking aloud can work too if you are not a fan of writing. The point is to vocalise it in coherent manner. Very often, emotional flashback is experienced by the part of ourselves that is very young. Providing our inner child a method of expressing its pain is extremely important in making it feel safe and heard.
3. Understand
How can you make sense of your experience? What is really happening? You are experiencing a flood of feelings and emotions – where are they coming from? What is the cause of them? What's the situation from the past (childhood) that they are connected to?
Notice the difference between the current situation that has caused you to feel in a particular way and compare it to childhood situation where you felt exactly the same. Can both situations be interpreted in exactly same way? Are you the same person with the same resources and strength as you were in childhood?
Positive and encouraging self-dialogue is particularly helpful at this stage. CPTSD survivors are often overwhelmed by a powerful inner critic and so challenging and replacing hateful or helpless self-talk is crucial to building safe and healthy mental state.
4. Bring yourself to the present moment
Now that you understand your experience thoroughly, go back to the present moment. Although you can't change your past, what can you do differently now? Is there an alternative way of interpreting your experience? What resources can you use to manage the distressing situation?
If performed correctly, the above steps will support you in getting outside the emotional flashback and reduce distressing emotions. Bear in mind, the process is not always linear and you might need to revisit earlier steps in order to understand your situation thoroughly.
Flashback management is about self-care and doing everything you can to comfort yourself in a manner that's consistent and healthy, in contrast to following familiar coping strategies which are not supportive to your growth.
Supporting video on Schizoid Personality Disorder & CPTSD
** Disclaimer: The article has been written by a coach and should not be treated as a substitute for therapy. If you are in distress, please contact your local mental health services. **