What Are Flashbacks?

Understanding Trauma and How Therapy Can Help

Flashbacks are a common experience for people who have endured trauma and are often linked to post-traumatic stress disorder (PTSD). They feel like vivid, intrusive replays of a past event, making it seem as though the person is reliving the moment. These episodes can be distressing and disruptive (American Psychiatric Association, 2013).

This blog explores what trauma is, why flashbacks occur, how they show up, and how therapy can help.

What Is Trauma?

Trauma is an emotional and psychological response to deeply distressing or overwhelming events that surpass a person’s ability to cope. Examples include abuse, accidents, violence, or natural disasters (American Psychiatric Association, 2013).

Trauma affects the brain, particularly areas involved in memory and emotional regulation, like the amygdala, hippocampus, and prefrontal cortex. These changes can lead to heightened emotions, hyper-vigilance, and intrusive symptoms such as flashbacks (van der Kolk, 2014).

What Are Flashbacks?

Flashbacks are intense, involuntary memories that feel as though they’re happening in the present. Unlike typical memories, which are recognised as events from the past, flashbacks can involve powerful sensory and emotional experiences, making them feel real and immediate (Brewin, Gregory, Lipton, & Burgess, 2010).

Types of Flashbacks:

1. Full Flashbacks: A complete immersion in the traumatic memory, with a sense of losing connection to the present.
2. Partial Flashbacks: Resurfacing of specific elements of the memory, such as an image, sound, or emotion, without full immersion (Brewin et al., 2010).

Why Do Flashbacks Happen?

Traumatic memories are processed differently than everyday memories. The brain’s normal memory system becomes overwhelmed during trauma, leading to fragmented or unprocessed memories (Ehlers & Clark, 2000).

Key factors include:

• Amygdala Overactivation: The amygdala, the part of the brain which detects threats, becomes hyperactive during trauma, making the memory feel emotionally intense and storing it as a danger signal (van der Kolk, 2014).
• Hippocampal Impairment: The hippocampus, the part of the brain responsible for organising and contextualising memories, may not function properly, leaving memories disorganised and fragmented (Brewin et al., 2010).
• Trigger Sensitivity: Flashbacks are often activated by sensory or emotional reminders of the trauma, like sounds, smells, or specific situations (Ehlers & Clark, 2000).

How Do Flashbacks Manifest?

Flashbacks vary in intensity but commonly include:

• Sensory Experiences: Vivid sights, sounds, or smells tied to the trauma.
• Emotional Flooding: Overwhelming feelings such as fear, anger, or helplessness.
• Dissociation: Feeling disconnected from the present, as though being “transported” back to the event (Shapiro, 2017).

These episodes can disrupt daily life, leaving individuals feeling unsafe or out of control.

How Can Therapy Help?

Therapy is a key tool for managing flashbacks and healing from trauma. With professional guidance, individuals can process unprocessed memories, manage triggers, and regain control.

Evidence-Based Interventions:

1. Trauma Processing

• • Therapies like Eye Movement Desensitisation and Reprocessing (EMDR) and Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) help reprocess and properly store traumatic memories, reducing flashbacks (Shapiro, 2017).

2. Identifying and Managing Triggers

• • Therapists work with clients to identify triggers and develop strategies to minimise their impact. Learning about the brain’s trauma response can also reduce the fear and stigma around flashbacks (Bisson, Cosgrove, Lewis, & Roberts, 2015).

3. Grounding Techniques

• • Grounding exercises keep individuals anchored in the present moment, helping to manage flashbacks effectively. Examples include:
    
    1. Sensory Engagement: Using touch, sight, or sound to focus on the present.
    2. Cognitive Grounding: Naming objects around you or repeating a calming phrase.
    3. Mindfulness Practices: Staying non-judgmentally aware of the present (Linehan, 2015).

4. Emotional Regulation

1. 1. Skills from therapies like Dialectical Behaviour Therapy (DBT) and mindfulness approaches can help manage the intense emotions that flashbacks often bring (Linehan, 2015).

5. Building Self-Compassion

1. • Therapy encourages kindness toward oneself, helping reduce feelings of shame or guilt connected to the trauma (Germer & Neff, 2013).

Moving Forward

Flashbacks can feel overwhelming, but they are a natural response to unprocessed trauma. With the right support from a Clinical Psychologist, it’s possible to reduce their intensity, regain control, and live fully in the present.

Healing takes time, but reaching out for help is the first step toward reclaiming your sense of safety and well-being.

If you would like to learn more about how therapy can help with trauma and flashbacks, feel free to reach out to us at Fortitudo Therapy.

Related reading

• What is EMDR? — A deeper look at one of the main NICE-recommended treatments for trauma.
• What is a Clinical Psychologist? — What a Clinical Psychologist does, and how to find one who is properly qualified.
• Why Do I Overthink Everything? — Why post-traumatic worry and rumination so often go together.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Bisson, J. I., Cosgrove, S., Lewis, C., & Roberts, N. P. (2015). Post-traumatic stress disorder. BMJ, 351, h6161. https://doi.org/10.1136/bmj.h6161

Brewin, C. R., Gregory, J. D., Lipton, M., & Burgess, N. (2010). Intrusive images in psychological disorders: Characteristics, neural mechanisms, and treatment implications. Psychological Review, 117(1), 210–232. https://doi.org/10.1037/a0018113

Ehlers, A., & Clark, D. M. (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy, 38(4), 319–345. https://doi.org/10.1016/S0005-7967(99)00123-0

Germer, C. K., & Neff, K. D. (2013). Self-compassion in clinical practice. Journal of Clinical Psychology, 69(8), 856–867. https://doi.org/10.1002/jclp.22021

Linehan, M. M. (2015). DBT skills training manual (2nd ed.). Guilford Press.

Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Press.

van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Penguin Books.