Understanding and Working with Flashbacks, Part Two

Using Flashbacks to Re-story Trauma

Posted Jul 01, 2015

Source: Photo: 123RF/arcoss

In Part One of this series, we explored the dynamics of sensory, environmental, and interpersonal triggers and how they can quickly put our clients into flashbacks that are experienced emotionally, visually, cognitively, and somatically. We processed some basic ways to help clients reground and reorient to the present, in part so they can reclaim feelings of genuine control, short circuit an age regressed state, and leave sessions with the ability to function effectively in the outside world.  This week, I’d like to focus on the clinical strategy of actually using a flashback experience to therapeutically “re-story” a traumatic event in an effort to help clients resolve it and deepen their healing.

When working with clients to re-story or change the experience of their flashbacks, it’s most effective to use the technique when you have discussed it in advance.  Walking clients through the process ahead of time ensures that you have emotional and cognitive buy in and gives the client a beginning sense of hope and empowerment regarding their flashbacks.  As is the case with other strategies, when “re-storying” has been discussed and even rehearsed in advance, it increases the likelihood that the client can more easily access the resource when it's really needed and the availability of the pre-frontal cortex is potentially compromised.

Here are some of the steps that can be incorporated into the exercise.  The strategies I use have been inspired by the work of Milton Erickson.  As the client begins to go into flashback, suggest that they have the ability to distance from the experience by putting it on a movie screen, Ipad, or laptop. Encourage them to “observe” the flashback rather than “participate” in it.  Then invite them to “freeze” the scene right before the actual victimization or scariest part occurs. I like to suggest that they have a remote control enabling them to freeze, fast forward, mute, zoom in or out, or turn off the image completely. This heightens their sense of control.  Once they have “frozen” the image, I encourage them to associate it with a color or colors. Typically, clients connect the worst part of the image with darker colors, but whatever they choose is fine. 

Next, ask them to imagine that they have the ability to re-story or change the outcome. They can “rescue” themselves by bringing any compassionate, loving person into the visualization including themselves as a healed adult, the therapist, a super hero, a pet, or any remembered resource that cares about them. Allow them to fully experience being extricated from the painful event.  Many clients also use this as an opportunity to let the perpetrator know how much they have been hurt.  Then encourage them to bring the victimized or wounded part to a “safe place” inside.  Build on this by installing positive affirmations that undo cognitive distortions including, “It was my fault, or ” I should have stopped it.”  As they experience the comfort and healing of being rescued, ask them to associate that with a color or colors.  Invariably, the colors become brighter and more soothing.  They can also notice somatic sensations as well.

This process isn't about pretending the trauma didn’t occur, but it does create the opportunity for the installation of compassion, cognitive re-frames, somatic release, and a newfound sense of empowerment.  When clients learn to use this strategy it makes them less afraid of their flashbacks, giving them a concrete and healing way to address them in the future. 

Missed Part One of this series? Click here. >