Tuesday, March 2, 2010

How to Handle Bad Flashbacks

Everybody has bad flashbacks from time to time. For years I've had multiple bad flashbacks every hour, every day. During my therapy I questioned whether this was normal or excessive, and I got very different answers depending on which counselor I talked to, so for now I feel that nobody really knows.

But over the last year or so I've combined many of my DBT skills and found a way to deal with them that actually works for me. I can honestly say the number of bad flashbacks I've had has decreased since I've started doing this, and the impact each one makes on my present moment is seriously reduced.

For me it's important to understand why something is the way it is, so here's some important background information first.

1. What's the difference between a bad flashback and a bad memory?
Bad memories are filed away nicely in the memory banks. Usually the pain is already dealt with unless you deliberately choose to start looking at it again, even though you might still be working through the after-effects of the event that caused the bad memory.

Bad flashbacks, on the other hand, are little landmines laid all around your brain. They strike when hit by a trigger, which can be any little thing on the outside world or any stray thought in your mind. You don't know when they're going to show up, and when they do they blast you with the full emotional impact of a punch in the gut. The pain can be just as bad as the moment it first happened, or even worse because it's been piled on over time.

2. Why do bad flashbacks happen more than good ones?
You'd think the good ones would be what the brain wants to keep, right? Not necessarily. The bad flashbacks start out as a trauma. The trauma doesn't need to be big-- it can be a small moment of embarrassment, regret, guilt, social mistakes, regretting what you said or didn't say, etc. The good moments move through the brain easily, because they're harmless, hopefully leaving good memories. But the bad moments inflict a small trauma as they pass through the brain. And like any other trauma to the body, it leaves a scar. Bad flashbacks are scars in your brain.

3. If it's in your mind, it's real to the mind.
Whatever emotion you're feeling, it's totally real at that moment, and it doesn't matter if that emotion was based on a current event or on a memory. So when flashbacks hit, you are reliving that exact moment.

Constantly reliving those small moments of guilt, embarrassment and regret over and over can make them pile up and lead to self-loathing. So I think it's very important to find a way to understand them.

Now, understanding that, here's what I do when one rears its ugly head.

1. Validate that it has upset me.
Trying to repress them often makes them worse. However, this is the natural first reaction to a bad flashback, because we don't want to face the pain they bring. So without dwelling on it, I simply acknowledge to myself, "Okay, that hurt."

2. Look at it in a non-judging manner.
I try to remove any emotional value from the memory. It's not bad or good; it simply happened. Remember that if it's in your mind, it's real to the mind, so by removing the emotional value of "good and bad" or "right and wrong," I'm left with just the facts of the event and can look at it in a more detached manner.

3. Reverse the roles
I find it much easier to forgive other people than to forgive myself. So I look at the event replacing myself with someone else. If the transgression was with a friend, I put the friend in my place and think "What if my friend had done that to me instead?"

Please note that this is different than putting me in my friend's place. Guilt usually comes because we've upset someone. I believe that flashback guilt comes from a certain degree of mindreading: yes, we've upset them, but did we really upset them so badly that we should still be this upset about it years later? Did I truly devastate my friend because I bought the last donut? Probably not. But I felt so bad about it that it's grown out of control. So I chose to look at it from my current perspective of "what if my friend bought the last donut today?" Usually I find I wouldn't care, or I could forgive him easily.

4. Transfer that forgiveness back to yourself.
This sounds hard, but it gets easier with practice. Holding that forgiveness in awareness, focusing all my attention on it, I allow the roles to slip back to how it really happened. And I allow the forgiveness to settle back into the memory. I choose to forgive my younger self in the exact same way that I chose to forgive the mistakes my friends have made.

5. What would I do today?
If I could Quantum Leap back into my younger body at that exact moment, how would I handle it differently? In the case of the donut, I'd say "Wow, I'm sorry man. Let's stop over at the other store, I know they sell donuts there too. I'll treat." Showing myself how I would handle the incident completely different now drives home to my mind that I've grown and I've learned from my mistakes. It lays down a new pathway for my mind to follow if that particular flashback hits me again.

I realize that these steps can sound difficult, and it's not something that immediately works over night-- like everything else I've learned in DBT, it's a skill, and the more I've worked on it and practiced it the better it's gotten for me. It's made a huge difference in my life.

I can't swear that this will work for everyone, but everyone I've talked to has told me that get bad flashbacks too, and no one's ever told me of a way to deal with them. So I couldn't keep this to myself. I hope it helps some!