Complex Post-Traumatic Stress Disorder (CPTSD) is a condition that can develop after prolonged exposure to trauma, especially during early life. For a more detailed explanation of CPTSD and how it differs from PTSD, check out this blog here.

One of the symptoms that can be the most debilitating when it comes to CPTSD is the flashback. Let's explore the CPTSD flashback together, then discuss how what you can do to manage it.

CPTSD Flashbacks

What is a CPTSD Flashback?

A CPTSD flashback is a sudden, involuntary re-experiencing of past traumatic events AND the emotions that occurred at the time. Unlike PTSD flashbacks, which often involve a clear sensory re-living of traumatic events, CPTSD flashbacks are commonly emotion-based.

This means that rather than re-seeing what happened, you may not see or hear the trauma but rather feel the same way you did in the trauma.

If your traumas made you feel helpless, fearful, ashamed, sad or angry, you may suddenly be feeling this way again, very intensely, but not know what memory or trauma this feeling comes from. This is called an Emotional Flashback.

Emotional Flashbacks

Emotional flashbacks are particularly common in CPTSD; The European Journal of Psychotraumatology reports that about 70% of folks with CPTSD experience frequent emotional flashbacks, with some research suggesting that they occur more often than visual or auditory flashbacks for those with CPTSD. During an emotional flashback, you may feel small, helpless, and overwhelmed, as if you are a child again experiencing the trauma. These flashbacks can be triggered by seemingly innocuous events, making them hard to predict and manage.

How to Identify a CPTSD Flashback

Because there is often no auditory or visual component to the CPTSD flashback, they can often be missed, with folks assuming they are experiencing an emotion in the present, rather than an emotion from the past. As such, the first step to managing a flashback is to identify that you are indeed having one.

Signs you might be experiencing a CPTSD flashback:

• Sudden Onset of Intense Emotions: If you suddenly are experiencing a very intense emotional response, one that may be larger than the situation at hand, you are likely having a flashback.

• Physical Reactions: If your body is responding as thoguh you are in danger, inclduing rapid heart rate, shallow breathing, difficulty thinking clearly, muscle tension and sweating, this may be signs of a flashback.

• Dissociation: Do you suddenly feel disconnect from your body, surroundings and thoughts? Some folks describe dissociation as a sense of floating beside themselves.

• Behavioral Changes: Suddenly acting in ways that are uncharacteristic or regressive (e.g., childlike behaviors).

• Negative Self-Perception: Sudden, intense feelings of worthlessness, unworthiness or self-blame.

If you suddenly feel an intense emotion and cannot identify why, but know you have felt this way before, it is safe to assume you are having an emotional flashback and to follow the flashback protocol. For those who may be worried, note that it will not harm you to use the emotional flashback protocol if you are not having an emotional flashback!

Common Triggers for CPTSD Flashbacks

Identifying the cause, or trigger, of a flashback can be very hard. Triggers are any stimulus that reminds your nervous system, in some way, of the traumas. Literally anything that reminds your system of the trauma can become a trigger, so it is not always possible or even advised to search for the trigger. Instead, it is usually more efficient to process the trauma itself, which causes the trigger to dissipate.

That being said, some folks find it helpful to understand possible triggers. Some common categories include:

Sensory Triggers

• Sights: Certain visual stimuli, such as specific places, objects, or people, can trigger a flashback.

• Sounds: Specific sounds, like loud noises, music, or voices, can bring back traumatic memories.

• Smells: Scents associated with past trauma, such as a particular perfume, food, or environment, can provoke a flashback.

• Tastes: Certain flavors linked to traumatic events can trigger emotional responses.

• Touch: Physical sensations, such as specific textures or being touched in a certain way, can act as triggers.

Emotional Triggers

• Stress: High-stress situations can increase vulnerability to flashbacks.

• Conflict: Arguments or confrontations can bring up past feelings of helplessness or fear.

• Emotional Overwhelm: Intense emotions, whether positive or negative, can trigger a flashback.

Situational Triggers

• Anniversaries: Dates or seasons associated with traumatic events or abusers can trigger flashbacks.

• Similar Situations: Environments or circumstances that resemble the traumatic event can act as triggers.

• Media: Exposure to media depicting violence, abuse, or other trauma can provoke flashbacks.

Remember that you do not need to be able to understand what triggered an emotional flashback in order to manage it.

What to Do During a CPTSD Flashback: A Step-by-Step Guide

If you are experiencing a CPTSD flashback, try this Flashback Halting Protocol, developed by Babette Rothschild (2000) and modified for the emotional flashback.

Say the following sentences filling in the blanks, following the instructions:

• Right now I am feeling ______ ,

(name the current emotion, usually fear or shame)

• and I am sensing in my body ______ ,

(describe current bodily sensations in detail),

• because I am remembering ______ .

(name the trauma by title, no details i.e. my childhood, my abusive ex partner, etc).

• And, at the same time , I am looking around where I am now in ______ (say the year),

• here ______ ,

(name the place where you are)

• and I can see ______ ,

(describe some of the things that you see right now, in this place),

• and so I know ______ ,

(name the trauma again)

is not happening now/anymore.”

• Repeat as many times as needed until you remember where you are and when.

TIP: If you are struggling to name the trauma, because you cannot connect the emotional flashback to when it happened, try simply saying “my past”.

Additional Ideas

Some folks find that shocking their senses, in a safe way, can be very helpful to pull them out of a trigger. If this sounds right for you, consider trying:

• Dunking your face in a bowl of ice water

• Holding your breath as long as you can then taking long, slow breaths; repeat as needed

• Having a hot shower

• Holding ice to sensitive parts of your body, such as your armpits

Seek Support: Reach out to a trusted friend, family member, or therapist. Talking about your experience can provide relief and support.

Professional Help: If flashbacks are frequent and debilitating, seeking help from a mental health professional specialized in CPTSD can be beneficial. Therapies such as EMDR (Eye Movement Desensitization and Reprocessing), somatic experiencing, and parts work therapy can be quite effective for CPTSD.

Additional Strategies for Long-Term Management

While the in-the-moment guide is essential, long-term strategies can also help manage CPTSD flashbacks:

• Trauma Therapy: Consistent sessions with a trauma therapist can help process past traumas and reduce the frequency and intensity of flashbacks.

• Mindfulness and Meditation: Practicing mindfulness and meditation can enhance your ability to recognize flashbacks and manage them when they occur.

• Healthy Lifestyle: while it’s been said lots before, the truth is that maintaining a balanced diet, regular exercise, and adequate sleep can improve overall mental health and resilience, leading to less flashbacks.

• Build a Support System: Even if they don’t really “get it”, connecting with others increases resiliency and improves mental health, leading to better emotional management.

Conclusion

CPTSD flashbacks, particularly emotional flashbacks, can be overwhelming and distressing. Recognizing the signs and having a concrete plan to manage them can make a significant difference. By acknowledging the flashback, grounding yourself in the present, and seeking support, you can navigate through these challenging experiences.

Remember, professional help is always available and can provide assistance that is tailored to your specific needs.

If you or someone you know is struggling with CPTSD flashbacks, WellMind Counselling is here to help. They offer both in-person sessions in Kamloops, BC and online therapy to all of British Columbia to support your healing process.