What is trauma?
Trauma typically refers to the experience and psychological impact of events that are stressful, out of our control, often threatening or involving a threat of danger or injury. It can be a single event or prolonged and ongoing. We do not all respond the same way to trauma. Our response to a traumatic event can vary along a continuum, from transient all the way to acute stress disorder, PTSD and Complex PTSD.
Not everyone develops post traumatic stress related symptoms - why?
Risk factors for the development of trauma related symptoms following exposure to trauma are best understood under three categories: pre-trauma, peri-trauma and post-trauma factors.
Research shows that there are a variety of pre-trauma vulnerabilities that may predispose or increase your risk to developing such symptoms. For example, research shows gender, poverty, level of education, prior coping strategies, personality factors, previous experience of trauma, previous psychiatric history, family psychiatric history and level of preparedness can serve as potential risk factors (e.g., Risk Factors for the Development of Psychopathology Following Trauma | Current Psychiatry Reports (springer.com)).
Peri-trauma refers to the nature, duration and severity of said trauma. For example, rape, war and childhood abuse are amongst the highest rates of PTSD (Posttraumatic stress disorder in the National Comorbidity Survey - PubMed (nih.gov)). Furthermore, the type of trauma can influence risk levels, traumatic events that are interpersonal (premeditated, planned, and caused by others), for example, sexual abuse, have an increased risk compared to traumatic events that are impersonal (for example, earthquake) or an accident. Another important consideration is whether the exposure to the trauma is cumulative or additive (e.g., Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. (apa.org)).
Post-trauma factors includes access to appropriate support and resources, including social support, psychological and physical safety, and sense making from the trauma (e.g., Understanding the Relationship of Perceived Social Support to Post-trauma Cognitions and Posttraumatic Stress Disorder - PMC (nih.gov)).
What are flashbacks and intrusive memories?
A flashback is part of the brain's way of working to process the trauma so that the experience can be filed away as a past memory (rather than a current threat). When we have experienced a traumatic event, sometimes, it is not processed and put away neatly. This is because parts our brain that are responsible for processing memories (for example, our hippocampus) can be overridden and essentially "turned off" in the context of threat due to our brain's alarm system (our amygdala). Trauma memories are a bit like items stuffed in a messy cupboard (I am sure we all have one of them at home, I know I do!). Whenever you brush past the dreaded stuffed cupboard, the door flies open and items fall out. Just like that, when you experience a reminder of the trauma, you have flashbacks or intrusive memories, and can often experience the same sense of emotional distress you did back then. Understandably, we may want to push it all back into the cupboard and to close it as quickly as possible, dismissing and pushing our traumatic memories away. However, as we all know, that cupboard door will just keep opening, even at the lightest touch. In accessing psychological support for trauma, you can begin to explore what is within the cupboard, fold them neatly and place them back into the right place.
The most important first step when dealing with trauma, is helping your mind, nervous system and body be grounded into the present and to feel safer by using grounding techniques.
Grounding skills
Grounding skills are useful in helping you cope with flashbacks. These techniques are used to help you re-connect your mind, nervous system and body to the present. It is important to find the right grounding skill for you. While it may involve some trial and error, don't give up! Reaping the benefits is well worth the effort. Persevere, practice is key.
Grounding phrases/statements:
Grounding statements are there to help remind you that you are safe now. They can used to comfort you.
Use flashcards (perhaps coloured so they are easily identifiable) to note these statements.
My name is __________________________
I am __________________________years old
I live at _______________________________
I have X children. They are called__________
This is a flashback. I am safe now.
This feeling will pass
5 4 3 2 1:
The 5 4 3 2 1 technique aims to effectively flood your senses and re-orient yourself to the present.
Here is the how to:
Look around and name five things that you can see around you
Focus on four things that you can feel and touch them
Name three things that you can hear around you ~(maybe even having a certain song you like to listen too to help you connect)
Notice two things that you can smell around you right now
Focus on one thing that you can taste OR take one deep breath
Grounding objects:
Some people find it helpful to have an object that is personally meaningful, tangible and portable. It could be a photo, a smell (for example, a cloth with a fragrance). I personally use a stone from a beach. In preparation for the court case regarding my experiences, my husband sprayed a handkerchief with his aftershave. This is something I regularly use (expensive option I know!)
Use Ice or Lemon:
You may be thinking, have I just read to use ice or a lemon? Well, you will be forgiven for questioning. But, just like an intense flavour can ground you, a sudden cold of ice can jolt you out of anxiety and back to the present. Try holding an ice cube and take slow deep breaths as you feel the temperature in your hand. Perhaps hold it against another part of your body.
Have you ever bit into a lemon? Biting into a lemon during a flashback or a panic attack helps bring the mind's awareness back into the body and present moment.
Butterfly Hug:
The butterfly hug is a form of bilateral stimulation and is a highly effective tool in soothing your emotional state and to come back in to your body. Cross your arms over your chest, so that the middle finger on both hands is placed just below the collarbone, with your hands pointing towards the neck (it should look like a butterfly's body). Closing or partially closing your eyes (looking to the top of your nose), alternate moving your hands, like flapping the winds of a butterfly. Try to breathe slowly and deeply, whilst observing what appears in your mind and body almost as if you are observing clouds in the sky passing by.
Here is a helpful link to the skill: The Butterfly Hug (youtube.com)
Move your body:
Moving your body can be incredibly powerful in helping you come back to the present. You could consider:
Changing position - stand up, jump, skip, walk fast
Making sure your feet are firmly on the ground - notice how the ground feels beneath you
Use your support networks:
Share with your loved ones what may help and work for you if you experience a flashback. You may need their help. You could ask them to remind you of the day, date, time, season, year, where you are now. You may find that them asking you questions is helpful.
After a flashback:
Flashbacks can be extremely emotionally and physically draining. You will need to rest. I would encourage you to be kind to yourself and focus on soothing. You could soothe using your senses, for example:
Light: go for a walk outside, looking at nature, look at the different colours in the sky
Touch: touch something soft like a soft blanket, take a warm bath, slowly rub a moisturiser,
Sound: perhaps make a playlist of all of your favourite relaxing songs
Smell: some people like to smell of nature and breathing in fresh air, some people like a smell that reminds of them of happy times, some like to use candles or essential oil
Taste: eat a favourite food (treat yourself!), make a soothing drink.
Spend time working out what soothes you, you deserve it.