Living with post-traumatic stress disorder (PTSD) can be incredibly challenging, often bringing with it distressing flashbacks that pull you back into painful past experiences and trauma. PTSD flashbacks can have a negative impact on your day-to-day life, and can feel both unpredictable and uncontrollable.
Here, we’ll help you to understand what flashbacks are, share practical coping strategies and explore therapies that can help keep them at bay.
Understanding PTSD flashbacks
Flashbacks are one of the most vivid and disturbing symptoms of PTSD. They happen when an ordinary, everyday thing – such as a sound, smell, place, or even an emotion - triggers a sudden, intense re-experiencing of a past traumatic event. During a flashback, you might feel the same emotions and physical sensations you felt during the original event. You might find yourself acting as if you're back in that moment, experiencing everything just as vividly, as if it's happening all over again.
However, it’s important to note that flashbacks are just one form of intrusive symptom and don’t encompass every experience of re-experiencing trauma. Unlike other forms of intrusive memories, which can involve recalling distressing memories without fully reliving the event, flashbacks specifically involve a sense of being ‘transported’ back to the traumatic event.
Signs and symptoms of PTSD flashbacks
Recognising the symptoms of flashbacks is key to managing them. Here are some common signs to help you identify when you or someone else might be experiencing a flashback:
- Physical sensations – you might feel your heart racing, sweat breaking out, or your hands trembling. Some people might also feel physical pain or discomfort that were part of the traumatic event
- Reliving the trauma – this involves acting out or feeling as though you’re living through parts of the traumatic event again. This might include instinctive actions you took during the event, such as hiding or defending yourself
- Dissociation – feeling detached from reality or feeling as though the world around you isn’t real. You might feel disconnected from the present moment, even though part of you understands that you’re not actually in the past
- Hallucinations – also known as ‘trauma-related sensory experiences’, these involve the person experiencing intense sensory impressions (such as smells, sounds or visuals) that were part of the original traumatic experience
- Intense emotional responses – sudden, overwhelming feelings of fear, anger, sadness or panic, that seem disproportionate to the current situation
Coping strategies for immediate relief
When a PTSD flashback strikes, grounding techniques and sensory coping strategies can provide crucial immediate relief. These methods can help to anchor you in the present and lessen the intensity of the flashback.
Grounding technique: the five senses
- Sight – look around you and name five things you can see. Focus on details like colours, shapes or patterns
- Touch – pick up or touch four items near you. Describe their texture, temperature and weight. Notice the sensations in your hands
- Hearing – listen carefully and identify three sounds you can hear around you. It might be the tick of a clock, distant traffic or birds singing
- Smell – notice any scents in your environment. If possible, try to find two things with a strong scent, like a coffee bean or a scented candle, and breathe it in deeply
- Taste – sip a drink or eat a small snack. Focus on the flavours and the sensations in your mouth
Sensory coping tips
- Music – create a playlist of songs that you find calming and uplifting. Music can alter your mood and bring you back to the present
- Touch – keep tactile objects like a stress ball, smooth stones or soft fabrics at hand. Engaging your sense of touch can divert your attention from the flashback to something comforting instead
- Smell – aromatherapy can be very effective. Essential oils like lavender, peppermint or eucalyptus can have calming effects. Inhaling these scents during a flashback can help to soothe you. You could consider using roller bottles, or aromatherapy jewellery, such as necklaces and bracelets, which allow you to carry and use these calming scents wherever you go
While using sensory techniques can be highly effective for grounding during a flashback, it's essential to choose stimuli that are neutral or positive for you personally. If you suspect or know that certain smells, sounds, textures or sights are linked to your trauma, it's best to avoid using those specific senses and focus on others that provide comfort and safety.
Effective therapies and managing triggers
Flashbacks can have a profound effect on your mental health. Their intense and unpredictable nature can disrupt your daily life, making even routine tasks daunting as you fear you might trigger another episode. Experiencing flashbacks can also lead to feelings of distress, low mood and even shame or embarrassment.
If you’re diagnosed with PTSD, there are several effective treatments available that can make a significant difference. At Priory, our specialists will be able to discuss your options and recommend the most suitable support to address your needs.
Therapies
There are a number of therapeutic approaches that are effective in treating PTSD symptoms. Each therapy type can be tailored to help reduce the distress associated with traumatic memories.
Eye movement desensitisation and reprocessing (EMDR)
This innovative technique involves asking you to recall distressing images while receiving what’s known as bilateral sensory input, such as side-to-side eye movements or hand tapping. This process is thought to lessen the emotional impact of the memories over time, helping you to process your trauma in a healthier way.
Trauma-focused cognitive behavioural therapy (TF-CBT)
This form of CBT is specifically designed for people who’ve experienced trauma. It involves identifying and challenging unhelpful thinking patterns that are related to your trauma, as well as incorporating exposure techniques. During exposure, you’ll be gradually and repeatedly exposed to your traumatic memories in a controlled and safe setting. The primary goal of TF-CBT is to help you to reframe your thoughts and reactions to traumatic events, reducing the power of those memories.
Prolonged exposure (PE) therapy
PE involves repeatedly talking about your trauma with a trained therapist, and confronting things you’ve been avoiding that remind you of the trauma. It’s designed to help you process your trauma and reduce your fear.
Cognitive processing therapy (CPT)
CPT focuses on addressing and reshaping negative thoughts related to your trauma. During CPT, you’ll explore and restructure your thoughts through writing exercises and cognitive restructuring techniques. You’ll be asked to write about the traumatic event and the emotions you feel, to help you identify unhelpful beliefs. This process helps you replace distressing thoughts with more balanced and realistic perspectives, directly targeting the cognitive aspects of trauma recovery.
These therapies are supported by extensive research and are tailored to each person’s specific needs, helping you to manage your symptoms and improve your quality of life.
Trigger management
It's important to remember that trauma is unique to everyone, and so are the triggers that can cause flashbacks. Recognising and understanding your personal triggers is a crucial step towards managing PTSD effectively.
Some triggers are common among many people who experience PTSD, although your experience may vary. Sounds, smells, locations, people and anniversaries can commonly act as a reminder of your trauma.
A good way to keep track of your triggers is by using a trigger diary. A trigger diary is a log where you record details of each PTSD flashback, noting where and when it happened, and how you felt at the time. This log can be written down in a notebook, or recorded digitally, such as using the notes function on your phone. By tracking these incidents, you can identify any patterns and common triggers.
Once you identify what your triggers are, you can begin to work on strategies to manage them:
- Planning and preparation - if you know you're going to be in a situation where triggers might be present, it’s important to plan ahead. This could mean having a support person with you, practising grounding techniques ahead of time, or setting time limits on how long you’re there for
- Controlled exposure - gradually exposing yourself to the trigger in a controlled and safe environment, with the support of a therapist, can help reduce the power the trigger has over you. This is often done as part of trauma therapy
- Mindfulness and grounding techniques - when you’re faced with a trigger, practices like mindfulness can help to keep you anchored in the present. Techniques such as focusing on your breathing or engaging your five senses can help you manage your reactions to the situation
While these strategies can be helpful, it’s really important that you reach out to a mental health professional to help you to manage and overcome your flashbacks in the long-term. A specialist will help you to develop personalised strategies for coping with your unique triggers.
Accessing therapy
Therapy can be a transformative process, providing you with the tools to manage your PTSD effectively. At Priory, we’re committed to supporting you, ensuring you receive the personalised care you deserve.
As a first step, consider booking an appointment with your GP to discuss what you're experiencing. They can assess your symptoms and, if needed, refer you to a mental health specialist. Alternatively, you can reach out to Priory directly to learn about our PTSD treatment options. You'll receive an initial assessment from one of our PTSD experts, who will then recommend the most suitable therapy for you. From there, we'll develop a personalised treatment plan tailored specifically to your needs.
Frequently asked questions
How can I reduce PTSD flashbacks?
Regular therapy, such as EMDR, CBT or exposure therapy, can significantly lessen the frequency and intensity of your flashbacks. They also help you to process and reframe traumatic memories to reduce their impact. Practising mindfulness and grounding techniques can also help you to manage your symptoms when they occur.
How can I stop a flashback when it’s happening?
Stopping a flashback in its tracks can be challenging, but grounding techniques can help. These include focusing on your breathing, describing your immediate environment in detail, using tactile sensations (like holding a cold object), and reminding yourself of your current place and time to differentiate the past from the present.
What are PTSD flashbacks like?
PTSD flashbacks are intense, involuntary recollections of past trauma that feel as though the traumatic events are occurring in the present moment. They can include vivid images, smells, sounds and physical sensations that are associated with the original trauma.
Can you talk during a flashback?
It can be difficult to talk during a flashback, as you may feel overwhelmed and disconnected from the present. Some people might not respond to outside communication during a flashback, while others might be able to hear and respond if they’re gently guided back to the present moment.
What are the main symptoms of PTSD?
The main symptoms of PTSD include:
- Intrusive thoughts
- Avoidance of people/places/activities that remind them of the trauma
- Negative changes in thinking and mood
- Alterations in arousal and reactivity, such as being easily startled, feeling ‘on edge’, sleep difficulties and experiencing angry outbursts
