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Complex PTSD Flashback And Panic Management

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anthony

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Complex PTSD is now being recognized as an attachment disorder as the trauma occurred in a relationship and while the juvenile brain was developing and thus the hard wiring around relational perceptions of trust, judgment, love, intimacy, fairness, rights, conflict etc., have to be reset as a first step to healing. This is a long term process. In the meantime, triggering situations which lead to flashbacks and panic attacks will occur. Exposure therapy can diminish the intensity of flashbacks and panic attacks, but can only be embarked on as a late stage therapy as the brain first needs to reset its relational thermostat. Complex PTSD sufferers need healthy ways of thinking about self and others; self-talk and true and realistic self-perception must be developed before exposure therapy can be embarked upon successfully.

There is a line of thought which suggests that exposure therapy can actually be harmful for Complex PTSD sufferers if embarked upon too early. A very gentle form of exposure therapy is recommended within a trusting relationship, once the brain has healthy options for coping.

It has recently become more widely accepted that Complex PTSD sufferers in beginning and middle stage recovery should avoid situations which cause panic and flashbacks. It is advisable for them to identify situations in which flashbacks and panic are triggered and to avoid unsafe people, activities and places.

“Emotional flashbacks are sudden and often prolonged regressions ("amygdala hijackings") to the frightening circumstances of childhood. They are typically experienced as intense and confusing episodes of fear and/or despair - or as sorrowful and/or enraged reactions to this fear and despair. Emotional flashbacks are especially painful because the inner critic typically overlays them with toxic shame, inhibiting the individual from seeking comfort and support, isolating him in an overwhelming and humiliating sense of defectiveness …. because most emotional flashbacks do not have a visual or memory component to them, the triggered individual rarely realizes that she is re-experiencing a traumatic time from childhood.” Pete Walker M.A., MFT, The East Bay Therapist, (Sept/Oct 2005)​

When Flashbacks do occur, the following steps will assist:
  1. Begin by telling yourself what is happening. Tell yourself that you are having a flashback and remember that flashbacks are accompanied by the helplessness, hopelessness and danger you experienced in childhood.
  2. Everything you feel and the sensations you experience now, come from the past and although they are overpowering in intensity, they cannot hurt you. In the present, you are an adult with adult skills and resources; remind yourself that you are in the safety of the present, which is a long way away from the danger of the past.
  3. Remember that you have rights now that you could not uphold in childhood. Remember that you can take action now if you are in danger or if your rights and needs are not met.
  4. The hurt ‘inner child’ inside your adult body is looking for affirmation and safety. Tell her that she is safe and she can rely on you to keep her safe from now on, that the fear she feels will end and that you will create a safe environment for her in which she can release her pain.
  5. Become aware of your body:
    • Stop what you are doing. Rushing about signals danger to the brain. Find a quiet space where you are safe and alone and will not be interrupted. Fold yourself up in a blanket, in a closet, in a dark corner or in bed and hold something in your hand to help ground you such as a rock, a stuffed toy, a rough hairbrush or frozen peas (this is entirely up to you – do what works for you, do what feels the best for you, everyone is different and has different sensory needs).
    • Be aware of the fear energy in your body. Be aware of where it is in your body. Remember that it cannot harm you unless you respond to it.
    • Relax every muscle group in your body beginning at your shoulders and neck and working down to your feet. Clenching sends danger signals to the brain and releasing muscle tension sends calming signals.
    • Take your heart rate for a full minute and record it.
    • Count your breaths for one full minute and record them.
    • Concentrate for a few minutes on slowing your breathing down, breathing deeply from your diaphragm through your nose for a count of four in and blowing out through pursed lips for a count of six. Visualize blowing a small paper sailboat across a very calm sea.
    • Take your heart rate again for one full minute. Your heart rate should be decreasing. The more you control your breathing, breathing deeply and slowly, the faster your heart rate will decrease and the quicker your recovery.
    • Count your breaths again and try to halve the number you take in a minute.
  6. Guide your thoughts away from the triggers and dangers you perceive by reminding yourself that you are safe and the adult "you" can be relied on to protect your "inner child."
  7. Counter every negative thought with a positive thought. Refuse to shame, blame, hate or abandon yourself. Fight for yourself, do not allow your inner critic to condemn you – these are not your words, but the words of your abusers – do not agree with them! Throw all negative thoughts back at your abusers. Shame is blame turned inwards and has NO place in healing. Soothe your "inner child" with compassionate words of safety and healing.
  8. Flashbacks have healing potential and offer you the opportunity to release the fear, hurt and pain of abandonment. Allow yourself to express feelings that have been suppressed.
  9. Grieve the loss of your childhood and the loss of trust and relationship. Allow your tears to be cried in compassion for your hurt and suffering, and your anger to become self-protection for your lost "inner child."
  10. Take time to rest and allow your body and mind to recover. The process of becoming un-adrenalized takes time and patience. Be aware of your breathing and be aware that you will be fragile and need a protective environment and safe people around you for a while. Remember that flashbacks signal that all is not well and that further healing is necessary. See flashbacks as opportunities to discover, validate and heal past pain and embrace them as part of your healing journey and in time they will decrease in intensity, duration and frequency.
(Interpreted from articles by Pete Walker, M.A., MFT)
 
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