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What's the difference between a flashback, being triggered and intrusive thoughts?

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barefoot

MyPTSD Pro
I've always thought that I've never had a flashback.

But in my therapy session last week, my therapist referred to an experience I described to her last year as being a flashback. When I first told her about the experience, she said it sounded like "a regressive experience." And last week she referred to it as a flashback.

I've been doing some online research since and a few things I've read have got me wondering whether I have had flashbacks a few times in therapy sessions. My therapist has referred to those times as me having "episodes" and I have never really known what to call them. They generally include dissociation and I can't feel my body so can't stand up and sometimes I have shaken violently for an hour and other times I have ended up standing with my nose and toes touching the wall.

When I've had these experiences in therapy, I have generally been confused and disorientated. I think I know I am with my therapist and in her room. But my understanding of that feels rather foggy, because I feel so disorientated and confused. I also have a hard time feeling my body's boundaries. So I'm not really aware of where my "edges" are, if that makes sense? It just feels like I (my body) is just merging with my surroundings. Which I think is maybe why I sometimes go to touch her wall if I'm getting overwhelmed and finding it difficult to stay fully present - I think the wall provides some kind of tangeable boundary/containment?

Sometimes when I have dissociated there, my head has been completely gone and I am just numbed out, no thoughts, no feelings. Othertimes, there has been a lot going on...I think I have got flooded/overwhelmed emotionally though I can't necessarily identify what the feelings are and I just feel sort of lost in the intense heaviness of those feelings. They feel all-encompassing and I feel kind of frozen in them. I think I am maybe feeling feelings that belong in the past. But, as I said, I think I do realise to some extent that I'm sitting with my therapist in her room. So, if I'm feeling old feelings and feel quite lost in them and am not feeling grounded and fully present but I sort of know I'm in my therapy room with my therapist...?

I now feel a bit confused about what's been happening when I've had these sorts of experiences.

On the one hand I think it probably doesn't matter whether my therapist calls something a flashback or a regressive experience or whether we refer to me being triggered or whatever. On the other hand, I kind of want to know what's going on, so that then I can try to understand it and manage it better.

I will ask my therapist about it but I still have another week before I see her again.
One of the things I'm confused about is what the difference is between having a flashback, having intrusive thoughts and being triggered. Can anyone shed any light? How do you experience these things?

Thanks!
 
I'm not sure @barefoot , but just for me by way of example, if I have a FB I am 'there', but feel like an observer, it's a replay with details and for a short time the emotions (I will not remember what they were if I don't write them down- I'm surprised and think 'ISo I guess that's what I felt then?' :confused: :wideeyed: , but I will remember details I forgot, though they're usually also moments I recognize but don't actively 'recall' irl), it seems to coincide with several things converging in memory- eg smells/ temperature/ visual things that are similar/ body posture, also sometimes gruesome 'flashes'; an Emotional FB is when I have feelings like my clothes are on fire and I have to run or get away, the feelings won't match what is going on. But for example once I had that, and I realized it was from a trigger seeing a man with his daughter; a trigger might be a cologne, an Oreo cookie, a type of car- before I know it I've taken safety, or am filled with shame or my heart is in my throat/ terror (I know why); intrusive thoughts are more to me like repetitive unwanted memories, beliefs, fears and assessing the validity of other's negative words. In terms of ptsd intrusive thoughts to me are the unwanted un-called upon mental reminders of past traumas. Just how I make sense of it. Or not. :(

Regression-like behaviour I've only experienced sometimes with extreme emotional devastation and following shock, and with near-catatonia.
 
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Thank you @Junebug

Yes, I think I understand that sense of feeling like an observer. The experience I described to my therapist last year (which she referred to last week as being a flashback) felt quite like that. And almost like I was having an old memory/experience sort of laid on top of current here and now. Like it was two moments in time running in parallel or something? I was somehow in it and observing it at the same time?! It felt very strange...

I have quite often had a sense of feeling "here but not here". Perhaps that's dissociation though - depersonalisation?

Hmm...so many labels and so many confusing and disorientating experiences!
 
im still struggling to understand it all. Last night in therapy my T said something very benign about my rape and the next thing I knew I couldn't get the image of a bloody cloth out of my head. I couldn't not stare at my foot and I couldn't speak. I could kinda hear his voice in the background and every few minutes I could answer a question but then I would slip right back into frozen silence. Have no idea what that was.
 
Thanks for the links @joeylittle

So, I have concluded that...it's all very confusing! Lots of overlap. I guess they are all related to some extent...being triggered, emotional flashbacks, dissociation... And then we each experience these things in our own way, which makes definitive answers even more elusive.

Maybe I am trying to pin down an answer that just isn't straightforward. And maybe, ultimately, it doesn't matter whether I'm dissociating, triggered, emotionally flooded, or having some kind of flashback. But at the moment, it feels important to know, to be able to make the distinction. Because if what happened last year was a flashback...I think that probably gives me new information about a particular historical event.

Also not sure why it's taken my therapist this long to name it as a flashback. Perhaps she doesn't think the distinction matters either.
 
my understanding is that in a flashback, one actually is reliving the experience...as if it is happening again.
 
Trigger: The brain stores information connected to existing information, and it will retrieve vivid memories (flashbacks) when exposed to any linked stimulus.
The trigger could be anything that is connected to your stored trauma.
I'm pretty sure it activates the limbic system which is the emotional flood.
Fight, flight, or freeze will then be activated by your vivid memories faster than you can think about acting normal because nothing's wrong.

For example, among other things, a child screaming a certain way (blood curdling) still triggers flashbacks for me.
Sometimes I only partially dissociate, where I can still see and hear what's around me, but I'll dual "see" in my mind all kinds of details of past events like they were yesterday.
My heart pounds and my face turns red with the surge of adrenaline. Hopefully, I can quickly focus on the present and continue talking and move on as long as I don't watch the replay of the trauma in my head.

Other times, fully dissociated, I can't speak or move, my body feels as if there are no boundaries, my eyes will stare without me being able to move them, and they are not seeing what's there anyway. My lungs take fast huge gasping breaths involuntarily, with a high pitched scream in between each breath. The back of my neck locks up, and my whole body stiffens and I am not just "seeing" what happened, but actually reliving it. Time does not seem to pass, and it seems I am out of my body watching it all happen from another completely normal state of mind.

Eventually, I can see the room again and hear someone speaking and respond to them. My mind will be racing and thinking random thoughts I had at the time of the trauma(s) which lasted about 7 years. In my head, I may still be 8 or 10 years old. I still want to wear my favorite shirt and hang out with my best friends.
My face will be covered in tears even though it's very different from crying out of sadness.

Years ago, I would have remained in a numb, dissociated space for days, weeks, or months. Lump in the throat, walking around in a trance, crying every time I was alone and avoiding speaking to people, because if I spoke I would cry. Everything triggered the crying.
It was if I was not really experiencing the feelings, just watching and hearing myself cry.
Hypersensitive to sounds and touch, processing stimulus at lightning speeds, deep internal shivering, hypervigilant to any possible threats or ill intention. I saw visions, had lucid dreams and nightmares, and lost myself in the void. I wouldn't speak in first person, and referred to "him", my kid inside. I didn't really exist.

I started getting better when I gave the kid a voice. I let him speak in first person and I let him write his story.
I still experience triggers that make me cry in front of everybody, but it hasn't been what my therapist called a full reliving "body aberration". Those are definitely not the same as "flashbacks".
Sleep helps.
 
One of the things I'm confused about is what the difference is between having a flashback, having intrusive thoughts and being triggered


My two cents:

Flashbacks are like dreams. All the images of the event that you keep seeing, the feeling that you are partially or completely reliving what happened. It doesn’t matter if you are not seeing again in front of you the whole event; small fragments of it reappearing before your eyes are flashbacks as well.

What triggers you is what sparks you off. It is the “device” that ignites, that brings the flashback, forward. It could be literally anything, from a song, a quote, a smell, a dress, a road, or even a constant trigger, like your husband or your job. Even roses could trigger a flashback for you.

Intrusive thoughts can be anything. From thinking that you are going to die or that something bad is going to happen either to you or someone else. All the thoughts that emerge, the thoughts that drop in against your will and make you feel uncomfortable. You never invited them, you don't want them there, but here they are, wanting you to believe that they are more powerful than you. But those too are you as well.
 
I've always thought that I've never had a flashback.

But in my therapy session last week, my therapis...

I have flashbacks for good and bad memories. When I have flashbacks, it's like you're watching a movie in your head but you express it verbally whether you're with someone or your therapist. But it's not the same case like you just got broken hearted, sometiems we talk about it if we got ourselves broken hearted in order to release it from our chest and heal. But, with trauma, it keeps going on and on and on for years even for things that have has happened many years ago. That's flashback for me.

Intrusive thoughts happen with me when I get triggered. I have flashbacks whether it's being triggered or not.I think what I want to find out here is how to manage when you get triggered. I don't think it's fair also to ask people to be nice and kind and compassionate and emphatic to fellow humans when they're not actually are or they don't know actually what you've gone through.
 
I think I've had a couple of flashbacks, triggered in session by goodness knows what to be honest. My hearing goes, followed rapidly by sight, speech and movement. Frozen. Sometimes I've kept one foot in the room and other times I've completely lost touch and then had my memory wiped immediately afterwards. When I find my way back I feel rather broken. It's hard to draw breath and say that I'm ok. I lose time - somewhere between seconds and forever. Who knows. The visual ones are literally flashes and are like clips from a movie. I have zero idea what is behind my flashbacks. Good times!
 
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