In my last blog post on complex post traumatic stress disorder (CPTSD)and flashbacks, I reproduced Pete Walker’s list of thirteen steps for managing emotional flashbacks.  These are all things a person can do on their own when they find themselves thrown into the overwhelming feeling states associated with a past trauma.  In this blog post, I will explain two simple techniques a therapist may use to help a person manage traumatic memories (flashbacks).  These techniques work with the body as well as the mind, as psychological trauma is often stored in the body in the form of “somatic memories”.  These techniques are adapted from the work of Babette Rothschild in “The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment.

The first technique involves developing what is referred to as dual awareness which means the ability to maintain awareness of two or more aspects of experience simultaneously.  Although this may sound simple, it can be difficult for people with with a history of trauma for a couple of reasons.  One reason is that people who have been traumatized may be habituated to focusing their attention inward towards compelling internal stimuli associated with autonomic nervous system activation (such as a speedy heart rate or shallow respiration), and they may therefore interpret the world exclusively from that point of view.  Another reason is that they are frequently triggered into a feeling state of the past by their current environments to such an extent that they feel as though the trauma is happening now.  When this happens people may lose the capacity to discriminate between or maintain simultaneous awareness of the past (when the trauma occurred) and the present (which is trauma free).

It is imperative for trauma survivors to have the capacity for dual awareness in order to address a trauma safely by knowing that their present environment is actually trauma-free.  Key to developing this capacity is to note and promote the distinction between the observing self and the experiencing self.  What is meant by this, is a person’s ability to witness (observing self) what they are feeling (experiencing self).  For example, someone experiencing a flashback may say “my heart is racing and my mouth is dry and I am feeling really scared right now” (experiencing self), and “I see that there is actually no danger to me in this moment” (witnessing self).

A simple technique a counsellor can use to facilitate the development of this type of dual awareness is to have a client bring to mind a mildly distressing event. This exercise intentionally uses a mildly distressing event to begin building the mental muscles associated with the capacity for dual awareness.  As this capacity increases, it can be used to work with more distressing events.  The counsellor would begin the exercise by assisting the client to notice the sensations in their body (experiencing self) using a series of questions .  Then the counsellor would ask the client to direct their senses to their present environment (witnessing self) using another series of questions .  The counsellor would then direct the client to keep their awareness on the present environment while remembering the mildly distressing event (dual awareness).  The counsellor ends the exercise by bringing the client’s awareness back to the safety of the present environment.

A related technique can be used when a client is experiencing an actual flashback.  First, the counsellor has the client notice and name the emotion(s) they are feeling, and what they are sensing in their bodies (experiencing self).  The counsellor then has the client associate these things with the memory of the trauma by asking the client to just name the trauma by giving it a title.  The counsellor instructs the client to be sure to leave out any details associated with the trauma.  Next the counsellor poses a series of questions to help the client locate themselves both in time and space in their trauma free current environment (the witnessing self).  The client is then directed to notice the safety of the present environment while naming the trauma (dual awareness).  Finally, the counsellor has the client name the trauma again (by title only) and ends by having the client notice that the trauma is not happening anymore.