Saturday 5 November 2011

Memories and Flashbacks - what's the difference?

This is loosely clinically based, but it's mainly my own experience, if you want more information about flashbacks, or are having issues yourself please see your GP.

This week a couple of the comments on my Daily Mail article criticised the use of the word flashbacks and said they were memories and everyone has those. I wanted to attempt to explain, in the context of what happened to me, what the difference is, in the hope that it might help others.

We all have memories. It's what makes us who we are, the things we have gone through and experienced form a library, that we can use and refer to. Quite clearly not all memories are pleasant, some are painful, some might provoke anger or fear. We can, if we learn how, choose how we recall those memories, and how we react to them. Sometimes we put memories away. A very good personal example is my grandmother. I was exceedingly close to her, and still feel pain at her passing. I have precious memories of her, but I don't recall them often, as they make me upset. But at times I can choose to recall them and have a little reminisce about her if I want to. Most of the time they are shut away.

To take a step back, psychologically, we are wired to react to trauma. Our senses are heightened in order to protect ourselves. Soldiers, emergency personnel, doctors and nurses, are trained to pick up on sights, sounds, smells, and other indicators to protect themselves and those around us, and to utlise and improve upon their own basic instinct. In traumatic situations, this happens automatically. For example, in the Neonatal Unit we are trained to look for very subtle changes in colour of skin, respiration rate, the way the chest rises and falls, every little thing. Monitors help, but they can fail. A soldier or policeman can pick an insurgent or a terrorist by their mannerisms and body language.

A funny story about this, one day I was doing Joseph's cares in the incubator, changing his nappy, doing his mouth care etc. I also changed the probe site on his foot. The probe was hooked to the monitor that measured his oxygen levels, heart rate and breathing. A doctor asked if she could do his routine checks, and I deliberately left the probe off, as I knew she'd be moving him around. I didn't silence or turn off the machine, as it shouldn't sound if the probe is not active.

Anyway, she was doing her checks and the monitor started sounding, I looked over and the sats were low, the heart rate high, immediately the doctor said "Joseph's colour is good, his breathing is sound, I am not sure why the machine is sounding", as she carefully examined him, using all her training to make sure he was safe. I walked over, smiling, I checked her face and watched her breathing and said "you look fine too but maybe you should get checked out", and drew her attention to the probe. It had attached itself to her! She decided she needed a chocolate bar, a coffee and a rest, a good prescription.

What can happen, particularly in anxiety disorders like PTSD is that the mechanism forgets to shut down. Like the probe and monitor left on when not in use, that warning system remains active. Smells, sights and sounds can trigger feelings and responses that are unnecessary and an over reaction, quite different to a memory. So for example when my PTSD was at its height, the sound of a machine in the supermarket to my brain illicited a "fight or flight" response, I'd look at Joseph and make sure he was ok, and then we'd leave. Not only the sound but the lights would set me off too.

The treatments for PTSD, talking therapies and medication, aim to switch this off, to reverse the state of high anxiety, and to help the person relax, and live a life not plagued by these flashbacks and nightmares.

1 comment:

  1. Well done, kylie. I'm a friend of Christina's and i know we have all suffered from PTSD because of our prem experience. Only simeone who has not suffered from it would take issue with your use of the word flashback, because thats exactly what it is. 5 years on i still get them if the circumstances are right, but I'm pleased to say it does gett better with time. Well done you for a fab blog.