Displacing Flashbacks with Visual Grounding

A flashback is a strong and involuntary sensory replaying of part of a traumatic experience for some people who experience traumatic events.  It rapidly takes clients out of the “now” and drops them inside a past traumatic experience.  During the flashback, they often feel what they felt when the experience occurred.  Flashbacks can occur across decades.  It’s the closest thing we have to time-travel and no one wants to go, because the destination is always horror.  Many flashbacks come as snapshots or as segments of “video” from the original trauma.  Some can also involve sounds, touch, or smells.  Many can involve a mix of all the senses.  Flashbacks do not necessarily “replay” the event exactly as the client experienced the event, although many can.  A client can have a cluster of flashbacks that jump between the various parts of an event or across several events.  Flashbacks take the person out of the present and flood the body with intense emotional and sensory memory.  Some can last a few seconds.  Others can loop for hours or days.  Flashbacks are distressing experiences for people with trauma and they are just one part of what can really sucks about having unprocessed horrible memories.

Nothing good comes from flashbacks.  The scene never plays out in ways in which the client is not victimized.  Early in treatment, the goal is to show the client how to quickly displace flashbacks, so that they are not trapped in them for extended periods of time.  Many clients are able to displace flashbacks within several seconds of onset once they have used grounding techniques several times.  It can take some clients many attempts to start to successfully and quickly displace flashbacks.  It can be empowering for a client to learn how to displace flashbacks.  However, teaching a client how to ground himself is not a cure for his trauma.  It is simple a fire extinguisher that he can use as needed to make this horrible symptom feel a little less horrible.

During a flashback and the accompanying emotional arousal, cognitive strategies are unlikely to work.  Most clients will not be unable to “talk themselves” back into the present.   What does work for the vast majority of clients is visual grounding.  To demonstrate this in session, ask the client to stare intensely at an object that is in the room.  The client can stare at a patch of carpet, a pastel painting on the wall, or a piece of furniture.  It’s often a good idea to avoid focusing on photos of people or photos that contain people.  It helps to ask the client to focus on a small part of the object and to notice the various shades of blues or to notice how the texture of an object looks like waves.  Ask the client to try this every time he has a flashback.

The purpose of this exercise in grounding is to saturate the visual parts of the brain with an actual object that is fully in the present.  Once the client is able to focus on the object, the visual part of the flashback will often be displaced with the object that the client is focusing on.  At this point, the client can make reinforcing cognitive statements of safety to help transition the client the rest of the way back to the safety of the present, “I’m okay.  I’m in my own house and I’m staring at my carpet.  I live here with my wife and my two children.  I’m okay right now.”

Review and summarize the technique with the client:

Nothing good comes from letting a flashback run.  As soon as you are aware that you are having a flashback, visually focus on something in your environment.  Stare at it very deeply and intensely, notice the small shifts of color in it.  Notice the texture of it.  Continue to stare at it for several moments after the flashback goes away.  Once your vision and your mind is fully saturated with the object you are looking at and you no longer see the traumatic images, tell yourself that you are safe and tell yourself (out loud, so your ears can hear) where you are located.  Will you be willing to try this every time you have a flashback?  I want to help you develop this technique, so that you can stop flashbacks quickly when they happen.  If you have problems implementing this technique, I want you to come back and tell me.  There are often ways around these problems.