It might seem odd initially that I, a talk therapist, wrote a blog post titled, “Talking About the Trauma Is Not Always Appropriate.” This might seem even odder when you know that I focus on treating trauma. So what do I mean?
Sometimes my clients deal with a surge of flashbacks. We will schedule a session specifically to address the flashbacks. Clients are usually feeling overwhelmed and helpless against the flashbacks. They come to the session tense and braced to have to talk about the details of the flashbacks and are surprised when the session ends and I haven’t asked them to talk about those details. I’ve heard more than once that previous therapists had asked them to talk about it. You may have had this same experience with being asked to share details of trauma and I want you to know when it’s appropriate and when it’s not.
If a person has a trauma-related disorder (such as PTSD or DID), flashbacks are something they are experiencing. These are memories of the trauma. But flashbacks are different from regular memories because of the way trauma affects memory formation. Trauma memories are usually much more intense and vivid. If you are telling me about your recent trip to the amusement part, you might be laughing and smiling as you recount the day. You probably have some warm, happy feelings about the day, too. But these qualities are muted as you think about them now compared to when you actually experienced them. If you tell me about how you screamed as the roller coaster scared you, you are remembering that you were afraid, but you are not feeling that fear as you did in the moment. With flashbacks, it is as though the person isn’t just remembering being in the rollercoaster and feeling fear; their brain experiences that memory as though they are in that rollercoaster at this very moment, with all of the intensity of the original feelings and perceptions.
When a person is experiencing flashbacks, then, their brain is reliving that memory as if it it happening right now, with all of the horror, pain, fear, and overwhelming experiences. If I ask them to tell me about it, it is extremely likely that they will not be able to tell me about it as if they are telling me about the rollercoaster ride from the trip. They will end up being ON the rollercoaster in their mind. Each time this happens, they are re-traumatized. There is no healing occurring, only unnecessary, unfruitful suffering.
Of course at some point, the trauma likely needs to be discussed. But how it is discussed makes all the difference. The person has to have a toolbox of skills for regulating their nervous system and staying grounded. Then, carefully, they can talk about the trauma while being anchored in an awareness of the present. This prevents re-traumatization and begins to help the brain reprocess the trauma into a less vivid “normal” memory. In the midst of a traumatic experience, the prefrontal cortex (the “thinking” part of the brain) is shut off. But revisiting the experience while remaining anchored to an awareness of the present allows that part of the brain to remain online, where it can start to add context, including an awareness that this event is now over and not still happening.
If you are someone who has experienced trauma, it’s important to understand how critical it is to remain aware of the present while talking about the trauma. Getting caught up in the memory of the trauma so that you are experiencing it again and are unaware of the present is not helpful and not healing. You are under no obligation to talk about your trauma with anyone, including a therapist, if you don’t feel safe. You can state, “I cannot talk about that right now.” If it is a therapist who is asking, ask how they can ensure it doesn’t re-traumatize you. Remember that you have the right to say “no” in therapy.
If you are interested in working with me, contact me to set up a free 10-15 minute video consultation. You can call or text me at 816-226-4678.