Flashbacks and dissociation in therapy?

As we talk more about trauma related stuff, I have been having more issues with checking out in therapy, and today had a lot of trouble. Had some weird flashback/body memory thing that involved severe pain in my back. My T insists this whole thing is not weird, and telling him about it is okay and asking for help getting back is not weak, and is actually a sign of progress. Not being able to do it on my own feels horrible to me, weak and disgusting. Asking for help seems like a drama queen, attention seeking over-reaction on my part.

I read a blogger who talked about the importance of a dissociative client staying present in therapy, and not dissociating or having flashbacks. T says he disagrees with her, and part of our work needs to be making the dissociation and flashbacks OKAY, in the sense of being normal given the circumstances, not in the sense of 'oh yay, let's dissociate and have flashbacks'

For those of you with this issue, what is your T's take on it? Are you working for control of the flashbacks and dissociation (as in preventing them), or just letting it happen and then working to get grounded afterward?

The first one I see does not have a clue. The second one asks me to describe it to her when it happens.

My T tries to watch for it, and if I dissociate to a point that I can't communicate in the here and now, she will change the subject and that will normally bring me back. I sort of zone out and can't tell her what's going on, even though a million thoughts may be flying through my head.

MKAC,

Before we got all the tools in place, my therapist would keep me grounded and in the "here and now" rather than the "there and then". She felt without the groundwork, I would be re-traumatized by memories and flashbacks. It was only after getting the tools I needed and I trusted her abilities, that we started to process a piece of traumatic memory.

It was necessary for me to stay with the emotions, while feeling the body sensations and connecting the knowledge to get a full picture. We would break the memory into smaller pieces if I started to feel flooded. I hated working through the issues, but that is what took all the power out of the memories. I gained mastery over them, rather than me being terrorized by them.

She would then lead me through a healing ceremony depending on what we had worked through during session. That is one thing I truly appreciated, I didn't have to leave her office feeling like my guts were falling out (sorry for the graphic). That had happened with a previous therapist, so it was hard for me to learn to really trust her and be able to do the work.

This was my experience,

Sabra

He talks to me while the flashbacks are occurring. Repeated dissociation during childhood makes your sense of self kind of like swiss cheese. Re-experiencing things helps make sense of the story, and helps integrate emotion both cognitively and in terms of sense of self. As much as it sux to experience, I can't see it as a bad thing.

The dissociation usually gets better in time. Repeatedly talking about difficult emotions increases your ego strength bit by bit, allowing you the capacity to tolerate higher levels of anxiety over time. I also think it's possible that the dissociation may originate from both the trauma and being vulnerable/feeling shame in sessions. Needing your therapist in itself sounds traumatic for you.

Sorry you are having a hard time with this. I truly think that your therapist's empathy, and especially containment, of your intense emotion during flashbacks should result in a more self-actualization and healing.

And I agree with your therapist that it is a sign of progress.

i think it is great that you can tell him when this is happening mkac .i bet your T can learn a lot about your history by sharing them with him.

Mine usually helps me get grounded again if he notices. He has asked me to let him know. Today was just unusually bad.

That's a very helpful way to frame this.

First for people who know what this is like, I am truly sorry. It is an awful experience, both flashbacks and dissociation, that I wouldn't even wish it on my worst enemy. For me there is nothing worse. Hyperarousal comes as a distant second.

My therapist says that first as you probably know dissociation is an adaptive defense and even when it occurs long after the things that caused it, it is still there for protection. So one thing about this that I would wonder about is whether it is actually safe enough to do the trauma work. Perhaps it is insisting, but still there are other ways to deal with it than taking it on.

My therapist thinks that the lack of dissociation, its failure as a defense, is often when someone is ready to do trauma work. Of course that often means jumping right into flooding, which then I guess can start some numbing.

This happened to me intensely to the extent that every single traumatic experience I've been through was being constantly played like a film in a theater I couldn't leave. And I couldn't dissociate either. I ended up doing therapy every day for 6 weeks to do the intensive trauma work and haven't been truly triggered since then.

When I have drifted off in a session either from dissociation or flashbacks, my therapists usually gives me a little space and quiet and then tries to approach me in a comforting way because he can tell that something is going on like that. He has just asked things like where are you going? or how old are you? or he has asked if he could move his chair closer. Sometimes he would just talk softly until he could tell that something had shifted. He knows I feel soothed by the sound of his voice so that why he does that.

I think just feeling like you are not completely alone is a basic necessity.

Its totally ok to ask for help. It can be really, really tough trying to get out of flashbacks.
We have DID and are always switching and flashbacking,i have several young alters who are stuck in their trauma and flashbacks and its just a normal part of our life. When it happens while we are talking with t, she has us try to tell her about it. She usually needs to help the younger gets to get out of it. There are only a couple of us who can do it on our own. It is totally ok to ask for help from t.

I don't generally have specific visions or anything in flashbacks. It is more like a wave of emotion, or weird smells, or pain. T says that is part of complex PTSD as opposed to PTSD.

When i have somatic re-experiencing, it's almost all pre-verbal trauma. Also, when stuff was from when I was very, very young, I often re-experience 'states of being' rather than emotions. I think that's because babies minds aren't developed that much yet....

Are the experiences you wrote about above from different ages?

This sort of happened to me last week. I have therapy today and am worrying about it. It's never happened before. One poster said their T asks them how old they are. My T also asked me how old I "feel," during this episode, and I was a bit irritated by that question. I told her I was "just me."

I found it embarrassing, and don't want it to happen again. But we were talking about something emotional, and she finally really had me in tears. Then I just shut down. She kept trying to talk me through it....eventually just covered me with a blanket and for the most part, let the quiet be.

I have no idea. That is part of the problem. It is this weird, amorphous stuff happening inside my heart. T says that is because the abuse began when I was an infant, and because it was such a day in, day out, grinding kind of thing. There are only a few huge instances that stand out in my head. Mostly it is a kind of generic thing. Like the smell of Spam, for instance, gives me this kind of generalized panic. There is no specific memory associated with it, but I will have a prolonged period of panic when exposed to the smell -- sweating, heart racing, etc. Someone cooked spam in our office and for literally DAYS, I was constantly sweating, nervous, on edge and super reactive.

For me, T is trying to pull me back to safety and to the present, so he asks what age I AM.

It's the same way for me. I don't have specific ages, or anything like that, because things were so constant. I can't handle certain cleaners, like Clorox, because they remind me of a million different incidents that all flood my mind when I use Clorox.