Friday, February 11, 2011

Plausibility Check: Can a loved one trigger a flashback?

Here's another question from Rachael at Writers' Chasm:
My male MC has a mother with PTSD. [Describes traumatic situation, after which mother believes son is dead for a brief period of time] She refuses to get help for her PTSD and never leaves home. She also has a panic attack whenever she sees her son because he reminds her of the terror of that day. Is this realistic? 
Rachael's character would probably be experiencing a flashback when something reminds her of the trauma, and flashbacks vary in their severity. During some, people re-experience the trauma to the point of temporarily losing their connection with reality. During others, it's just a momentary jolt at a reminder of the trauma (commonly called a "trigger"). It sounds like this character is having a pretty severe flashback if she's having panic symptoms.

In this case, the woman's son, someone she's lived with for a long time, is reminding her of the trauma. So the question is: Could someone's own loved one trigger a flashback?

Well ...

Yes.

With some caveats.

First, I'm not talking about whether a loved one's behavior could trigger a flashback. That DEFINITELY happens. For example, I've worked with women who had been battered by their boyfriends or spouses. Usually the reason they come to me is because their son or daughter is aggressive or defiant. And in the cases where the mother has been traumatized, sometimes the child's aggressive behavior toward her triggers a flashback (which, of course, leads to a less-than-effective parenting response to the aggression).

But that's not what I'm talking about here. In this case, just the loved one's presence is causing the flashback. And here's how it could happen for this character: She sees her son, and she re-experiences the horror of thinking he was dead and all the images/memories associated with that period of time. Now, just seeing him could then set off a feeling of relief, like "Oh, thank god, you're here and you're not dead." And that would help her calm down. BUT, if her thoughts spun in another direction: "If you died, I wouldn't survive, I couldn't go on, it would be so terrible, oh no oh no oh no ..." then it's a whole different ballgame.

It's all in the thoughts.

If you read Wednesday's post, you saw me say that treatment for PTSD involves helping the person reframe her thoughts to avoid that kind of panic. But also, treatment involves exposure to the memories of the event until the person is able to tolerate them.

And here's where a loved one as a trauma-trigger gets tricky. IF she was exposed to her son's presence every day, she'd be more likely to get over the trauma. That's because just being around him would trigger the memories, and if she remained in his presence for awhile, her distress would probably wane. BUT if she avoided him diligently, then that habituation (i.e., a reduction in her distress as she got used to his presence) wouldn't happen as quickly, if at all.

So--yes, a loved one could be a trigger for a traumatic reaction. But at the same time, just being around someone a lot would likely help recovery (from that particular trigger, at least). And again, if the thoughts are negative or maladaptive (e.g., "this is so terrible" as opposed to "thank god it wasn't worse"), then the trauma reaction will be stronger and more persistent.

If any of you have questions about mental disorders or the plausibility of psychological symptoms or reactions, please feel free to email me at strangestsituation (at) comcast (dot) net.

9 comments:

  1. Hmm I was wondering about that. Thanks for sharing.

    :-)

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  2. Whatever happened to anything goes in fiction? LoL. Kidding. It's always nice when books stay true to real issues and don't twist things around to just make it work for them.

    ~JD

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  3. This is why it's important not to fudge things even in fiction. Okay, especially in fiction. It can kill your crediblity as a writer. Great post as always, Sarah.

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  4. PTSD is one of those things that has as many presentations as people who have the disorder. On the other hand, there are some classic signs and symptoms that are so indicative of PTSD that you can't miss it.

    Nice post!

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  5. that makes a lot of sense! i love learning about the inner workings of people's minds over here! thanks for another informative post! :)

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  6. Tricky question and great answer! Sarah, you rock.
    :)

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  7. Great research material. I wouldn't have thought of a lot of that stuff.

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  8. Hmmn... that was a wonderful post. Keep writing more on such topics. Loved it!

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  9. Hi, Sarah,
    I just found you from a link on Stina Lindenblatt's blog and am a new follower. Thanks so much for blogging on these topics. Fascinating and useful!

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