Conscious flashbacks cause damage. Unconscious flashbacks cause double damage.
My client John had certainly overreacted to a little thing of a car backfiring, taking his hands off the steering wheel and covering his face.
When he finally gets to my office he hesitates and his eyes move up so he’s staring at the corner of the ceiling as he grumbles, “ I need to be hospitalized.” I was shocked. If I had been given a multiple choice test, hospitalization would have been the one answer I knew I could cross out. There are clients that you worry about, clients who are really depressed and have suicidal thoughts or maybe had actually attempted to hurt themselves in the past – where you realize that you may have to consider hospitalization to keep them safe. But that wasn’t John. So I just sat there puzzled and all I could say is, “Why?”
“I just tried to kill myself” he announced and then continued, “There must be a part of me that wants to die, or is going crazy, I must be losing control…I need to be in the hospital!”
So – in his mind – he must be a total nutcase. After all, he had just done something that was senseless, dangerous and so very stupid. People who take their hands off the wheel when they are driving on a major highway must subconsciously want to kill themselves – people who are suicidal need to be hospitalized to protect them from themselves.
Of course, it had nothing to do with his combat experience — it couldn’t have since he never thought about or consciously remembered those days. So the only other rational alternative was that he must be crazy or – at a minimum – there was a dark part of himself that wanted to die. Hospitalization was the logical option.
Thankfully, John was willing to consider my alternative to hospitalization – dealing with the root cause of his emotional overreaction, the mortar fire that killed his friend and caused him to cover his head.
Unconscious flashbacks – when a car backfire causes the memory of the mortar fire that killed your friend to pop into your mind and you suddenly feel the urge to cover your head – cause damage. Unconscious flashbacks – when the mortar fire triggers the mortar fire memory subconsciously so you suddenly break into a panic and cover your head but the memory never comes into consciousness – cause double damage. Both types of flashbacks can make you do things that make sense in the past but put your life at risk in the present. However, unconscious flashbacks – since their source is hidden – cause you to make up an explanatory fiction, some rational reason to explain why you are reacting in an irrational way.
Human beings are incapable of not having a theory about everything. The ancient Greeks came up with elaborate theories of chariots in the sky to explain why the sun rose in the east and set in the west. When a baseball fan’s team finally wins after several losing seasons the fan makes sure to wear the same cap in every future game to help them win again. These explanatory fictions are often cute and endearing when they surround little superstitions. But when they are powered by strong subconscious emotional reactions they can multiply the damage caused by the flashback itself. John almost killed himself because the flashback made him take his hands off the wheel. But his rationalization – I must be crazy and suicidal – changed his image of himself and almost led him to a totally unnecessary hospitalization.
- Blank, A. S. (1985). The unconscious flashback to the war in Vietnam veterans: Clinical mystery, legal defense, and community problem. In S. M. Sonnenberg, A. S. Blank & J. A. Talbott (Eds.), The trauma of war: Stress and recovery in Vietnam veterans. (pp. 293-308). Washington, D. C.: American Psychiatric Press.
- LeDoux, Joseph E. (1996). The emotional brain : the mysterious underpinnings of emotional life. New York: Simon & Schuster.
- Öhman, Arne, Carlsson, Katrina, Lundqvist, Daniel, & Ingvar, Martin. (2007). On the unconscious subcortical origin of human fear. Physiology & Behavior, 92(1-2), 180-185.