Friday, January 15, 2021

Fight, Flight, Freeze

Fight or flight. We hear this all the time, but freeze is the red-headed step-child of trauma. Fight, flight, and freeze are all normal neuro-biological responses to fear, but, if we don’t know this, we can feel guilty or angry or like we “let it happen” when our body freezes in the face of trauma. 

First, let’s wipe out the fantasy that we have a choice whether our body goes into fight, flight, or freeze - because that’s not a thing. When we’re in danger, our brain kicks into high gear and takes over to protect out life. You do not get a choice; in a split second your brain makes the choice for you. 

Think about those nature shows where lions are hunting gazelle-snacks. No gazelle is going to get its back up and whoop some lion’s ass, so he’s left with two choices: flight or freeze - and both of these are legit survival methods. The eye sees what is moving (“I’m up, they see me, I’m down”) so a lion may not notice the stock-still gazelle frozen right next to him. The folks who design military training know this and we go to great measures to train the freeze out of us. Live-fire exercises, rote memorization questioning techniques, fire and movement - we do this training over and over again so that our brain passes over freeze and jumps into habit under fire. But no one trains us how to get raped, or how to hold a buddy while they die, or how to respond when we see a detainee get schwacked. That is not a thing, my friends. There is no fighting back, there is no running away; we freeze. 

The degree of self-blame that comes with freeze is overwhelming. Sometimes we have this fantasy that, “if I didn’t freeze, everything would have been different,” or “if I didn’t freeze, I could have fought back.” 

I say this with love: it’s possible that you’re wrong. Freeze is not a choice; your brain took over and kept you alive.

Bottom line is that you deserve to get your life back, and there are therapy treatments (like Prolonged Exposure Therapy, Cognitive Processing Therapy, and EMDR) that are designed to help you with your symptoms. You can do this.

Friday, January 1, 2021

Hallucinations & Flashbacks - an Expected Part of PTSD


As a clinician, I want to be straight with you: I have never seen a case of PTSD without hallucinations. Never. And we need to talk about this openly because hallucinations make us feel legit crazy in a way other symptoms don’t. Ditto for flashbacks.

What’s a Flashback? So glad you asked because flashbacks are nothing like we see in the movies. That would be nice, but real flashbacks are way worse. They are like waking talking nightmares; intense episodes that happen while we’re fully awake. Just like an intruder, flashbacks strike suddenly and feel uncontrollable. Flashbacks are more like a nightmare than a memory because sometimes we can’t tell the difference between the flashback and reality. They’re vivid and feel unbelievably real. Unlike a movie clip, in flashbacks we can see, hear, taste, and smell things. It’s fucking terrifying because it is like the trauma is happening all over again in the moment. Those of us who experience flashbacks often feel like we’re going crazy. You’re not; this is a PTSD symptom. 

When we don’t know that hallucinations and flashbacks are an expected part of PTSD, we can feel like we’re going crazy and very seriously consider suicide - and this makes a lot of sense. We stop feeling like we can trust our brains and our bodies and we can literally start becoming frightened of ourselves and our reactions. We start asking ourselves, “what if I hurt my family?” or “what if I lose my shit in the Walmart?” I very much get you; it can feel like we’ll never come back from this. But you will.

For now, just let this sink in: hallucinations and flashbacks are a normal part of PTSD. Normal doesn’t mean that it’s okay, it just means that hallucinations and flashbacks are common and not unexpected. This is par for the course; you are not a freak. 

Bottom line is that we all deserve to recover from our PTSD symptoms and get our lives back. Get the help you need.