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.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

What is "Recovery" from PTSD?

 

"Recovery" is a term often used with addiction issues, and it can apply to other issues related to mental health as well. We can experience recovery from depression, PTSD, anxiety, eating disorders, and other issues. I've had readers reach out and ask if recovery from PTSD means that all our symptoms will go away, or if we will not remember our traumatic experience, or if our lives will go back to how they were. Unfortunately, the answer is no. But this does not mean that we cannot have a recovery journey and live a meaningful life.

Recovery can mean different things to different people. It isn't straightforward, it isn't linear, and that is okay. For me personally, my recovery from PTSD has been 20 years in the making. For me, it has meant reducing my symptoms so that I could function, building a strong social support team, and sharing my experience, strength, and hope with others. As you may have read in The Soldier's Guide to PTSD, my journey was messy, and I made a lot of mistakes along the way. But I'm here, and I own every step in my recovery journey - good, bad, and ugly. For me, recovery is an ongoing process rather than a destination.

For some of us, recovery will mean managing or reducing symptoms. For others, it will mean learning new coping skills and ways to live. Other goals could be connecting with others, engaging in self care, or starting on a spiritual path. Whatever our path is, it is individual to us. 

Recovery is often described as a process, meaning it isn’t always straightforward and there may be bumps and bruises along the way. We might have a period of time when we feel great and then an unexpected relapse in which our symptoms return. When I experienced this, I felt angry and frustrated - like all my work was for nothing. I had to remind myself that recovery is about progress, not perfection.

When it comes to recovery, what helped me was thinking about what a meaningful life looks like for me. I talked with my support team (my therapist and battle buddies), set small, attainable goals, and asked my team to keep me accountable. For me, having support was vital.

“Most people overestimate what they can do in a day, 
and underestimate what they can do in a month. 
We overestimate what we can do in a year, 
and underestimate what we can accomplish in a decade."

-Matthew Kelly from the book The Long View

I love that quote because it reminds me that recovery is not a "drive-thru breakthrough;" it takes time. Unfortunately, help for PTSD is not "my way, right away" like the drive-thru at Burger King, and I still have to remind myself of that because I am not a particularly patient person. Yes, it gets easier over time, but there is no rushing it.

There's a popular Chinese proverb that says: “The best time to plant a tree was 20 years ago. The second best time is now.” There is no time like the present.

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD

Keeping First Things First - Ways to Connect

 

There is a lot going on right now. For many of us (including me) it's one final push to the end of the semester, offices are under-staffed and over-worked, everything feels phenomenally expensive, and our "to do" lists are overwhelming. On top of this, world events are dire.

How can we stay grounded in a crazy world and keep first things first? Let's start with perspective. 

My favorite version of the Serenity Prayer goes like this: "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know that that is me." 

It's a short prayer, but there is a lock packed in it. Serenity, acceptance, courage, and wisdom are simple concepts, but they are not easy. In order to find serenity, or peace, I have to practice recognizing what is and is not in my control (again, this is simple but not easy). 

With PTSD and Moral Injury, we can become prisoners of our past. As for why, this starts off with who we were before we joined the military or public service. It takes a certain type of person to commit to service. Most of us were young and inexperienced in life when we joined or were drafted into service.

When we started out, we wanted to help others and make a difference. We made a commitment - to the service and to each other - and there was something simple and pure about that. Never leave a buddy behind. Follow the Rules of Engagement. Bring everyone home. But that didn’t always happen. We used deadly force, gave orders, and followed orders; it was neither simple nor pure.

Whether we perpetrated it, witnessed it, or failed to prevent it, things happen in war and in life that make us question who we are now and who we can be going forward. 

The Serenity Prayer is about letting go of situations beyond our control and taking action toward things within our control. This is not easy and it is definitely not an overnight process; serenity is a life-long practice. We will never get it right, and we don't have to.

In this overwhelming season, I have been reaching out and connecting with others - and it has helped. I can get stuck in my own head and lure myself into a self-condemnation spiral easily. I have a strong therapy group I am in and I work hard to surround myself with supportive people. My support network took a while to build, and here are some resources we can access from the comfort of our own homes right now:

Warmlines are peer-run listening lines staffed by people in mental health recovery themselves. Sometimes, we all need someone to listen but we know that a call to a crisis line may not be appropriate. Warmlines fill this gap. Here is a directory of warmlines across the U.S. 

12-step programs are powerful in terms of providing social support and accountability, and there are anonymous groups for any number of addictions. In addition to AA, NA, and Al-Anon, Codependents Anonymous (CoDA) is a powerful change agent, as are groups for Gambling and Survivors of Incest. Not everyone is a fan of the program, and I get it – there are plenty of lousy groups and crappy sponsors. There are also dynamic, inspiring groups and amazing sponsors. Since the pandemic, many groups have gone online and meetings are on Zoom. Here is the line to AA Online Intergroup for a list of online meetings. (The only requirement for AA membership is a desire to stop drinking.

Support groups bring together people who are going through similar experiences. Visitors are welcome to share as little or as much as they like. Support groups can be powerful because it reminds us that we are not alone and that others have also persevered through challenges. Support groups can help us feel less isolated, especially when we can relate to others in a similar situation. NAMI.org lists support groups for mental health issues and SAMHSA.gov lists many resources for alcohol and substance use, as well as mental health and other important topics. Survivors of Loved Ones' Suicides (SOLOS) is an especially powerful peer-led support group.

Online groups. Full disclosure: I have not fully leapt into the 90s in terms of keeping up with social media, but I am impressed at the amount of social support my clients have found available online in chat forums and social media groups. To find one, try using a search term like “online support group PTSD." 

Fr  Friend, this is a batty season for lots of folks - you are not alone. And what do you have to lose by trying one of the suggestions here?

*****

“If you believe change is possible, you want to change, and you are willing to do the work, you absolutely CAN get your life back.”

Get your copy of The Soldier's Guide to PTSD, The Soldier's Workbook, 

or Acknowledge & Heal, A Women's-Focused Guide to PTSD