Flashbacks

A flashback is a sudden, vivid re-living of a traumatic event, as if it were happening again right now. Sights, sounds, smells, body sensations and fear return, and for a moment you may lose track of where you are. Flashbacks are a core symptom of post-traumatic stress disorder (PTSD), and they’re treatable.

Also called: re-experiencing; intrusive re-experiencing; trauma flashbacks. In films and novels, a “flashback” is simply a scene set in the past; this entry is about the symptom.

Signs and symptoms

Feeling or acting as if the event is happening again, not remembering it from a distance
Images, sounds or smells from the event returning uninvited
Your body reacting as it did then: pounding heart, sweating, shaking, freezing
Losing track of your surroundings for seconds or minutes, then “coming back” shaken
Avoiding places, people, topics or sounds in case they set one off

Flashbacks are usually set off by a reminder: a smell, a song, a raised voice, the sound of a generator, the anniversary of the event, or a news report.

Types

Clinicians describe a range. At one end, you know where you are but the memory arrives with its full feeling and body sensations. At the other, you completely lose awareness of the present and respond as if you were back in the event. Nightmares are the sleeping form: the same re-living, during sleep.

Causes

Flashbacks follow extremely threatening or horrific experiences: an accident, armed robbery, kidnapping, sexual assault, violence at home, war, a frightening birth, a death you witnessed. WHO’s diagnostic manual defines PTSD as re-experiencing the event in the present, through intrusive memories, flashbacks or nightmares, plus avoiding reminders and a constant sense of threat, for at least several weeks and badly enough to disrupt life. Most people exposed to trauma don’t develop PTSD. Distress in the first weeks is a normal reaction, not a disorder. Symptoms can also start months or years later, and prolonged abuse in childhood can lead to complex PTSD.

Treatment

The treatments with the strongest evidence are trauma-focused CBT and EMDR, delivered by a trained therapist over a number of sessions. They include learning to manage the body’s alarm and the flashbacks themselves, before any work on the memory. Across 23 trials, trauma-focused therapy didn’t make PTSD worse on average. A psychiatrist may add medicine when symptoms are severe. Working through the memory on your own, without a therapist, isn’t advised.

In the moment, two things help: name five things you can see and feel your feet pressing into the floor, and remind yourself out loud of today’s date and where you are.

In Nigeria

Many Nigerians carry trauma from road accidents, armed robbery, kidnapping, insurgency, domestic violence and harsh childhood punishment: a national survey found roughly 9 in 10 children had experienced violent discipline. A flashback is often read as a spiritual problem. WHO notes that in many cultures, traumatic events are put down to fate, envy, witchcraft or vengeful spirits. Faith can be a real support, but the symptom has a psychological explanation and a treatment, and someone living with it deserves to hear that both exist.

Flashbacks vs memories, intrusive thoughts and nightmares

A memory is something you recall as past, with some control over when you think of it.
A flashback is involuntary and feels present. The body reacts as if the danger is now.
An intrusive thought is an unwanted idea or image, often about something that never happened; it’s a feature of OCD and anxiety as well as PTSD.
A nightmare replays the event during sleep. Repeated trauma nightmares are part of PTSD.
Dissociation can happen during a flashback, but it also happens on its own: feeling unreal or far away without reliving anything.

When to get help

If flashbacks have brought thoughts of harming yourself, or you can’t keep yourself safe, get help now: call 112 (or 767 in Lagos), or Safe Place Nigeria on 0800 800 2000. The full list is on our helplines page.

See a therapist if flashbacks have gone on for more than a few weeks, or you’re organising your life around avoiding them. You can book a licensed therapist on Mytherapist.ng who works with trauma and PTSD, by video, voice or chat.