“One more time with feeling”: Dealing with flashbacks
In his film, One More Time With Feeling, singer and songwriter Nick Cave spoke about his experience of losing his young son in a tragic accident and the trauma and grief that lives with him. He allowed me to quote him directly in my book The Policing Mind with something very specific that has stayed with me since I first heard it. Cave refers to time being “elastic”, how in any unexpected moment while he is going about his day in the present, he can -without warning- be ‘pinged’ back to the heart of his deepest pain and the shock of his loss.
Yesterday, it was my turn.
Post-Traumatic Stress Disorder definitions call these moments ‘intrusive thoughts’, other definitions are “unbidden memories” or, more commonly, ‘flashbacks’. The media portray these as very dramatic moments in an attempt to depict their visceral, evocative, sensory explosivity with the dark gravitas of how they feel on the inside.
The weird thing is that, actually, when we have flashbacks there is pretty much nothing to see from the observer’s point of view. Yet, inside our mind, the snippets are vivid and sharp, fleeting and yet spikey, leaving you with a freaky resonance of knowing you’ve just been transported somewhere else- but your body and your ’self’ will just appear as present as ever to anyone else.
Everyday is a school day in my world and yesterday was no different. It was horrible, I won’t sugar-coat it. But there are some things to come out of it that might be good things or nearly interesting ; )
My developmental trauma reached a peak in 1985 (yup, I’m that old) when I emerged from being incarcerated in a full body cast, head to toe, in “home” circumstances that are too vile to go into, nor safe to do so. After 2 months in the cast, I was to have physio to try and get me standing, at least. What no one knew was at that time in my life, barely 7 years old, I’d decided that if I couldn’t get back on my feet and get out into the world, then I was going to give in and end things. In this very young and confused mind, that physiotherapy session had become critical in my decisions on whether to invest all I had into getting out into a beautiful world, or to accept my defeat. How that session went, was literally a matter of life and death in my inner world.
The session itself was, being back in the ‘80s, not like physio today. It was pretty brutal. I was pushed, ridiculed, and shamed, then cajoled, patronised and coerced. (And that was after my mother was asked to leave the room). Alone, on two skeletal pins, buckling underneath me, giddy at being vertical, in pain and with my heart pounding, unable to find my words, all I wanted to do was to get out.
I did get out. And as you can probably tell, I made the decision to fight. That night, I started my own action plan of waiting until everyone had gone to bed and were asleep, then getting to my feet and using the walls and furniture in my room to find my way to the door (which I then ceremoniously locked and unlocked, reminding myself of my own agency). I did OK. I recovered well, doing it my way and reminding myself I was more and more safe, the stronger and more agile I became. Which makes sense.
Yesterday, I was booked in for physio on my shoulder, 4 weeks after some pretty extensive survey but nothing too bad. The word ‘physio’ always spikes a tiny adrenalin pip in me, and I see a lot of white (I guess the uniform and the décor of your typical NHS facility) and then I feel the need to gird my loins and crack on. I rocked up fairly enthusiastic because, quite frankly, not being able to use my arm is a massive nuisance and the pain has been bloody awful (I’m one of those 10% of us who don’t have opioid receptors so I’ve had no post-op analgesia other than paracetamol and Pinot Noir).
I walked into a completely empty clinic and there was a slight chill in my stomach which soon disappeared as a very friendly chap bumbled in explaining he was just finishing his lunch and he’d be with me in a minute. The session started well with a synopsis of the surgery and some factual exchanges and a bit of neuroscience talk which eased me into the room. I explained the lack of sleep and pain was becoming a bit much but he reassured me I was hard as nails for having coped without proper pain relief and that I really did need to go to my GP ASAP to get it sorted. Feeling a bit buff, I took off my jacket and waited to start the exercises he was going to show me.
Then it happened. I looked left and all of a sudden I wasn’t actually looking left. I was in a much whiter room looking at my feet, with pain coursing up my legs and down both arms as I wobbled in between 2 parallel bars and I heard myself say in my head “It’s not going to happen, Jess, this is your last day, just get out of this moment”. It was literally less than 2 seconds I imagine. Then he’s still talking (well, his lips were moving but I couldn’t really hear words) and the room darkened back to the beigey cream glow it was before, and I could feel the temperature of the room was warmer again and could feel the weight of my fully developed body was heavier, and realised I was sitting down. I tried to reconnect to his gaze but the tears welled up in my eyes and I couldn’t focus.
So. So I realised I’d had a flashback. I took a breath. He was still talking and invited me to come and sit on a chair next to him so I could see his computer screen.
In this moment, I also faced a decision. Do I pretend nothing has happened and risk being prey to those unfiled spikes of memory again? Or, do I take my brain into my own hands, and call it? I called it. I stopped him. I apologised for interrupting and said very simply that unfortunately I had been remiss and not warned him that I actually have well-managed CPTSD but that I have just had a flashback and need to just take a second. He was brilliant. Probably didn’t say all the right things, but he gave me a second to reclaim the dignity that I thought I had lost (which I hadn’t, because he’d not noticed a thing). He let me explain in one sentence what the trauma was and why the physio setting was a little tricky for me. He kindly spoke about how the NHS and physio is different nowadays and how he, as my physio, is always going to be rooting for me and that I have a good can-do attitude and that I will be fine and we can take it at my pace. In a warm rush, I thanked him and informed him that now he needed to stop being nice or I’d cry and we had to crack on and had a plan to make.
I slowly joined in again with the present and was delighted when the opportunity for humour was presented to me like a gift from the universe, out of nowhere (as much as the flashback itself was). A colleague of his tapped on the screen to gain his attention on her way out, off shift for the day. She just looked at him brightly and smiling and bold and loud and just said four words “See You Next Tuesday”. My adult childishness kicked in straight away and as she left I followed it up with “Know you well, does she?” His face was confused and I may have got away with it.
The session culminated in some proactive planning, dates and exercise sheets. When we parted I knew that I needed to carry on being the boss of my brain and be gentle with him and myself and so I thanked him for being good with me and said that next time I should be fine.
I might not be fine next time. But this time, I tapped into how it felt to be flung back to that time, how it felt to come back to the room, to connect with the reality of the present and the goodwill of those who work in our sector, who want us to be healthy and safe. I came fully into the present, fully intact, sensing it all and accepting everything as it was.
If there is a flashback next time, I am confident that if it does happen, it will be one more time with feeling.