Steve Andreas’ NLP Blog

NLP Articles, News, and Tidbits about Psychotherapy and Personal Development

PTSD, Taking Action, and Flashback Memories

“Always get your patients to do things.”
—Milton Erickson

Taking Action

I recently read about some research that found that saying “Ow!” or pushing a button increased tolerance to pain, but that simple relaxation or hearing a recording of themselves or someone else saying “Ow!” made no difference. The researchers concluded that making some kind of vocal utterance may be an effective way of coping with pain, and they described this as “distraction.” However, I have a different interpretation of the results of this study.

If pushing a button works as well as saying “Ow,” that clearly indicates that a larger category of behavior than vocalization is the key, namely taking some kind of action. It may not matter what the action is, or whether it is effective — only that the person is engaged in some kind of activity in an attempt to cope with the situation causing the pain.

This may result in “distraction,” but I think it is different than simply attending to something other than the pain. Many people who have been badly injured in an accident feel little or no pain while actively attending to other injured people or coping with the situation — until they stop what they are doing.

Someone else responded to the article, describing the effect as “releasing the feeling,” but I think that is also misleading, implying that a feeling is something tangible that can be held onto or released, rather than an important signal. The purpose of having pain or discomfort in response to noxious events is to alert us to take corrective action to protect the body. Saying “Ow” is an action taken to alert others and often to solicit their help; species that don’t help each other don’t cry for help, because it would do them no good. Once the action commences, there is no need for the pain signal, and it makes sense to focus attention on the action being taken.

I once knew someone who had been in the Peace Corps in Micronesia. Walking on the beach, she got a nasty injury from a fishbone in her foot. The natives immediately got a mango and a knife, and told her to stab the mango with the knife to reduce the pain. I don’t think you have to use a knife or a mango, but taking some kind of action — particularly if it mimics the mechanism of pain, in this case stabbing in the same way that the fishbone did — can make a difference.


Action and PTSD

Now let’s explore how this may be relevant to the resolution of PTSD. In a terrifying experience, there are 3 fundamental categories of response, fight, flight, or freeze. The first two are actions, and whether or not they are effective, they appear to protect against PTSD. However, freezing is the absence of action, and those who freeze are most likely to suffer PTSD later.

For over nine years I was an emergency “first responder” for our rural volunteer fire department, responding to accidents and medical emergencies as well as fighting fires. Quite often I would arrive on the scene to find someone unmoving, staring into space, not able to do anything in response to what had happened. They surely had read about accidents and emergencies, but they had never thought it could happen to them, so they were totally unprepared, frozen.

The broader message is that being prepared to do something in a terrifying situation is important. Undoubtedly there are a few situations in which doing nothing is the best — or the only — option. But generally speaking, doing something — even if it’s not the best thing — at least has the possibility of coping with a difficult situation. It will usually have a better chance than doing nothing, and it will probably protect from developing PTSD later.


Flashback Memories

When someone has PTSD, a “flashback” memory is usually understood to be a terrifying one. However a flashback can also be to a memory with more positive emotions, as described in Wikipedia:

“A flashbulb memory is a highly detailed, exceptionally vivid ‘snapshot’ of the moment and circumstances in which a piece of surprising and consequential (or emotionally arousing) news was heard.”

“A flashback, or involuntary recurrent memory, is a psychological phenomenon in which an individual has a sudden, usually powerful, re-experiencing of a past experience or elements of a past experience. These experiences can be happy, sad, exciting, or any other emotion. The term is used particularly when the memory is recalled involuntarily, and/or when it is so intense that the person ‘relives’ the experience, unable to fully recognize it as memory and not something that is happening in ‘real time.’ ”

Some time ago I started thinking about positive flashback memories, wondering what we might learn from them that we could apply to the resolution of negative flashbacks. Let’s start with a few examples.


Positive Flashback Memories

1. When I was in my mid-20’s, living in the San Francisco Bay area, I did a lot of sailing on the bay in a 14’ boat. One afternoon I was far out on the bay, happily “planing” in which the boat skims across the surface of the water, going much faster than usual. My toes were hooked under the lip of the centerboard housing, and most of the rest of my body “hiked out” to balance the boat, as shown in the photo below.


And then my toes slipped, and I tumbled backward into the water. Now, a half-century later, I still have a vivid snapshot of the moment when I was about 3 feet under the surface of the water, looking up at an oval of sky framed by a transparent wall of water all around it, just before the water closed in over my body. I am laughing uncontrollably at the shift from supreme confidence and skill to utter chagrin.

2. One afternoon in fall, I walked out on our back deck and saw a large black bear about 20 feet up in the ash tree about 25 feet away from me. Another 25 feet away was my wife, Connirae, who was leaning down to check our tomato plants, obviously not aware of the bear. I thought she ought to know about it, so I called out her name. My voice frightened the bear, which slid quickly down the trunk of the tree and rushed away from me—and directly toward Connirae. Connirae stood up and turned toward me to see what I was calling about—and there was the bear, charging directly toward her, only a few feet away. Before Connirae had time to recognize it was a bear, she was looking into its eyes, which were also looking right at her. It looked terrified, and Connirae felt instant compassion for the poor creature, rather than fear.

3. Walking up a narrow rocky trail from a delightful swim in the clear creek at the bottom of the canyon. I suddenly found myself about 3 feet to the right of the trail where I had been walking. Only then did I become aware of the rattlesnake coiled right in the trail, which was now to my left. I was very alert, but not afraid. I walked around to get past the snake and continued up the trail.


In the first example, I was able to have an enjoyable response because of my knowledge and experience. I knew how to swim, and I also knew that since I had released the rope that held the sail, the boat would immediately head into the wind and drift slowly, so that I could easily swim to it, get in, and continue sailing. Someone without this knowledge probably would have been terrified of drowning, but I had only the surprise of being unceremoniously dunked.

In the second example, Connirae saw a relevant aspect of the rushing bear that most people might not have noticed, so she had an unusually resourceful response in what would otherwise have been a very scary experience. By the time Connirae realized it was a bear, it had dropped on its haunches, skidded to a stop, and turned 90 degrees to run away from her. She was thankful that the bear saw her before she saw the bear, because “The bear became afraid before I had a chance to.”

In the last example I must have unconsciously seen the rattlesnake and taken appropriate action, long before my conscious mind caught up with what was happening. I had a lot of experience with rattlesnakes from my childhood on a ranch in Arizona, so I knew what to do, and no thinking or deciding was necessary.

In the first example, my knowledge and experience protected me from terror, in the second, Connirae’s perception protected her, and in the third, my perception and action protected me. It’s important to realize that in all three examples no conscious thinking or decision process was involved. Now let’s explore how this information can be used with PTSD.


Resolving Negative Flashback Memories

When someone has a terrifying flashback experience, they are always back inside the experience, reliving it, re-experiencing the feelings that they had in the original. The first thing to do is teach them how to re-view the same experience in a different way, namely as an outside observer watching themselves go through it. (This process is probably very familiar to most readers of this blog, demonstrated in an 8-minute video on YouTube, made over 30 years ago. This process is also demonstrated in a 14-minute video with an Iraq vet.) After this process, the client has a neutral emotional response to the flashback memory.

Although this process resolves the memory by eliminating the terror, it doesn’t teach someone how to respond more resourcefully to any future repetition of the terrifying event. If something similar to the flashback event were to happen in the future, they would be just as unprepared as they were the first time.


Creating a More Positive Alternative Scenario

If we create an alternative movie in which we respond more resourcefully, and rehearse it in our imagination, that can prepare us for any potential repetition of a troublesome event. The primary purpose of this is to program us with alternate ways to cope with a similar event if it were to occur in the future. We will also feel more secure about our capability in the present, but that is a secondary benefit. The instruction for creating a new scenario is fairly simple, but certain criteria need to be met for it to be really effective.


Selecting, Eliciting, and Rehearsing a New Response

“I want you to recall the event that was terrifying. Without directly changing anything external to you, how could you respond differently to lessen the negative impact of that event, neutralize it, or possibly even make it positive? This could include any additional preparation, knowledge, understanding, perception, or action that is within your control. The goal is to make you more resourceful and empowered in responding to that kind of event in case something like it ever happens to you again.

“Here are some examples of what I mean. You already know that something like this could happen to you, so that knowledge is already one kind of preparation. You also know that you survived that event, so that is additional preparation for any repetition. Instead of tensing up just before the crash, you could relax instead, so that your body is more supple and less likely to be injured. You could raise your arm to ward off the assailant’s blow to protect your head. You could smile at the mugger and ask him for the time, hoping that might puzzle and distract him. You could deliberately misunderstand what someone else said. You could perceive the signs that warn you of danger, or refuse an invitation, avoiding the event altogether.

“A thorough search of alternative actions will usually turn up many, many possibilities, and some of the most uncommon or bizarre ones may be the most useful in changing the impact of that situation. If your creativity runs down, ask others for help in generating additional possibilities. After an extensive search, you may still conclude that doing nothing was actually the best option in that situation. If so, make freezing into a choice, rather than a default—something that you do, rather than the absence of doing.

“When you have identified something that you could do differently, create a scenario of you doing that in the context, with you inside the movie, looking out from your own eyes as the event unfolds. As you imagine doing something different, it is fine if that changes the situation indirectly—for instance someone else involved may respond differently to what you did differently.

“If you were to imagine a scenario in which external events are directly changed (for instance, a rescuer enters the scene, or the assailant does something different on his own, etc.) since those changes are not under your control, they would be useless in any future repetition of the event. Furthermore, changing external events implies that you are not able to influence the situation yourself, the opposite of empowerment.

“If you make a change that is within your control (such as refusing an offer of a ride home) that may change external events through changed consequences (no rape/assault). This is a legitimate and very useful change, especially if is based on specific sensory warning cues that were available but that you ignored in the original event.

“In his really excellent book, The Gift of Fear, Gavin de Becker teaches assault victims what cues to search for in the original event, in order to protect themselves from a future repetition. After doing this with a woman who was brutally raped, and barely escaped being murdered, she said something like, ‘You know, it’s funny, but I feel safer now than I did before the assault.’

“When you have created a new scenario that changes the impact of an event, test it in your imagination to be sure that it has the desired effect, and find out if you can improve it in any way. Then create at least two additional alternative scenarios — the more the better — and test them in your experience, to be sure they are effective in reducing the negative impact of the event.”


Carefully rehearsing a variety of more positive alternative scenarios in this way prepares you to respond resourcefully with unconscious choices. When done thoroughly, this prepares you to respond to any repetition with a variety of actions for coping with a difficult situation, reduce its harmful impacts, and at the very least it should protect you from a recurrence of PTSD.

Other resources:

Resolving depression/suicide/aggression

The current issue of the Psychotherapy Networker includes a “case study” describing helping a young man who was depressed in response to his internal dialogue, and in danger of being rehospitalized.

This session demonstrates how to use the comprehensive method for working with a troublesome internal voice described in detail in my recent book, MORE Transforming Negative Self-Talk.

The link to the article is good now, but may not be in another month or so; if you want to read it, do it soon.

Read the article here: Voices of Reason: Empowering clients to alter their internal experiences

We’re pleased to include this guest post written by our son, Mark Andreas. It first appeared on Mark’s Blog “Tools & Tales of Change.”


Over the years, many people have asked me, “What was it like growing up with your parents using NLP on you all the time?”

To which I like to respond, smiling, “How would you feel if your parents NLpeed on you your entire childhood?”

Then I point out that there is a big difference between using NLP on someone and using NLP with someone. Just think about the presuppositions (assumptions) of each statement:

“I use NLP on someone” presupposes that I am the actor using NLP on a passive person who is the object of my activity. Whether used for good or bad, it is manipulative. There is separateness and disconnection from the other person, with no attention given to how the other person might experience the interaction. The assumption is either that they are powerless to help themselves, that I know what they want better than they do, or that I’m going to manipulate them into doing something that goes against what they want, or some combination of these. From a metaphorical standpoint, I have to be above someone to use something on them. So I’ll be looking down on them, and they will likely feel the burden/impact of the tool I’m pushing on them from on high. The image that comes to my mind is a stone-worker chiseling away at a figurine until it looks the way he wants it.

“I use NLP with someone” presupposes that we are both benefitting from NLP together. It can only be used for good; it is cooperative. There is togetherness and connection with the other person, with equal attention given to how I and the other person each experience the interaction. The assumption is that both of us have the ability to help ourselves, that I’m using my tools to support us both discovering what we each want, and in service of us both getting more out of the relationship than either of us would have discovered alone. From a metaphorical standpoint, I have to be on the same level as someone to use something with them. It will be much more likely that we see eye to eye, and there is room for the give and take of feedback. The image that comes to my mind is of a dance between two people, or two people walking side-by-side.

So after my humorous response to people about being NLpeed on as a kid, I tell them that my experience growing up was that my parents used NLP with me and my brothers. They used NLP communication tools to support us in gaining clarity and connection with what we wanted, and to support them in communicating clearly with us about their needs and boundaries. The goal was always about finding solutions that worked well for everyone in the family.

As young kids my parents often asked us, “Mark, Loren, Darian, would you like to go to bed now, or in five minutes?” Of course we responded with “five minutes, five minutes!” But our parents weren’t using this clever presuppositional form to manipulate us into going to bed against our will. On the contrary, they were using NLP with us. They were acknowledging and honoring our ability to act and choose to a degree that was appropriate to our age. They were also front-loading the idea that it was almost time to sleep, so we could start preparing ourselves internally for that stage of the day—an essential need of every human being, both parents and kids.

Could we have said “no” to the five minutes question? Of course. But why say no to something that is done with us, and for us?

So if you find that an NLP tool isn’t working, one thing to check is, “Have I been trying to use NLP on someone? Or am I using these tools with someone?”

Using with:

1. First, change your language. Instead of “I want to use NLP on them,” or “I’m going to talk to them,” or “I was really laughing at them,” see what happens when you change to using with: “I want to use NLP with them,” “I’m going to talk with them,” “I could try out laughing with them,” etc.

2. Notice how your own internal experience changes when you change to using with. For me with is an experience of being on the same level as the other person, with eye contact, give and take, stepping into the others’ shoes, working together side-by-side, going in the same direction, and cooperation.

3. The next time you want to be more with someone, make the specific internal changes you noticed above. So for me, I picture me and the other person both at the same level and making eye contact, (even if we’re different actual heights, or about to have a conversation over the phone where I can’t actually see the other person). I picture us both together, with space between us for give and take, like a flow of energy that for me represents feedback flowing back and forth between us. I’m also aware that I can step into the other person’s perspective at any time, seeing from their point of view. Just as you make these internal changes, you can also make specific external changes that match the with. If I’m talking to a child, I like to crouch down so I’m literally at eye level with them. If I’m sitting with someone, I like to position my chair by their side, so I can literally be on their side (rather than in a face off). While making these internal and external changes, my main focus is to notice what commonalities we both have, so that we can work together on those going forward.

Learn more about using NLP with yourself and others in this 1-day Introduction to NLP with Mark Andreas, Saturday March 14th, in Boulder Colorado.

New Video of Metaphors of Movement Free

Watch this video for a fresh introduction to Metaphors of Movement.

The video is of Mark Andreas presenting at the ACHE conference, and includes some interaction with the audience plus a great example at the end.

We invite you to come to a live MoM training with Andy Austin, the developer of Metaphors of Movement, in Boulder on April 17 – 20, 2015. This will be our fifth time hosting Andy’s training, and his model continues to get better and better every year.

Click here to find out more about the training.

After sending that post, I realized that one of the results of changing auditory self-talk to a visual representation is that it strips out all the auditory tempo, tonality, accent, etc. (Words on a page have no tonality except what is provided by our reading voice, plus a few clues provided by punctuation (;!?,. etc.)

And since those tonal qualities are the major drivers of the emotional/feeling state, it creates a shift even before any other changes in punctuation, tonality, tempo, etc. That elicits a more neutral response that makes it easier to introduce a different tonal pattern or tempo, etc. when going from the visual back to an auditory representation. This seems totally obvious to me now.

Generalizing, this could be a very useful first step when working with any troublesome dialogue—write it out on paper, or a flip chart, or in space in front of a client before intervening in some other way. (This will tend to strip out the existing nonverbal qualities that are driving the bad feeling in problem contexts.)

Bruce Teall pointed out to me that this is likely an unrecognized factor in CBT’s writing out a sentence on a card to read periodically, and may be a factor in the usefulness of journaling.

This bit of clarity has given me a delicious little burst of pleasure.


CBT and nonverbal interventions

In that same post I wrote that I was not aware that CBT utilized changes in nonverbal aspects of internal self-talk, and asked for references to CBT’s use of nonverbal interventions. Maarten Aalberse, in France, sent me a reference to ACT (which is a “3rd generation” form of CBT) that does indeed include changes in accent, tonality, tempo, location, changing the auditory to a visual representation and then changing the visual representation, as well as a number of metaphors that achieve these kind of changes. I’m glad to be corrected on this.


New video on the resolution of PTSD

At the March, 2014 Psychotherapy Networker Symposium, I was part of a panel on Neuroscience. The title of my presentation was, “Therapy Isn’t Brain Science,” taking the position that neuroscience findings have no more relevance to therapy than the chemistry of wood has to a carpenter—no matter how true neuroscience is (and there is some doubt about some of it) it is a different level of knowledge that doesn’t tell us what to do with a client. I showed my 30-year-old video of resolving PTSD as an example (which at the time I called a phobia). I began with some explanation of how the basic “movie theater” visualization works, and followed the video with further explanation.

Many readers may find this presentation redundant, but the context of presenting at a national therapy conference lends some additional authority to what I have been saying for years—I didn’t just record something in my basement. The first comment on the video has already made it worthwhile to post it, because there are few experiences as satisfying as knowing that someone has made good personal use of something. I hope Santa puts something as delicious under your tree:

“Extraordinary! As I watched him work with this person, I went along with his instructions and entertained a traumatic experience I had in Vietnam.

Wow. I felt the resolution of the event—it just drained away leaving me with a sense of peace, a sense of being me without a certain background uncomfortableness that has been there for decades. A different me. A me clear. A me not affected any longer. A me with no emotional reaction to a memory of something that always used to produce nausea and upset if I thought about it.

This process is so simple and so profound all at the same time. I will be sharing this with all my therapist friends. The possibilities it offers for extraordinary relief are astoundingly powerful, assuming that the results are consistently duplicatable.

Thank you Steve Andreas.”

Real People Press

Andreas NLP Trainings banner


This blog contains NLP articles and news from Steve Andreas, NLP author, trainer, and developer.

If you enjoy these articles, please visit the Real People Press NLP bookstore for great books, CDs, and DVDs on personal change, therapy, and communication.