Autism and C-PTSD: What’s the difference between flashbacks and meltdowns?

At the end of my first post on autism and complex PTSD, I emptily promised a follow-up article pondering the nature of flashbacks vs. meltdowns.

Many autistic folks also have C-PTSD (= more or less permanent habit and perception shifts in response to repeated trauma – which doesn’t have to look “dramatic” from the outside; see a good short explanation here, or if you are familiar with the topic, check my various other articles on it; if you think you might have it, check out this brilliant and sensitive blog on healing and this supportive blog on mental health by a neurodivergent queer; and if you want to touch it hands-on (bleh), read Pete Walker’s book “Complex PTSD”). Since one of the things that can cause it is discrimination (see short def. above), queer and/or non-white and/or otherwise disabled and marginalised people might be especially familiar with its patterns (which can also run in families, for example in mine).

One of the defining features of C-PTSD is flashbacks, which however look different from the “classic” flashbacks you might be more familiar with in “classic” PTSD. “Garden-variety” (excuse my humour, not sure how else to call it) PTSD is usually caused by specific identifiable events, and flashbacks centre on impressions from these coming back into awareness. Complex PTSD can be the result of a series (could be years or decades) of accumulated stressors, where each individual stressor might not even produce a very distinct or dramatic memory – rather, it is the accumulated “feel”, or the soul state that was created over time, that “befalls” you. It might be images, but it might also be weird psychic and bodily “shifts”, either gradually or suddenly slipping into a different “mode of being”, one that is not actually a response to what’s happening now, but to your accumulated pain (that’s why it’s a flash-back, too).

I'm writing this article because in my experience, if you're also autistic, you'll confuse this with meltdowns, or it will cause meltdowns, or meltdowns will cause it. The two things will become entangled. 

Why care? Because, as I’ve mentioned in that first article, the “best practice” for dealing with these two disasters (ups, let’s call them “phenomena”?) actually really differs. At least in my experience, by various Gods and Goddesses, understanding the basics of how to avoid meltdowns improved my life a lot. And then, understanding how to “milk” flashbacks for healing (when possible) or just survive them without spiralling further down, made the difference between being often disabled by them for hours or days (or longer?) and utilising many, many of them as a learning and strengthening experience (yes, actually. But it took years that I don’t wish on anyone).

So after this introductory blah, let me try to jot down some of the differences, and above all, redirect to relevant strategies for fruitful (or at least non-escalating and non-retraumatising) encounters with both our protagonists.

Actually, first, the similarities. If you are an autistic with complex PTSD, why are you probably confusing meltdowns and flashbacks? (Ok, I don’t know about you, this is purely based on why I did.)

Why confuse flashbacks and meltdowns?

  1. They both “come over you” suddenly and make you feel crappy.
  2. Though you can learn “early warning signs” for both coming on if you try.
  3. Both can be brought on by physiological factors like exhaustion, hunger, and general stress.
  4. Both can impair your ability to wield the powers of your own mind like Master Yoda – what I mean is, they can screw up your thinking. You get fixated on things, you loop and spiral, things appear gigantic and final, tragic and inescapable, black and white … etc. You can’t stop thinking about stuff, or you blank out. Balanced logic and perspective is not always your loyal friend here.
  5. They also kick you out of your emotional balance (if you ever managed to have any, as an autie with C-PTSD. For me that was rather rare :D). You experience various emotions at an intensity that isn’t manageable unless you’ve invested substantial efforts in learning how to do so. The emotion (in both cases) can be anything: it can come from the sadness/despair family, the depression/suicidality family, the anger/rage family, the panic and dread club, and – in my experience – you might even randomly switch into euphoria, elation, and visions of light, but these will usually have a “weird”, ungrounded (not peaceful and solid, but nervous, flimsy, unsettled) quality to them.
  6. Both deplete your physiology, as well as your mental and emotional energy, and leave you exhausted, and often hyper-sensitive and irritable.
  7. Relatedly, both need substantial recovery time, or else they might amplify in a feedback loop (more meltdowns and/or flashbacks => greater sensitivity to both triggers and sensory stressors => more of the same fun).
  8. Of course, both can lead to burnout, or aggravate it. Both affect and specifically deplete the body, its resources and energy.

Now, the list of differences, as far as I’ve discovered it mostly with the help of Pete Walker’s materials, and various uncounted somatic practices that I’ve probably already forgotten about:

How meltdowns and flashbacks are different animals

  1. I understand a “pure” meltdown as a physiological crash caused by depletion – being out of energy, my system deregulates. I haven’t eaten or slept => my body doesn’t have the resources to keep the mood stable and the mind running calmly. There was too much sensory stress => similarly, my body and mind have used up too much energy (probably physiological and neurobiological factors at play, too) compensating for it, and now it’s too late and there’s nothing left to keep up normal balanced existence.
  2. And that’s pretty much it. The way the meltdown looks can be more or less spectacular, everyone has their personal flavour, from rage attack to blackout to migraine, but essentially – we over-pushed all physiological lines of stress, and now only rest and comfort (food, sleep, sensory pleasantness) and time can help.
  3. Coping strategy: there isn’t much to mess with here on a psychological level. There is nothing to psycho-analyse (I wish my first therapist had known this). You just have to figure out how to not get that hungry, that tired, that overwhelmed, by adapting your activities, rhythm and environment (I assume every autistic person knows more or less what I mean here). You can also work on strengthening your health / physiology, but above all – know your physiological and stress limits, and if you are lucky, you can find a way not to overstep them by lightyears.

At least that was my experience with meltdowns. I learnt to recognise, and in large part avoid, what stresses and depletes me. Yes, there were elements of psychological learning in here in that I had to learn to assert my needs more – and the perspective / memory of meltdowns actually helped me to for the first time take this seriously and do it without guilt (the reasoning: seriously, everyone is better off if I don’t get another meltdown, so I’m actually doing them a favour by asserting what I need to stay out of it). Frankly, I don’t think I’ve had a major meltdown in … years? Ok, perhaps months, I’m not sure, but it’s been long. I used to have multiple ones in a week for most of my young adult life before I understood the above (and before I understood I’m on the spectrum).

But I still had plenty of flashbacks after I halfway managed meltdowns. And here is how I think they are different:

(1.) Physiology isn’t the cause

While being tired and depleted definitely increases the chances to land a flashback (for me, it’s still close to guaranteed), this one is not a simple physiological crash. It’s more than that. It has a definite “flavour”; it catapults me into a “story” – I suddenly experience myself and the universe in a different way, and that way is not just “disorganised”, “acute” or “painful” (as I’d describe a meltdown) – there is some sort of structure to the chaos.

There’s a motive – and often a meaningful emotional motive.

Examples from my own life, that are similar to some from Pete Walker’s book: I may fixate on feeling insanely humiliated, suddenly live the “story” of being belittled, undermined, and I’m totally immersed in it, and seeing everything through that one lens (even things I might otherwise ignore).

Or I might suddenly (gradually is an option, too, but mine were typically sudden) be thrown into a universe in which everything is a threat. It’s not just that my startle response is heightened (as might be the case in a meltdown for physiological reasons) – there’s again a “story” to it, my mind is actively fantasising about threats, elaborating on them, projecting them, and this nightmare feels completely real (I had this variety less, filling in the gaps here).

One of my own favourite varieties was abandonment: the sudden overwhelming misery has the structure of being alone and utterly abandoned in the universe, a cold, contracted state (looking back) in which the existence of warm or responsive others isn’t even imaged or a possibility. This is accompanied by an all-swallowing panic. In this state, it often doesn’t matter if a friend is there and tries to comfort me – my mind is in its own “story”, again, and it will spin anything the friend does to feel like abandonment and loneliness, anyways (e.g. they say or do the wrong thing, “don’t understand me”, etc. – even though in another state of mind I would perceive them (correctly) as clearly caring).

So unlike a meltdown, a flashback does not need to be activated by physiological or even psychological stress. It’s not a response to it as such – it’s just that being tired can do one of two things: a) it can act as a “trigger”, reminding your body of times when you felt crappy, and thus bringing on the emotional part of that “memory”, too; b) I think tiredness and stress can also simply weaken our (my) capacity to consciously keep perspective on things and calm my emotions; that’s why dark memories have an easier time really blossoming out into full detail, where in a less tired state I would have “caught” myself and realised “hey, are you drifting into some sort of doom fantasy here?”

I think the second scenario applies mostly after I’ve already learnt to manage flashbacks somewhat, and I simply can’t do it when tired.

Still, the main point here is that the tiredness or stress isn’t the cause of the flashback (as it is for the meltdown) – it’s just an invitation, so to speak. The real cause is the series of painfully emotionally and/or physically overwhelming experiences you’ve had in the past, which resurface – at an (or any) occasion when something very vaguely resembles them (which might be a situation, image, sound, scent, person, but also just a similarly stressed feeling in your body) – and, as I’ve learnt to think of it (credit to Bonnie Badenoch’s lectures on trauma, despite the weird neuroscience theories), they resurface because they ultimately want to be healed and for you to become a stronger, more balanced and empathic person.

Which brings us to …

(2.) Psychonalyzing recommended

Unlike meltdowns, I’d say that flashbacks have a “purpose”, or at least they can be usefully thought of as having one. A flashback, I’d argue, is just an “accident”, an undesirable side-effect of over-stressing. Its one function is perhaps to teach us to respect our limits and force us to rest – but then, frankly that can (and would better be) learned without going through multiple meltdowns a week for years.

On the other hand, flashbacks aren’t just a side-effect (my personal view, taken from Badenoch) – the point of remembering is to integrate and heal. It’s a bit like splinters coming to the surface of the skin – they’re not just there to pique you, they actually need to “pass through” your adult awareness to become a “normal” (tolerable and thinkable, though unpleasant or tragic) part of your biography, rather than traveling around your insides unseen doing continued damage … so to speak.

So yes, there actually is a point here to “psychoanalysing” a bit and trying to understand what’s happening, what “story” came up, perhaps where it originated (can be helpful, though not crucial to know), and above all, what my stance is on this story now – how do I cope with the experience after the fact, typically years later, from the perspective of perhaps being a different person in different circumstances, with other capacities and perspectives and friends and resources, but above all – not being in the situation now, having time and space to more slowly digest it and its ramifications while mentally and emotionally protecting myself (which I couldn’t in the original situation). Perhaps having more skills – above all emotional skills, in my case often simply the skill to validate my own experience, tell good from bad, and find peace of mind in acknowledging “yes, that was bad, and yes, it shouldn’t have happened and shouldn’t happen to others”. Or find peace of mind in a myriad other skilful ways, with the help of others, or even just – in my case, with the help of new ways of thinking and feeling that I’ve learnt over time from humans (therapists and mere mortals), spirits, nature, and even just books.

(3.) Rodeo strategy and a lot of personal development

It’s taken me probably months of practice to even start getting a handle on emotional flashbacks even after having received plenty of useful information, so I’m not going to try to teach you in this blog post.

A starting point is Pete Walker’s website, and specifically the list “13 Steps for Managing Flashbacks“. It’s better to know the whole C-PTSD book, and it may be necessary (as it was for me) to first learn to be present in the body, feeling sensations and emotions and not freak out before being able to do anything like this with the mind. In my case, the Vipassana type of mindfulness meditation helped, but it can backfire, too (caution). Also identifying and understanding emotions (including very extreme emotions) helps a lot, and my best teacher on those remains the founder of Dynamic Emotional Integration.

A short overview over the relevance of emotions written by me is on here, and a few paragraphs on the body are here. I hope I can compile a more orderly resource list at some point, specifically with autistics with complex PTSD in mind.

Summary of solutions

In summary, the “solution” (for me) to meltdowns is awareness of physiological and psychological limits and not over-stretching them too much, and once a meltdown has happened, the strategy is to rest and replenish.

A flashback is a different animal – the only way to prevent them from happening that I’m aware of is to actually learn to “digest” and integrate (with various methods listed above, and others) the “states of being” from the past that they bring up. As we learn to manage them, they become shorter and take far less energy, and as more life experience is digested, they pop up less often.

Respecting our exhaustion limits helps in both cases, as being depleted can bring on floods of flashbacks as our body is reminded of unpleasant experiences, and as our mind is too tired to apply any management / healing steps.

Learning to identify and digest flashbacks in my experience is much more complicated than learning to limit meltdowns, as we often need to first learn new emotional skills and new ways of thinking and understanding reality that help mentally cope with our life experience. Still, the latter is both possible and in my experience completely worth it, even if it takes long, because even small improvements bring surprising experiences of inner peace, meaning, connection; and the renewed love, fascination and energy for life that arrives after a certain threshold is passed is just something everyone deserves.

Atypically for me, I finish on this optimistic note, and hope that this has been useful for someone. I’ll be happy about any feedback as to the relevance and accuracy of this, additional experiences, resources, thoughts (by autistic folk and others also). Given that I’m stuck in a curfew and my offline social life is limited, I hope I will actually manage to answer comments in a reasonable time frame. Thank you in any case!

6 thoughts on “Autism and C-PTSD: What’s the difference between flashbacks and meltdowns?

  1. Thank you. This all makes so much sense. Will ponder & process.
    I do appreciate the way you share your wtf is going on here journey.

    1. Thanks for the nod. It’s mostly content I couldn’t find in any book, so I’m making it up and wondering if it applies to others. All the best on whatever your journey is.

  2. What I like about your writing is that it has so much depth, reading it once isn’t enough. There’s a lot to consider here.

    The other thing I’m getting out of this is that I should probably read Pete Walker’s book. 🙂

    1. Haha I hope that doesn’t mean it’s overly confusing. It’s the result of years of reading and reflections on the topic, so I imagine it’s mostly relevant to people who are on a similar path and have asked themselves similar questions. But I’m not sure.

      I think the same actually goes for Pete’s book. It was a major help for me because it was the right moment to read it. I recommended it to friends, and one finds it relevant but too emotionally difficult to read; another didn’t get much from it. I think sometimes books are like puzzle pieces, they are only interesting / helpful if you have some other compatible pieces to fit them with.

      1. Oh no, I don’t think it’s confusing. It’s just very thought-provoking.

        That’s an interesting point. Yes, how useful a book is varies based on your life experiences and needs.

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