Understanding Nightmares, Memories & Flashbacks

Cinnamon:
Hello.

Erin:
Hi.

Cinnamon:
It's Erin and Cinnamon.

Cinnamon:
We're Back

Erin:
Guess who's back. Back again.

Cinnamon:
to talk about my favorite thing in the world.

Erin:
PTSD.

Cinnamon:
Okay, yes, and that,

Erin:
I thought childhood trauma was your favorite thing.

Cinnamon:
well, it, so, okay, like, so, yes. So maybe it's just like all the things that go with trauma. I find super interesting and it feels like, as if I was a detective, not because I'm necessarily, trying to figure out about my clients. I'm not invested in detective work there, but in terms of figuring out all the ways the dots connect. Like when somebody is experiencing something, or even I'm experiencing something, you know, how that dot to dot to dot, I'm like, oh, that makes sense.

Erin:
Mm-hmm.

Cinnamon:
Um, there is a comedian. I think her name's like, is that Lily Tomlinson? Have you seen this girl?

Erin:
There's Lily Tomlin,

Cinnamon:
No.

Erin:
right?

Cinnamon:
Ah, see, yes. That's what most people think. But, or Taylor, Taylor Tomlinson is her name and she had the funniest standup, uh, little tidbit that I watched. And it was like, um, how like, what's it like to go to a therapist? And she says, you know, basically, you connect all this, you take the red string to connect all these dots. And it's like the row, the board that the rogue detective that got too personally involved and got kicked off the case has 

Erin:
in his bedroom.

Cinnamon:
like up on his wall at home. Right. And, and so she's like, so when you take the string and move it here to here to here, now you can see why every single thing that's going wrong in your life is directly related to a childhood trauma. And then Taylor's like, so does that mean that I'm fixed? And she says in the voice of the so-called therapist, oh no, no, come back next week with your credit card. And

Erin:
Hehehe

Cinnamon:
she's like, well, how long do I have to come? And she's like, we'll talk about it later, just come with your credit card. And I find that one hilarious because she talked about that stereotypical. rogue detective that got kicked off the case that has it on his wall at home. And also just the reality of how the way we move throughout the world is so deeply tied to the

Erin:
childhood.

Cinnamon:
things that we learned in childhood

Erin:
Mm-hmm.

Cinnamon:
that we wouldn't even have thought of those things as being something we learned. We oftentimes conceptualize it just what, what it is. Not

Erin:
Yeah.

Cinnamon:
that it's a perspective, but, you know, as a child, I thought that was one way to make lima beans and it was disgusting. Like so, so gross.

Erin:
I mean, they're still not that great.

Cinnamon:
They're not that great, but I didn't know, I thought that's how you prepared lima beans. And I always called them pus pockets because

Erin:
Ew, God.

Cinnamon:
I know, that's why I didn't eat them, cause they're so gross. And then, I go out to fancier restaurants and they have lima beans or even a fava bean. And I'm like, oh, okay, so these aren't what I learned. And I'm not disparaging my mother's cooking. She is a wonderful cook. And she also is not going to be surprised about how I feel about lima beans. This has been a lifelong journey. So when you get exposed to different things and then you're like, oh, so the way that I thought it was is just one possibility, then those are things that come to our attention, but we don't know what we don't know.

Erin:
Yeah. Well, and that's what we're going to talk about today. And we promised this educational series, which we have yet to come up with a different name, but it works. Whatever, we'll just stick with it

Cinnamon:
you know what we're talking about.

Erin:
Yes, you do. 

Cinnamon:
our cleverness has been dispersed in other areas, but we will sling back here at some point and come up with a fun name. If you have a suggestion for what we can call our educational series, feel free to call the hotline on the website or quote, call the hotline, more so go to the website and record yourself and give us a suggestion for what to call this.

Erin:
or even more streamlined would be to just figure, fill out the contact form on the website

Cinnamon
Oh, yeah, The contact us form,

Cinnamon:
Yeah.  And be like, ladies, how did you not know that we were going to, you should just call it this.

Cinnamon:
I have a feeling.

Erin:
But if you want to call the hotline and also say that about what we should call it and leave a message about something different, then go for it.

Cinnamon:
Feel free. All right,

Erin:
So

Cinnamon:
so today we're breaking back into the post-traumatic

stress disorder criteria, and we're talking specifically about the second group of symptoms, which we lovingly call criterion B. And so with that being said, Erin, would you like to break it down and read? to us the actual official language of the DSM. The diagnostic and statistical manual.


Erin:
All right, we're going to rant back in. All right, so criterion B, and this is from the DSM-5, which Cinnamon talked about what that was on the last episode,

Erin:
so criterion B is presence of one or more of the following intrusion symptoms associated with a traumatic event or events beginning after the traumatic event has occurred. Number one, recurrent involuntary and intrusive distressing memories of that traumatic event. Number two, recurrent distressing dreams in which the content and or affect of the dream are related to the traumatic. event or events. Number three, dissociative reactions, for example, flashbacks, in which the individual feels or acts as if the traumatic event were reoccurring. Number four, intense or prolonged psychological stress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event or events. marked psychological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic events. Number five, marked physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event or events.

Cinnamon:
So now imagine that you're just an everyday person and You're reading this. How many of those of the five would you just be like, oh yeah, that totally sounds like me.

Erin:
I mean, the one thing that like stands out and that makes sense, I think the most would be flashbacks, because it says, for example, flashbacks, you know,

Cinnamon:
Also,

Erin:
it tells me

Cinnamon:
I,

Erin:
specifically right there.

Cinnamon:
and distressing dreams, like that, you know, to me, let's just call it a nightmare.

Erin:
Nightmare.

Cinnamon:
But

Erin:
Yeah.

Cinnamon:
I think this is part of the reason that we're even doing this is because this wasn't meant for our audience. This was meant for us. But we, we, us meaning as clinicians, but in reality. Like there's still a gap if we don't know how to explain it and we just read this and the answer is like yes or no or to what severity? Like most people are gonna be like, mm no, I don't have that. Cause they're like, what the hell are you talking about? I don't know.

Erin:
It's easier just to say, no, I don't have it, than ask, what does that mean?

Cinnamon:
Right. So

Erin:
Yeah.

Cinnamon:
that's why we interject these like daily experiences that can close that gap between what we are experiencing as and what the DSM likes to use this language. So, Erin, will you read number one again for us, please?

Erin:
scroll. Number one, recurrent and voluntary and intrusive distressing memories of the traumatic event.

Cinnamon:
Okay,

Erin:
So this

Cinnamon:
so.

Erin:
is different than flashbacks. This is just

Cinnamon:
This

Erin:
memories

Cinnamon:
is

Erin:
that

Cinnamon:
different.

Erin:
come out of nowhere. Okay.

Cinnamon:
Yes, so one of the, the way we talk about this category is we talk about the word intrusive, but there's also a lot of dialogue around the word re-experiencing. And when we say that, I always like to think it didn't get invited to the party and yet here it is. Right, so it doesn't have to be that we are intentionally thinking about it, these are things that just like pop in our head and we're like, where did that come from? Or we don't necessarily have to be like talking about it, thinking about it at a particular place, you know, anything is just for whatever reason, something has reminded our brain, even if it's the potential of a threat that then brings this about. So,

Erin:
So it's like that

Cinnamon:
we

Erin:
idea

Cinnamon:
see

Erin:
of like

Cinnamon:
this

Erin:
coming

Cinnamon:
happen

Erin:
out

Cinnamon:
a lot.

Erin:
of left field.

Cinnamon:
Yeah. And we see this a lot, I think, with suicidal ideation where people are like, I don't wanna kill myself. I don't wanna hurt myself. And yet this thing just like popped into my head and it freaked me out. And so that is super sexy. Yep, Aaron's eaten a grilled cheese, a t'wa tree, a t'wa. Trois-formage sandwich. Yeah. So

Erin:
Thanks for watching!

Cinnamon:
did you like how I know how to say three cheese in French?

Erin:
Do your

Cinnamon:
Yeah.

Erin:
brains hot.

Cinnamon:
Or trace queso. Like I can do it. I'm multilingual. So these intrusive memories that we're talking about where they are uninvited, they oftentimes will take like a visual image. of like a part of a traumatic event, or it can just be like a thought where when you've had a trauma experience and there's been a threat, your brain is going to make those offerings of protective questions. Is it possible that this could be happening or this did happen? I had a friend disclosed to me recently that because of a past experience of hers, um, and we've been friends for, I don't know, four years now. And she didn't tell me this until recently that, um, she had a thought of, was cinnamon sent in by X organization to monitor me. And it was so

Erin:
Mmm.

Cinnamon:
interesting to hear this super healthy. you know, her self-care is on point, takes care of other folks, and still because of her past traumatic experience, knowing me, knowing, you know, what I do, who I have been to her, that it still popped into her head. What if these people hired her? And I just thought that was so intriguing.

Erin:
So that would fall into number

Cinnamon:
an intrusive

Erin:
one.

Cinnamon:
thought. Yeah.

Erin:
Yeah, so like the first thing I thought of in my own life is this thought that pops in my head often about something happening to my children or them like passing away suddenly. And it will come out of absolutely nowhere. It would come out of a place where we're having fun, and then out of the blue I'm like, oh my gosh, they could die tomorrow. It's like random, would that

Cinnamon:
Yeah.

Erin:
be the same thing?

Cinnamon:
I mean, I would say that that would fall into the category of an intrusive thought, but I would also separate that out from post-traumatic stress disorder from like just parenting or what our friend, Brene Brown likes to call foreboding joy.

Erin:
Ah, yeah. What's just

Cinnamon:
Right.

Erin:
a whole other podcast episode?

Cinnamon:
That's a whole nother podcast. So like, why, why we just like live in disappointment rather

Erin:
Yeah.

Cinnamon:
than be disappointed. Um, so this can, so intrusive memories can be, uh, you know, I'm talking about a car accident that I got into and all of a sudden you started thinking about your car accident. Or we. could be doing nothing with cars and it pops into your head. So it's kind of imagine it as if your mind's eye has snapshots, which is why we like to get rid of those in counseling, but it doesn't end at just these images. It can be thoughts where there's no image, like what I just described. It also can be sounds, smells, tastes. and bodily sensations. So most first responders that I've spoke to about this can tell you what blood, like what blood can smell like, different types of fire they can determine from the smell and our olfactory senses, which is our smelling, is actually our most sensitive when it comes to flashbacks. or I'm sorry,

Erin:
Yeah.

Cinnamon:
not flashbacks, but those intrusive symptoms. Like I had this weird thing happen, and this was years ago, I was walking through the perfume section of a shopping mall in like a Macy's or a Lazarus or something like that. And I smelled this perfume and I immediately said, that's Mrs. Rowley. That's, and I mean,

Erin:
What?

Cinnamon:
I easily was like in my 30s and Mrs. Rowley was my kindergarten teacher.

Erin:
Yeah, I have

Cinnamon:
And

Erin:
that same experience

Cinnamon:
I.

Erin:
with my mom in perfume.

Cinnamon:
Yeah, I went on Facebook Messenger and messaged my kindergarten teacher's daughter and said, can you verify what perfume your mom wore?

Erin:
Ha ha.

Cinnamon:
And sure shit. Like that was it. And which without disclosing my age, like kindergarten was a minute ago. And

Erin:
it yes

Cinnamon:
it's still yes. So this is very specifically where you're not asking. for these thoughts to come in. You're not actively thinking about it. It just, you're in a situation that for whatever reason, it triggers your brain, not necessarily you, but your brain to offer up this intrusive image, thought, or other sensory signal that brings you back to the traumatic event or events. Now we keep going back and forth. The criteria for PTSD varies specifically about like the way we read it. It's about like one thing, right? So it's assuming that traumatic event is a one-time occurrence. So like a car accident or an assault, things like that. Whereas we know that our people, they don't necessarily know the different smells of different kinds of fire because of one. incident. So even though

Erin:
very

Cinnamon:
we

Erin:
unlikely.

Cinnamon:
go as far as saying the S is like in parentheses at the end of traumatic event, it is written in a way that we use in singular form. Whereas the reality is, is that even if there is a critical incident that is what we're focusing on, that does not discount years of service before and the years of service to come.

Erin:
Mm-hmm. Or anything outside of the profession that

Cinnamon:
Oh

Erin:
can

Cinnamon:
yeah.

Erin:
be tangled up in all of this.

Cinnamon:
Absolutely.

Erin:
Mm-hmm.

Cinnamon:
So. We know that even though we're talking about PTSD, there is another diagnosis called acute stress reaction or acute stress disorder. And I feel the biggest reason for his existence is because PTSD doesn't kick in until 30 days after an event. That's when we

Erin:
Mm-hmm.

Cinnamon:
start identifying it as problematic. But if some shit goes down, we don't, we're never going to say, Hey, we can't help you because it happened three days ago. So, and for the purpose of insurance and getting diagnostics taken care of if we couldn't diagnose somebody with post-traumatic stress, if it hadn't been 30 days. And we'll talk about that towards the end of this particular diagnostic series. But so what do we do for those people that are still within that 30 days? Well, that's considered an acute stress reaction. So we know that after a traumatic event, like a lot of these intrusive memories are going to decrease over time. So there was a study done on motor vehicle accident patients and. they monitored them from the time of the accident moving forward. And I wanna say like the last check-in was at a year. And so like at the beginning in the first few weeks, like 76% of those patients reported intrusive memories, but then it dropped to 25% at three months, and then it dropped to 24% at one year. So the presence of those don't necessarily indicate that they're gonna be persistent. Um, some they will, some they won't, but that's why we're not necessarily going to, um, require this full blown diagnosis if that's one of your presenting symptoms early on, because we're hoping that with time it will decrease organically. Um, even if this is the only symptom that you have, uh, this is pretty distressing in its own right. Like it doesn't, um, whether you have a diagnosis or you don't, it can be really, really bothersome, uh, to have these, whether it's constant or infrequent, but regular and consistent intrusive thoughts or memories. And it can be frustrating because when we're so used to being the helper, or we're so used to being in control of situations, and then we are having these uninvited thoughts and images pop in our head that we feel completely disempowered to do anything

Erin:
Mm-hmm.

Cinnamon:
about. Like it's frustrating. And a lot of times frustration can look like anger.

Erin:
Yeah.

Cinnamon:
And so if this is something that somebody is experiencing by all means, there are interventions that clinicians can use that can help decrease that, even if that's the only thing that's bothering you. And I think, you know, one of the reasons I wanted to go through these criteria, the criteria for the diagnosis like this is because of people's beliefs about whether or not they could or do have PTSD.

Erin:
Mm-hmm.

Cinnamon:
And the reality is, you know, meeting the threshold for a diagnosis, it's only as important as how you value it, right? So if you're looking at like a disability situation, yeah, we would need you to meet criteria. But the reality is, is that you do not have to meet criteria for this to be causing a struggle in your life. And

Erin:
Mm-hmm.

Cinnamon:
that, and I want people to understand all of the ways that these struggles can occur and look and examples of how they can show up in our lives.

Erin:
Yeah, and you don't have to wait to actually have the diagnosis of PTSD to find treatment for any one of these factors too. You don't have wait until...

Cinnamon:
Well, and the reality is most people wouldn't know what the criteria is to know that they would be diagnosable or like you have to go see somebody to get diagnosed.

Erin:
Mm-hmm. Yeah, I mean, I guess I think about the context of our first responders, this idea that it's not unheard of for PTSD to be a part of their lives. You know?

Cinnamon:
Well,

Erin:
It's...

Cinnamon:
what happened with your uncle this weekend?

Erin:
Yeah, at a family reunion with my uncle, well, he's my cousin, I started to say uncle, with my cousin is, you know, he's a 60 year old retired firefighter. And he had shared with me that it would be hard to, you know, pass the dead baby on that you know, he knew was dead to, you know, the hospital or whoever, and then just go back to the firehouse and go to sleep. And that, that's one of those things that, it just doesn't go away. And so all of those situations can linger for a long, long, long time.

Cinnamon:
Well, and even when you told him that we were doing this podcast, didn't he is PTSD

Erin:
The first thing he said was, is it about PTSD? Yeah. Yep.

Cinnamon:
Yeah, so, and this happened before where someone who never would have been known in their active career as a proponent of mental health care and how it impacts them as retiree was like, oh, like it's about time we're doing this because this is so needed. And it was shocking to some of their former coworkers. because that was just not their MO. And I'm like, sometimes it takes a little time, a little space. And sometimes they were thinking that all along, but it just wasn't in an era where you could talk openly about it. Um, also the trick with these unwanted and upsetting or intrusive and re-experiencing memories is that they can drive other symptoms. So when we talk about in the following episodes, um, the criterion C, D, and E. Um, when we get into those, the avoidance symptoms, the negative alterations in cognition and mood, and then the hyperarousal symptoms. Like when you are having these intrusive memories and intrusive thoughts, it's going to jack up these other areas that, you know, if it's intrusive and you don't want it, then of course, it could easily result in avoidance, right? Like,

Erin:
Mm-hmm.

Cinnamon:
how do I avoid these intrusive things? And, and we work really hard. But that's not how it works. We can't just avoid them

Erin:
Mm-hmm.

Cinnamon:
Um, the other thing about the intrusive memories is even though we don't like it and we want to get a handle on it, that doesn't mean that it is not our brain trying to keep us safe. Right? So it's some adaptive function of survival. Now, albeit maladaptive. but it still is an effort for that physical and psychological self to survive out of, you know, what's happening. So think of it as like a warning signal or our brain's way of helping us from further future harm. So I used to say a lot, the PTSD patty running around in people's heads, She never wanted anyone to live in a household with electric and running water because God forbid the blow dryer drop in the bathtub. You know, so that is the degree that our brains are working to keep us safe. So even if it's not effective, that doesn't mean that the effort isn't there. sense.

Erin:
Mm-hmm.

Cinnamon:
And the idea of these intrusive or persistent distressing memories, they happen for normal people, right? Like this is not an exclusive experience for somebody who's experienced trauma or even meets the criteria for PTSD. But it's kind of like one can be two, but two can't be one. So Intrusive thoughts can show up in multiple issues, like anxiety or depression, grief, obsessive thinking. But we're talking about it specifically as it relates to trauma. But I don't want anyone out there to think, oh, I have these intrusive thoughts, you know,

Erin:
I must have PTSD.

Cinnamon:
right? Like, ah, I just remembered that I need to go to the grocery store. Like that's, that's that we're not going to call that an intrusive thought. We're going to call that means and ways of not getting in trouble at home. 

Erin:
Just a regular old memory

Cinnamon:
Right.

Erin:
regular old thought. Okay.

Cinnamon:
So the interesting thing about this is there are ways to reduce the impact as well as the frequency as well as to get rid of all of them. But it requires talking about it.

Erin:
You

Cinnamon:
Right?

Erin:
mean to

Cinnamon:
So

Erin:
another person?

Cinnamon:
like to another person, this

Erin:
not just to myself but out loud

Cinnamon:
one of those Stuart Smally kind of things

Erin:
Although that probably wouldn't hurt too, in addition.

Cinnamon:
Hey, I have a mirror in my office that says, I'm good enough, I'm smart enough, and gosh darn it, people like me, that you too can hold up to your face if you are...

Erin:
and be reminded

Cinnamon:
my office. So yeah, like two factors that increase the likelihood that this is gonna stick around is that preexisting negative emotions. So I already felt bad, right?

Erin:
Mm-hmm.

Cinnamon:
Like I felt bad about myself. I felt about the way the situation went down, how I performed in it, how I handled it, and the negative emotions like sadness or anger or frustration or embarrassment. The other is just like that negative appraisal style. Right, the way I evaluate myself is by all definition harsh. Right, so like, man, I screwed that up, I'm a piece of shit, I'm so embarrassed that everyone saw that and I'm frustrated that I didn't do better. That is an ideal setup for those intrusive memories to keep going. So

Erin:
that negative

Cinnamon:
the way...

Erin:
like I'm, I always do this. I'm just a piece of crap. I can never get anything right. Is that the same thing? Okay.

Cinnamon:
Yeah, yeah. So that the, I can never get anything right. I'm a piece of crap. That's gonna fall under that negative appraisal style.

Erin:
Mm-hmm.

Cinnamon:
Like how are you appraising yourself? How are you evaluating yourself? And then the preexisting negative emotions are, you know, we all know the grumpy guy, right? And if you don't know the grumpy guy,

Erin:
You're the grumpy guy.

Cinnamon:
you're probably the grumpy guy.

Erin:
Ha ha ha ha.

Cinnamon:
So yeah, if I'm already, feeling bad about how a scene went, and then I am really self-critical, then yeah, we're going to increase the likelihood of those intrusive memories or thoughts. They're just gonna keep coming. So even if, you know, your idea is, I don't need therapy, but I need to talk about this. Reach out to a friend, a loved one, a peer support. Like this is where word vomit can be helpful and get that another perspective or just the ability to have someone listen while you get it out. The other option is if you don't feel comfortable going to people in your personal life or your professional life and talking about that, then contact a therapist. This is, again, we'll go back to, this is why we like to have our folks. um, really think about seeking out a therapist, vetting a therapist, having a therapist, you know, on speed dial.

Erin:
in your pocket.

Cinnamon:
So in your pocket, so if something does happen, there's not a question of what you'll do. That doesn't mean that you have to be in therapy every week for the rest of your life. It just means you already have the resource in the moment rather than having to look around for it.

Erin:
Mm-hmm.

Cinnamon:
Um.

Erin:
Yeah, so. folding into number one, which is the while you're awake intrusive thoughts.

Cinnamon:
Hehehe

Erin:
There is the while you're asleep intrusive thoughts, if you will, or what are called nightmares. And the specific definition for number two from the DSM-5 is recurrent distressing dreams in which the content and or affect of the dream are related to the traumatic event or events.

Cinnamon:
So my husband and I watch A Million Little Things and we are also very, very behind. But we are watching it and this actually came up because one of the characters who is married to a psychologist had a dream. So of course she runs into the living room where there's wall-to-wall bookshelves and she grabs her dream interpretation book.

Erin:
Hmm.

Cinnamon:
and is getting ready to figure out what it meant. And my husband just kind of laughed because this is the shit I do, right? I'm like, ooh, hold that thought. And

Erin:
Yeah.

Cinnamon:
then I'll go grab a book off the bookshelf and then therapy is him and he just really enjoys that.

Erin:
Well, it's like what happened with my son, you know, having that god awful dream that he called me about that really was distressing for him. And

Cinnamon:
Yeah.

Erin:
the first thing he wanted to do was interpret it. Like, what does, when this happened, what does that mean? What does it

Cinnamon:
Right.

Erin:
actually signify? Whereas his mother and a clinician, I'm like, oh, well, it sounds like in fact, it's PTSD. I mean, not in a joking way, but I'm like, this is deeper than trying to pick apart a dream. which

Cinnamon:
Yeah,

Erin:
I won't get into his personal story but...

Cinnamon:
well, and luckily you know more of his symptoms than just one out

Erin:
Exactly.

Cinnamon:
of criterion B.

Erin:
Right, right. So I don't want people to think because you you have a negative, a bad dream. All of a sudden

Cinnamon:
Yeah, Erin's like, PTSD it is!

Erin:
Right. No, there's more to the story, but obviously I don't want to get into his stuff on here. But it's just that example of

Cinnamon:
Yeah.

Erin:
we want to understand, like there's got to be a logical thing like...

Cinnamon:
We're curious, yeah

Erin:
it's like what, when you dream of walking into school naked, what is that whole thing? You dream of walking into school naked, it really means that you need more hugs. I mean, I don't know. I don't know really what that means, but it's

Cinnamon:
But

Erin:
like.

Cinnamon:
I'm going to need you to put clothes on first before

Erin:
I hug you.

Cinnamon:
I hug you. Yes.

Erin:
Right, but the point is, it's like, it usually has, even when you read these dream interpretations, it usually has nothing to do with what's actually happening in the dream. So.

Cinnamon:
So well, and that's dream interpretation books are a little bit different, like, okay, well here, let me explain. So when we dream specifically during REM sleep, it is intended to help foster like problem solving, memory consolidation and emotion regulation, right? Like

Erin:
Yeah, like

Cinnamon:
that.

Erin:
the movie Inside Out. The movie Inside Out.

Cinnamon:
Yes.

Erin:
Where it

Cinnamon:
Yes.

Erin:
takes the dreams from short term to long term. I always

Cinnamon:
Yes.

Erin:
picture those little guys of running around in my mind. Anyway,

Cinnamon:
So cute.

Erin:
watch the movie if you haven't watched it, folks.

Cinnamon:
And what's it called?

Erin:
Okay, Inside Out.

Cinnamon:
And is it a Pixar film?

Erin:
Yeah, you've seen it, haven't you?

Cinnamon:
I have. It's been a few years. I just remember somebody was blue.

Erin:
Yeah, oh my gosh, we gotta take it to Geneva's.

Cinnamon:
We got to take it to grandma Geneva's

Erin:
I'm sorry.

Cinnamon:
to the, do we have a DVD player that we can, we'll hook up. Okay. So, so anyway, we're trying to, uh, our brain is wide awake while we are asleep and it is at work and it is doing the job to take everything that happened that day and consolidate it, make sure that emotionally we're regulated and that, you know, we can figure out our shit. But we also know that while we're in REM sleep, our brain chemistry changes and our adrenaline level drops to nearly zero. And so that allows us a very safe, soft place in our dream life to be able to process these dreams. and work out this stuff where there is absolutely no stress. And in that way, sleep is kind of like therapy

Erin:
Mm-hmm.

Cinnamon:
because it's giving, which is why we say therapy or sleep is so, so important, but that's what's happening for a normal person. However, for folks with post-traumatic stress, the adrenaline-free environment does not exist. And in fact, the levels of adrenaline don't change and it can actually get even higher. And so in that adrenaline free environment, the brain can process the memories while stripping away like the emotional edges. Whereas for folks with PTS, the adrenaline is still there. all of the emotional edges are still there and it's going to be harder to process. And we know that 71% to 96% of people with post-traumatic stress have nightmares. And then when there's like another co-occurring disorder, so let's say you have anxiety or you already had depression, those, the number, the percentage of people that are having those nightmares, it's gonna increase.

Erin:
So

Cinnamon:
And,

Erin:
when you say, let me ask you a question. You say

Cinnamon:
okay.

Erin:
the studies show that it's a 71 to 96% chance that you're gonna have nightmares, but everybody has nightmares. So is it like that they have consistent nightmares or it is like basically a guarantee? I mean, I guess I just want some explanation there. So,

Cinnamon:
So what you just said reminded me of the weather. And when I learned what the difference between, when I learned what it meant when people, when the weatherman said a 30% chance of rain, because I took it literally,

Erin:
Mm-hmm.

Cinnamon:
I thought that that meant there was going, there's a 30% chance that it will rain. That is actually not what it means,

Erin:
Now

Cinnamon:
even

Erin:
it

Cinnamon:
though

Erin:
means

Cinnamon:
that's what they say, it's not

Erin:
30%

Cinnamon:
what it means.

Erin:
of the area in which,

Cinnamon:
Yes,

Erin:
yeah.

Cinnamon:
why don't they just say that? So, but I say all that to say that in this particular study, 71% to 96% of the people in the

Erin:
Mm-hmm.

Cinnamon:
study with PTSD experienced nightmares. So it's not that if you have PTSD, you have a 71% chance of having nightmares. It's we're taking this one group of people and... then we're going to say in general, it's gonna be pretty common across the board for people with post-traumatic stress disorder to have nightmares.

Erin:
Got

Cinnamon:
Now,

Erin:
it.

Cinnamon:
so here's where we kind of get into it. I wanna throw in just real quick about the reason that... when we process the day and we have these dreams, sometimes we remember them, sometimes we don't, that adrenaline level is bottoming out and it is a stress-free environment to process that. There is a theory out there for those who have post-traumatic stress that that adrenaline doesn't go away completely. And so it actually becomes very difficult to process those tough memories of what... a critical incident or some experience was. And so it just continuously cycles through them. And when that happens, it makes it even more difficult for the brain to like decipher what kind of memory it is, long-term, short-term, as well as like how to store it and process it.

Erin:
Yeah,

Cinnamon:
And...

Erin:
it's like the data is too, the file is too large to be downloaded in that other drive almost. So it gets stuck.

Cinnamon:
Yeah. And I would even go as far as saying the contents in the file get stuck and the file is actually corrupted because of the environment, the stress, like heat, right? Like heat will destroy a computer thing, I guess they tell you not to leave it,

Erin:
Like

Cinnamon:
you

Erin:
your

Cinnamon:
know, in

Erin:
phone,

Cinnamon:
certain

Erin:
if

Cinnamon:
places.

Erin:
you leave your phone in the heat.

Cinnamon:
Yeah. So if that is, if that, if we can compare heat and your phone and it can destroy the information or it doesn't know how to work properly. It's like taking those memories and putting them all in one folder and that folder getting corrupted. And

Erin:
Mm-hmm.

Cinnamon:
so it's just making it harder and harder to process that memory into a healthful place. And that's why we have like reoccurring nightmares. But there's two kinds. might help people understand the difference between, you know, possibly, um, I woke up and I had, or I woke up from a dream where I was walking through the school hallway, you know, with a clown wig on, you know, like what the hell does that mean? So there's two types, one is the replicative and then the other is the symbolic and those are pretty, um, easy to understand in the sense that replicative and this is, this is when it's going to incorporate some element or contain like exact replications of that actual traumatic event. And those are the obvious ones, right? Those are the ones that we don't pull the book down or the dream interpretation book down from the shelf.

Erin:
because it's the exact thing that happened, right?

Cinnamon:
Yes,

Erin:
Or

Cinnamon:
or it's so

Erin:
it's...

Cinnamon:
obvious it contains parts of it. Yeah.

Erin:
Like it might be different people, but the event is the same.

Cinnamon:
Yes.

Erin:
Or

Cinnamon:
And.

Erin:
people are faceless or something in the dream, but it's clear.

Cinnamon:
Yeah,

Erin:
Uh-huh.

Cinnamon:
but it might be, you know, the same kind of call,

Erin:
Mm-hmm.

Cinnamon:
right? Or it's maybe a different cast of characters, but the location is the same,

Erin:
Mm-hmm.

Cinnamon:
that kind of thing.

Erin:
Yeah.

Cinnamon:
But there's some element of the actual traumatic event that shows up. The other kind of nightmare is symbolic. And the symbolic nightmares are where people are usually going to the bookshelves to pull down the dream interpretation book.

Erin:
Mm-hmm.

Cinnamon:
And this is only like a quarter of those nightmares that people experience. But I find this really interesting because it doesn't exactly replay the traumatic event, but it's symbolically related to that traumatic event. So it might not be too far to

Erin:
Ooh,

Cinnamon:
say,

Erin:
I have an idea. Okay,

Cinnamon:
okay.

Erin:
tell me if this would be an example. So like reoccurring nightmares about being stuck in quicksand, for example, and you're sinking in quicksand and you can't get out. Well, that might actually symbolize this idea of being stuck in depression or stuck in a bad relationship or stuck. And I'm not saying this is what the dream books say, but I'm thinking

Cinnamon:
Yeah.

Erin:
about this idea of being like, when you're in the quicksand, it's like this idea of being stuck in something in your life with that.

Cinnamon:
or held down on gunfire,

Erin:
Mm-hmm.

Cinnamon:
or being stuck after having fallen through the floor at a live fire,

Erin:
Yeah.

Cinnamon:
right? Just that stuckedness.

Erin:
Mm-hmm.

Cinnamon:
So that's exactly what it is. Like the symbolism of what is, what the critical incident or traumatic event, it's there if you look for it and piece it together. I know, right?

Cinnamon:
Number three...

Erin:
OK. Number three, dissociative reactions. For example, flashbacks in which the individual feels or acts as if the traumatic event or events were recurring. That one's like the one that I said was the most obvious. I mean, obviously nightmares, but the most obvious of them all.

Cinnamon:
And yet there's still a tricky twist. So when we just look at the definition of flashbacks, that's when your brain gets flooded with those images, physical sensations or a sense of reliving a trauma. I always use the example like when you hit the ground and you think you're back in NAMM in the jungle, right?

Erin:
Mm-hmm.

Cinnamon:
Like that is that stereotypical. commercialized made for TV movie kind of image of what a flashback is.

Erin:
Yeah.

Cinnamon:
But there's also a second kind of flashback and that's an emotional flashback. And they're not visual, they're just emotional. And more often this actually can be associated with a more complex level of PTSD. So think of that in terms of... I, when we talk to clients about, when they are told by somebody that they're overreacting, right, that overreaction, it's, whoa, however you are handling this is way more intense and above what's appropriate for what just happened. And I said, it's not because you're having an overreaction, you're having a multi-reaction.

Erin:
Mm-hmm.

Cinnamon:
The, if, you are in, if I, Aaron, if you and I are fighting and we're fighting because you moved a Post-It note and I get like super angry

Erin:
Ha ha.

Cinnamon:
and livid and just start screaming at you, you're going to be like, whoa, cinnamon, like that is so over the top and so

Erin:
Oh,

Cinnamon:
disproportionate.

Erin:
you mean like that time where you were supposed to spend the night and then my son was spending the night and you couldn't have the bed. And so

Cinnamon:
Where did I go?

Erin:
you and I said, well, our solution is to have this air mattress. We can move people around. And it really hit you hard

Cinnamon:
Oh yeah

Erin:
that I gave up the bed that I promised you. But now I know, you know, there was there were other things going on in your life that I didn't know at the time. but it was one of those things where to me it felt like, whoa, that was really over the top about sleeping arrangements, but it had nothing to do with sleeping arrangements.

Cinnamon:
And that's where it parallels with complex PTSD. It's that emotional flashback of I have felt this message before.

Erin:
Yeah.

Cinnamon:
I am insignificant, I am not important, I don't count, I can be disposed of, you know, those emotional flashbacks. So when we see something in somebody that feels like an over the top reaction, it's often... It could be, let me not say it often, but it can be an emotional flashback where they're not responding to what actually just happened. They're responding to all of the past events that what just happened triggered them

Erin:
Yeah,

Cinnamon:
to think of,

Erin:
I just had

Cinnamon:
right?

Erin:
one of those experiences on Saturday morning where it was very, very similar in relation to not feeling like I matter in the role that I'm playing in an individual's life, trying to be cryptic about it. But the message that I received was, you will always be second to this individual. you know,

Cinnamon:
Yeah.

Erin:
and I know that was not, that was not the case.

Cinnamon:
the intention.

Erin:
The intention was not that, but that was how I interpreted it. And it, I was very upset by it. And it's just one of those things

Cinnamon:
So then of course we, in addition to the emotional flashbacks, I kind of like skipped over the actual flashbacks. You know, the actual flashbacks are going to be more what is commonly associated with a like traumatic event rather than like complex PTSD. Let me rephrase that. So flashbacks... in general, right? The way that we think about flashbacks when we hear that term. That's when our brains are getting flooded with images, our bodies get flooded with physical sensations, and we have this sense of reliving the trauma. Like what we see out of our eyeballs, what we feel in our body, what we sense on our skin, all of that is taking us back to the actual Whereas the emotional flashback, we're still gonna know the time and the space and where we are, but we're not going to have the ability to recognize our reaction to something is that multi-reaction. And I think we all know the person who when they retell a story about something that happened, it can be helpful to get that out. But we

Erin:
Mm-hmm.

Cinnamon:
also know the person that when they are retelling the story, they can get just as mad as they were in the moment that it happened. And that is more along the lines of what we're talking about in an emotional flashback.

Erin:
Okay.

Cinnamon:
So number four.

Erin:
I gotta keep scrolling back down. Number four is intense or prolonged psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event or events.

Cinnamon:
All right, so let's break that down. An easier way to say it is emotional distress after exposure to a traumatic reminder.

Erin:
So just emotions

Cinnamon:
Yeah. So if if you're hearing a story around the firehouse kitchen table, and you're noticing that you're having these negative emotions, just from hearing the story. And I don't say just to diminish that. I wanna put it in the, like, what is happening is you are hearing the story. That's it, right? It can cause that level of emotional distress. And of course, one of the easier ways to notice that is when we... start to have our logic center, that prefrontal cortex shut down and our emotions take over.

Erin:
So

Cinnamon:
Right.

Erin:
like those times where I'm like, I know that this is irrational as hell right now. Like this reaction to this specific thing feels very out of left field, off kilter, irrational. Is that an example?

Cinnamon:
Yeah, but that's because that's that's if somebody has the self awareness to recognize that, right? It's the difference between being in it and being mad or being guilty or being sad or embarrassed,

Erin:
Mm-hmm.

Cinnamon:
versus being able to step back and say, Wow, I am becoming embarrassed again. After hearing this story. So

Erin:
Mm-hmm.

Cinnamon:
what you're describing kudos to you.

Erin:
Ooh, I'm

Cinnamon:
Like,

Erin:
so zen.

Cinnamon:
well, and also 2020 hindsight is beautiful.

Erin:
Right.

Cinnamon:
But yeah, so I mean, that's part of where we want people to get to where they can take that step back and be like, I'm becoming emotionally distressed because I was exposed to this traumatic reminder. And this is a symptom that I'm not folded back into whatever happened.

Erin:
Okay,

Cinnamon:
Whereas...

Erin:
so more like that night out getting wasted, blacked out, and this particular thing happened, and it left a lasting impression. And when I think about it, I feel embarrassed or shamed, like

Cinnamon:
Absolutely.

Erin:
shameful or disgusted or more something like that.

Cinnamon:
Yeah, and that it is, you know, persistent, that it doesn't go away, that it's like that intense or prolonged. So it's not just like, oh, that made me feel bad to think about it, but like it disrupted and impaired my day, kind of like when I had to cancel a whole day of sessions.

Erin:
Yeah.

Cinnamon:
That would be more along those lines.

Erin:
Mm-hmm.

Cinnamon:
And then. To partner with that, let's go to number five, Vanna.

Erin:
Number five, mark a physiological reactions to internal or external cues that symbolize or resemble an aspect of the traumatic event or events.

Cinnamon:
Okay. So. let's kind of break this down. Let's talk about in terms of like physical reactivity. So with number four, we had like that emotional distress, right, we feel a certain way. Well, with five, we're actually looking at like the physical reaction. So that may be, you get a red face, you get a tight throat, you start tearing up, your chest get tight, your chest gets... tight. You have butterflies in your stomach or, you know, IG distress, tingling sensations in your body, increased heart rate, more rapid breathing, jaw clenching, those are the things that we're looking for. And it's really important to differentiate between the emotional state and the physiological state or the psychological state and the and the physiological state versus emotional and physical because


Cinnamon:
They are very, they're related, but they're different. And again, when we think about our population, all you listeners, like being emotional isn't necessarily something that you show. Or when you do show it, maybe it doesn't have a physiological cue. the way we're talking about in terms of that physical reactivity.

Erin:
Mm-hmm.

Cinnamon:
And then other people that may be your only giveaway, they're starting

Erin:
Yeah, like,

Cinnamon:
to tear up.

Erin:
well, and as far as the physical reactions, I often call them the dashboard lights. Like, so often folks are disconnected, like their mind and their body are disconnected. They're just running around the world like a head on a toothpick, forgetting that they have an entire body to signal or suggest that something else might be going on. And so... when we can get in tuned with those sensations in our body or noticing those things come up, then it can be a warning sign like, uh-oh, dashboard lights are going off. You know, it takes practice, but like I know my dashboard light is this weird, like tightness in my stomach, almost like someone's like gripping my stomach. And I know that when that sensation's happening in my body, I'm like, shit, I better call somebody, you know? Or I better reach out

Cinnamon:
My

Erin:
for

Cinnamon:
check

Erin:
support.

Cinnamon:
engine lights on.

Erin:
Yeah, exactly. But you know,

Cinnamon:
I

Erin:
mm-hmm.

Cinnamon:
so funny story, the You know, people ask all the time, how did Whole House get its name? And it really has a lot to do with four and five and what you just said, Erin, is after I had a traumatic event in 2016, I, it took a while, but I realized I had completely disconnected from my body and was only working from my head up, neck up,

Erin:
Mm

Cinnamon:
right?

Erin:
hmm.

Cinnamon:
Neck up.

Erin:
Neck out. Yeah.

Cinnamon:
And I had cut off everything neck down. And that was a really hard way to live. And I did that from like December to August. And then I called in a trauma yogi to work with me. And while I was on the mat, what came to mind was, I need my whole house.

Erin:
Mm-hmm.

Cinnamon:
I can't, I can't live life, do my job. be a friend, be a wife, I can't do these things if I am just living in the space between my ears. I have to reengage my body, which meant my whole house.

Erin:
Yeah.

Cinnamon:
And that is where the name of my private practice was born.

Erin:
And thus we

Cinnamon:
Here

Erin:
present

Cinnamon:
we are.

Erin:
whole house counseling.

Cinnamon:
Yeah. And it is that idea that, you know, so many of us have found maladaptive strategies, coping mechanisms, that the intention is good. You know, it's how we forward on,

Erin:
Mm-hmm.

Cinnamon:
but it's not sustainable because we're designed to live thriving lives. But if we're only pulling from survival, coping mechanisms, there's gonna be an impasse. And mine was August, 2016 on a yoga mat, where I was like, yep, this is gonna take all of me to live a life that I wanna live. And that's

Erin:
Yeah.

Cinnamon:
how I've worked to build this practice where it incorporates all those components.

Erin:
Mm-hmm. And you too, like having that willingness to be like, alright, this isn't working. It

Cinnamon:
Oh yeah.

Erin:
just goes to show that clinician, first responder, human being, we're all human beings, that we all experience traumatic, stressful things in life in some capacity or the other. And it's about willingness to surrender and reach out for support.

Cinnamon:
Well, and recognizing the strength that it takes

Erin:
Yeah.

Cinnamon:
to surrender, right? A lot of times it's so much easier to just fight on and to

Erin:
Yeah.

Cinnamon:
say, I'm fine, I'm fine, I'm fine.

Erin:
Right, well, it's like the Wizard of Oz paying no attention to the man behind the curtain, you know? But

Cinnamon:
Yeah, you

Erin:
the

Cinnamon:
need

Erin:
man

Cinnamon:
courage.

Erin:
behind the curtain, mm-hmm. Yeah.

Cinnamon:
You need courage.

Erin:
Yep. Yeah. Oh, these good children's movies. Everybody watch Inside Out and Wizard of Oz and pick up all the metaphor.

Cinnamon:
Well, but not,

Erin:
That is your homework.

Cinnamon:
isn't it Wizard of Oz that has like some shadow of someone hanging in the back because of a crew?

Erin:
I mean, I don't know if that's true or not.

Cinnamon:
Is that a myth that we need to

Erin:
Bust, I don't

Cinnamon:
bust?

Erin:
know.

Cinnamon:
I was just thinking that.

Erin:
I'm saying, I'm just talking about the metaphors of the courage and the

Cinnamon:
Yeah.

Erin:
brain. And they would

Cinnamon:
Yeah.

Erin:
have never known if you didn't point that out. Now everybody's gonna go look for that.

Cinnamon:
Yeah. Well, or the cover of the one

Erin:
Aladdin,

Cinnamon:
mermaid movie.

Erin:
Little Mermaid.

Cinnamon:
Yeah, I mean, there's all kinds of Easter eggs like that. But

Erin:
But anywho!

Cinnamon:
so, so running back down this list, to make this so much more simple, we're looking today, what we talked about was these our trauma can revisit us and cause almost like a re-experiencing. and cause a re-experiencing. So we've got those unwanted and upsetting memories. We've got the distressing dreams or nightmares. And remember the dreams or nightmares can be either symbolic or.

Erin:
Replicative.

Cinnamon:
Replicative. And then we also have those flashbacks, which can be the true literal definition of just a flashback, or they can also be emotional flashbacks, which are more challenging to detect because there isn't like that dissociation of an actual flashback. But it's oftentimes when we have a multiple reaction rather than what we oftentimes. heard as an overreaction. And then we have the emotional distress and the physical reactivity after exposure to traumatic reminders, which can either change how we're feeling emotionally or how we're feeling physically.

Erin:
Mm-hmm.

Cinnamon:
And this is, I hope today, and the goal of what we are trying to do specifically with this episode, but just in general, is make. this information way more accessible. to the people who need it and not just those of us who can multitask by using the DSM and a thesaurus at the same time.

Erin:
Yeah, they need to have like a Cliffs Notes version of the DSM just in case. Maybe that's our next to do.

Cinnamon:
Maybe

Erin:
The

Cinnamon:
it

Erin:
DSM

Cinnamon:
like it burns

Erin:
by

Cinnamon:
a noble

Erin:
at

Cinnamon:
right next to what's that? Oh, the, what's the one Emily Bronte book that's so dark that has like Hugo in it?

Erin:
No idea.

Cinnamon:
I don't know, I'll think of it. Don't

Erin:
You

Cinnamon:
include

Erin:
are the,

Cinnamon:
this.

Erin:
you are much more well-read than I am. The joke is my books, you know, they may be well-traveled, but they're not well-read or some stupid thing like that.

Cinnamon:
Yeah

Erin:
My books are well-traveled, but not well-read. I

Cinnamon:
I mean,

Erin:
always

Cinnamon:
I

Erin:
have

Cinnamon:
take

Erin:
the intention.

Cinnamon:
them on every vacation.

Erin:
Yeah.

Cinnamon:
Doesn't mean anything changes.

Erin:
But yeah, we'll

Cinnamon:
No.

Erin:
do the after the tones drop DSM for the everyday person.

Cinnamon:
Okay. I'm going to Weathering Heights. That's what it was. Right next to the Cliff Notes for Weathering Heights by Emily Bronte that was written in 1847, we would also have the Cliff Notes to the DSM.

Erin:
Great. I'm sure people are gonna be running to their Barnes and noble. Like right now.

Cinnamon:
God, I can't even tell you how many times I've read Weathering Heights. It's like one of my favorites.

Erin:
never read it. Well, onward and upward. We hope this

Cinnamon:
So what

Erin:
helped.

Cinnamon:
are we gonna do next? Like in our to be named educational series, what are we gonna cover next time? So, we're gonna talk about the

Erin:
with the criterion C.

Cinnamon:
Ooh, ooh, and what is criterion

Erin:
Because of A,

Cinnamon:
C?

Erin:
B, C, that's how it goes. That's the order.

Cinnamon:
Yeah, you are good. Yep,

Erin:
I know,

Cinnamon:
those are

Erin:
gosh,

Cinnamon:
letters.

Erin:
alphabet. So, but when we're looking at criteria and see. It is about what language?

Cinnamon:
Why can't I find my drive?

Erin:
So

Cinnamon:
I've lost.

Erin:
criterion C, the avoidance of trauma-related stimuli after the trauma in the following ways, trauma-related thoughts or feelings, and trauma-related reminders.

Cinnamon:
Yeah, so this is our avoidance category. So, which is, um, it makes sense, right? If I'm having these unwanted intrusive things then, and I can't stop them, then my most likely next step is to avoid them. Dip and dodge to decrease

Erin:
Yeah. Yep.

Cinnamon:
the likelihood of them happening. So we'll talk a little bit about that next time.

Erin:
just prolongs it, man.

Cinnamon:
Yeah, I have, I like the analogy. You can't go under it, over it, or around it. You gotta go through it.

Erin:
Yep.

Cinnamon:
And you can sit on this side of it. Oh, wait, this would be where your cows and your buffalo story

Erin:
I know

Cinnamon:
comes

Erin:
and I will

Cinnamon:
in.

Erin:
talk about the cows and buffaloes

Cinnamon:
Oh yeah!

Erin:
next time because

Cinnamon:
Can we wear cowgirl hats?

Erin:
Yeah, if you got one.

Cinnamon:
Um, let me check out Etsy and or Amazon and get back to you.

Erin:
Okay.

Cinnamon:
But I do have a belt from when I was little, it's probably 14 inches long. And

Erin:
Aww.

Cinnamon:
it's leather and it has my name branded into it because when I was little, I used to show animals at the state and county fair and most of my animals weighed like 15 times the amount that I did.

Erin:
Mm-hmm. Well now you can wear it as a headband.

Cinnamon:
Pfft

Erin:
Alright, I'm stopping.

Cinnamon:
Please do.