‘Something happened to me when I was 11… I couldn’t talk about it because they wouldn’t believe me, and it would tear (the family) apart for nothing… I don’t know why the picture keeps coming back to me… I talked about it once to a professional, but they didn’t say anything like ‘I’m sorry that happened.’ They didn’t say anything. It made me feel like it was normal…nothing…and all that did was to make me feel ashamed… I’ve tried to move on, but it doesn’t go away. It’s like there all the time and it’s affected my relationships. My partner tries to understand but it’s hard because there are just some things he does when we’re close that make it all come back…I’m scared I might lose him as well.’

‘There are things I just can’t talk about. Pictures I’ll never get out of my head. My mate…he took a step back…and then it just blew him into the air…that should’ve been me…there’s too much time to think in here. I’m better when I’m busy…I don’t know if I’ll cope if I start opening up about it while I’m in here…I need to be able to hold it together in here.’

These are just two more examples of the many that we have heard from men and women across UK prisons. In this article we will share some simple tips that you can try when you get symptoms of Post Traumatic Stress Disorder (PTSD). We’ll also share briefly what treatments can be offered, although not all of these may be available in your prison or suitable for you at this point in your journey. 


Tips on coping with flashbacks 

Flashbacks can be very distressing but there are things you can try that might help.

  • Notice your breathing: During a flashback, the hormones cortisol and adrenaline, which are usually released when a person is in danger to prepare the body for a ‘fight, flight or freeze’ response, may be produced. This can make breathing fast, shallow, or irregular, which increases feelings of fear or panic even more. If you concentrate on breathing slowly, in through your nose while counting to 5, and out through your mouth, counting to 5, this can help.
  • Carry an object that reminds you of the present: Some people find it helpful to touch or look at a particular object during a flashback. We recognise that it might not be easy to carry something around with you in prison, but you could try carrying around a pocket diary, a photo or something small and special to you, that you can touch or look at.
  • Tell yourself that you are safe: It may help to talk to yourself and tell yourself that the trauma is over and that you are safe now. It can be hard to think like this during a flashback, and it may not feel safe if you are out on a noisy wing when a flashback happens, so it could help to write down some words that are calming and hopeful when you are not experiencing the distress so that you have something to read through to remind yourself.
  • Comfort yourself. For example, you could curl up on your bed and listen to soothing music or a story episode on National Prison Radio.
  • Keep a diary. Making a note of what happens when you have a flashback could help you spot patterns in what triggers these experiences for you. You might also learn to notice early signs that they are beginning to happen.
  • Try grounding techniques. Grounding techniques can keep you connected to the present and help you cope with flashbacks or intrusive thoughts:
    • Try tuning into different sounds around you.
    • If you are in your cell, take your socks off, stand barefoot. Notice how the ground feels.
    • Wrap yourself in the blanket or sheet and notice how it feels around your body.
    • Try splashing cold water on your face.
  • NICE, the organisation that produces guidelines on best practice in health care, currently recommends two types of talking treatment for PTSD:
  • Trauma-focused cognitive behavioural therapy (TF-CBT). This is a type of cognitive behavioural therapy (CBT) adapted for PTSD. NICE recommends that you are offered 8–12 regular sessions of around 60–90 minutes, seeing the same therapist at least once a week. 
  • Eye movement desensitisation and reprocessing (EMDR). This treatment is quite new. It can reduce PTSD symptoms like being easily startled. It involves making rhythmic eye movements while thinking back through the traumatic event. The aim of the rapid eye movements is to mimic the way the brain processes memories and experiences while a person is sleeping.

If you would like to find out more about ways to cope with PTSD and the anxiety or depression that can often go with it, put in an application, or speak to one of the healthcare team. They can put you in touch with the right person to help you, whether that is a GP or one of the mental health team. Lastly, remember, if you have been affected by some of the things you have read in this article, please talk to someone – tell chaplaincy, talk to a Listener, speak to one of the healthcare team. You don’t have to struggle alone.

Dr Caroline Watson and Dr Richard Kirk are lead prison GPs. Both are members of the Royal College of General Practitioners (RCGP) Healthcare in Secure Environments Group.

If you have a question relating to your own health, write a brief letter to Inside Time (Health), Botley Mills, Botley, Southampton, Hampshire SO30 2GB. Everyone will receive a reply, however only a selection will be published each month and no names will be disclosed.

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