Journal of Contemporary Psychotherapy

, Volume 26, Issue 2, pp 177–191 | Cite as

Flashback phenomena in survivors of childhood sexual abuse: A four-stage treatment model

  • Lesli Musicar
  • Nina Josefowitz


There has been a growing awareness of Post-Traumatic Stress Disorder (PTSD) as a consequence of childhood sexual trauma. Central to this diagnosis is the flashback experience. Flashbacks are essentially memories which have not been integrated into everyday consciousness and return as intrusive symptoms, usually accompanied by dread and panic. This article presents a treatment strategy based on a four-stage model. The model includes (1) education; (2) assisting clients in identifying their flashback patterns; (3) designing coping strategies; and (4) processing the flashback. The goal is to assist the client with the management and integration of traumatic memory.


Public Health Treatment Strategy Social Psychology Sexual Abuse Coping Strategy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. American Psychiatric Association, (1994).Diagnosis and statistical manual of Mental Disorders. (fourth ed.). Washington, D.C.: American Psychiatric Association.Google Scholar
  2. Barlow, D. H. (1988).Anxiety and its disorders: The nature of treatment of anxiety and panic. New York: Guilford Press.Google Scholar
  3. Bass, E., & Davis L. (1988).The courage to heal. New York: Harper & Row, Publishers.Google Scholar
  4. Beck, A. T. & Emergy, G. with Greenberg, R. (1985).Anxiety disorders and phobias. New York: Basic Books.Google Scholar
  5. Blank, A. S., Jr., (1985). The unconscious flashback to the war in Viet Nam veterans. In Sonnenberg, S. M., Blank, A. S., Jr., & Talbot, J. A. (Eds.)The trauma of war. (pp. 295–308). Washington, D.C.: American Psychiatric Press Inc.Google Scholar
  6. Briere, J. (1989).Therapy for adults molested as children. New York: Springer.Google Scholar
  7. Burstein, A. (1985). Post traumatic flashbacks, dream disturbances, and mental imagery.Journal of Clinical Psychiatry 46 (9), 374–378.PubMedGoogle Scholar
  8. Chandler, C. (1990). Flashbacks: Their retrieval, care and management for childhood sexual abuse. From Survivors of Long-term Victimization. Richmond Hill, Ont.: Audio Archives International, Inc.Google Scholar
  9. Chu, J. A., & Dill, D. L. (1990). Dissociative symptoms in relation to childhood physical and sexual abuse.American Journal of Psychiatry, 147, 887–892.PubMedGoogle Scholar
  10. Courtois, C. A. (1988).Healing the incest wound. New York: W. W. Norton & Co.Google Scholar
  11. Ellenson, G. S. (1986). Disturbances of perception in adult female incest survivors.Social Casework, 67, 149–159.Google Scholar
  12. Fairbank, J. A., & Keane, T. M. (1982). Flooding for combat-related stress disorders: Assessment of anxiety reduction across traumatic memories.Behaviour Therapy, 13, 499–510.Google Scholar
  13. Foa, E. B., Rothbaum, B. O., Riggs, D., & Murdock, T. (1991). Treatment of PTSD in rape victims: A comparison between cognitive-behavioral procedures and counseling.Journal of Consulting and Clinical Psychology, 59, 715–723.PubMedCrossRefGoogle Scholar
  14. Foa, E. B., Steketee, G., & Rothbaum, B. O. (1989). Behavioral/cognitive conceptualizations of post-traumatic disorder.Behavior Therapy, 20, 155–176.Google Scholar
  15. Grigsby, J. P. (1987). The use of imagery in the treatment of post traumatic stress disorder.The Journal of Nervous and Mental Disease, 175, 55–59.PubMedGoogle Scholar
  16. Hermann, J. L. (1993).Trauma and recovery. New York: Basic Books.Google Scholar
  17. Hermann, J. L., & Schatzow, E. (1987). Recovery and verification of memories of childhood sexual trauma.Psychoanalytic Psychology, 4, 1–14.Google Scholar
  18. Horowitz, M. J. (1986).Stress response syndrome (2nd ed.), New Jersey: Jason Aronson Inc.Google Scholar
  19. Keane, T. M., Fairbank, J. A., Caddell, J. M., & Zimering, R. T. (1989). Implosive (flooding) therapy reduces symptoms of PTSD in Vietnam combat veterans.Behavior Therapy, 20, 245–260.Google Scholar
  20. Keane, T. M., & Kaloupek, D. G. (1982). Imaginal flooding in the treatment of post-traumatic stress disorder.Journal of Consulting and Clinical Psychology, 50, 138–140.PubMedGoogle Scholar
  21. Maltz, W. (1992).The sexual healing journey. New York: Harper Collins.Google Scholar
  22. McGee, R. (1984). Flashbacks and memory phenomena.The Journal of Nervous and Mental Disease, 172 (5), 273–278.PubMedGoogle Scholar
  23. Meichenbaum, D. (1985).Stress inoculation training. New York: Pergamon Press.Google Scholar
  24. Meiselman, K. C. (1990).Resolving the incest trauma. San Fransisco: Josey Bass.Google Scholar
  25. Mellman, T. A., & Davis, G. C. (1985). Combat-related flashbacks in post traumatic stress disorder: Phenomenology and similarity to panic attacks.Journal of Clinical Psychiatry, 46(9), 379–382.PubMedGoogle Scholar
  26. Miller, I. P. Stiver, & J. L. Surrey (Eds.), (1990).Women's growth in connection: Writings from the Stone Centre. New York: Guilford Press.Google Scholar
  27. Peniston, E. G. (1986). EMG Biofeedback-assisted desensitization treatment for Vietnam combat veterans post-traumatic stress disorder.Clinical Biofeedback and Health, 9, 35–41.Google Scholar
  28. Putnam, F. W. (1989).Diagnosis and treatment of multiple personality disorder. New York: The Guilford Press.Google Scholar
  29. Rothbaum, B. O., & Foa, E. B. (1991). Exposure treatment of PTSD concomitant with conversion mutism: A case study.Behavior Therapy, 22, 449–456.Google Scholar
  30. Surrey, J. L., Kaplan, A. G., & Jordan, J. V. (1990).Empathy revisited. Stone Centre working paper #40. Wellesley: Wellesley College.Google Scholar
  31. van der Kolk, B. (1987).Psychological trauma. Washington, D.C.: American Psychiatric Press.Google Scholar
  32. Williams, C. C. (1983). The mental foxhole: The Vietnam veteran's search for meaning.American Journal of Orthopsychiatry, 53, 4–17.PubMedGoogle Scholar

Copyright information

© Human Sciences Press, Inc. 1996

Authors and Affiliations

  • Lesli Musicar
  • Nina Josefowitz
    • 1
  1. 1.TorontoCanada

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