Reliving a bad memory after encountering a trigger can be a very hard experience which can leave you feeling very shaky, powerless, distressed and vulnerable. Triggers might be all around us and it is important to be aware of them as even though we might feel that our trauma or post-traumatic stress disorder (PTSD) symptoms are happening out-of-the-blue, that is rarely the case. Whether we are aware of it or not, we can be triggered or cued by something in our internal (thoughts or feelings) or external environment (a particular object or situation for instance).
A trigger can be described as a feeling, thought, memory, smell, sound or sight that brings up a bad feeling or past trauma. Trauma reminders or triggers can cause your body to react without warning as reminders of the traumatic experience such as seeing or hearing something similar to your experience or hearing the name of the perpetrator or even thoughts about your trauma can cause intense physical reactions. It can make individuals feel an overwhelming sadness, anxiety, or panic, have flashbacks or even lose track of their surroundings and “relive” a traumatic event. When it comes to triggers, You can prevent or lessen the impact of certain PTSD symptoms by identifying what specific types of thoughts, feelings, and situations trigger them, and then, take steps to limit the occurrence or impact of those triggers. This piece will shed some more light on the various forms triggers can take and how we can better cope with our triggers.
Triggers can take many forms. For instance, it could be a physical location or the anniversary of the traumatic event or an internal build-up of stress. Some triggers might also be predictable such as an abuse survivor having flashbacks while watching a violent movie. Some on other hand might be less intuitive such as a person who might have a panic attack on smelling a particular incense in a store which reminds them of their traumatic experience. Trauma triggers are very often linked to our senses where we might see, feel, smell, touch, or taste something that brings on the symptoms. While triggers themselves are usually harmless, they cause the body to react as if it is in danger. Triggers can be broadly categorised as internal and external triggers. Internal triggers are things which we feel within us such as our thoughts, memories, body sensations or feelings. External triggers on the other hand include factors like situations, people, certain dates, seasons, or places that you might encounter throughout your day (or things that happen outside your body).
You might wonder, how do triggers form? The answer lies in the body’s reaction to when it is faced with danger. Usually, in such cases, the body will prepare to fight, flee or freeze and we may notice that our heart beats faster, our senses are on high-alert and our brain might stop some of its functions to deal with the threat. However, in case of PTSD or traumatic experiences, the brain doesn’t process trauma right away and the process of making the memory an event of the past takes longer. As a result, you might find yourself feeling scared, stressed or frightened even when the event is over, and you know you're safe. In such events, the brain also attaches details, like sights or smells, to that memory which then become triggers going ahead. These triggers act as buttons They act like buttons for our body’s alarm system - so when one is pushed, our brain instantly gets into ‘danger mode’ which can then lead to heightened responses and even flashbacks in some cases.
When it comes to coping with triggers, you might feel that staying away from people, places, and situations which trigger you can be helpful, but using avoidance as the only strategy can be more problematic than helpful as we cannot always try to avoid them. Avoidance might cause you feel even more anxious or feel restrained by your traumatic experience. Another thing is that we cannot always control our thoughts, emotions and body sensations, and when it comes to external triggers, we cannot control everything that will happen to us.
Given that we cannot avoid our triggers all together, it is helpful to look at other ways to cope. Having a range of coping mechanisms when it comes to triggers gives us an abundance of tools which we can reach out to in times of stress. Some of these are:
Develop a Safety Plan.
While having awareness of your triggers is helpful, doing that can cause some distress as well. Thus, it is often recommended that before you begin the exercise of identifying triggers, you build a safety plan for yourself. A safety plan, or a crisis plan, is a plan which is designed to keep you safe when you are suddenly confronted with a crisis or difficult situation. It is an effective way of planning ahead in terms of how to cope with problems or triggers when they are encountered. This plan can include tips to cope, early warning signs and emergency contact numbers as well. You may also choose to share this with a loved one so they can better assist you in times of crisis.
Know and track your triggers.
When you think of the times you have felt your symptoms spike, you can ask yourself a few questions which can help you to identify potential triggers and patterns. You may look at the situation you were in, what was happening around you, what emotions you were feeling and the thoughts you were experiencing at the time. You can write these internal and external triggers down so you can use them as a reference to try and see if there are any patterns or things you need to be vary of. Regular tracking of your moods and emotions can help you recognise certain patterns be it with regards to your triggers or times which make you feel more vulnerable. You might choose to track your mood in a journal or using an app for it. The essence is that having this information can help you guide positive change and allow for reflection.
Validate your feelings and experiences.
What you have experienced is real and hurtful, and by validating your feelings and experiences you let yourself know that whatever happened to you is not your fault and that there is nothing “wrong” with you for having a hard time with coping with triggers. What you’re going through is actually a normal response to abnormal experiences. It’s important to remind yourself of this as you go through challenging symptoms because self-validation is an important piece in the journey of healing and recovery.
Use deep breathing techniques.
Breathing exercises are an easy to use tool which you can use almost anywhere and anytime. Simple techniques like taking deep breaths through your nose and having long exhales or trying box breathing can be helpful as it can activate your parasympathetic nervous system. This will help you to think clearly, calm your body systems down and return to the present moment.
Focus on your senses.
A simple grounding technique which draws on your 5 senses can be helpful to bring you back to the present moment. You can start with 5 things you can see, hear, sense/ feel, taste and smell and then bring it down to 4, 3 and so on. As you notice the things around you, try being specific when listing them so you can really focus and concentrate on these external factors. You may also choose to look at things like shape, scent, texture and colour as well.
Understand your ‘Window of Tolerance’.
The ‘Window of Tolerance’ (WoT) is a way to identify and talk about your current mental state. To explain it simply, being inside your window means that you’re doing okay and can function effectively. When you’re outside of the window, it means you have been triggered and you are experiencing a traumatic-stress response. Initially, you might have a small window due to having a limited capacity to process and manage when presented with difficult information or triggers, but as you learn tools to help you manage yourself better, you window expands. Being able to notify others of the size of your window, which side of it you are on, your triggers and your tools allows for realistic expectations of what you can handle and what you need to do to stay present and grounded.
Using the ‘COPE’ approach.
The ‘COPE’ approach is one which can be very helpful particularly in case of coping with triggers, intrusive thoughts or sudden anxiety. It involves Cleansing breathing exercises (‘C’) with deep breaths inhaled through the nostrils and exhaled from the mouth which helps activate the parasympathetic nervous systems. Next is Observation (‘O’) which involved scanning the environment. This is followed by using Positive Self-talk (‘P’) and affirmations such as ‘I am safe’, ‘I am ok’, or ‘I am in control’ for instance. Lastly, the final phase is Explanation (‘E’) where you understand that what happened was only a trigger and the situation will subside. This entire process can be coupled with deep breathing exercises till the reaction settles down.
Reframe & try to think of something positive.
There has been research by neuropsychologists which suggests that it takes 12 seconds for the brain to form new neuron connections. In this regard, if you can try to think of something positive in the moment such as a beautiful sunset, a photograph you took that you really like, the smile on the face of a loved one for instance and really focus on it for 12 seconds, it can make a big difference. Through this, as you take deep breaths, you will notice the impact this has on your body and emotions as well and it can help you move out of the space of fear-based thinking.
Look after your Physical Health.
Our physical health plays a big role in helping us prioritise our overall wellbeing. Think about your diet and ensure you are eating regularly and staying hydrated. Try to get outside and get some exercise if you can as fresh air and movement are really helpful in boosting our mental wellbeing. It is also important at this time to ensure you are getting adequate sleep and rest. Triggers and PTSD can make falling asleep difficult and you might find using a weighted blanket helpful. Through this time, be mindful of how you are coping and avoid falling into the trap of using alcohol or drugs to cope with your difficult feelings, memories or physical pain but know that these substances will only make you feel worse in the long run.
Talk to a trusted person or a professional.
There is no shame in needing help or wanting to talk to someone, be it someone you trust, a GP, a helpline or a Mental Health professional. You can contact a trusted person or reach out to a trained professional and find a safe space in which to talk, ask for help and receive support. There is no prescription for how to get over this or how to heal from trauma and learn to cope with triggers; it is an ongoing process and can take a long time. Having a reaction to something triggering doesn’t mean you have taken a step back, it just means that you need some help and support. Know that whatever you are feeling is valid and matters, it doesn’t make you weak or a failure. Emotion regulation is a difficult skill to master for most people, and it’s not always easy to identify triggers on your own. Often times, our instinctive reactions to triggers become ingrained in our behaviour and we may not even notice how they are harming us, and in such cases, therapy can be helpful as it provides a safe, non-judgmental space to identify triggering situations and explore potential reasons behind your triggers. A therapist can also be helpful in assisting you to practice more effective communication techniques to express emotions around the situation, offer you guidance and support as you work through identifying your triggers and help explore tools to aid coping.
Triggers can be traumatising and hard to cope with as they remind us of very painful moments or unleash very uncomfortable feelings. Having a range of coping strategies however can make us more in control of the situation and put us in a better position to manage ourselves when faced with a trigger. Additionally, the greater the number of coping techniques we have, the less likely we are to fall prey to unhealthy techniques like alcohol or drug use. Being aware of your triggers goes a long way as it can make the situation feel more valid, predictable, understandable and less out of control - and that itself can have a positive impact on our overall mood, Mental Health and Wellbeing.
Written by: Vedica Podar
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October, 2021