On triggering, and avoiding it

Oh, triggers. (I’m sure I’ve done a post about this before, so my apologies for any repetition.) In the crisis plans we do at work, there is a section on triggers. I wish I had my work laptop with me so I could copy down the list, but I actually managed to find it on about.com; it’s the external trigger list here:

Kinds of Triggers

Triggers can fall into two categories: Internal Triggers and External Triggers. Internal triggers are things that you feel or experience inside your body. Internal triggers include thoughts or memories, emotions, and bodily sensations (for example, your heart racing). External triggers are situations, people, or places that you might encounter throughout your day (or things that happen outside your body). Listed below are some common internal and external triggers.

Internal Triggers
Anger
Anxiety

Sadness
Memories
Feeling lonely
Feeling abandoned
Frustration

Feeling out of control
Feeling vulnerable
Racing heart beat
Pain
Muscle tension

External Triggers
An argument (both my own, or seeing/hearing someone else’s)
Seeing a news article that reminds you of your traumatic event
Watching a movie or television show that reminds you of your traumatic event
Seeing a car accident
Certain smells or tastes (I added tastes, as that’s on the list from work I’m referring to)
The end of a relationship
An anniversary
Holidays
A specific place
Seeing someone who reminds you of a person connected to your traumatic event

about.com, PTSD Triggers- coping with PTSD Triggers

Emphasis mine, on my own personal triggers. Dear lord, but there are a lot of them! Other triggers include: too much caffeine; insufficient or poor sleep; getting overwhelmed or overstimulated, particularly in a high-stress or noisy environment; changes- positive or negative, I don’t cope well with either; being around drunk people- my friends can drink but once they cross the drunkenness threshold, I don’t deal well; certain textures or types of fabric. I know that one’s weird, but it was HUGE when I was a kid.

We had a day-long training on Friday about motivational interviewing, which is a clinical technique to help clients open up more to us about whatever their issue is. We had a lot of role-plays in the afternoon, and one of them triggered me particularly badly. The clinician leading the training is one of our alcohol and drug counselors, and the AoD program makes up a huge chunk of our agency, so obviously there’d be alcohol and drug references. During one of the break out groups we were having trouble coming up with an example of a five-year plan from a client, and I joked: “I have a plan to quit crack. I’ll use for 4.5 years and then quit.” Clearly I’m fine with references to drugs, mostly because I have no personal experience with drug use in myself or my family. Alcohol, on the other hand…

One of the last scenarios we used was an individual whose family and/or work was having problems with the individual’s use of alcohol, and fear of the person using it while on psychiatric medication, but the individual didn’t see it as a problem. One of the gentlemen in our group was the alcoholic client, and his excuses were so much like my father’s and then my stepdad’s that I simply couldn’t cope with it. I got up, uncomfortable, and left the room for the rest of that roleplay. This wasn’t the first time I’ve been triggered at a training, but I handled it a LOT better. I didn’t end up sobbing in the bathroom this time; I went into the hallway, found a chair, and did some deep breathing and meditation to figure out what it was that was bothering me, and address it in myself.

The more I think about triggers, the more I realize I have different triggers that lead to different symptoms. I have PTSD/anxiety triggers, mania triggers, depression triggers… I’m working really hard on identifying and coping with the mania and depression triggers (too much caffeine, regular sleep cycle, eating in an intuitive, healthy way, trying to increase how much exercise I get, etc) but I’m not entirely sure how to address the PTSD/anxiety triggers. The downstairs neighbor’s yelling has been mostly covered up by the addition of a white noise machine in my bedroom on top of the fan I already use, which drowns out most of it and keeps any sudden outbursts from waking me up (at least not as often.)

From the same article listed above:

Identifying Your Triggers

Try to think of when your PTSD symptoms usually come up. Ask yourself the following questions to identify your triggers: What types of situations are you in? What is happening around you? What kind of emotions are you feeling? What thoughts are you experiencing? What does your body feel like? Get out a sheet of paper and write down as many internal and external triggers as you can.

Coping with Triggers

Now, the best way of coping with triggers is to avoid them altogether. However, this is almost impossible to do. Why? Well, you cannot really avoid your thoughts, emotions, and bodily sensations. Much of these are out of our control. In regard to external triggers, we can take some steps to manage our environment (for example, not going to certain places that we know will trigger us), but we cannot control everything that happens to us. For example, you might inadvertently come into contact with a news story or conversation that reminds you of your traumatic event.

Because we often cannot avoid triggers, it is important to learn ways of coping with triggers. Effective, healthy coping strategies for lessening the impact of triggers include:

Mindfulness
Relaxation
Self-soothing
Grounding
Expressive writing
Social support
Deep breathing

The more strategies you have available to you, the better off you will be in managing your triggers. In addition, the more coping strategies you have, the more likely you will be able to prevent the development of unhealthy coping strategies, such as alcohol and drug use.

Further, simply being more aware of your triggers can be beneficial. As a result of this increased awareness, your emotional reactions may begin to feel more understandable, valid, predictable, and less out of control. This can definitely positively impact your mood and overall well-being.

Some Final Important Information About Triggers

Although it is important to increase your awareness of your triggers, doing so can cause some distress. Some people might actually become triggered by trying to identify their triggers. Therefore, before you take steps to identify your triggers, make sure you have a safety plan in place in case you experience some distress.

I included all the embedded links from the article, because they’re all very valid techniques. I know the relaxation and mindfulness, as well as meditation, which isn’t mentioned in the article, helped me not to have a complete breakdown (not feeling like I was being bullied helped, too; this was a far more innocent trigger than at the last all-day training I mentioned before.) Learning how to cope when triggered is good, but man, I’d like to figure out how to not be triggered in the first place.

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