If you have taken the time to get yourself to this site, I would make an educated guess that you know what triggers are. However, if you’ve never delved that deeply into the ‘why’ and ‘how’ of your trauma, then, most simply put….
‘A trigger is something that causes a certain symptom to occur in a person who has a disease’ – medicinenet.com
The merits of calling PTS a ‘disease’ aside, that’s the gist of it. A trigger is something that sets off certain reactions, feelings, or emotions in you due to your trauma. It could be internal or external, physical or psychological, minor or debilitating. Sometimes you can see them coming and sometimes they blindside you like a freight train. Triggers aren’t just related to PTS, either. They can be associated to actual physical ailments, other psychological issues, even fears and phobias. We know it best, however, for its trauma-related use.
(There is also some argument out there with regards to the very term ‘trigger’ itself. Trigger has the connotation of being associated to weaponry and violence. In some quarters, people have taken to replacing the phrase ‘trigger warning’ with ‘content warning’ or ‘subject matter warning’. For the purposes of this piece, I’m going to stick with trigger. Okay? Okay.)
Flare ups of PTS rarely occur out of the blue. Generally, something in your environment causes a symptom to rear its ugly head – a comment made at a party, a smell, a visual, a news article, a certain emotion, even a certain face. Usually you can’t see them coming and when they do, you’re forced to process them. If you have the luxury of being able to process them in private, great. But humans are social animals, generally meant to run in packs, and we can’t control what other people do or say. A perfectly innocent word, question, or joke can turn what was an otherwise normal day into one where you feel like the earth suddenly drops away from your feet and you’re falling through space.
(Luckily, some potential triggers CAN be foreseen and prepared for – anniversary dates, avoiding certain places or people, being quick on the remote and changing the channel before a certain piece airs on the news or a particular movie scene comes along. Its nice to feel like we have some control over one part of this roller coaster of PTS.)
I would argue that one of the biggest issues around triggers is how other people deal with you being triggered, if they notice it. People who are close to you, who love you and know you, will notice that thousand yard stare you suddenly develop, the shaking hands, quaky voice, panicky looks around the room for an exit, the hyperventilating. But you can’t always be with those who know you. A trigger, like I said, can happen anytime – school, work, while you’re driving, at a social function, or at a hockey game surrounded by thousands of people (I’m Canadian, so I said hockey. Please feel free to sub in any sport of your choosing!) In one of these situations, someone sitting next to you may think you’re having a panic attack, or a heart attack, or some other kind of physical ailment. I’ve heard more than one account of a well-intentioned person who calls 911 to report someone having a seizure or stroke (which demands a very fast, very thorough emergency response,) only for the ‘victim’ to have to explain to EMS or police that they were riding out a PTS trigger.
Since we can’t wear signs that say ‘PTS SURVIVOR – IF I LOOK LIKE I’M FREAKING OUT I’M JUST FEELING TRIGGERED’, we need to learn how to cope with triggers as they arise. I remember this being one of the first skills my therapist taught me – how to ride out the storm when it hits. She broke that down into two parts:
1 – Learn to identify my triggers and put together a ‘profile’ of what may bring them on. In my case it was crowds, deep water, vehicle collisions, red minivans, broken glass, and a certain stretch of highway in southern Ontario, Canada, where I work. Some of those are pretty rare; some you may come across on any given day. Life is a crapshoot in that sense.
2 – Learn to cope with the impact when one of those things came up. I would never presume to try to tell anyone else how to cope; there are likely as many ways as there are people with PTS, so this will take some work with your caretakers and maybe some experimentation. For me, managing my environment (avoiding trigger possibilities where possible,) grounding myself to remind my brain that I’m safe (through touching cold metal as a tactile sensation,) deep breathing, and journalling were my primary tools.
Your own toolbox may contain going for a walk, self-talk, mindfulness mantras, exercise….the options are limitless, really.
Hopefully, once you start to get a handle on your triggers, your reactions start to become predictable and understandable. This reinforces your belief in yourself and builds your confidence (mind over matter!) Feeling validated improves your overall psyche and mood, which reinforces your power even more.
Three strong suggestions, if I may:
-Healthy coping skills help avoid unhealthy coping skills like substance abuse and risk-taking. Having gone down both of those roads, I can attest that any feelings you generate of well-being or control are illusions. Those roads lead nowhere.
-Pondering on what your triggers may be might be a trigger itself. When you are going to do this kind of looking inward, have a plan in place as to how you will cope with it if you experience distress or become highly emotional. Here’s where working with a trusted therapist or counsellor pays off!
-Build social support. Let the people who you are with the most know what triggers you and why, and how you cope; so your spouse, for example, is not left wondering why you suddenly dropped your drink and bolted from a room full of people or your office mate gets why you pushed back from your desk to close your eyes for a few minutes of deep breathing.
Admittedly, this takes a high level of comfort with the facts of your trauma, so this may be something that you have to build up to!
In an article of this size, one can barely scratch the surface of the phenomenon of triggers. In coming entries, my goal is to break down specific triggers and lay out more specific ways to help cope with them.
I’m also very pleased to announce that I will be hosting the Wednesday #PTSDchat on this topic on June 22nd. Check out the main PTSDchat.org site for more details on getting in on the chat, which has a different enlightening and thought-provoking topic every week.
Till next time, stay safe and stay healthy!
Brian is a PTSDchat blogger and the author of the book ‘On the Other Side of Broken – One Cop’s Battle With the Demons of PTSD’, which is available here.