What is a trigger-really?

What is a trigger-really?

Trigger-warning. Probably you’ve heard this term, or seen it in text somewhere recently. It has filtered into awareness over the past few years. Netflix even has a show called ‘Trigger Warning.’ It’s talking about hot-button issues.

I am a psychotherapist, and many of my clients have experienced trauma and are diagnosed with Post Traumatic Stress Disorder (PTSD). One of the hard things about helping people with trauma is that they are hyper-reactive, or really their bodies are.  Their bodies are off in so many ways, including everything from heart rate to sleep. Physically, this condition makes it more likely that someone who has experienced trauma will over-react to everyday events. They are MORE upset and MORE hurt in circumstances where it would be better to not be so reactive. And yet, they are getting ‘juiced’ by their own chemistry.

In traumatic states the body is not balanced and perception is affected. That’s right, we actually don’t see or hear in the same way. For example Kids who come into foster care with abuse/trauma histories are likely to look at a smiling face and see either a frown or a sinister intention. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2268025/    Imagine trying to make friends, work or go to school with this problem.

In therapy we must reduce this physical reactivity before real progress can happen. If perception and understanding are being influenced, then you really can’t respond reasonably to the events in your life. Lots of times, not being able to ‘deal’ makes basic life skills hard to do, like going grocery shopping. ‘Not dealing’ in this case means trembling, sweating, feeling flushed, feeling icy, feeling jumpy, and, feeling like you are going to ‘snap.’ Something gets started inside that you just can’t stop. People who can’t deal for these reasons retreat from those around them. Their lives become smaller, and they actually cope with less and less.

A short-term solution to this is to identify what most likely to cause an extended problem and change it. The purpose is to reduce the internal ‘static’ that makes good problem solving impossible. For example, when riding our city bus system it’s not unlikely that you will encounter belligerent or intoxicated individuals, who may even have soiled themselves. Depending on your past, you may begin having flashbacks or feeling sweaty and breathless because that combination of smells and behavior is something you experienced when something really bad happened. Your body just takes off. You are Triggered. If you ride the city bus to your therapy appointment, we won’t be doing much good problem solving until we do other techniques to help you focus and feel calmer. That might take your whole session, so if possible we will plan for you to get to your session some other way.

There is a down-side to identifying triggers. That is when what is being ‘triggered’ is actually just having to struggle with feelings you would rather not have. Let’s go back to the bus example, and this time I’ll go along. I feel sitting near that uncomfortable and disgusted near the drunken, smelly and belligerent person. I am a bit angry that the city service is so unpleasant. But my sudden internal experience doesn’t really compare with yours. “I feel triggered because it stinks in here and it shouldn’t be like this” is not the same thing as “Due to flashbacks I have left the area of myself and won’t be back for hours.” 

Again, it is useful to help you be more specific about the feelings you are having when you are “triggered.” Being upset that the pharmacy bungled your prescription on the Friday before a three-day weekend is not being Triggered. If your pain doctor doesn’t look at you when you are trying to explain what hurts you may or may not be triggered. Are you angry because you feel that they should do it differently? Probably not Triggered. Do you feel like you are in a tunnel and don’t even know what you are saying? Probably Triggered.  Are you in “the tunnel” because you got so mad at the doctor for not treating you right that you dissociated? Interesting, that is self-triggering. This is using triggering as a protection strategy.

To return to the beginning: a ‘trigger warning’ is a curious thing. It says “I am not triggered (because if I were I wouldn’t be approaching this material), but I think you might be.”  I think the intention is to be polite and caring about possibly hurting another person. But do things really work like this, and what are the larger implications?

Back to my trauma clients. Over time and with many clients there have been lots of triggers to discuss. Pretty much anything can be considered a trigger; it really depends on your response to it. The glass that my grandma used to water the flowers brings sadness and missing her, and may bring me to tears. The ASPCA ads that show abused animals while Sarah McLaughlin’s haunting song “In the Arms of the Angels” plays (That one makes me really sad/mad). Yes, I would prefer not to feel that helpless horror and an urgent desire to rush out and save every living thing. But the ad is not a trigger taking me back to a horrible place.  It’s exposing me to something hard to see, while suggesting a way to do something about it.

Experience has taught me that using the language of trauma creates a fearful focus on avoiding what is upsetting.  For those who are already traumatized it spreads a sense that triggers are everywhere. Now there is anxiety from the possibility of feeling anxiety.

Hopefully it’s clear that this simply makes things worse. “Trigger Warning” says: Here is a place where anyone who has ever had a flashback could possibly have one. It feeds a constant preoccupation with “Am I safe?” Then it says: “Hadn’t we better avoid this, or shut it down, to relieve the tension of our wondering and worrying?” No, that’s not the way.

If you are my client, and you have memories of trauma that trip you up, we will work to separate fear of emotion from true triggers. Once we do that, we work to increase your ability to hold the line with your feelings. That way, when you encounter them you won’t feel unnecessarily victimized and shut down while life goes on around you.