Triggers

by the Crisses

Please see our "Anatomy of a Trigger" video on YouTube about triggers and metabolism, etc.

What is a Trigger?

A trigger is anything (an event, object, smell, food, etc.) that sets off an autonomic nervous system (ANS) reaction of some type, because the trigger can be anything the body (yes body) takes as a signal that is a precursor to trouble and sets off an automatic autonomic (metabolic/nervous system) reaction.

Usually what TYPE of trigger is implied by context but can be specified (examples: allergy trigger, anxiety trigger, panic trigger, migraine trigger…), and is dependent on the type of nervous system reaction the trigger causes.

How do multiples react to (PTSD) triggers?

Trigger events can cause symptoms such as sensory or emotional flashback reactions in someone who has (C-)PTSD, DID, or other similar conditions. Triggers are entirely subjective, often centered around something seemingly innocuous, and usually dependent on what the trauma in question is/was (see below), although they can become "generalized" -- i.e. a trigger for a wartime veteran can be from gunfire or a mine or grenade exploding but can generalize to any loud noise and cause an automatic nervous system reaction. It doesn't have to be exactly the same (no matter what anyone THINKS — this is a nervous system reaction, not a thought issue).

Important enough to repeat: There's a pervasive myth that triggers are in the brain-mind but, no, they're in the nervous system, which gathers sensory information and can react to it even before sending it to our basic-survival-brain (amygdala), and eventually to our thought-brain (frontal cortex).

How are triggers formed? Why do they sometimes seem so disconnected from trauma?

Usually a trigger is something generally “innocent” but the nervous system has tagged as “Oh crap! What comes next is bad so quick harden our defenses!” We have an anxiety trigger from the smell of coffee — it raises our anxiety level because our emotionally manipulative egg donor used to brew a full 10-12 cup pot every day.

Unfortunately triggers can be cumulative. Just like immune reactions to allergy triggers, etc. — anxiety triggers can build up to an anxiety attack or panic attack — or increase other symptoms such as immune flares. So every day if we smell coffee, our anxiety level starts to go up cumulatively every day. Our nervous system thinks something bad will happen eventually, so every day that passes we get more hypervigilant, more activated, more "Ready", more defensive, more on-edge. It also affects other symptoms and systems in our body by rerouting resources to be ready for danger — so our neuropathy will get triggered as well. Eventually we're just having anxiety attacks and a hair-trigger away from panic attacks, our pain level increases, our dexterity suffers from neurological issues, digestion gets screwed up, etc.

Note that some people tend towards panic attacks. We tend towards anxiety attacks. And we're certain different systems, and different headmates, can have different reactions to panic (see Panic Reactions New).

The y-axis is ANS (autonomic nervous system) activation level — i.e. panic or anxiety. The x-axis is the span of time from before a panic-worthy situation (PWS) or traumatizing situation occurs, until well after it has subsided. There's no specific span of time this occurs in — it will vary from system to system, possibly system member to system member, depending on a variety of factors such as resilience levels.

So this chart above shows how our nervous system, as part of PTSD (and C-PTSD by extension), reacts (hours, days, weeks, months…) after trauma to try to find a predictor of trauma as a warning sign of danger for in the future. It wants to protect us — that's our autonomic nervous system's job. It will try to find something — sometimes several things — that happened before the PWS that can predict when that PWS may happen again in the future.

This goes way back to before we had a frontal cortex. "When the leaves rustle in the bushes: freeze! Because it might be a tiger." The trigger causes the panic reaction before there's any verification of actual immanent danger.

It’s really that simple. Whatever might be a precursor for danger is catalogued not in the mind, but in the vagus nerve, spinal cord, & brain stem. See also Polyvagal Theory: the ANS is controlled by the vagus nerve, a bundle of nerve ganglia running down the body that affects a lot of autonomic systems. Either way, our nervous system, not our frontal brain nor our mind where we can choose our thoughts, reacts to environmental information and circumstances that it already has "tagged" as being danger signs or precursors to danger, and will raise physical cortisol and epinephrine (adrenaline) levels in preparation for a panic reaction New.

Our egg donor was emotionally manipulative, every day she’d make a pot of coffee (and have however many cigarettes). Our nervous system now associates coffee with severe threats to belongingness, emotional blackmail and other emotional crap, so coffee is an anxiety trigger and leaves us hypervigilant. Because when she was crappy, there was always coffee around. Our nervous system picked up “coffee” smell as a predictor of emotional abuse. It was always there when she was.

But it wasn't "that bad"…

Trauma is trauma. Our nervous system doesn’t make a distinction between emotional, mental, physical etc. trauma — ego death or loss of innocence is as violative and traumatizing as far as the nervous system cares. No matter what our thinking brain considers trauma, our body may "know" differently.

Ego death, threats to belongingness, death threats, loss of food, safety or shelter, all can be seen as existential threats by the body.

With regard to C-PTSD, there's also issues of intermittent conditioning. When the PWS comes up repeatedly, even with times that the PWS doesn't happen — it actually creates a worse reaction than if it happened every time then suddenly stopped altogether. Because you never know whether that was the last time.

Thus even though we might visit another house and smell coffee without follow-up trauma, the fact that it happened intermittently our body holds on to the trigger longer in order to be prepared for panic reactions regardless of the breaks due to intermittent trigger reinforcement. It might happen again next time. OR a month later. Or a year later. It never knows when the trauma situation is really over to let go of the trigger altogether. It's stuck in hypervigilance whenever the trigger is present.

So when a situation happens once, and then stops completely — it's easier to let go (PTSD). Or if the situation happens exactly the same every time, even if it goes on for years, it may be easier to shed the trigger once it's truly over. Intermittent issues make it harder to get rid of the trigger, because the body is not sure how long of a gap it needs to know it will never happen again.

Somatic Processing Issues

It is very difficult to "deprogram" triggers with “just talk” therapy. So cognitive-behavioral therapy and other talk therapies tend to be the least effective, where other more visceral, somatic, sensory, or nervous-system-oriented therapies (polyvagal therapy, EMDR, ART - accelerated resolution therapy, Revisioning - which targets the mirror neuron network in the brain, somatic experiencing, sensory reprocessing, etc.) are more effective with triggers in general. For those doing self-help work try EFT (emotional freedom technique New) paired with Implementation Intentions for deprogramming triggers.

How can we discover triggers?

In multiples, decyphering triggers so that they can be diffused can be tricky business because of such generalizations. It can help to actually catalogue when you get activated — just like you might look for food allergies with a food diary — and try to figure out what in the environment may have prompted the reaction.

Then to figure out the trauma associated with the trigger — you play Sherlock Holmes and look at all the evidence (the reactions the trigger caused, any sensory or emotional flashbacks, etc.) and try to figure out what triggered y'all and what trauma it came from so the trigger & trauma can be processed (generally in therapy though there are some other potential methods).

How to avoid triggers?

Tricky, sometime you can — sometimes you can't. Usually what folk end up doing is eliminating the triggers as much as possible until they're able to process the trauma.

Does exposure therapy work?

Exposure therapy is great for phobias. Trauma triggers are not phobias. Please do not allow your therapist to use exposure therapy for trauma — stop them and ask them to please research using exposure therapy with C-PTSD & DID before they proceed.

Exposure therapy works well when a phobia trigger is "irrational" — i.e. the person is afraid of a critter even though they have never met that critter before in their life (to their knowledge). Then it may help a lot. But with trauma — it really happened. Your nervous system and body KNOWS it's a problem. Exposing you repeatedly to a trigger (or the trauma) is not helpful and can cause other trauma reenactments, flooding of flashbacks, and devolving into panic and crisis.

How are triggers (& trauma) processed?

For our latest article on processing triggers/trauma see memory reconsolidation New.

That said there are methods that involve processing traumas and/or triggers that you may carefully and slowly visualize the trigger or the trauma while processing it with the trained professional in order to deprogram the trigger & work on the trauma. So long as they know how these methods work for DID or C-PTSD rather than one-incident PTSD you should be good. Please double-check that they are aware of any changes in their methods needed to compensate for intertwined layers of trauma, and make sure that trauma-processing appointments are alternated with stabilization appointments.

There are other methods of working on trauma: Revisioning New, Somatic Experiencing, Polyvagal therapy, Soul Retrieval (shamanism), etc. And one method we know of that y'all can learn and use on your own — but requires modifications as mentioned above for C-PTSD & DID — called EFT or emotional freedom technique. Make sure to practice on other things than trauma until you learn the modifications needed for working with chronic trauma. See the Treatment Modality Index New.

Unrelated Innocuous Triggers vs. Retraumatization

Ok, we realize we haven't addressed the difference between these triggers which seem innocent vs. actually re-experiencing a traumatic event and it does bear saying. So -- for us coffee smell is an innocuous trigger. The coffee did not harm us, it was just omnipresent when our abuser was present.

However, being emotionally blackmailed again would be another issue. Whether or not coffee (or the egg donor) is present, someone attempting to be manipulative in this way is actually re-experiencing a trauma event again. And as such, it's going to throw our nervous system into an immediate panic or anxiety attack, not just hypervigilance or a slow escalation pattern awaiting a possible future trauma. It's happening, it's real, it's in now-time, so it's going to arm all defenses immediately and come entirely online all at once.

Some may say they were triggered, we prefer the term "activated" for when there's an active reexperiencing event going on. There's some wiggly grey areas in between where enough triggers may cause a panic reaction activation, or where you may be threatened with reexperiencing trauma that immediately activates your system into full (or more full) defenses.

This is not a 'trigger' just becoming active — this is 'retraumatization' and a full panic reaction. You can usually debrief after the fact and come to describe your experiences (after time) with any needed nuances and these are all just words for experiences that aren't strictly defined. But it's important to notice that there is a difference in an escalation of hypervigilance, versus an actual system panic/emergency lockdown. The real important thing is being able to recover and being able to put some type of words to what happened so you can get help, and so that you can process the new experiences and put them away — even if you can't process and put away the original experiences in long-term memory storage yet.

Resources

• Place to report Movie & TV show triggers - https://www.doesthedogdie.com (Crowdsourced emotional spoilers)

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