Last week I received a message from a really good friend of mine who has been struggling with some panic attacks. She had been listening to the podcast and reading some of our recent posts and asked me what a mental health trigger is. I don’t think we have ever actually gone into the definition before, what they do and how we manage them.
What is a trigger? I found a couple of definitions, the second of which we think is really comprehensive.
Mentalhelp.com
Triggers are external events or circumstances that may produce very uncomfortable emotional or psychiatric symptoms, such as anxiety, panic, discouragement, despair, or negative self-talk.
Goodtherapy.org
A trigger is a reminder of a past trauma. This reminder can cause a person to feel overwhelming sadness, anxiety, or panic. It may also cause someone to have flashbacks. A flashback is a vivid, often negative memory that may appear without warning. It can cause someone to lose track of their surroundings and “relive” a traumatic event.
Triggers can take many forms. They may be a physical location or the anniversary of the traumatic event. A person could also be triggered by internal processes such as stress.
Sometimes triggers are predictable. For instance, a veteran may have flashbacks while watching a violent movie. In other cases, triggers are less intuitive. A person who smelled incense during a sexual assault may have a panic attack when they smell the same incense in a store.
Some people use “trigger” in the context of other mental health concerns, such as substance abuse or anxiety. In these cases, a trigger can be a cue that prompts an increase in symptoms. For example, a person recovering from anorexia may be triggered by photos of very thin celebrities. When the person sees these photos, they may feel the urge to starve themselves again.
In terms of my vomit phobia, triggers can be stories about someone else getting sick such as someone talking about their family being sick on a Facebook post. Sometimes it’s the word vomit on a particularly bad day. This can lead to immediate panic and also an increased need to to protect myself and others from getting ill as well. My OCD tendencies can increase dramatically such as the over use of hand gel, cleaning my phone or just having really bad nightmares.
For my podcast co-host, Leora, she experienced generalized anxiety at around the same time that she got her new puppy, and so for her, seeing or hearing about any act of abuse committed against a dog can be particularly triggering for her, leading to increased anxiety and a feeling of panic.
How do we manage them in the Mirkin-Ace Household?
The Mirkin-Ace household is a huge fan of horror movies, serial killer documentaries and all things spooky. Each of the 3 adults under has a trigger associated with an anxiety, trauma or phobia. We each are aware of and talk openly about the others triggers. So when we go to pick a horror movie, we will look at the trigger warnings on a site called www.doesthedogdie.com … a resource to find out what emotional triggers exist within tv shows, movies or books. We love this option as it allows us to be prepared. On some days, we will wait for them and skip through them. On other days when the triggered one feels stronger, they will brave it out. It’s not an exact science, and it is not always the same on any given day. Sometimes I’m ok with seeing someone throw up as part of an exorcism. On other days, I’ll close my eyes. Or we will skip it.
Why?! Because some of us are in active therapy, active healing, active treatment where we are working on ourselves in a way that leaves us more raw on some days than others. Our tolerance levels will change depending on how we feel that particular day.
The most important thing about how we manage our triggers in our household, is our open communication on the topic. None of us are ever made to feel like we’re being annoying. Each of us is given the autonomy to decide what we feel capable of on any given day and whatever we decide, each one of us is given the utmost respect.
Why Avoidance Isn’t Always The Goal - A Phobia Example.
The difficulty with triggers is that they are usually associated with something negative - meaning that they trigger our fears, panic attacks, PTSD flashbacks, etc. The consequence of this is that those around you may want to protect you from your triggers which to a certain extent is ok. But if you’re in treatment where exposures are necessary, or if you’re full on into your recovery and are starting to see them change, all that protection does is reinforce the avoidance behavior that we are trying to reprogram. I can’t speak for others, but I know that this is the case in my own OCD and phobia recovery journeys.
Let me give you an example. When I first went into therapy, for my vomit phobia, I was absolutely terrified of the word “sick”. In my OCD state of mind, I truly thought that saying the word would lead to someone I knew and was close to getting sick. I believed, irrationally, that I would be responsible and I would bring this ‘terror’ upon myself. My family had stopped saying the word around me, my boyfriend used to cover my ears when it was brought up on TV or if he overheard someone saying it. My terror response was enough that those around me changed their behaviors to protect me.
However, when I went into therapy, the very first thing I had to do to break free from this belief was to begin saying it myself and to allow others to say it around me. It was really hard for everyone because we knew it would ignite a fear response in me for a good chunk of time until I proved to myself that it didn’t cause bad things to happen. Eventually, my family and friends started using the word in normal conversation.
Those who know me and love me and know that I still struggle with my phobia, especially around certain times of year, still have a hard time with the words ‘vomit’ ‘sick’ or ‘barf’ etc…just the other day, my current partner was watching an episode of Criminal Minds with me and during a particularly gruesome scene she said “oh barf” and then immediately apologized. I explained to her that although she cares and wants to protect me, apologizing after saying the word only reinforces the fear, which means it’s really important that she doesn’t do that moving forward, knowing that it actually aids in my healing.
Facing a trigger is ONLY EVER the decision of the one who is being triggered or their mental health professional.
I have a fear associated with talking about triggers and healing. My fear is that someone might take it into their own hands and expose someone to a trigger because they believe they can help them heal. So I want to make something very clear.
The person who has the trigger is the ONLY one allowed to set the boundaries. The timeline pertaining to trigger exposure should be between them and their therapist or trained professional only. Understanding how they work or how they are used in therapy treatment, does not in any way shape or form, make it your job to decide when someone should be exposed to a trigger. I cannot stress this enough.
If you are someone who cares about someone who has obvious triggers, encourage them to get help and to seek treatment from a trained professional and then ask how you can be supportive. I have had my previous partners sit in on therapy with me at critical times so that they understand how my triggers work, what their role is and what the boundaries should be, and I recommend this to anyone who is bringing a new partner into your life in a serious way.
Tools:
If you think you might have mental health triggers, reach out to a therapist. A therapist will be able to help assess what your triggers are and work with you to come up with a plan to heal.
If you think someone you love is suffering from mental health triggers, talk to them and encourage them to get help. Remember that it isn’t your place to start managing them. They must work with a trained professional to avoid creating more trauma around the trigger.
