5.12 | What is PTSD and how do you define "trigger"?

[blackandwhite]

From the United States Department of Veterans Affairs National Center on PTSD

(www.ptsd.va.gov/public/pages/what-is-ptsd.asp)



What Is PTSD?

Posttraumatic stress disorder (PTSD) is an anxiety disorder that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or that happens to you. During this type of event, you think that your life or others' lives are in danger. You may feel afraid or feel that you have no control over what is happening.

Anyone who has gone through a life-threatening event can develop PTSD. These events can include:

   * Combat or military exposure

   * Child sexual or physical abuse

   * Terrorist attacks

   * Sexual or physical assault

   * Serious accidents, such as a car wreck.

   * Natural disasters, such as a fire, tornado, hurricane, flood, or earthquake.

After the event, you may feel scared, confused, or angry. If these feelings don't go away or they get worse, you may have PTSD. These symptoms may disrupt your life, making it hard to continue with your daily activities.

How Does PTSD Develop?

All people with PTSD have lived through a traumatic event that caused them to fear for their lives, see horrible things, and feel helpless. Strong emotions caused by the event create changes in the brain that may result in PTSD.

Most people who go through a traumatic event have some symptoms at the beginning. Yet only some will develop PTSD. It isn't clear why some people develop PTSD and others don't. How likely you are to get PTSD depends on many things:

   * How intense the trauma was or how long it lasted

   * If you lost someone you were close to or were hurt

   * How close you were to the event

   * How strong your reaction was

   * How much you felt in control of events

   * How much help and support you got after the event

Many people who develop PTSD get better at some time. But about 1 out of 3 people with PTSD may continue to have some symptoms. Even if you continue to have symptoms, treatment can help you cope. Your symptoms don't have to interfere with your everyday activities, work, and relationships.

What Are the Symptoms of PTSD?

Symptoms of PTSD can be terrifying. They may disrupt your life and make it hard to continue with your daily activities. It may be hard just to get through the day.

PTSD symptoms usually start soon after the traumatic event, but they may not happen until months or years later. They also may come and go over many years. If the symptoms last longer than 4 weeks, cause you great distress, or interfere with your work or home life, you probably have PTSD.

There are four types of PTSD symptoms:

  1. Reliving the event (also called re-experiencing symptoms):

     Bad memories of the traumatic event can come back at any time. You may feel the same fear and horror you did when the event took place. You may have nightmares. You even may feel like you're going through the event again. This is called a flashback. Sometimes there is a trigger -- a sound or sight that causes you to relive the event. Triggers might include:

         * Hearing a car backfire, which can bring back memories of gunfire and war for a combat Veteran.

         * Seeing a car accident, which can remind a crash survivor of his or her own accident.

         * Seeing a news report of a sexual assault, which may bring back memories of assault for a woman who was raped.

 2. Avoiding situations that remind you of the event:

     You may try to avoid situations or people that trigger memories of the traumatic event. You may even avoid talking or thinking about the event. For example:

         * A person who was in an earthquake may avoid watching television shows or movies in which there are earthquakes.

         * A person who was robbed at gunpoint while ordering at a hamburger drive-in may avoid fast-food restaurants.

         * Some people may keep very busy or avoid seeking help. This keeps them from having to think or talk about the event.

  3. Feeling numb:

     You may find it hard to express your feelings. This is another way to avoid memories.

         * You may not have positive or loving feelings toward other people and may stay away from relationships.

         * You may not be interested in activities you used to enjoy.

         * You may not be able to remember parts of the traumatic event or not be able to talk about them.

 

4. Feeling keyed up (also called hyperarousal):

     You may be jittery, or always alert and on the lookout for danger. This is known as hyperarousal. It can cause you to:

         * Suddenly become angry or irritable

         * Have a hard time sleeping.

         * Have trouble concentrating.

         * Fear for your safety and always feel on guard.

         * Be very startled when something surprises you.

What Are Other Common Problems?

People with PTSD may also have other problems. These include:

   * Drinking or drug problems.

   * Feelings of hopelessness, shame, or despair.

   * Employment problems.

   * Relationships problems including divorce and violence.

   * Physical symptoms.

Can Children Have PTSD?

Children can have PTSD too. They may have the symptoms described above or other symptoms depending on how old they are. As children get older, their symptoms are more like those of adults. Here are some examples of PTSD symptoms in children:

   * Young children may become upset if their parents are not close by, have trouble sleeping, or suddenly have trouble with toilet training or going to the bathroom.

   * Children who are in the first few years of elementary school (ages 6 to 9) may act out the trauma through play, drawings, or stories. They may complain of physical problems or become more irritable or aggressive. They also may develop fears and anxiety that don't seem to be caused by the traumatic event.

What Treatments Are Available?

When you have PTSD, dealing with the past can be hard. Instead of telling others how you feel, you may keep your feelings bottled up. But treatment can help you get better.

There are good treatments available for PTSD. Cognitive behavioral therapy (CBT)appears to be the most effective type of counseling for PTSD. There are different types of cognitive behavioral therapies such as cognitive therapy and exposure therapy. A similar kind of therapy called EMDR, or eye movement desensitization and reprocessing, is also used for PTSD. Medications can be effective too. A type of drug known as a selective serotonin reuptake inhibitor (SSRI), which is also used for depression, is effective for PTSD.

****

A member on the coping with relatives board, Emmy24, started an interesting thread called "triggers list" at https://bpdfamily.com/message_board/index.php?topic=124151.0. I think this is a great topic to explore. We use the word "trigger" a lot on the Coping and Healing Board, sometimes rather loosely. Emmy defined it as "things that trigger feelings of FOG, anxiety, or those bad memories/disappointments in ourselves," which is a nice definition, but I find it can be a bit of a squishy word and be used in different ways. In particular, in the context of PTSD, "trigger" is something that leads to PTSD symptoms. That's a pretty specific use of the term. More generally and out of a PTSD context, "trigger" may have other meanings for some of us. It can help to be clear about what we mean.

How do you define "trigger"?

B&W

[LOAnnie]

I would say that for me anyway, I use the word "trigger" to mean something that instantly generates a strong negative emotional response in me.  For me a "trigger" bypasses the more rational, logical parts of my brain and instantly presses some negative emotional button or other.

Sometimes it takes a LOT of effort to pull back the reins and stay in the moment and realize that its not OK to act on the triggering event/words/situation, even if I'm feeling the emotion strongly.  I can't help my lightning-fast emotional feeling RE a trigger, but I can help how I act.  Unlike my BPD/NPD momster, I can put on the emotional brakes.  I can leave.  I can count to ten.  I can maintain self-control (most of the time.)

For example, having someone crowd me in line to the point of bumping me with their cart, or touching me with their body or breathing on me will trigger my irritation. (But I react by repositioning myself, such as placing my cart between me and the pushy person.  That usually works.)   A sudden, loud, unexpected noise near me can trigger my startle reaction and a brief but mindless fear.   (I just try to breath slowly, let the pain pass, and not let it ruin my day.)  Seeing some adult physically assault a child triggers my anger.   (This one is hard, but I try to switch into "investigator" mode and not sound angry or upset.  Instead I try to find out what's going on first.)  Discovering that I'm about to drive over a tall, long bridge can trigger a panic attack. (This one is hard, too.  If I can turn around, I will.  If I'm stuck with no options, I have a few techniques that can help distract me from focusing on the height and the edge of the bridge, but they don't last very long.)

Me personally, I don't think of a "trigger" in association with positive emotions, although a good joke will actually "trigger" a laugh, I suppose.

-LOAnnie

[MagentaOrchid]

I just started using the word because I just started noticing them.  But I am with LOAnnie in definition. 

Sometimes its like a tiny thing, like hearing someone who breathes like my father, and I feel a panic triggered.  I know it isnt him.  I know he isnt going to hurt me.  But panic takes over.

Then other times its kind of pulling me into a flash back or into a specific time/moment.  Triggering a memory or set of feelings.  Like my niece texting me when her parents were fighting. 

[justhere]

I agree blackandwhite that the word 'trigger' can mean different things but I use it when I'm referring to something that's caused a negative emotional response for me. The degree or intensity can be different and the response can come on in an instant and be strong and terrifying or it can come on slow and be uncomfortable but not a 'matter of life and death' .   

I may have made the decision to go and visit my mother and it's a nice day and I feel that I can handle it but slowly I begin to feel anxious and may react to someone's driving or that the light turned red just as I got there and sometimes it seems that all the traffic lights are turning red on me or I need to stop and get gas or do some chore for my mother and I start feeling 'closed in.'   These small, barely noticeable things seem to keep increasing and my anxiety too is increasing so now by the time I've arrived at my mother's, I've changed from the calm and happy person who I was when I started out to be irritable, angry, and already exhausted with feelings of doom.

Then there is the instant triggers that send me into a panic. I didn't mention the problems I have with necklaces/chains or something that is around my neck.  It's not that I can't wear this kind of jewelry or even certain clothes but at the second that I feel it has to come off, it has to come off or I freak out. I usually don't have the time nor can I find the clasp without some fumbling around and I end up pulling it off in a panic, breaking/tearing it.

At this point anyway, I'm not able to control that panic because all rational thought just stops and it's like this blindness to everything else comes over me and nothing, absolutely nothing else is important but stopping the feeling.  This is when I 'run' or 'escape' to get out of the situation in what ever way I can and some of my 'exits' have not been pretty.  I have not been able to find any other way of lessening, soothing or calming the terror I feel when the panic sets in other then getting myself away physically.

justhere

[bpdfamfan]

Great question!

I agree with the others:  definitely a negative thing for me.

It's an overreaction on my part to something going on around me.

[blackandwhite]

Interesting observations on the term "trigger" so far. I'm seeing as some factors:

*negative

*overreaction

*varying in degree and intensity (from mild anxiety to full panic, perhaps along other feeling scales as well?)

*being pulled into a past experience (flashback), memory, or set of feelings

Here's one definition, from wikipedia:

www.en.wikipedia.org/wiki/Trauma_trigger

A trauma trigger is an experience that triggers a traumatic memory in someone who has experienced trauma. A trigger is thus a troubling reminder of a traumatic event, although the trigger itself need not be frightening or traumatic.

Triggers can be quite diverse, appearing in the form of individual people, places, noises, images, smells, tastes, emotions, animals, films, scenes within films, dates of the year, tones of voice, body positions, bodily sensations, weather conditions, time factors, or combinations thereof. Triggers can be subtle and difficult to anticipate, and can sometimes exacerbate post-traumatic stress disorder, a condition in which trauma survivors cannot control the recurrence of emotional or physical symptoms, or of repressed memory. A trauma trigger may also be referred to as a trauma stimulus or a trauma stressor.

I'll try to find other formal definitions. The term is used quite extensively in relation to PTSD/trauma recovery.

B&W

[bpdfamfan]

from dictionary.com

nanything, as an act or event, that serves as a stimulus and initiates or precipitates a reaction or series of reactions

vto initiate or precipitate (a chain of events, scientific reaction, psychological process, etc.): Their small protest triggered a mass demonstration.

also, from www.psychcentral.com

What is a Trigger?

By U. of Alberta

A trigger is something that sets off a memory tape or flashback transporting the person back to the event of her/his original trauma.

Triggers are very personal; different things trigger different people. The survivor may begin to avoid situations and stimuli that she/he thinks triggered the flashback. She/he will react to this flashback, trigger with an emotional intensity similar to that at the time of the trauma. A person’s triggers are activated through one or more of the five senses: sight, sound, touch, smell and taste. ... .


www.psychcentral.com/lib/2008/what-is-a-trigger/

[CalicoSilver]

A trigger for me, is any person, place or situation that invokes the "fight or flight" impulse within.

[allergictodramaSD]

In the context of experiences with a  less-than-entirely-functional FOO (and no FOO is *entirely* functional), I'd say that a trigger is an action, pattern of speech, etc., that "pushes a button" -- instigates a longstanding negative-thought loop -- that the FOO installed/originally created in the individual in question (who said, "they know how to push our buttons; they installed them"?; it was somebody here).  The FOO doesn't have to be present for the button to be pushed/trigger to be triggered, the situation, wording of a comment, thinking underlying the comment, etc. just has to resemble the one from the FOO.  I suspect the same can be true for people who experienced trauma (war, rape, etc.) not associated with a FOO. 

Interestingly, my uBPD stepmother rarely does things, accidentally or on purpose, that trigger me.  She doesn't know or understand me well enough to really hurt me (except by separating me from my father), nor do her values, frames of reference, etc., overlap much with mine. My father, on the other hand, can definitely trigger me, as can situations, professional or personal, that in some way resemble those in my FOO (e.g. high expectations combined with not-so-benign neglect; the suggestion that my preference for spending considerable amounts of time alone means there's something wrong with me; other forms of diagnosing/psychologizing of disagreements). 

I think there's also a related but somewhat different meaning associated with addiction: in that context, a trigger is a situation that creates or strengthens the impulse to behave in an addictive/self-destructive way.  E.g. an alcoholic might realize that he/she typically coped with a fight with an SO by going on a drinking binge (i.e. that fighting was one of the triggers for his/her drinking), and would resolve to call a sponsor or head for a meeting after a fight instead. 

For FOO or other trauma-created triggers, I think the issue is not so much to avoid the reaction that usually follows (partly because that's impossible; as others have suggested above, these reactions have often become "built in" biochemically), but to recognize that the reaction, because it's associated with past experiences, may be disproportional or even inappropriate to the actual present situation, and to try to delay any response long enough to allow the more rational part of the mind to kick in and play a role in assessing what's actually going on in the present.  I think it also makes sense to share triggers with people we care about and interact regularly with (at least the sane ones), since it can help them understand our reactions and, when possible, avoid triggering us unnecessarily (on the other hand, I'm a pretty strong believer that each of us is responsible for managing his/her own emotions, and reactions to them; a completely trigger-free environment, even among intimates, is probably not possible or even, perhaps, desirable). 

[growndaughter]

allergic to drama summed up my triggers. I do need to tell the difference between trigger and legitimate fears. 

[Penguinectomy]

For me, it's anything that sends me into insta-rage, anxiety or FOG and leaves me wondering "where the hell did THAT come from?"  I'm getting better at noticing the relationship between events and my reactions, and being able to identify what triggered me, but it's not me-proof yet.

[tenacity]

I agree, it can definitely be a ptsd reaction. For me triggers would be defined as definitely negative.

I can feel really sick, really fast sometimes, it is that upsetting.

A flash of anger sometimes.

A deep sadness others.

[healinghome]

for me, its an emotional response that takes me back to the group of emotions i experienced as a child growing up with a uBPDm and uNPDf. those being; feeling trapped, panic, overwhelmed, fear, intense anxiety, unable to breathe and fear for my life.

they are thankfully becoming less and less in my life, and the people who do cause them knowingly, i am nc with now. 

[blackandwhite]

Thanks for the info, BPDfamfan! There's also quite a good article about this at about.com: www.ptsd.about.com/od/selfhelp/a/CopingTriggers.htm. It defines "trigger" as "something in our internal (anything that happens within your body, such as thoughts or feelings) or external (anything that happens outside your body, such as a stressful situation) environment" that cues PTSD symptoms.

Many of you on this thread and on the other one I referenced have identified specific things that are triggers for you.

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 [to follow].

Internal Triggers

•Anger

•Anxiety

•Sadness

•Memories

•Feeling lonely

•Feeling abandoned

•Frustration

•Feeling out of control

•Feeling vulnerable

•Racing heart beat

•Pain

•Muscle tension

Most of the examples on this thread so far are external, cued from outside you. Do you experience internal triggers? If so, what are they?

It's probably a chicken and egg question sometimes, but I certainly have (internal) memories and even sensations that trigger me. Several of you described feelings of panic or flashes of anger. Justhere, you mentioned sensitivity around a specific area of your body. I have that as well, and if I feel physically constrained (even by just a blanket) I can get panicked and start down a fight or flight spiral.

External Triggers

•An argument

•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

•The end of a relationship

•An anniversary

•Holidays

•A specific place

•Seeing someone who reminds you of a person connected to your traumatic event

allergictodrama said:

For FOO or other trauma-created triggers, I think the issue is not so much to avoid the reaction that usually follows (partly because that's impossible; as others have suggested above, these reactions have often become "built in" biochemically), but to recognize that the reaction, because it's associated with past experiences, may be disproportional or even inappropriate to the actual present situation, and to try to delay any response long enough to allow the more rational part of the mind to kick in and play a role in assessing what's actually going on in the present.

Has anyone ever kept a journal of triggers, or otherwise tried to identify them systematically? (Emmy's thread and this one provide a good opportunity!). It might be worth trying for a few days and seeing what you learn. Once we have a good sense of our triggers (and some will already have done this work), it's much easier to start to figure out what to do about them.

If you've identified your triggers, you might try describing for yourself or here what exactly they trigger. What feelings, sensations, memories?

I've identified many of my main triggers:

•being in the car

•anything near the front of my neck

•sharp noises (like whistling)

•anyone coming up behind me

•things flashing in my peripheral vision

•certain songs

•being tickled

•being physically constrained

•witnessing certain kinds of violence

•someone relentlessly coming at me (even just verbally)

Some of the feelings, sensations, and memories they trigger include rage, terror, panic (heartbeat goes up, rapid shallow breathing), irritability, confusion, sadness, and a "freeze" reaction.

B&W

[justhere]

I think that it would be good to keep track of the triggers and in a way I've been already doing that and it's helping me to see the connection between my feelings/emotions and my environment and the other people in my life. I never realized though until reading this thread that the sadness I feel some days in the summer just before the sun sets was a trigger to me for past memories as some of these triggers are so subtle and appear to have little to do with the actual pain/feeling.

I can see how even the thought of going to visit my mother would set off feelings of anger, resentment, feeling trapped etc but the other triggers, the ones that bring me the terror and panic, I have no idea what they are about or where they come from and their meaning for me is hidden.  I know that I'm not in any danger from a necklace but either the sensation of it being around my neck or the thought that I can't get it off for some reason sets off the alarm that this is a matter of life and death and I must protect myself.  I have no memory of anything that happened in the past and I don't feel any other feelings either before or after with the exception of relief that I survived.  Even the embarrassment that you'd think I would feel from over reacting and running around like a crazy person to something that was no threat, doesn't fizz on me because in my mind my actions were justified because I had no choice and that makes no sense at all to me.

The other big trigger for me is when I think about my breathing.  I'm ok for a couple of breaths and then I start to feel that I can't breathe, that the air is not going in even though I know that I'm still breathing and the more I try to logically deal with this, the faster I go into a panic. As this usually happens when I'm laying down in bed, I can stop the panic by getting up and distracting myself, have something to eat, watch television, even read and I've always been able to settle myself but it will start right up again if I think about it.

justhere

[LOAnnie]

I find the definition of "internal triggers" (indicated in the post quoted below) confusing.  It seems more logical to me that a racing heart, or anger, or fear are the result of being triggered, not the trigger itself.

Wouldn't an "internal trigger" be more like a bad memory that then results in a racing heart or anger or fear?

Or is that what you were referring to when you said it was a "what came first, the chicken or the egg?" kind of situation?

If you start out from a "point zero" of calm centered-ness, wouldn't a trigger then by necessity have to be either:

(a) external sensory input (words, speech, visuals, sensation, smell, taste),

or

(b) an internal random memory

that then generates:

(c) the negative emotions (fear, anxiety, anger, shame)

that results in:

(d) the physical symptoms

(rapid heartbeat, sweating, breathing hard, feeling like you're going to pass out, etc.)?

-LOAnnie

Thanks for the info, BPDfamfan! There's also quite a good article about this at about.com: www.ptsd.about.com/od/selfhelp/a/CopingTriggers.htm. It defines "trigger" as "something in our internal (anything that happens within your body, such as thoughts or feelings) or external (anything that happens outside your body, such as a stressful situation) environment" that cues PTSD symptoms.

Many of you on this thread and on the other one I referenced have identified specific things that are triggers for you.

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 [to follow].

Internal Triggers

•Anger

•Anxiety

•Sadness

•Memories

•Feeling lonely

•Feeling abandoned

•Frustration

•Feeling out of control

•Feeling vulnerable

•Racing heart beat

•Pain

•Muscle tension

Most of the examples on this thread so far are external, cued from outside you. Do you experience internal triggers? If so, what are they?

It's probably a chicken and egg question sometimes, but I certainly have (internal) memories and even sensations that trigger me. Several of you described feelings of panic or flashes of anger. Justhere, you mentioned sensitivity around a specific area of your body. I have that as well, and if I feel physically constrained (even by just a blanket) I can get panicked and start down a fight or flight spiral.

External Triggers

•An argument

•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

•The end of a relationship

•An anniversary

•Holidays

•A specific place

•Seeing someone who reminds you of a person connected to your traumatic event

allergictodrama said:

For FOO or other trauma-created triggers, I think the issue is not so much to avoid the reaction that usually follows (partly because that's impossible; as others have suggested above, these reactions have often become "built in" biochemically), but to recognize that the reaction, because it's associated with past experiences, may be disproportional or even inappropriate to the actual present situation, and to try to delay any response long enough to allow the more rational part of the mind to kick in and play a role in assessing what's actually going on in the present.

Has anyone ever kept a journal of triggers, or otherwise tried to identify them systematically? (Emmy's thread and this one provide a good opportunity!). It might be worth trying for a few days and seeing what you learn. Once we have a good sense of our triggers (and some will already have done this work), it's much easier to start to figure out what to do about them.

If you've identified your triggers, you might try describing for yourself or here what exactly they trigger. What feelings, sensations, memories?

I've identified many of my main triggers:

•being in the car

•anything near the front of my neck

•sharp noises (like whistling)

•anyone coming up behind me

•things flashing in my peripheral vision

•certain songs

•being tickled

•being physically constrained

•witnessing certain kinds of violence

•someone relentlessly coming at me (even just verbally)

Some of the feelings, sensations, and memories they trigger include rage, terror, panic (heartbeat goes up, rapid shallow breathing), irritability, confusion, sadness, and a "freeze" reaction.

B&W

[blackandwhite]

Quote from LOAnnie

I find the definition of "internal triggers" (indicated in the post quoted below) confusing.  It seems more logical to me that a racing heart, or anger, or fear are the result of being triggered, not the trigger itself.

Wouldn't an "internal trigger" be more like a bad memory that then results in a racing heart or anger or fear?

[Note: I wrote the first two paragraphs below before I read justhere's post--wow, we seem to have a lot in common around this issue. Justhere, have you tried any breathing exercises? I started doing them when I began practicing yoga. I found them very, very, very challenging at first, and then I got the hang of them, and they actually cured my breathing issue (though I still cannot handle anyone touching my neck; necklaces are not a problem so I guess I should say "anyBODY" near the front of my neck). Same as you--getting someone away from my neck feels life or death as well, though I have no actual memory to link to the feeling, just a general association (sexual abuse I experienced as a 7-9 year old).]

The difficulty of teasing out what causes what is indeed how I meant by the chicken-and-egg comment, relating to my own experience. Memories certainly seem like internal triggers, but they're not the only ones for me. I have, for example, a history of getting panicked as the result of feeling like I'm short of breath (from exercising). The physiological state (shortness of breath) actually came first, and then came the panic, followed by... .more shortness of breath, etc. It's a feedback loop. I think I have an association with being short of breath and being deprived of breath... .I'm not sure, seems to relate to my issues around my neck and there may have been some experiences that I don't remember well in which I had my breathing constricted. So for me, I have the physical state, which triggered a PTSD response, but not a lot of the memory (about this particular thing I have a fair bit of traumatic memory loss).

I'm not sure it's critical for me to know what comes first except that I learned to be mindful of my reaction when exercising and breathe more deliberately, which has pretty much eliminated that trigger for me. Yay yoga!

Which leads back to the main topic of what triggers are and maybe now into what we do about them?

Several strategies have been mentioned so far:

*avoidance (when possible and not disruptive to your life)

*delaying response long enough to let your higher thinking process kick in

*exercises (like the breathing ones I've used) that divert the triggered pattern

allergictodrama wrote (my emphasis):

I think it also makes sense to share triggers with people we care about and interact regularly with (at least the sane ones), since it can help them understand our reactions and, when possible, avoid triggering us unnecessarily (on the other hand, I'm a pretty strong believer that each of us is responsible for managing his/her own emotions, and reactions to them; a completely trigger-free environment, even among intimates, is probably not possible or even, perhaps, desirable). 

*How do you cope with your triggers--what are your strategies?

*Do you talk about them with your loved ones?

*How do you balance avoiding triggers with creating a comfortable environment/relationship--which is probably not trigger free-with your loved ones?

B&W

[DeityorDevil]

For me, a 'trigger' is anything that drops me out of my "normal" state of being/thinking. They can also change, depending on how stable I am at a given time.

*How do you cope with your triggers--what are your strategies?

Noticing them, identifying something as a trigger, not necessarily a fact.

*Do you talk about them with your loved ones?

Incessantly. But, yeah. We talk.

*How do you balance avoiding triggers with creating a comfortable environment/relationship--which is probably not trigger free-with your loved ones?

I don't ask my loved ones to avoid triggers. For one, it's impossible and not fair to them. For two, it's my own stuff in my head to deal with, not theirs.

[justhere]

It does seem blackandwhite that we do have similar triggers concerned with someone or something touching our neck area as well as feeling that we can't breathe. I'm really sorry that SA was a part of your childhood/life and any feelings or even partial memories from that time must be painful and have a devastating effect on your (conscious/unconscious )psyche.

It's not a big stretch to think that these feelings could have something to do with chocking or restriction of air to us in some way, maybe form smothering whether accidental or from the intent of another person. I wonder too if these kind of reactions can stem form something more psychological in nature and are just being displayed in the physical.  Like if we are mentally exhausted from dealing with a mother who is stiflingly and sucking everything out of our life, can we equate that emotional distress with being smothered physically? 

 

Reading what you posted about yoga, helped me to remember that I did do yoga back in my twenties and I don't remember having any trouble with the breathing exercises so now I'm trying to figure out just how long I've been dealing with this. Thank you for this suggestion as it might help keep my mind from wandering if I tried to practice my breathing with a yoga instructor directing my thoughts and actions like in a yoga class. This is the first time I've really thought about this and I haven't told any counselor nor do I talk about these kind of things to my family. 

I think though that if a person is having the kind of 'panic attacks' that are interpreted by that person to be a serious threat to their life, they must have originated from some event or experience that was very traumatic or perceived as life threatening to them. The confusion comes from there being no or little memory available but the feelings or panic and terror are just as raw and intense as if it was happening so I wonder if there's a way to get from the feelings to the memory? And could knowing the reason/cause stop the attacks?

justhere

[marlo6277]

I am finding out quite quickly that being a stepparent to children of a BPD mother is quite triggering.

I had a not so hot childhood - went through emotional abuse of my own and some physical abuse as well.

I am, however, much better equipped for some reason in helping the children deal with their traumas in a more calm way (despite what my insides are doing to me) than dealing with my DH who may 'trigger' things in an argument with me.

I think part of the reason is that I can recognize the children's perspective and I can truly empathize with how they are feeling.  And in turn, the 'fight or flight' kicks in... .but no 'flighting'.  The fight in me kicks in. HARD. And I do talk myself through it.  It's not that I want to 'fight' with the kids. Not at all. I want to fight with the person who is doing this to them.

But to me, 'Trigger' makes me think of a gun. You pull the trigger and an explosion happens.  BANG!  And for me, it is lightning fast - just like that.  An event happens, and immediately my stomach is in my throat, my heart palpitates, my sight is very focused and it feels like my insides are running as fast as they can.

I can talk myself through it - deep breaths, calm, stop. Think. Playback slowly. Take it in. Analyze. Breathe. Okay, what is the crux of this situation.

My latest 'trigger' is actually my partner at work.  I am realizing more and more every day that he has got to have some form of paranoid personality disorder or something. It's pretty bad.  As I am getting closer to work, I can feel my stomach in knots, the headache starts, the palms get sweaty as I begin to think about all the things that he is going to come up with today.  All the conspiracies that he is fabricating of the entire work location being out to get him.  I begin to think of ways I can use my 'flight' response - go for a walk across the compound, find someone - anyone - to have a convo with. 

I find myself using my 'flight' response more with him than the 'fight'.  But sometimes I'm feeling strong. And the fight in me kicks in. But thanks to validation techniques and other stuff, I can fight in a calm manner (even though my insides are racing). 

Not sure if I answered your question B&W. 

Marlo  xoxox

[MagentaOrchid]

I have recently identified a trigger and wanted to share and see if anyone has something similar.  When something is pulled out from under my head, like a pillow, I am startled seriously.  I feel a rush of anger and fear.  But I have also found when someone moves me, I feel the same way.  Well who would move me?  My kids.  When they want my attention and I am writing or working on the computer, to be fair to them, I might totally ignore them for a moment.  They grab my chair and turn it.  I will yell.  I dont mean to.  Sometimes, often, I scream.  Not at them, just "Ahh!".  It really upsets them.  But then they get my attention.  My heart is pounding, but they are crying and I feel awful so I am trying to soothe them.  I feel like a monster!

I have tried to talk to them about how I dont like it, how it startles me.  But they keep doing it.  I want to learn how to manage it instead of scream.  Any ideas?

Really, it isnt though my kids are hurting for attention.  They get quite a bit of it all day long.  This usually happens when they are arguing about a toy or begging for snacks... .I think I zone them out because I hate the screaming too.  So maybe its a bit of dissociation and a sudden wake up?  Hummmm... .any ideas?

[MagentaOrchid]

I am finding out quite quickly that being a stepparent to children of a BPD mother is quite triggering.

I find that as well.  My mom is also BPD, my step-kids mom is as well.  I didn't understand there was a connection until recently.  I wish I had.  For several years I found her behavior very triggering.

[ennie]

I do not have PTSD, so maybe it is inappropriate for me to comment here.  That said, I have noticed that I have been "traumatized" by dealing with the BPD mom of my step kids, and that I do notice the physical changes in my body.  This feeling is different than dealing with something challenging emotionally, like a conflict with a friend, or dealing with someone difficult.  The kids' BPD mom has not been extremely violent, but there have been two interactions I have had with her where she threatened to kill me and my husband, and threatened physical violence, and did attempt violence.  In both cases neither my husband nor I was injured, except I had her nail marks on my wrist.  She was physically abusive to my DH in their marriage. 

But these experiences of her physical threats make her general rage and unpredictability much more scary, and scary in a physical way rather than a mental way.  When she calls, I get butterflies in my stomach, as I do when we see her. 

While I do take her violence seriously (we did call the police, though they did nothing), I also feel that my responses are very effective at getting her to be totally non-violent in the moment; this means that mentally, I do not really think she is a threat to me.  But that physical trauma of being accosted and held down does impact my sense of basic body fear, and that makes me feel differently about her.  Even if I am committed to having compassion for her (with boundaries), and not disliking her, my body is afraid of her.  I have had to really accept these limits, to recognize that to take care of myself, I want to be sure I am safe.  For the kids sake, for example, I would like to have her over to the house.  She is kind at times.  But I do not feel okay about her coming to her home because of my fear about her violence, even though I do not THINK she will hurt me if she comes for dinner, it would feel disrespectful of myself to override that basic physical fear I have. 

[DreamGirl]

I have recently identified a trigger and wanted to share and see if anyone has something similar.  When something is pulled out from under my head, like a pillow, I am startled seriously.  I feel a rush of anger and fear.  But I have also found when someone moves me, I feel the same way.  Well who would move me?  My kids.  When they want my attention and I am writing or working on the computer, to be fair to them, I might totally ignore them for a moment.  They grab my chair and turn it.  I will yell.  I dont mean to.  Sometimes, often, I scream.  Not at them, just "Ahh!".  It really upsets them.  But then they get my attention.  My heart is pounding, but they are crying and I feel awful so I am trying to soothe them.  I feel like a monster!

I don't think you're a monster.  It's like those moments we're deep in thought and someone interupts us unexpectedly and we jump and say "You scared the begeezus out of me"

I think those of us that struggle with PTSD have a heightened level of being "on guard".  I have an otherwise silly "trigger" where I get those same rush of emotions (anger and fear) whenever anyone (including my kiddos) is standing in close proximity behind me. i.e. when I'm at my computer, sitting in a chair, watching TV, standing in line, reviewing paperwork. You name it... .and I literally can feel my heart start pounding and my stress  reactions (fight or flight) start to kick in.  I almost ripped off my boss's head off at one point when he bent over me from behind to look at something I was reviewing.  I couldn't help myself and pushed him off and told him that I can't stand it when people do that.  

So I could see when someone flips your chair around or is trying to get your attention with tactics that make you feel a loss of control, it could be very upsetting.  I also think it feels like a violation of a boundary when you said "don't do that, it startles me" and they do it anyways.  So while you might be having a bit of an "over" reaction (due to the PTSD), it's still a reaction just the same.  I wouldn't like my chair flipped around either to demand my attention.

I've found that in my own ways of dealing with some of my symptoms of PTSD that it isn't always about tackling the issues head on.  I don't like when people stand behind me. Can I ever change that? I don't know... .maybe. My therapist often talks to me about accepting that I may always be a high strung person. Part of that is that I can't change the (traumatic) things that happened to me that have caused me to be this way.  So while it may seem like I'm over-reacting to someone's harmless action of standing behind me, it's also my own body's way of valiantly attempting to keep me safe.

I do know that when I strengthen the other parts of me and I feel more relaxed, I don't react so harshly when someone does impede innocently on my personal space.  I sometimes have to remind my kiddos of my little quirk (trigger) and let them know it has nothing to do with them and everything to do with me. That way they don't try to take on the responsibility of their mama's reactions.  

[DreamFlyer99]

It's also interesting to note "complex PTSD" and "chronic PTSD."

the first, Complex PTSD is the type of PTSD born from the early years of our lives in non-nurturing homes where our simplest needs were unmet by our parents/caregivers, thus building into us a reaction pretty much built in from a time we had no words for it. That makes it written deeply in our core, the feeling of abandonment or being unloved. Mine can be awakened into an "emotional flashback" by having my husband tell me things in a confrontational way about how I am disappointing (not necessarily using the word "disappointment" but clearly indicating those are his feelings.) Or that same "emotional flashback" can be triggered by the feeling that "i am a bother" or "i am useless," those sorts of things. It throws me back into that dark place of my early childhood where I felt utterly alone in the world knowing nobody was going to help me through my sadness and aloneness.

I'm learning to just ride it out and to parent myself in those times, allowing the feelings and horrible silent sobs I can get to pass.

Chronic PTSD means we've been experiencing it for more than 6 months, so i'm guessing that since I'm now 60 and allowed my uBPDh to trigger my childhood ptsd through our 37 years of marriage because I didn't understand what was going on and I was so busy trying to make him happy (not possible, that's his job) that it's been more like 60 years rather than 6 months!

This is all stuff I've only recently been reading about and doing something about since my therapist and psychiatrist have brought it up. Fascinating.

[Crumbling]

I was diagnosed with PTSD a long time ago, did lots of therapy, got it under control.  I knew my triggers, and learned tools that helped me cope/manage them.  The tools sort of became instinctual, and I could deal with things far better than I even realized I could.

Fast forward to last month.  I was tired, worn down, frustrated with things at home, stressed from a new job, and I was faced with a known trigger, someone yelling at me.  Initially, I went into my self-soothing mantra "you're okay, you're okay, he cant hurt you, etc." in my head. This time, tho, it didn't work.

It was like the words faded out, and I was frozen in the situation.  I couldn't say anything, I couldn't move, I don't know if I was even breathing. And the yelling continued, escalating on until I broke emotionally and lashed out.  I was shaking, visibly.  I couldn't stop the tears.  The pain in my chest was so real.  Well, I crumbled.  I was in a heightened emotional state for days after this, crying at everything, not wanting to see or speak to anyone, lots of self hate, etc.

So this post is here as a warning to others.  Even tho your PTSD may be 'controlled' it is never fully gone.  We need to ensure that our lives aren't so absorbed with our partners issues that we forget about our own mental health.  I know I did, and learned the lesson the hard way.  It cost me a job.  Don't let this happen to you!

cheers,

c.

[Bloomer]

So I've definitely wondered if the effects of my r/s with dBPDh have resulted in PTSD before but I don't think until now I've considered it so seriously. I have experienced all of the following:

*eye twitch (on and off but currently going on about a month of semi-regular almost daily occurrence)

*Being overly startled over surprising incidents (i.e. H being in a room when I didn't realize, H being behind me without hearing him, H walking in the front door when I didn't expect him home so soon, etc.)

*severe episodes of anger outbursts/crying that all lead to shame

*severe depression

*self harm

*Replaying old arguments/episodes from memory often when something reminds me of the incident

I for some reason feel like I want H to recognize my PTSD bc the only thing he does is criticize my current outsburst/depression and tell me I need to move on bc he has improved a lot and things aren't as bad as they used to be. Is it possible to treat the PTSD effectively without H recognizing it as my diagnosis?

[DreamFlyer99]

Bloomer--

It really is our own work to recognize our triggers and manage them with healthy self talk etc., but it's defininitely easier in a supportive environment (but then, isn't everything?)

[Michelle27]

After 8 years of what I started calling "episodes" and now know them to be dysregulations, always leading to rages from my uBPDh, I learned to associate a certain tension in the muscles of his face as impending trouble.  Over the years that always called a rise in anxiety to the point that now I know I have full blown C-PSTD.  He is working on his issues including taking CBT classes, working through on his own through a DBT workbook for PD sufferers, attending a men's group where anger issues are talked about a lot and just today I found out he has an intake to DBT classes.  His dysregulations now hit maybe a 3 or 4 on the Richter scale instead of a 9 or 10 but I am still affected in the same way... .with intense anxiety and an intense feeling of fight or flight. 

*How do you cope with your triggers--what are your strategies?

I've only just realized I'm having these triggers.  My first strategy was to implement a boundary.  When he's heading into dysregulation, he MUST leave the house.  That years of carrying around a bag of clothing, pj's and other overnight things and having to leave myself have left me with the constant feeling that my home is emotionally unsafe for me and if he truly wants to stay with me and try to make it work, he needs to respect my need to have my home be an emotionally safe place.

*Do you talk about them with your loved ones?

Ad nausea.  Even showed him articles on C-PTSD and explained that I needed time to learn my own coping strategies and needed to be trigger free for long enough to get a handle on it.  He swore he understood and yet, after a dysregulation in which he was proud to hit 3 on the Richter scale (as he calls it), and he didn't leave, it took a counselor friend explaining it with the same words I did for him to go "ohhh, I get it now".  He now has a key to that friend's house and knows to leave on the first sign of what he describes as the inability to hold back the racing freight train of his feelings.

*How do you balance avoiding triggers with creating a comfortable environment/relationship--which is probably not trigger free-with your loved ones?

We are in a precarious position right now.  I have been "done" and ready to call it quits for a long time.  He knows this and REALLY wants to make it work.  I have allowed for a limited amount of time to see if I think he's serious about persuing treatment or not and at the end of that time, knowing he won't be well yet, but will be at least on his way (or not), I will decide whether I can stay or not.  I am also no longer working on "fixing" or "helping" him but focused on me and my own issues.  So no, it's not always "comfortable" but it's better than it used to be for years.