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Triggered!

1/25/2017

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John has parked his car and is heading into his office.   A black mini-van is parked nearby.  The reflection of the sun off the windshield catches his eye.   Without warning the sensations of a panic attack take over.  John’s hands are sweating, he is clenching his jaw, his vision narrows and his breath is shallow.  He admonishes himself and tells himself to get a grip.  The reaction emotional disturbance he is experiencing does not make any rational sense for his current situation.  He goes to the office the same time each day without any disturbance.  John has never had anything like this happen before.  John could be reacting to a trigger.   Something in this setting has activated his entire system.  His body is reacting to the stress hormones that are being secreted. 
 
A trigger is something that sets off or activates the sympathetic nervous system, preparing the body to react to situations of stress or emergency.  It activates our body's alarm system eliciting the Fight, Flight or Freeze reaction.  

An expression that sums this up is, "If it is hysterical it is historical."  Our mind & body may seem at odds with the external event (the trigger).    The attempts to make sense of a trigger are varied.  Sometimes we try to rationalize our reaction to something that seems in hindsight to be an overreaction to the trigger event. We may externalize our focus and reinforce our narrative that the trigger (external event) is the problem and our reaction to it is appropriate.  We may internalize it to the degree that we beat ourselves up, and question why without reaching any conclusion.  We may choose to ignore it.  

No one is immune to triggers.  Our physical body has a triggered response to certain substances which produce an allergic reaction.  Our immune system responses as if the body is under attack creating distressing symptoms.   Psychological triggers have the same impact. Our mind and body prepare to manage a perceived threat. 
 
John does not have to do any deep introspective work to recover from his trigger.  We could speculate that he had some past trauma with a car like the one he saw or that the light catching off the window reminded him of another time in which he perceived he was in danger.  However, John does not have to determine why he was triggered or what the actual trigger was.  John already has many coping skills that he uses on daily bases.  He may not identify them as coping skills. 
 
In the office parking lot, he focuses on orientating himself to the present.  He reminds himself that he is going to work and he is safe.  He exhales and takes a big breath in.  John looks to the doorways entry and reminds himself he works in the building.  He walks inside and the experience of disorientation and panic subside.  None of his co-worker sense anything is amiss.
 
If John continues to have panic attacks when he sees a black minivan or the sunlight glinting off a vehicle windows he could allow his mind to float back to see if he can determine explore the trigger event’s origins.  This event can be processed through therapy so that it is no longer disturbing .

It is more important for John to learn to identify when he is triggered.  He can do this by learning to listen to his body.  He can notice when his shoulders are pushed up towards his ears or his stomach is churning, his jaw is clenching or his breathing is shallow.  John can learn to intervene by using some of the coping skills below:
 
Self-coaching-silently coaching yourself to take the next step. Use your name and encourage yourself that you are safe, capable and so forth.  "John, you're here at your office.  You are safe.  You can do it."
 
Breathing-Exhale!  Deep breath in.  Exhale!   Here is a great resource:  Breathing exercises
 
Grounding-Grounding is another term for reorienting yourself to the present.  The link below has more information.  Grounding
 
Compassion/Non-Judgement-Beating ourselves up does not calm our system down.  Triggers can be deep rooted in childhood experiences.  The reality is triggers are normal.  We have all had events that we wish we could erase from our mind.  When we label or judge ourselves it will exacerbate the symptoms.  If John can practice self-compassion and non-judgement, he will be much quicker at recovering from any triggers that come up.

 Bessel Van Der Kolk, MD has a beautifully written book titled, 'The body Keeps the Score "   The title alone speaks to how much our bodies will inform us when we are triggered.  Triggers are not right or wrong they just are.  When we listen to our body we can learn what our triggers are.  If we do this with compassion and empathy when we are triggered, we can stabilize quicker and develop strategies to manage trigger events in the future.  

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