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Intrusive memories and flashbacks are brought on by triggers — and though the connection between some cues and the trauma that caused PTSD are obvious, that isn't always the case.

Seemingly random stimuli — things that can range from a song to a smell, and from seeing a news report to encountering a person with the exact same gait as someone you once knew — can trigger memories for everyone.

If you have PTSD and such random and unexpected stimuli remind you of the trauma you lived through, consciously or sub-consciously, this can lead to an immediate barrage of symptoms as well as a nasty, lingering, fog. 

The very word "trigger" is reminiscent of violence, but this phenomenon could also be described as a cue, prompt, spark, or catalyst. Either way, it's not pleasant. Learning more about your own triggers can help you develop better coping mechanisms if you live with post-traumatic stress disorder, and understanding what triggers someone you care about can allow you to better support them. 

PTSD: What kind of triggers exist?

Too many PTSD triggers exist to list them all, probably — so there's a risk we'll miss some. Please add your own in the comments below if you'd like to share. I'll sort triggers into categories that make sense to me, but others might group them differently. Anything you experience could be a potential PTSD trigger. 

  • Non-human, concrete, environmental triggers could include smells, tastes, sounds, colors, shapes, temperatures and other weather conditions, and environmental brightness levels. (For me personally, for instance, the smell of a particular disinfectant presents a big problem even years and years after the trauma, and after therapy. The sound of a doorbell will do it, too.)
  • Triggers in some way related to people could include seeing a certain person or someone who reminds you of a certain person, someone suddenly coming up on you from behind, someone yelling, a feeling of powerlessness produced by another person, and someone touching you in a certain way. These triggers, like the non-human ones, don't have to actually present a risk to a PTSD sufferer to be triggering. (For me, it's hard to see anyone I knew at the time of the trauma, and I also definitely struggle with unexpected touch, to the point of finding it hard to not punch that person.)
  • Situational triggers could include finding yourself back in the location of your trauma (this could be as specific as, say "your parents' house" or "London", or as broad as "a car" or "a crowded environment"), finding yourself in a location that reminds you of it (maybe the scene of a car accident, a room reminiscent of the one you suffered trauma in, or another combat situation), anniversaries, situations in which other people have power over you, or financial struggles. 
  • Other random triggers could include therapy sessions, personal trauma-processing ventures such as journaling for PTSD, experiencing physical pain, a bereavement or the end of a friendship or relationship (inducing feelings of grief and social isolation both), or going though a stressful patch at work. 

Some triggers will be quite obviously connected to your trauma — as in, if you have lived through a war, loud bangs or the sound of airplanes may induce heightened PTSD symptoms. Others won't be. Both myself and numerous other people I've talked to report, for instance, that their PTSD symptoms get worse around the time of anniversaries even if they don't consciously remember that it is anniversary time. 

This is because trauma-related memories aren't filed the same way other memories are. A trigger can beam them to the forefront of your active brain without any notice whatsoever, kick-starting debilitating reexperiencing symptoms that appear to be happening in the present. Some part of your brain has made the connection, even if it wasn't the part of your brain that allows you to engage in metacognitive processes. 

You may also be interested in knowing that research has found that reminders of things that happened shortly before (the worst parts of the) trauma tend to be relived with even more potency than reminders of the trauma itself.

Finding out what your triggers are

Keeping a matter-of-fact journal (different from an emotional journal you may also use) to record how you are doing on each day and what happened that day may help you recognize triggers you weren't cognitively aware of until that point. Therapy can help, too, but don't forget — if you're up for it — to ask the important people in your life what they've noticed about your behavior. Your partner may notice that you cower when a dish breaks, while you never knew you did, for instance, or your good friend may have observed that you get edgy any time you're in a noisy environment. 

Can therapy for PTSD help you get 'desensitized' to a trigger?

We'll not say that this is successful for everyone with PTSD, but yes, therapy can help many people eliminate or reduce the severity of particular PTSD triggers. This can be done by processing the trauma and giving it a conscious place in your memory, and then by breaking the association between the trauma and the trigger by giving it a novel meaning — instead, that is, learning to associate it with less threatening or even safe events. At the same time, the person with PTSD and their therapist work on reducing other symptoms, such as excessive worry, avoidance symptoms, and hypervigilance. 

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