Isn’t it frustrating to be afraid to leave your house because you are sure something will trigger you, causing a panic attack? Even at home you may have panic attacks. It doesn’t feel like you are truly safe anywhere. It is so frustrating when it seems like so many things (and sometimes things you can’t even pinpoint) trigger you, causing panic attacks.
When something happens to you that your brain can’t file away as “just a memory,” it seems like everything reminds you of that event. Sometimes, literally EVERYTHING seems to remind you of it. This can cause bothersome and recurrent thoughts of the event, or bring you right back to the event, making you relive the event in every aspect – physically feeling it, smelling it, hearing everything clearly, seeing it like it is happening right now, anything you tasted comes back to you, and even the emotions, just as strongly as you felt them then, happen now. This is a flashback and is often just as scary as the original event because you aren’t fully in reality at that time. You are reliving the event. We’ll talk about flashbacks at a later date, though. For now, suffice it to say that having flashbacks does not mean you are crazy.
So how do you deal with life when you are being triggered daily? How do you function in society when you are so afraid of being triggered? I believe that knowledge is power. When you understand something, it takes so much of the fear away. Unknowns are scary for everyone. We tend to go to the worst case scenario when faced with an unknown. When something becomes a “known,” it is easier to deal with. Then you can tackle it because there is only one situation – the known situation. For example, do you have, or know someone who has, fibromyalgia? It wasn’t that long ago that fibromyalgia wasn’t a diagnosis. People would struggle with the symptoms for years. Doctors weren’t able to explain their pain, fatigue, and other symptoms. Was I going to die and the doctors just couldn’t find the problem? Do I have some sort of cancer that they don’t see yet? Do I have some sort of neurologic issue that will cause me to not be able to walk, talk, or function in the next couple years? Am I crazy? Is this real or just in my head? Once doctors were able to put a diagnosis to those symptoms, it wasn’t so scary anymore. Now it is frustrating because they don’t know what to do or if they can cure it. But it isn’t so scary anymore. Understanding what triggers are and what triggers you can take some of the fear out of it. THAT is the first part of dealing with life when being triggered daily.
The second important part in dealing with daily triggers is understanding the difference between real and perceived danger. Right now, in this very moment when you are triggered, are you physically in life threatening danger? I don’t care about 5 seconds from now…right here, right now, in this very moment, are you in danger? (If you don’t react right this very second, will you die)? If the answer is “yes” – react. However, if the answer is “no,” ground yourself. Use your senses to stay in the moment. When your mind goes back to the traumatic event, bring it back to the present by pointing out things you see currently with your eyes, what you hear currently with your ears, what you physically feel (even if just the clothing on your body or the wind, or the chair you are sitting on). The key with grounding also lies in understanding. When you are triggered, the stress hormone, Cortisol, is pumped into your body, giving you what you need to fight, flee, or freeze. Just because you recognize you are not in danger in this very moment, and you work on grounding, doesn’t mean the Cortisol will just settle back down. It takes time for the chemical to reabsorb into your body. When you understand that you have been triggered (it doesn’t matter what triggered you necessarily), that you are not in physical danger at this moment, that the Cortisol will take time to settle back down, and you use grounding techniques, you are well on your way to successfully dealing with daily triggers.
This is only step one. Until the memory is “just a memory” you will likely be triggered by things in the environment. It can be very tiresome and frustrating to deal with triggers until the memory becomes “just a memory.” Work with a therapist on getting through what happened to you. Give yourself permission to work on it and feel safe. If you need help finding a therapist, I will be more than happy to help you. I do not know therapists in every state, but I will still do what I can to help you. You can call me at 860-501-9767 or 941-462-4807 or email me at megberrylcsw@fastmail.com. I wish you the best on this journey!

Let’s talk about triggers. Let’s get rid any stigma that you are weak because you have PTSD. Let’s better understand what it means to be triggered. Let’s answer the questions such as: Why do triggers have so much power? And can triggers ever decrease in power/intensity? Later we will talk about how to deal with triggers when they can be in your life every day.

When you are suffering from the effects of PTSD, you have an exaggerated startle response. This means, simply, that you get jumpy much more easily than others. It can be incredibly frustrating to jump just because someone closes a book behind you, or look around terrified because you smelled something upsettingly familiar. Just to ease the moment, you might even laugh at yourself, but inside you’re dying. It can be very difficult to explain to others what you’re going through. You might even be telling yourself to stop it. An exaggerated startle response happens to mostly everybody immediately following an incident. The problem is when the brain hasn’t been able to process the incident(s), causing the startle response to happen weeks, months, and years after the incident(s). That’s when it is no longer an acute trauma response, but potentially PTSD, depending on other criteria.

Triggers are something in the environment that reminds you of the initial traumatic experience(s). This can be something you see, hear (whether caused by something – a book slamming closed behind you, or someone talking – their voice, something they say, etc), feel (physically or emotionally – even emotions can be triggers), smell, touch, or taste. It can also be completely unknown at the moment. For some reason, you end up in a panic attack, or remembering the incident(s) very clearly. It is helpful to understand that there is ALWAYS a reason. There is always something in your environment being sent to your amygdala (the brain’s alarm system) setting off the alarm, reminding you of the trauma(s). This is one of the most important things to understand about triggers. There is ALWAYS a reason, even if you do not consciously understand or know it. You are not “crazy” or “broken” and there is nothing “wrong with you” for being triggered even when you don’t understand what triggered you.

Triggers are so very powerful because the brain hasn’t made sense of the incident(s) yet, therefore the incident(s) stays raw in your brain. The brain maintains the same power of the incident(s) with each trigger as when you went through the incident(s). Until your brain is able to file the incident(s) away in the proper place, the memory stays as “fresh” and “raw” as the time it happened. How can the brain decrease the trauma’s power if the brain hasn’t made sense of it? How can it decrease the power of the incident(s) if the brain doesn’t even know what to do and how to process the incident(s)? Triggering situations will maintain their power until the brain files the incident(s) away in the right place as “just a memory.” This can and does happen with traumatic events just as it does with non-traumatic events. Even if the trauma was years ago, don’t give up hope that the brain will heal as long as you are working on healing. It does not have to stay stuck forever. There are great modalities of therapy (EMDR – Eye movement desensitization and reprocessing, ART – Accelerated Resolution Therapy) that will help the brain make sense of the incident(s) and heal. I have been privileged to see the transformation from people being triggered daily for years to having them so rarely it doesn’t impact their lives anymore. I have also personally experienced the benefits of EMDR therapy in my own life.

I just mentioned EMDR and ART therapies to help the brain process the incident(s) and heal, decreasing both the intensity and frequency of triggers. But can triggers go away on their own? What about with other therapy, such as cognitive behavioral therapy? Although these are more complicated questions as people are complicated beings, the answer to both of these questions is yes. Triggers can go away on their own and can go away with other therapy modalities. They can also go away by use of alternative therapies such as yoga, acupuncture, acupressure, etc. The brain, like skin having a splinter, wants to heal. The body will do what it needs to in order to get rid of the splinter and heal the skin. The brain does the same. Sometimes the brain heals on its own without the need for outside assistance, just like sometimes the splinter gets pushed out on its own without the help of tweezers. Other times the brain or splinter in the skin needs additional outside assistance to heal. Who can say why sometimes the splinter forces its way out without assistance and sometimes it doesn’t. Same goes for the brain. It is unknown why some people, after weeks, months, or years of being triggered by something, just aren’t anymore. You wouldn’t think something is wrong with you at your core if you need to use tweezers to get a splinter out, right? So why would something be wrong with you at your core if something is stuck in your brain?

Triggers are so powerful and so frustrating. However, they do not have to be a life sentence. Don’t give up hope that even years after the traumatic experience(s), you can live a productive, stable life. With the right support, your brain can heal from anything. It is an amazingly resilient organ! Next week I’ll talk more about dealing with triggers when they happen. Comment below if there is anything you’d like me to talk about specifically next week. Or send me an email (megberrylcsw@fastmail.com) or call me: 860-501-9767; 941-462-4807.

Last week we discussed coping skills for intrusive thoughts, especially when you are cooped up inside for any reason. What makes intrusive thoughts so horrible is literally their intrusiveness. They come up unwanted and unbidden. No matter what you try, intrusive thoughts seem to never stop or go away. I hear it so frequently “I can’t stop these thoughts.” Or “I’m doing things I enjoy and all of a sudden these thoughts come up.” It is so draining and so frustrating. For many people it makes day to day activities difficult. How do you conquer these thoughts when they just don’t seem to stop?

Another frequent complaint I hear is “people tell me I should be over this by now.” Or “I should be over this by now.” The first question I always ask is why? Why should you “be over it” even if it is many decades later? The second question I ask is would you tell your best friend, child, or someone else very close to you to “get over it” if they were going through this? Sometimes I get a “yes” to this second question because it is hard for loved ones to see someone they live in agony. Often people don’t know what to say.

What if intrusive thoughts had a purpose? Often people handle things easier if there is a purpose to it. What about you? If you understood somethings purpose, does it seem easier to deal with? Well, intrusive thoughts actually do have a purpose…and not just to frustrate or upset you. Have you ever obsessively thought about something small you did that you regretted? You ruminated over it and what you could have done differently for awhile. Eventually the obsessive thoughts ended; you realized there is nothing you can do about it now and let it go.

Intrusive thoughts are the brain trying to make sense of an event. It does this by bringing up parts of the event it hasn’t made sense of in an effort to file it in the proper place. It’s like holding a book and not being able to figure out where to put it on the shelf. It isn’t quite a mystery…not quite a drama. You end up putting it down with the mysteries, but it seems misplaced; it doesn’t seem to quite fit there. You keep looking at it until you pick it back up and put it with the dramas. However that also looks misplaced. The cycle continues until the book (or memory) is placed in the right place. The brain does not give up trying to file it away correctly.

Understanding the purpose doesn’t make the thoughts stop, though. Even with therapy, the thoughts haven’t seemed to stop completely. The only thing that will stop traumatic intrusive thoughts is the brain filing the event in the right place. The brain is very complicated, making this no easy task. Complicating matters more is the body also stores memories. Have you ever noticed that when someone vomits, you can taste it? Or your own stomach flops? Or you look at someone’s injury and feel it in your own body? The body holds memories of events being brought up again in the present causing current symptoms. There is quite a bit of current research regarding the importance of healing both the brain and the body memories in order to help the brain file events properly. That being said, intrusive thoughts can be significantly minimized without working on body memories. If you’ve had a lot of therapy and still having intrusive thoughts, talk with your therapist about techniques that will heal body memories.

There are some very awesome techniques including EMDR (Eye movement desensitization and reprocessing), ART (Accelerated resolution therapy), and body-centered psychotherapy (or somatic psychotherapy) among others, that I may not be aware of. It is very important to work with someone fully trained in these modalities instead of someone who is partially trained. Practitioners of EMDR for example can start using EMDR after the first part of training, but aren’t fully trained until they have completed the full basic training, or level 2 training.

If you aren’t sure where to find a therapist trained in one of these techniques, there are many websites that can help you find someone, or feel free to call or email me. I will help you find someone in your area, even if you aren’t in CT or FL. 860-501-9767; 941-462-4807 or megberrylcsw@fastmail.com.

As I’m sitting here, looking outside at the snow falling (we’re supposed to be getting 10-14 inches today), I can’t help but think about the stressors of being stuck inside with intrusive or racing thoughts. Whether you are stuck inside due to weather, child/elder care, transportation, or other life situations, the inability or serious lack of desire (for example in my case I have no desire to be outside whatsoever in snow) can cause your intrusive or racing thoughts to increase immensely. The feeling of being “caged” inside the house increases the feeling of being “caged” within your head as well.

It is a terrible feeling to not be able to get away from racing or intrusive thoughts to begin with. However, often times just getting out of the house – being able to take a short walk – makes people feel better. There is evidence that exercise helps release the endorphins in the brain, making you feel better. There is also evidence that being outside releases those endorphins. Recently I saw an article that explained when people walk outside versus inside, there is a huge difference in their endorphin release. So, being stuck inside can be very frustrating.

Obviously there are things you can do when you are inside to get away from the racing or intrusive thoughts. You do a variety of things everyday. However, just the belief that you are stuck inside with no escape can make the brain work overtime with regard to racing and intrusive thoughts. Personally, I don’t know what exactly causes this; I have not done any research on it, but I know it happens to many people. Sometimes people get “cabin fever” and start to get tired of being inside. They get bored and don’t know what to do to occupy themselves anymore. When you have PTSD, cabin fever can feel like jail within yourself and your head. You start by doing all the things you normally do. You feel ok for awhile. As the hours drag on, you get tired of doing all that stuff, and even if you wouldn’t go out anyway, just knowing you really can’t (or don’t want to), is enough to drive you crazy. Then the racing or intrusive thoughts get worse and you still try to do all the coping techniques you usually use. It seems to get harder as the hours go on. At some point many people just give up trying to stay busy or stay mindful.

What do you do when you are cooped up? What helps you keep the racing and intrusive thoughts from overtaking your day? I have found it does help to start early. Start before you are feeling cooped up. If I start doing things before feeling cooped up, I tend to be able to last longer before feeling bored, caged, start pacing anxiously, etc. As long as the power is on, I like to bake. I like to read. I like to build my business and help others (even if only indirectly at the moment). What about you? Comment below to tell me, and help others who just don’t know what to do deal with the racing and intrusive thoughts. I’d love to hear your feedback!