Surviving a traumatic experience can impacts us in almost countless complex ways, but perhaps the most disruptive lingering effect of trauma is what is known as “Triggers.” Triggers are an often misunderstood aspect of trauma and trauma recovery, and the subject of several of my illustrations. In this post, I dive into the basic concepts behind understanding trauma, trauma triggers, and how good therapy can help minimize the impact of triggers.
What is Trauma?
When you think “trauma response,” you may think of ambulances and firetrucks – but psychological trauma is a form of trauma that’s every bit as real, but often difficult to understand for those who haven’t experienced it directly.
Psychological trauma is a public health epidemic 1. Acute stress following trauma, chronic Post Traumatic Stress Disorder (PTSD), and the “slow burn” impact of traumatic experiences early in life affect many – perhaps even most – individuals. In 2016, a multi-national group of researchers conducted a study of 68,894 people from 24 countries and found that over 70% of respondents reported having experienced a traumatic event – while 30.5% were exposed to four or more 2.
Trauma is common, and commonly misunderstood
Despite the fact that most people in our schools, workplaces, and social circles have experienced trauma, few of us know how to respond well to a person suffering from the acute symptoms of trauma or the longer-term symptoms of those who have developed Post Traumatic Stress Disorder. While nearly every profession, workplace, and institution have protocols in place for emergency response – very few individuals ever receive training in recognizing and responding to intrusive trauma symptoms 3.
When someone’s trauma-related symptoms intrude into life in disruptive or unpleasant ways, this is called being triggered.
The 24-hour news media has had a field day polarizing the word “triggered” with decisive meaning, but often the modern use of this word isn’t actually accurate to its actual meaning. To understand what it means to be triggered in the context of trauma: consider the original meaning of the word: The act of pulling a trigger releases a bullet. Once the bullet is “triggered” to fire, it cannot be reversed – only dealt with until the energy generated disappears through exhaustion or landing someplace that can absorb it. Trauma triggers are the same.
What is a Trauma Trigger?
While it is normal to feel upset or uncomfortable when encountering something difficult, or to have a strong reaction to something troubling – trauma triggers go beyond this, and often have a more complex explanation for why a person may experience a specific reaction.
Considered a “trigger” because it “sets off” intense emotional reactions, trauma triggers can be sparked by smells, sounds, sights, sensations, or other sense-provoking stimuli. While the felt experience of a past trauma being triggered varies person-to-person, it generally involves a dissociation (loss of a sense of time/space/self) and/or change in emotional state (numbed emotion/intensified emotion).
Developing Empathy for People Who Experience Triggers
Imagining ourselves in someone else’s shoes can be one of the most powerful ways to cultivate empathy. To redefine being “triggered” from a political buzzword to a psychological state, listen for stories. Consider a person who was recently in a serious car accident. Months may have passed, and generally, that person seems to be doing well. However, upon smelling the scent of burning rubber while out on a walk, they begin to experience heaviness in their chest and a fogged brain-state.
As their body physiologically returns to the state it was in the last time it sensed the smell of burning rubber, the person might struggle to communicate with others, find their way home, and may even require emergency medical services. This would be an example of a clear-cut trauma trigger (although some triggers are far more subtle or limited to certain bodily systems).
A person is been triggered usually has some awareness that they are unwell, often doesn’t recognize it as a trigger- especially if they have not had access to mental health treatment. If they are aware they are triggered, the individual is often confused about why they are triggered.
The self-awareness to recognize being triggered while actively experiencing a trauma trigger, and the capacity to communicate about that state is generally a skill gained through effective trauma processing in good therapy.
How Do You Know When Someone is Being Triggered?
Because trauma responses are filtered through individual experience, it’s hard to develop a concrete list of signs someone is being triggered into trauma.
At my first placement as an intern therapist, I worked at a community mental health agency where my role included working with clients to create a plan for how they could keep themselves safe when they felt like harming themselves.
One thing always included in their safety plan was their response to the question “What are the signs that I and others can look for as a cue that I am not doing well?” – a question that often formed the roadmap to an important conversation that helped individuals develop a sense of what being triggered looked like for them.
When people are triggered by PTSD triggers, they usually don’t know it. With good self-reflection and insight, they might be able to reflect hours or days later on how triggered they were, but in the moment, people who are triggered often just feel Very Very Upset™.
For Friends, Parents, Coworker’s and Teachers of Trauma Survivors:
Consider having conversations with your clients, students, or even employees to help you as a caregiver, teacher, or supervisor know what *their* signs are that they are not doing well.
Common Signs of Being Triggered Include:
- Detachment, silence, or dissociation (this can sometimes look like daydreaming that a person “snaps out of”)
- Anger that’s out of context (particularly for men and boys)
- Immobility or stiffening OR a sudden inability to remain still
- Harmful behaviors to self or others
- and many other forms of behavior
For Trauma Survivors:
Many of us won’t have an answer the first time someone asks up what being triggered looks like for us. However, (as curiosity often does) the question itself may lead to greater self-awareness as we begin to notice and take inventory of what it feels like when we’re triggered. Bullet journaling, keeping a therapy journal, or just filling out a daily mood tracker can help us notice, learn, and better self-advocate for ourselves.
How Therapy Works for Trauma Triggers
The assumption of many people who have experienced trauma entering therapy is that good therapy will “get rid of” those triggers that suddenly launch people who have experienced trauma into anxiety, flashbacks, dissociation, or other trauma symptoms.
Good trauma is a little more than that- and, simultaneously, a little less. Good therapy doesn’t get “rid” of triggers, but helps their impact to shrink. Trauma therapy also always includes what therapists call psychoeducation. Psychoeducation refers to those moments when, rather than listening, a therapist takes a few moments to provide information. Instead of a dry, droning lecture, good psychoeducation is a 2-to-3 minute explanation of relevant topics.
Often, psychoeducation itself can be deeply therapeutic. For example, in my clinical experience, many trauma survivors immediately experience a boost in self-compassion when they learn about the anatomical changes that trauma causes within the brain, and self-compassion- itself- can improve PTSD symptoms ((Hoffart, A., Øktedalen, T., & Langkaas, T. F. (2015). Self-compassion influences PTSD symptoms in the process of change in trauma-focused cognitive-behavioral therapies: a study of within-person processes. Frontiers in psychology, 6, 1273. https://doi.org/10.3389/fpsyg.2015.01273)). For people who experienced early childhood trauma and neglect, learning about how attachment styles form and change can provide hope and a roadmap towards deep, transformative recovery.
Trauma triggers are activated by experiences – big or small – that remind our brains and bodies of past traumatic experiences we’ve gone through. While triggers may be complex to navigate or understand, and while they never truly go away, good trauma therapy can reduce the impact of triggers.
More Resources on Trauma Triggers
To learn more about the topic of trauma triggers and navigating the coping process, consider browsing these resources:
This research study presents compelling artument that trigger warnings may do more harm than good. While this study’s methods may overlook that a trigger warning along with the choice to opt-out has the potential for self-care (in abstaining) and empowerment (in feeling free to abstain or choose exposure), the results are notable, particularly given that they reinforce identification with one’s trauma (which is known to complicate trauma recovery) and that previous research demonstrated that trigger warnings may decrease resiliency to future traumatic events in non-traumatized individuals. When we effectively communicate content, the need for trigger warnings, even among populations who might be helped, becomes unnecessary.
Trauma Triggers Before vs After Good Therapy
When we endure traumatic events, the experience may stay with us in various ways – and even in ways we may not readily realize. From lingering emotions to disruptions in our daily routine, coping with trauma takes work. Good trauma therapy can help alleviate the experience by allowing helping understand and cope with triggering situations. Avoidance can transform into engagement, self-contempt into self-compassion, and coping skills can be enhanced as to better navigate a triggering experience. Good therapy can help us to manage in a way that allows us to live life in a way that is not limited by trauma triggers.
Not all triggers are what you’d think of as difficult topics, not all difficult topics are triggers. Triggers are intensely personal to each individual and can range from people/places/things to relationship dynamics, and just about anything else. Learning to recognize triggers as we work through trauma is not so we can carefully and precisely avoid them. Instead, naming triggers as we work through trauma is all about growing awareness of how we are impacted, developing self-regulation skills, and creating a game plan so that we can find ways to return to ourselves after a trauma trigger. With time and practice, triggers can shrink from giant trapdoors in our path down to little puddles we know how to splash through.
Dismantling mental health triggers often involves a little detective work. Although awareness of “being triggered” can be very obvious, for many people, figuring out specific triggers can be a puzzle. Solving the puzzle requires developing a capacity to seek to know ourselves better, then noticing and tracking backward chronologically to begin to locate exact triggering events, experiences, and sensations. The bullet journal model of capturing main points without a lot of writing works perfectly for this worksheet. Long format journaling can have major mental health benefits, but for the purpose of locating patterns and themes in your everyday experience, a pared-down form of long-format journaling (shown by research to be helpful in trauma recovery) helps create a personal data set that can be more easily reviewed and organized, towards the goal of locating triggers.
Perfect for parents, teachers, and those in the mental health field, this simple card game is designed to be a fun and engaging way to invite kids, adults, and groups to refocus their attention on specific body sensations in a trauma-sensitive way – which can help soothe a frazzled or dysregulated brain. This 36-card Mindfulness Card Deck features 34 different grounding ideas, 1 instruction card, and 1 card with a blank front (so you can add your own favorite activity to the set!).
- Magruder, K. M., McLaughlin, K. A., & Elmore Borbon, D. L. (2017). Trauma is a public health issue. European journal of psychotraumatology, 8(1), 1375338. https://doi.org/10.1080/20008198.2017.1375338
- Benjet, C., Bromet, E., Karam, E. G., Kessler, R. C., McLaughlin, K. A., Ruscio, A. M., Shahly, V., Stein, D. J., Petukhova, M., Hill, E., Alonso, J., Atwoli, L., Bunting, B., Bruffaerts, R., Caldas-de-Almeida, J. M., de Girolamo, G., Florescu, S., Gureje, O., Huang, Y., Lepine, J. P., … Koenen, K. C. (2016). The epidemiology of traumatic event exposure worldwide: results from the World Mental Health Survey Consortium. Psychological medicine, 46(2), 327–343. https://doi.org/10.1017/S0033291715001981
- Mental Health and Substance Abuse Team. (2013). Mental health action plan 2013-2020. World Health Organization. https://www.who.int/publications/i/item/9789241506021