On Triggers
This is about triggers in the technical sense, of the "cues" mentioned by the DSM-IV in its criteria for PTSD: "intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event."
I have a much more detailed explanation of triggers here. (Warning: uh, triggery in that it contains descriptions of PTSD and abuse.)
In LJ/DW culture, people often use "trigger" in a much more colloquial sense, to mean "a thing which is upsetting/disturbing/unpleasant." But in the technical, trauma-related sense, this is what a trigger is:
Triggers are not merely upsetting in general. They are things which bring back memories or feelings associated with trauma.
Triggers are highly, highly idiosyncratic. (There are exceptions to this, which I'll get into in a moment.) They don't have to directly relate to the general nature of the trauma. In fact, they are at least as likely to relate to some random thing associated with the trauma, not with the nature of the trauma itself.
For instance, a person who was raped in a car would be at least as likely to be triggered by hearing the song which happened to be playing on the radio during the rape, or by the feel of a vinyl car seat, as she would be by fictional depictions of rape, discussions of rape, or the word "rape." (Some people, of course, do end up triggered by all fictional depictions of rape, etc. I'm just saying, not all people, not always.)
I suspect that the reason for this is that "rape" is a very general thing. But a specific trauma is specific. A fictional rape may bear very little resemblance to one's real rape, and so not touch off any specific memories. But the song, the vinyl seats, the smell of the man's cologne, and so forth, are real things which get burned into the very cells of one's brain, and the fibers of one's nervous system. They may bring up reactions which happen before you even know why you're reacting.
ETA: Forgot about the exceptions to the "idiosyncratic" thing. There's two big categories of those:
1. Most people whose traumatic reactions reach the level of diagnosable PTSD will be physically triggered by sudden loud noises and unexpected touch. It has to do with how our nervous systems are wired. Those things are inherently startling, and if your startle reflex is cranked up past a certain point, inherently startling things will provoke the same level of physiological/emotional reaction people normally have when, say, someone suddenly leaps out of a dark alley and sticks a gun in their face.
2. When similar sorts of traumatic things happened at the same time, in the same space, to large groups of people, you can take a pretty good guess at what triggers will affect many or most of them simply by looking at notable features of the trauma or the area in which it took place. For instance, some insensitive landscape designer stuck a bamboo grove on the grounds of the Veteran's Administration. Unsurprisingly, you can tell who the Vietnam vets are by which ones are taking a very wide path around the bamboo. In the unlikely event that burning papers start fluttering down from the sky, the people who have very strong reactions are probably the ones who were present in New York during 9/11.
End ETA.
People often warn me about fictional depictions of child abuse. I am not triggered by that, or by fictional anything. I was tied up and abused. I'm not bothered by rope bondage in fiction. (Feel free to rec me rope bondage in fiction!) But I did have something trigger me yesterday, and I'm writing it up because it was such a great example of how triggers actually work - and can be dealt with.
We were all sitting on chairs in a semi-circle in class, with the professor at the front. She dropped her pen. No one was close enough to be able to easily reach over and pick it up, and she reached down and picked it up herself.
This completely innocuous moment reminded me of how, when I'd been a child and a teacher dropped a pen, every kid would dive forward to grab it and hand it back. If you didn't do that - if you were nearby, but didn't move fast enough, and the teacher picked it up herself - that would get you a beating.
Sitting in class yesterday, I registered that I hadn't moved to go for the pen. I registered that I'd had the dropping of the pen set off that memory. As the professor went on with her lecture, I let myself mentally check out for long enough to consciously evaluate what had just happened and how I was doing with it:
This thing just happened. This is a trigger. This is the memory. How am I doing right now? (Okay.)
Briefly review associations: the memories themselves. Don't go too deep, just a little "this is what that reminded me of."
Mentally check back into class. Do I need to be paying attention to the present? Should I be paying attention? Or should I take a little more time to mentally deal with myself? Decide to take a little more time.
Check in with myself physically. Breathing seems normal. Heartbeat seems normal. I can feel my body, the floor under my feet. (If I couldn't, or if my heart was racing or anything else was off, I'd have worked on that.)
Think that ten years ago, that pen dropping would have sent me into a physical and emotional tailspin. It didn't this time. I'm okay. I'm okay.
Set it aside for further review. Mentally check back into class.
That being said, I do think I was a bit off-kilter for the rest of the class. I got really defensive at something someone said to me, and I felt briefly tearful at something else - both reactions I might have had anyway, but stronger than they probably otherwise would have been.
I wrote the whole thing up because I don't usually go through that process that step-by-step, or that slowly. (I think I took three to five minutes with it.) It's normally a matter of seconds - That thing happened. It reminded me of that other thing. Am I okay? I'm okay. The pen was more of an intense, direct reminder than my triggers usually are, now. (Mostly they involve stuff like, What was that noise? Who's behind me?)
Written out in full, it sounds kind of laborious and like I'm still deeply damaged, etc. But it doesn't feel that way. It's certainly better than what I used to do, before I had these tools, which was generally to suddenly and, inexplicably to onlookers, burst into tears, flee the room, and be a depressed, jumpy mess for the next few hours or days.
I look forward to teaching these sorts of skills to others. It is amazing and wonderful how completely we can rebuild ourselves from what seems to us like rubble and ash.
Crossposted to http://rachelmanija.dreamwidth.org/1013380.html. Comment here or there.
I have a much more detailed explanation of triggers here. (Warning: uh, triggery in that it contains descriptions of PTSD and abuse.)
In LJ/DW culture, people often use "trigger" in a much more colloquial sense, to mean "a thing which is upsetting/disturbing/unpleasant." But in the technical, trauma-related sense, this is what a trigger is:
Triggers are not merely upsetting in general. They are things which bring back memories or feelings associated with trauma.
Triggers are highly, highly idiosyncratic. (There are exceptions to this, which I'll get into in a moment.) They don't have to directly relate to the general nature of the trauma. In fact, they are at least as likely to relate to some random thing associated with the trauma, not with the nature of the trauma itself.
For instance, a person who was raped in a car would be at least as likely to be triggered by hearing the song which happened to be playing on the radio during the rape, or by the feel of a vinyl car seat, as she would be by fictional depictions of rape, discussions of rape, or the word "rape." (Some people, of course, do end up triggered by all fictional depictions of rape, etc. I'm just saying, not all people, not always.)
I suspect that the reason for this is that "rape" is a very general thing. But a specific trauma is specific. A fictional rape may bear very little resemblance to one's real rape, and so not touch off any specific memories. But the song, the vinyl seats, the smell of the man's cologne, and so forth, are real things which get burned into the very cells of one's brain, and the fibers of one's nervous system. They may bring up reactions which happen before you even know why you're reacting.
ETA: Forgot about the exceptions to the "idiosyncratic" thing. There's two big categories of those:
1. Most people whose traumatic reactions reach the level of diagnosable PTSD will be physically triggered by sudden loud noises and unexpected touch. It has to do with how our nervous systems are wired. Those things are inherently startling, and if your startle reflex is cranked up past a certain point, inherently startling things will provoke the same level of physiological/emotional reaction people normally have when, say, someone suddenly leaps out of a dark alley and sticks a gun in their face.
2. When similar sorts of traumatic things happened at the same time, in the same space, to large groups of people, you can take a pretty good guess at what triggers will affect many or most of them simply by looking at notable features of the trauma or the area in which it took place. For instance, some insensitive landscape designer stuck a bamboo grove on the grounds of the Veteran's Administration. Unsurprisingly, you can tell who the Vietnam vets are by which ones are taking a very wide path around the bamboo. In the unlikely event that burning papers start fluttering down from the sky, the people who have very strong reactions are probably the ones who were present in New York during 9/11.
End ETA.
People often warn me about fictional depictions of child abuse. I am not triggered by that, or by fictional anything. I was tied up and abused. I'm not bothered by rope bondage in fiction. (Feel free to rec me rope bondage in fiction!) But I did have something trigger me yesterday, and I'm writing it up because it was such a great example of how triggers actually work - and can be dealt with.
We were all sitting on chairs in a semi-circle in class, with the professor at the front. She dropped her pen. No one was close enough to be able to easily reach over and pick it up, and she reached down and picked it up herself.
This completely innocuous moment reminded me of how, when I'd been a child and a teacher dropped a pen, every kid would dive forward to grab it and hand it back. If you didn't do that - if you were nearby, but didn't move fast enough, and the teacher picked it up herself - that would get you a beating.
Sitting in class yesterday, I registered that I hadn't moved to go for the pen. I registered that I'd had the dropping of the pen set off that memory. As the professor went on with her lecture, I let myself mentally check out for long enough to consciously evaluate what had just happened and how I was doing with it:
This thing just happened. This is a trigger. This is the memory. How am I doing right now? (Okay.)
Briefly review associations: the memories themselves. Don't go too deep, just a little "this is what that reminded me of."
Mentally check back into class. Do I need to be paying attention to the present? Should I be paying attention? Or should I take a little more time to mentally deal with myself? Decide to take a little more time.
Check in with myself physically. Breathing seems normal. Heartbeat seems normal. I can feel my body, the floor under my feet. (If I couldn't, or if my heart was racing or anything else was off, I'd have worked on that.)
Think that ten years ago, that pen dropping would have sent me into a physical and emotional tailspin. It didn't this time. I'm okay. I'm okay.
Set it aside for further review. Mentally check back into class.
That being said, I do think I was a bit off-kilter for the rest of the class. I got really defensive at something someone said to me, and I felt briefly tearful at something else - both reactions I might have had anyway, but stronger than they probably otherwise would have been.
I wrote the whole thing up because I don't usually go through that process that step-by-step, or that slowly. (I think I took three to five minutes with it.) It's normally a matter of seconds - That thing happened. It reminded me of that other thing. Am I okay? I'm okay. The pen was more of an intense, direct reminder than my triggers usually are, now. (Mostly they involve stuff like, What was that noise? Who's behind me?)
Written out in full, it sounds kind of laborious and like I'm still deeply damaged, etc. But it doesn't feel that way. It's certainly better than what I used to do, before I had these tools, which was generally to suddenly and, inexplicably to onlookers, burst into tears, flee the room, and be a depressed, jumpy mess for the next few hours or days.
I look forward to teaching these sorts of skills to others. It is amazing and wonderful how completely we can rebuild ourselves from what seems to us like rubble and ash.
Crossposted to http://rachelmanija.dreamwidth.org/1013380.html. Comment here or there.